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Authors: Pat Brown

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After my second child, I had a tubal pregnancy and couldn’t get pregnant again, so we adopted a third child, Jeremy, who was six years old at the time. We were warned that he had learning disabilities, which I always thought was bunk. I said, “The only disability he has is the fact that the adults around him don’t want to be responsible. How can a child pay attention at school if he must live in foster
care and doesn’t know where his home is?” I realized school wouldn’t be good for him, either, so I homeschooled him as well, and he’s done just fine.

We read a lot of books together and because of my weakness, we went to see many, many musicals. Usually, it was at the local high school because that was all I could afford.

We attended a small community Christian church where most of the kids were homeschooled. The area homeschooling group with which we were involved included people of many different religions, or nonreligions as my atheist friend, Jack, might say, or changed religions, such as Zelda, the Jew turned Buddhist.

Today David is on his way to a master’s program in economics after studying in Mexico, Hawaii, and India. Jeremy is a federal officer who runs a SWAT team as part of his work in security for NASA. And Jennifer, my oldest, is a detective working for a local police department. Homeschooling did okay by them, and I didn’t ever have to go to the state prison on visiting days or pick up my kid from rehab.

AS THE KIDS
matured, I thought I should have some kind of a career, because what would happen to me when they all went to college? By now I had a bachelor’s degree in liberal arts, but I wasn’t sure what to do with it.

I remembered how much I loved working with deaf children, so I took sign language classes in the evenings and brushed up on my rusty skills.

I did well enough that I was asked to take in a thirteen-year-old, deaf, pregnant foster child. That was one of my first life experiences dealing with someone who was struggling in a difficult situation.

Meanwhile, my husband and I were struggling in a different way. I was home full-time, raising the kids, and he went off to work to pay the bills. We started renting rooms in our big house in order to survive.

Even there, however, we were selective, preferring foreign students above other boarders. Our first was from Iran; he stayed with
us for three years. Over the years we hosted quite a few from China, so there was often Chinese food cooking in the kitchen, and my children learned a lot about Asian lifestyles. I thought these relationships added color to my children’s experience. Our boarders were all graduate students and most of the time studied engineering or mathematics or something else quiet and peaceful. Nobody drank; we had strict rules. They couldn’t have overnight guests, so nobody brought home ladies or guys from bars. Everything fit with the lifestyle we lived.

I did read the paper, but while our county had crime like anywhere else, my neighborhood didn’t. It was a peaceful little town with one thousand single-family homes, no apartments, and no businesses except on the outer limits. We have always had our own police force, our own mayor, and our own town council. The weekly town bulletin would report that there was a loud party, or maybe somebody’s teenager did some silly thing, but we hardly paid any attention to the police report.

I eventually became a certified medical sign language interpreter, working with deaf people who were brought into area hospitals. That was when I started learning more about crime, because I dealt with emergency room admissions, and there were usually people there who were victims of crime.

I SPENT TEN
years working in the emergency rooms at DC General, Washington Hospital Center, and Howard University. I learned a lot about forensics when my clients rolled in on stretchers.

Washington Hospital Center has one of the finest trauma units in the area and anyone who has a choice will tell the ambulance driver to bring him there. DC General—which closed in 2001—was located in the most violent ward of the city, a city with a gunshot victim a day. There was a big book that sat on the admitting desk in which they wrote the names of everybody who died each night, and some nights the list seemed to go on forever. It was a true community hospital where all the homicide, assault, and rape victims went, so when you worked at DC General, you saw just about everything.

Whenever I was called in, it was usually for something pretty
vicious. I would walk in and see guys with holes in their bodies and blood pouring out of them from gunshot wounds. I saw people with stab wounds, people who had been beaten. I saw a lot of domestic abuse. I interpreted for dozens of rape cases, and because I was an interpreter, I was in the room with the doctor the entire time. If the patient went into surgery, I often went with them until they went to sleep. If they didn’t go to sleep, I stayed throughout the operation and watched the doctors work.

Many times, I was called back within the next few days if the patient had a follow-up appointment with the doctor. I got to know a lot of the regulars. I spent time on the psych wards, too, learning a good deal about psychology, and I began to recognize the “frequent flyers.” If they were psychopaths, I got to watch them over a decade’s time; I watched their ongoing manipulations and how they behaved in the hospitals when they were trying to mislead the doctors, telling outright lies and seeking drugs they didn’t need. I could see the psychological progression.

I studied forensic medical books while my patients slept, and all around me in the hospital I saw what I was reading about—what a stab wound, an abrasion, and a laceration looked like, even what happened when somebody took a hammer to the head. I looked at x-rays with the technicians and the doctors. I saw cases come to life. It was a tremendous learning experience.

People who came into these ERs weren’t terribly wealthy. They lived in bad neighborhoods, suffered a lot of injuries, and were often victims of crimes.

An interpreter is considered a machine in a hospital. An interpreter is not allowed to interfere with the process between the medical staff and the patient; they are only there to interpret what the medical staff says and what the patient says. The deaf patients understood this very well, so they knew whatever they told me before or in between the doctors coming in and out of the room I was not allowed to express to the staff. So some of them, the psychopathic ones, would behave one way with me, and they would act in a different way with the doctor. It was absolutely amazing to watch.

Eric, for example, liked to get Percocet. He claimed to have sickle
cell anemia. He had a friend named Desmond who
did
have sickle cell anemia and for whom I also interpreted and from whom Eric learned all his tricks. Desmond had legitimate sickle cell attacks that would put him in the hospital because he was in such severe pain. I interpreted during many of Desmond’s sickle cell crises, so I knew what they looked like and how he often needed Percocet to take home with him. I saw how agonizing it was for him. He sometimes had problems getting the drugs he needed because a lot of medical personnel don’t understand sickle cell and they thought he came in to get drugs to sell to other people. I can’t honestly say that Desmond wouldn’t do this on the side. He was poor and sick and he needed money. His buddy Eric, however, learned how to copy Desmond’s behavior quite convincingly.

Eric would lie on a stretcher, clutching his chest, signing, “Oh, the pain is so bad! Oh, pain, pain, pain!”

“Where is the pain?” the doctor would ask, and I’d sign for Eric.

“Pain in the chest, pain in the back, it’s really bad, bad,” Eric would sign back.

“On a scale of one to ten, how bad is it?”

Eric would sign, “Ten, ten, ten,” putting his thumb up in the air and shaking it back and forth for “ten.”

“What do you need?” The doctor would always ask this, as each sickle cell patient had a regimen that worked specifically for him.

“Intravenous Demerol and Percocet” was always Eric’s reply.

The doctor would say, “Okay,” and leave the room to order the medication.

Sometimes Eric would clutch my hand to his chest or his face in front of the doctor as if I were providing him comfort. Once the doctor would walk out of the room, Eric would open up one eye and a big grin would hit his face. He’d sit up and sign, “Hey, what’s up?” and chat on perfectly calmly.

Then he’d see the doctor coming in his direction and would throw himself back down and groan, the pain having returned again.

I was not allowed by the code of ethics of interpreters to tell the doctor that the guy was a lying dog, that he did not have any pain at all. I just watched the doctor write out the prescription and hand it to
Eric, and then he’d be happy. He got what he wanted and he’d saunter out the door. I think it took five years for one of the doctors to say, “I don’t think that guy has sickle cell!”

THESE WERE THE
kinds of things I watched at the hospital as an interpreter. I was an observer more than I was ever a participant in a lot of this, and I was never allowed to speak for myself.

But one day I had to speak up. I broke the code of ethics, because I couldn’t stand it anymore.

A young man came into the hospital. He was a really strong-looking fellow who played football at Gallaudet, the university for the deaf in Washington, D.C. Students from all over the world came to Gallaudet to get the college education not available to them in their home countries. This young man was from Africa and he came in with kidney failure. Nobody knew why he was in kidney failure. He did not use drugs, he did not drink, and nobody the medical staff interviewed knew anything about this young man’s lifestyle that would have led to such an illness. He was a sports and health nut.

His mother was in Chicago and they notified her that her son was in critical condition with kidney failure.

“Oh, do you think I should come?” she asked.

The nurses said, “What the heck’s wrong with this woman? She doesn’t want to come?”

Three days later she arrived via Greyhound Bus.

When she came into her son’s hospital room, she didn’t say hello to him, give him a hug, or ask him how he was feeling. She didn’t even bother to look in his direction. Instead, she started chatting up the nurses: “Thank you, thank you, you are such wonderful people. I so appreciate what you’ve done. You’re helping my son. That’s so marvelous. What’s this piece of equipment? Oh, what does this do? How does that flush out the kidney?”

I looked at the boy’s mother, thinking,
She’s paying no attention to her son whatsoever!
I got graveyard chills from this woman. I began to wonder if she had Munchausen syndrome by proxy, a
disorder in which a person, usually a woman, harms her children for attention. These women love to visit hospitals and interact with doctors and nurses, being in the spotlight and the center of a drama. It is a type of psychopathy.

Women who hurt, smother, or kill their own babies are the most common presentation of Munchausen syndrome. These psychopaths murder their babies one after the other and hope the doctors think it’s sudden infant death syndrome, or SIDS. And most of the time they do—that is, until someone realizes it has happened nine times. Many of these women are interested in the nursing profession in some manner or form. They like to be involved in medical procedures, because it gives them the thrill of controlling life and death. They like pulling plugs and causing emergencies so they can be heroes when they save the patients. Or they like to watch everyone else scurry about trying to save the person they just sent into cardiac arrest. They also love a good funeral.

When this mother eventually sat down next to her son, he looked at her like she was a big cockroach and he moved away from her. I thought,
That’s an odd response to your mother
. For the rest of the day the mother ignored him and spent almost no time tending to her poor, miserable son, but she said to the nurses, “I can’t leave his side. No, I can’t go down to eat now, I must stay with him.” Yet she never looked at him. The woman enjoyed talking with me about herself. She bragged about this and that and most of what she said was not all that believable. She never talked about her son, about how he was doing in college or about his deafness, nor did she express any worry over his possible future demise. She was narcissistic and grandiose and lacked empathy for her own flesh and blood, all traits of a psychopath.

I wondered if this woman could be the Munchausen type who liked working in the medical field.

I said to her, “Are you a nurse?”

“Yes, I am,” she said, beaming at me.

“Do you work in a nursing home?”

“Yes.”

“Midnight shift?”

She nodded, looking at me suspiciously, wondering how I knew that.

I thought,
I wonder if they have any suspicious deaths at that nursing home?

I asked the nurses if they knew where the son had been recently. They said he had just gotten back from visiting his mother in Chicago when his kidneys failed.

I thought about whether the mother administered something from the nursing home to her son, some kind of drug that caused kidney failure. I asked whether they had tested him for drugs or any kind of medications that could be available in a medical setting, and they said no, because they had no reason to test for that. Yet none of the tests they had done offered any clue as to why this boy’s kidneys had suddenly gone into failure.

When I couldn’t stand being alone with my suspicions another minute, I went to the hospital authorities. “Look,” I said, “I’m breaking the code of ethics but I cannot stand by and watch this. I’m not saying I know that this woman did anything to her son. I’m saying you need to test for medications that she could have gotten from her place of work.”

I explained Munchausen syndrome by proxy, and they all looked at me like I had horns growing out of my head. They didn’t know a thing about it. That’s not surprising; most medical staff never learns of this form of psychopathy and that’s why so often women get away with it.

The blank looks told me they just weren’t getting it. I said, as I was leaving the room, “If he ever ends up dead in the future, you better check that mom out.” The young man survived, and I hope he was smart enough to never get near her again.

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