Chapter Ten

 

Noreen drove home on automatic pilot, dizzy from the scenarios galloping across the fields in her mind. Munchausen’s. Her heart missed a beat each time the word repeated in her head. Munchausen’s by proxy manifested a gulp of air and a hard swallow. If what Blake said was remotely true, Argia might be in imminent danger. Why didn’t he see that? Why hadn’t he contacted the authorities? Had Lynne arrested or at least investigated? How could he casually watch his child walk out of the ice cream store, her hand locked in that’s monster’s grip?

And the biggest question of all—how could he leave Argia in that house and move out? Deliberately abandon her? He professed his love for his daughter but what type of man walks away and leaves a child standing in harm’s way?

The minute she arrived home, she kicked off her shoes, tossed her things on the couch and trudged to the basement where all of her textbooks and medical journals from college were stored. Granted, the information might be outdated, but it was a place to start.

She hauled the cardboard box off the shelf and searched through the volumes, selecting the books that might contain helpful information. There were only three that seemed applicable so, leaving the opened box and pile of papers, notebooks and textbooks scattered on the floor, she carried the relevant ones to her kitchen table. Deliberately trying to calm her nerves, she brewed a cup of coffee, and then began to scan the pages.

Ongoing research changes the medical field almost daily and her books were all at least five years old. Still, the basic information frightened her. She’d recalled the specifics well.

A caretaker, most often the mother, deliberately causes a child to appear ill, sometimes by adding blood to the child’s urine or stool. Had she read that in one of Argia’s medical files? The caretaker might withhold food so the child didn’t gain weight. Blake said Lynne refused to eat correctly during her pregnancy and claimed Argia wouldn’t take a bottle. Tears blurred her vision when she read further.

The caretaker might claim the child suffered a high fever and as proof to medical personnel, warm the thermometer in hot water or apply heat to the child’s face to redden its appearance.

A caretaker might deliberately make the child sick to cause diarrhea or vomiting. Argia had been rushed to the hospital for uncontrolled nausea. Reported by her mother.

A caretaker might infect an intravenous line to make the child sick. Noreen didn’t suspect that but what had set off the emergency alert on Argia’s monitors that night?

She pressed her fingers to her temple. The nurse in her couldn’t conceive of this type of conduct and least of all, from a mother. She reached for her laptop and searched a private medical reference forum for physicians, finding an article that detailed signs and symptoms of Munchausen’s. The adult caretaker, usually the mother, was often in the medical profession or was highly educated regarding health care and frequently detailed the medical issues of the child using professional references and terminology. The caretaker was actively involved in the child’s care and regularly attempted to insert herself into the health care team.

Noreen sat back in her chair after reading the final sentence of the article, her pulse racing. “Given the devotion shown by the mother and attention to the child’s well-being, a diagnosis of Munchausen syndrome by proxy is difficult and sometimes impossible to diagnose.”

She took her search out onto the Web, knowing that an Internet search would not necessarily provide facts. But there might be news reports of arrests made or Munchausen’s investigations that made headlines in other states. Plenty of articles about the syndrome itself popped onto the screen but she found minimal information about actual cases where authorities had suspected or proved the disorder. One headline declared a dozen shocking Munchausen’s cases but as she read each one, the facts proved neglect and abuse. It appeared medical and law enforcement personnel hesitated to attach the actual syndrome to the crimes. The more she studied the information, the tighter her stomach knotted. Dear Lord. What if Blake was right in his assessment? How would he ever prove it? How could she help?

Their conversation tonight remained unfinished. Maybe he had contacted the authorities. She’d been unable to ask. If so, whom had he contacted? The police? Did they have jurisdiction? Had he spoken his concerns to Argia’s doctors? Did they believe him? Would she have believed him that first night she met him in the hospital?

No, she wouldn’t have. Lynne lobbied quickly to paint the absent father as a villain, a man who abandoned his sickly child and desperate wife. She flung medical jargon around like one recites the ingredients of a cherished recipe. Noreen asked her that night if she was a nurse and Lynne had lowered her eyes demurely and said no, but her investment in Argia’s health necessitated an education. She’d been flattered that Noreen had mistaken her for a trained professional.

In retrospect, she’d viewed a concerned mother well-versed on her daughter’s health issues. It had been refreshing. Now a cloud of doubt loomed over her impressions along with more questions than she could articulate. She needed professional advice.

While she attended nursing school, she’d worked as a part-time bank teller and became friends with Mackenna McElroy, a woman who’d been treated badly by her ex-boyfriend and then became the focus of an FBI investigation into a bank robbery ring. Most of their co-workers believed the worst, but Noreen had seen Mackenna’s vulnerability and believed her. It had been a harrowing experience for Mackenna but one with a happy ending, considering she’d fallen in love and now lived with the FBI agent who saved her life. And she and Noreen remained friends.

Noreen felt comfortable calling Jake Manettia about Argia, even though she doubted the FBI had jurisdiction over this type of problem. Jake was trained to recognize criminal conduct and knew the law. She wanted reassurance that she wasn’t fast becoming an eyewitness to crimes being committed against Argia. But after hanging up the phone, she still didn’t have her answers.

“There’s nothing illegal about an overzealous parent,” Jake told her, “and you haven’t told me anything to prove otherwise. You have no medical proof that she taints the child’s food or that she abuses her. Until the broken arm, there was no physical injury that you know of. Kids fall down steps all the time. You’re describing a mother who overreacts if her child gets a splinter and a divorce that, based on what little you know, is far from amicable. If anything, the father sounds more suspicious to me. If he thought the mother was harming the little girl, why’d he leave in the first place? Why not stay and build a case against her?”

It was a question she wanted answered as well. She’d ask Blake.