Frowning, I looked behind me and caught the eye of Dr. Simpson, the longest serving doctor in the ER, and gestured at him to come look at the kid. During the examination it became clear what we were dealing with – yes, the kid was sick, but so was the mother. There were signs to watch for, and she pretty much ticked all the boxes as she over described things, and added in her own probable diagnosis. Factitious Disorder Imposed on Another – FIDA – aka Munchausen by proxy, and it was confirmed when I got his previous doctor’s name and rang through while Dr. Simpson carried out Barium tests on poor little Oliver’s stomach.
The mother, Siam, had been diagnosed with Munchausen five years previously. At the time, she’d presented with such specific symptoms, that she’d had four surgeries in the space of thirteen months, during which they hadn’t found one thing wrong with her.
Sure, the argument is always there that the doctors should have known she was perfectly healthy from her test results, but sometimes things can go undetected and lead to the loss of the patient through negligence. Millions of dollars are paid out every year because of medical negligence cases, some sadly resulting in the death of a patient. It’s not the fear of being sued, it’s someone dying that doctors fear the most, especially when a patient can give symptoms that few people not suffering from a serious illness would be able to describe.
So, they’d gone in repeatedly, worried that something had been missed, and had eventually organized a psych eval when she’d continued to press for more. That’s when they’d realized what they were dealing with.
Afterward, she’d brought Oliver to a hospital in a different state, with symptoms that had ended up with him in surgery twice by the time he was three years old - during which nothing had been found unsurprisingly. She’d persisted again, and had tried to convince doctors that he’d been diagnosed with different illnesses, so they had carried out an investigation on her medical history. Putting the two together, CPS had been called in, and a therapist had diagnosed her with both Munchausen and FIDA.
She’d apparently been doing well, until four months ago when her husband had left her for another woman and she’d moved without telling anyone, including CPS. Which led us to now – all the tests and scans we’d done on the boy had come back clear on anything serious, but he had something that was causing severe acid reflux in his stomach which could cause long-term problems for him if we didn’t do something. That ‘something’ had shown up in one of his blood tests – high levels of the antidepressant medication Siam had been prescribed to help with her problems.
After a quick discussion with Dr. Simpson about the results and what I’d found out from her previous doctors, we were calling in the police and CPS. Our procedure was to secure the safety of the child first while we waited for CPS to arrive, so I picked up the phone and rang through to the police. It wasn’t always necessary to dial 911 in a small town, something I was hugely grateful for at that moment… or at least I had been grateful for it.
“Piersville Sheriff’s Office, how can I help?” a nasal voice that I recognized as belonging to Rory answered.
“Hey, Rory, it’s Rose here. Can you put me through to Sheriff Bell, please?”
There was a pause and then she came back sounding like the real Rory, the one she hid from the men. “No, stop wasting his time. He’s in his office with someone right now and is very busy,” she snapped, and then just hung up on me.
This wasn’t unusual for the woman, seeing as how she’d made it her life’s mission to give us shit for calling the department on numerous occasions. Normally I would laugh it off, but this case was different because it involved the welfare of a child, so right now I wasn’t laughing at all.
It also left me with two choices – calling Raoul or Logan, and with the former being the most experienced out of the two, the decision wasn’t a hard one.
So, picking up my cell, I hit the call button and waited, grateful when he answered after the first ring. “Rose?”
Glancing quickly over at the little boy again, I closed my eyes and filled him in while all the paperwork that had been emailed through to me from the previous doctor printed beside me.Nine hours later…
I only just managed to drag my ass through my front door, kicking my shoes off and throwing my purse on top of them tiredly.
People misconstrue what nurses do every day. Some think we’re there to put a Band-Aid on and smile, others think we’re there to diagnose it all and then get a doctor to sign off on it, and some think we’re just there to make coffee. In all honesty, our daily duties and tasks depended on the department you worked in and if you were a nurse practitioner or not, which was the level between nurse and doctor. Working in the ER, my day consisted of everything, but at no point was I the authority in diagnosing a condition or anything close to it. Which is why today had my hands shaking and my stomach twisting, because I’d caught something which could have ended up in the death of an innocent child.