Sunday, August 21, 2016

Medical child abuse revisited 4

Gypsy was a tiny thing, perhaps 5 feet tall as far as anyone could guess. She was confined to a wheelchair. Her round face was overwhelmed by a pair of owlish glasses. She was pale and skinny, and her teeth were crumbling and painful. She had a feeding tube. Sometimes Dee Dee had to drag an oxygen tank around with them, nasal cannula looped around Gypsy’s small ears. Ask about her daughter’s diagnoses, and Dee Dee would reel off a list as long as her arm: chromosomal defects, muscular dystrophy, epilepsy, severe asthma, sleep apnea, eye problems. It had always been this way, Dee Dee said, ever since Gypsy was a baby. She had spent time in neonatal intensive care. She had leukemia as a toddler.

The endless health crises had taken a toll. Gypsy was friendly, talkative even, but her voice was high and childlike. Dee Dee would often remind people that her daughter had brain damage. She had to be homeschooled, because she’d never be able to keep up with other kids. Gypsy had the mind of a child of 7, Dee Dee said. It was important to remember that in dealing with her. She loved princess outfits and dressing up. She wore wigs and hats to cover her small head. A curly, blonde Cinderella number seems to have been her favorite. She’s wearing it in so many photographs of herself with her mother. She was always with her mother…

Sometimes, listening, Amy Pinegar found herself overwhelmed. “I wondered,” Pinegar told me over the phone last fall, “keeping this child alive… Is she that happy?” All she could do was be a good neighbor and pitch in when she could. She’d drive Dee Dee and Gypsy to the airport for their medical trips to Kansas City, bring them things from Sam’s Club. Ultimately, they did seem happy. They went on charity trips to Disney World, met Miranda Lambert through the Make-a-Wish Foundation. Looking back on it, Pinegar was sometimes even jealous of them…

She had met Dee Dee and Gypsy in 2009 at a science fiction and fantasy convention held in the Ozarks, where Gypsy could wear costumes and not be particularly out of place. “They were just perfect,” Kim said. “Here was this poor, sick child who was being taken care of by a wonderful, patient mother who only wanted to help everybody.”…

It turned out that, in fact, Gypsy hadn’t used a wheelchair from the moment she left her house a few days earlier. She didn’t need one. She could walk just fine, there was nothing wrong with her muscles, and she had no medication or oxygen tank with her either. Her hair was short and spiky, but she wasn’t bald — her head had simply been shaved, all her life, to make her appear ill. She was well-spoken, if shaken by recent events. The disabled child she’d long been in the eyes of others was nowhere to be found. It was all a fraud, she told the police. All of it. Every last bit. Her mother had made her do it…

Gypsy was healthy at birth, Rod said. But when she was 3 months old, Dee Dee became convinced that her baby had sleep apnea, that Gypsy would stop breathing in the night. It was then when Dee Dee began taking her to the hospital. As Rod remembers it, the doctors couldn’t find anything, in spite of three rounds of tests and a sleep monitor. The conviction that Gypsy was a sickly child took hold. She explained the increasingly bewildering array of problems to Rod by saying that Gypsy had a chromosomal defect. Many of Gypsy’s health issues, she claimed, stemmed from that one thing…

Dee Dee always had a new idea about what was wrong with Gypsy, a new doctor, a new drug. She had once worked as a nurse’s aide; she had a knack for remembering medical terminology and spitting it back. The information overload acted as a kind of wall around mother and daughter. It always seemed that Dee Dee had things under control. She knew so much, and she was never troubled by questions — she always had an answer…

Dee Dee and Gypsy spent their years in Slidell living in public housing and visiting doctors at the Tulane University Hospital & Clinic and the Children’s Hospital. Dee Dee told doctors there that Gypsy had seizures every couple of months, so they put her on anti-seizure medications. Dee Dee insisted to one doctor after another that her daughter had muscular dystrophy even after a muscle biopsy proved she didn’t. There were problems with her eyes and ears, too, Dee Dee insisted, poor vision and frequent ear infections. Doctors dutifully operated on her. If Gypsy had a cold or cough, she was taken to the emergency room…

She told the shelter staff she didn’t have Gypsy’s medical records with her because they’d been destroyed in the flood.

One of the doctors at the shelter, Janet Jordan, was from the Ozarks. (She declined to be interviewed for this article.) She was charmed by Gypsy in the shelter: “When I first met her, I had to cry a little bit, and she goes, ‘It’s okay, you’re only human.’” Jordan told a local news station in 2005…

While Gypsy had been involved with charities for children with disabilities from the time she was quite small — Dee Dee often stayed at Ronald McDonald houses — this was obviously the largest benefit Dee Dee had managed to arrange. It seemed to give her an appetite for more. While in Springfield, they’d benefit from free flights from a volunteer pilots organization, stays at a lodge for cancer patients, free trips to Disney World through various charity organizations. (None of the organizations with which the Blanchards had confirmed links returned requests for comment.)…

“I think Dee Dee’s problem was she started a web of lies, and there was no escaping after,” Rod said. “She got so wound up in it, it was like a tornado got started, and then once she was in so deep that there was no escaping. One lie had to cover another lie, had to cover another lie, and that was her way of life.”…

Gypsy’s medical records are sobering. All the way back in 2001, doctors at Tulane University Hospital tested Gypsy for muscular dystrophy. Her tests came back negative. In fact, all scans of her brain and spine were relatively clear. The records of all those tests survived Katrina. Nonetheless, Dee Dee continued to insist to doctor after doctor in Louisiana and Missouri that Gypsy had muscular dystrophy. Most doctors appear from these records to have taken her assertion at face value and didn’t probe. Instead they proceeded to treat Gypsy for various vision, hearing, sleep, and salivation problems that were presumed to flow from the muscular dystrophy. (The records I reviewed for this article appeared to cover only some of Gypsy’s care. It’s impossible to say how many other relevant records might exist.)…

Some interventions were surgical. Gypsy’s eye muscles were repeatedly operated on for alleged weakness. Tubes were put in her ears for alleged ear infections. She was given a feeding tube and ate very little by mouth, surviving on cans of the meal replacement PediaSure well into her twenties. Her salivary glands were first injected with Botox, then removed because her mother complained that she drooled too much. Gypsy’s teeth rotted out and had to be extracted, though whether that was because of poor dental hygiene or a mixture of medications and severe malnutrition, it’s hard to say.

The repeated invasions of Gypsy’s body in the name of these illnesses she turned out not to have were, in short, serious and prolonged. It is difficult to say now whether any of it was medically needed at all. What is not difficult to say is that all of it began when Gypsy was impossibly young and could hardly have been expected to challenge authority figures — her mother or her doctors — about how she was feeling.

For their part, doctors did not pick up on innumerable hints that Dee Dee’s stories did not add up — not even the sleep doctor, Robert Beckerman, who saw Gypsy both in New Orleans and in Kansas City. Instead he featured his treatment of Gypsy in the hospital newsletter and mentioned repeatedly in the medical files that she and Dee Dee were his “favorite mother, daughter patient.” (Beckerman did not reply to requests for comment for this story.)

There was one exception. In 2007, a pediatric neurologist named Bernardo Flasterstein, consulting on the case in Springfield, became suspicious. In a recent phone conversation, Flasterstein told me he had his doubts from the first time he saw Dee Dee and Gypsy. Dee Dee’s stories about Gypsy’s myriad illnesses didn’t fly with him. In his notes to Gypsy’s primary care doctor after the first visit, he wrote, in bold, underlined type, “The mother is not a good historian.”

There was an “unusual distribution” to Gypsy’s weakness for a muscular dystrophy patient, he wrote in his notes. Still, Flasterstein says, he gave the case the “benefit of the doubt” and sent Gypsy for all the usual tests, the MRIs and the blood work. It all came back normal. “I remember having her stand up,” he told me, “and she could hold her own weight!” He said he told Dee Dee, “I don’t see any reason why she doesn’t walk.”

In between his visits with Gypsy, Flasterstein tracked down a doctor who had seen Gypsy in New Orleans. That doctor told him that the muscle biopsy in New Orleans had been negative for muscular dystrophy, and that Gypsy’s previous neurologist had explained that to Dee Dee. When confronted with the problem, Dee Dee simply stopped seeing those New Orleans doctors.

“Analyzing all the facts, and after talking to her previous pediatrician,” Flasterstein wrote in the file, “there is a strong possibility of Munchausen by proxy, with maybe some underlying unknown etiology to explain for her symptoms.” Dee Dee stopped seeing him after that visit. “I assume she got my notes,” Flasterstein says. He said nurses told him later that on the way out of his office on that last visit, Dee Dee was complaining that he didn’t know what he was talking about.

Flasterstein never followed up. He told me that in the network of Springfield doctors Dee Dee saw, “everyone bought their story.” He remembers being told to treat the pair with “golden gloves.” He says he thought that if he reported it to social services, they wouldn’t believe him either…

It was not the only missed opportunity for authorities to intervene. In the fall of 2009, someone made an anonymous call to the Springfield Police Department, asking for a wellness check. The person said that they had doubts that Gypsy was suffering from all the ailments her mother described. (Flasterstein says it was not he who made that call.) The police drove over to the house, but Dee Dee put their fears to rest…

Gypsy is now an inmate being processed at the Women’s Eastern Reception, Diagnostic and Correctional Center in Vandalia, Missouri. Her hair is long, her skin clear and healthy, and she wears proper adult glasses. She’s off all her medications, and there have been no health problems in the year she’s been out of her mother’s control. “Most of my clients lose weight in prison,” Stanfield pointed out, because the food is so bad. Gypsy gained 14 pounds in the 12 months she spent in Greene County Jail before her plea.

Kim Blanchard, who visited Gypsy once in jail, told me, “She looked much more like the person that she was, which was the complete opposite of the person that I knew, and it was like she had a costume on that whole time and then took it off.”…

About her mother, her opinion seems to waver. “The doctors thought that she was so devoted and caring,” Gypsy said. “I think she would have been the perfect mom for someone that actually was sick. But I’m not sick. There’s that big, big difference.”

Gypsy still doesn’t feel she actively deceived anyone. “I feel like I was just as used as everybody else,” she said. “She used me as a pawn. I was in the dark about it. The only thing I knew was that I could walk, and that I could eat. As for everything else… Well, she’d shave my hair off. And she’d say, ‘It’s gonna fall out anyway, so let’s keep it nice and neat!’” Gypsy said her mother told her she had cancer, too, and would tell her that her medication was cancer medication. She just accepted it…

She will admit only to frustration. “It makes me frustrated that none of the other doctors could see that I was perfectly healthy. That my legs were not skinny, like someone who was [really] paralyzed. That I can’t… I don’t need a feeding tube. Stuff like that.”


Courtesy of my daughter 

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