I remembered her mother. Heavyset and pleasant, fragrant of dough and sugar. Blue numbers on a soft white arm.
“Get an SAP card,” she said. “It’s a kick.”
“Don’t know if I’d qualify. My appointment’s across town.”
“I think you would. Just show them your faculty card and pay a fee. It takes about a week to process.”
“I’ll do it later, then. Can’t wait that long.”
“No, of course not. Listen, I’ve got plenty of time left on my account. My chairman wants me to use all of it up so he can ask for a bigger computer budget next year. If you want me to run you a search, just let me finish up with this, and we’ll find all there is to know about people who proxy their kids.”
We rode up to the SAP room at the top of the stacks. The search system looked no different from the terminals we’d just left: computers arranged in rows of partitioned cubicles. We found a free station and Jennifer searched for Munchausen-by-proxy references. The screen filled quickly. The list included all the articles Stephanie had given me, and more.
“Looks like the earliest one that comes up is 1977,” she said. “Lancet. Meadow, R. ‘Munchausen syndrome by proxy: The hinterland of child abuse.’ ”
“That’s the seminal article,” I said. “Meadow’s the British pediatrician who recognized the syndrome and named it.”
“The hinterland... that’s ominous too. And here’s a list of related topics: Munchausen syndrome, child abuse, incest, dissociative reactions.”
“Try dissociative reactions first.”
For the next hour we sifted through hundreds of references, distilling a dozen more articles that seemed to be relevant. When we were through, Jennifer saved the file and typed in a code.
“That’ll link us to the printing system,” she said.
The printers were housed behind blue panels that lined two walls of the adjoining room. Each contained a small screen, a card slot, a keyboard, and a mesh catch-bin under a foot-wide horizontal slit that reminded me of George Plumb’s mouth. Two of the terminals weren’t in use. One was marked OUT OF ORDER.
Jennifer activated the operative screen by inserting a plastic card in the slot, then typing in a letter-number code, followed by the call letters of the first and last articles we’d retrieved. Seconds later the bin began to fill with paper.
Jennifer said, “Automatically collated. Pretty nifty, huh?”
I said, “Melvyl and Orion — those are basic programs, right?”
“Neanderthal. One step above cards.”
“If a hospital wanted to convert to computerized search and had a limited budget, could it go beyond that?”
“Sure. Way beyond. There are tons of new software programs. Even an office practitioner could go beyond that.”
“Ever hear of a company called BIO-DAT?”
“No, can’t say that I have, but that doesn’t mean anything — I’m no computer person. For me it’s just a tool. Why? What do they do?”
“They’re computerizing the library at Western Pediatric Hospital. Converting reference cards to Melvyl and Orion. Supposed to be a three-week job but they’ve been at it for three months.”
“Is it a huge library?”
“No, quite a small one, actually.”
“If all they’re doing is probe and search, with a print-scanner it could be done in a couple of days.”
“What if they don’t have a scanner?”
“Then they’re Stone Age. That would mean handtransfer. Actually typing in each reference. But why would you hire a company with such a primitive setup when — Ah, it’s finished.”
A thick sheaf of papers filled the bin.
“Presto-gizmo, all the gain, none of the pain,” she said. “One day they’ll probably be able to program the stapling.”
I thanked her, wished her well, and drove home with the fat bundle of documents on the passenger seat. After checking in with my service, going through the mail, and feeding the fish — the koi who’d survived infancy were thriving — I gulped down half a roast beef sandwich left over from last night’s supper, swigged a beer, and started in on my homework.
People who proxied their kids...
Three hours later, I felt scummy. Even the dry prose of medical journals had failed to dim the horror.
Devil’s waltz...
Poisoning by salt, sugar, alcohol, narcotics, expectorants, laxatives, emetics, even feces and pus used to create “bacteriologically battered babies.”
Infants and toddlers subjected to a staggering list of torments that brought to mind Nazi “experiments.” Case after case of children in whom a frighteningly wide range of phony diseases had been induced — virtually every pathology, it seemed, could be faked.
Mothers most frequently the culprits.
Daughters, almost always the victims.
The criminal profile: model mommy, often charming and personable, with a background in medicine or a paramedical field. Unusual calmness in the face of disaster — blunted affect masquerading as good coping. A hovering, protective nature — one specialist even warned doctors to look out for “overly caring” mothers.
Whatever that meant.
I remembered how Cindy Jones’s tears had dried the moment Cassie had awakened. How she’d taken charge, with cuddles, fairy tales, the maternal breast.
Good child rearing or something evil?
Something else fit too.
Another Lancet article by Dr. Roy Meadow, the pioneer researcher. A discovery, in 1984, after examining the backgrounds of thirty-two children with manufactured epilepsy:
Seven siblings, dead and buried.
All expired from crib death.
7
I read some more until seven, then worked on the galley proofs of a monograph I’d just gotten accepted for publication: the emotional adjustment of a school full of children targeted by a sniper a year ago. The school’s principal had become a friend of mine, then more. Then she went back to Texas to attend to a sick father. He died and she never returned.
Loose ends...
I reached Robin at her studio. She’d told me she was elbow-deep in a trying project — building four matching Stealth bomber-shaped guitars for a heavy metal band with neither budget nor self-control — and I wasn’t surprised to hear the strain in her voice.
“Bad time?”
“No, no, it’s good talking to someone who isn’t drunk.”
Shouts in the background. I said, “Is that the boys?”
“Being boys. I keep booting them out and they keep coming back. Like mildew. You’d think they’d have something to keep them busy — trashing their hotel suite, maybe — but — Uh-oh, hold on. Lucas, get away from there! You may need your fingers some day. Sorry, Alex. He was drumming near the circular saw.” Her voice softened: “Listen, I’ve got to go. How about Friday night — if that’s okay with you?”
“It’s okay. Mine or yours?”
“I’m not sure exactly when I’ll be ready, Alex, so let me come by and get you. I promise no later than nine, okay?”
“Okay.”
We said our goodbyes and I sat thinking about how independent she’d become.
I took out my old Martin guitar and finger-picked for a while. Then I went back into my study and reread the Munchausen articles a couple of times over, hoping to pick up something — some clinical cue — that I might have missed. But no insights were forthcoming; all I could think of was Cassie Jones’s chubby face turned into something gray and sepulchral.
I wondered if it was even a question of science — if all the medical wisdom in the world was going to take me where I needed to go.
Maybe time for a different kind of specialist.