Mother, Heal Thyself

Susan Hyde’s daughters spent years in and out of hospitals with a puzzling array of ailments. But what if they weren’t the sick ones?

by Katy Vine

January 2010

(Page 2 of 4)

“Looking back, you said you did exaggerate some things,” Patricia said.

“Exactly,” Susan replied.

“You didn’t realize you were doing it at the time, but—”

“I’m not saying that I was perfect,” Susan said. “I’m not saying that, um, I absolutely didn’t do those things.”

She simply doesn’t think she should be judged so harshly. After her children were taken from her, Susan saw a psychiatrist, who diagnosed her with bipolar disorder, a condition that, he said, could have explained Susan’s behavior. There were allegations she flatly denied, but she agreed that she had stretched the truth when she was in a manic period. For instance, when she brought Amy to the ER with breathing problems: “I would be, like, ‘She was blue. She wasn’t breathing. You guys need to do something with her.’ That’s when my overexaggeration would come in. They’d say, ‘How long did it last?’ I’m like, ‘Too long.’ If it happens a second, it was too long. It was my child.”

In retrospect, Susan says she can understand why people were skeptical of her. By the time of her custody trial, Susan had recognized that she might have overreacted, though she says she did so only to make sure her kids got the best treatment. “I was intimidating. I was belligerent,” she told me. “It doesn’t make me a criminal.”

Listening to Susan tell her story, it was difficult to imagine the monster portrayed at her trial. She’d grown up in Iowa, an outgoing middle child in a happy family. She was rambunctious, always running around outside and riding a Big Wheel, not afraid to get dirty. At day care, she was a typical kid who got into trouble for acting wild. “I was kind of hellacious,” she said.

This largely normal childhood was marred by one horrific experience. At age five Susan was walking down the hallway of her house, playing with cheerleading pom-poms, when she stepped into a bedroom and saw her father lying in bed, covered in blood. He had committed suicide by cutting his throat. “I saw my dad laying on a white bed with his face down. His bare feet were facing toward the door, and there was blood on the bed,” she said. “I remember little things about my dad before, but not that much.”

Patricia took her children to see a child psychiatrist to help them heal from the trauma, but the incident wasn’t discussed much in the household, to the extent that Susan’s sister, Julianne, would later testify at the trial that she thought her father had died from an overdose of medication. Patricia says she answered any questions her children had. She just didn’t want to tell them everything at once.

“To be honest,” Susan said, “we never asked about it. We just eventually knew he committed suicide. We didn’t want the gory details.”

Patricia, who was a nurse, later dated and married Brian Andersen, an anesthetist whom Susan calls a stable role model. The couple were good providers, but they were also strict; Patricia and Brian regularly checked the mileage on the car Susan drove to and from school. Susan played clarinet and saxophone and worked as a cashier at the Hy-Vee grocery store with Julianne and her aunt. After graduation, she attended the University of Northern Iowa. She hadn’t been able to participate in sports since her sophomore year of high school, when she injured her knee, but she was a sports fan and decided to work as an athletics trainer at the university.

One day, a football player collapsed with a spinal injury, and the trainers labored to get him into a halo device and off the field. It was an eye-opening experience. “I didn’t really want to do the long-term care with patients, but the short-term care with EMS—I liked it,” she said. “Quite frankly, it’s an adrenaline rush.”

Eventually, Susan transferred to Creighton University, in Omaha, Nebraska, just over the border from Iowa. In 1999, soon after she’d graduated from the school’s paramedic program, she became pregnant with Heather. The father was a blond-haired, blue-eyed man nicknamed Sonny whom she’d met at a cookout. Susan thought he was sweet, though she says he wasn’t ready for fatherhood. She wasn’t sure she was ready for motherhood, either. “What were you thinking?” her mother asked after hearing the news. “I wasn’t,” Susan replied. After Heather’s birth, Susan says, Sonny paid child support, and Susan set up a nursery in her parents’ spare room in Iowa.

In the weeks that followed, Susan repeatedly rushed Heather to the ER, reporting that she had stopped breathing. No medical provider seems to have witnessed any such episodes. As Heather got older, Susan would bring her in with concerns that her blood sugar was fluctuating. But tests revealed nothing out of the ordinary. To most people, Heather seemed to be a reasonably healthy girl.

Many books and hundreds of reports on the subject of Munchausen by proxy have been written. Experts testify in court and host seminars in which they explain the warning signs to doctors and social workers. Typically, they say, women are more likely than men to exhibit MBP. A mother who engages in MBP is medically knowledgeable and reluctant to leave her child’s side. She is unusually calm when given terrible news or, conversely, abusive of the medical staff. She may flatter the doctors and be rude to the rest of the staff. She is overeager for treatments. She is the only one who seems to witness the child’s supposed episodes. She may have another child who has also suffered from a puzzling illness or even died.

As researchers studied more cases, they began to disagree about the most fundamental issues, such as whether the perpetrators were mentally ill or simply criminals and liars. Munchausen by proxy, some argue, is something one does, not something one has. “We assume people who commit suicide have some kind of mental illness but don’t assume that people who kill someone else have a mental illness, except maybe for antisocial personality disorder,” said Munchausen by proxy expert Marc D. Feldman, a clinical professor of psychiatry at the University of Alabama. “There is a kinship between suicidal patients and those who harm themselves—or get doctors to do it—in factitious disorder. There is also a kinship between homicidal patients and those who harm others in MBP. Thus, the former is a mental illness and the latter is not.”

But this is not a universally held opinion. “Factitious disorders have similarities to addictions, eating disorders, impulse control disorders, pedophilia, and some other established disorders related to both the persistence of the behavior and to the intentional efforts to conceal the disordered behavior,” says Brenda Bursch, a professor of clinical psychiatry and biobehavioral sciences and pediatrics at UCLA.

In the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, factitious disorder by proxy appears in an appendix along with other conditions that are being considered for future inclusion in the main body of the book as stand-alone disorders. The fifth edition of the manual, which will be released in 2012, will likely list factitious disorder by proxy as a formal psychiatric disorder. This shift is already a source of controversy.

“There was a four-hour conference call with a few experts from the U.S.,” Feldman told me. “I participated and I was the only one who had concerns about making factitious disorder by proxy a formal mental disorder. The rest felt that it would facilitate intervention with these mothers, perhaps improve the possibility of treatment. The majority ruled.”

By 2002 Susan had landed a job with an ambulance service when a one-night stand with a co-worker left her pregnant again. Daunted by the concept of another child, she decided to give the baby up for adoption and chose a nurse named Teri DeVine as the adoptive mother. A few months before the baby’s due date, DeVine became concerned with Susan’s behavior. At about week 22 of her pregnancy, Susan entered the hospital with a marginal abruption, which is when the edge of the placenta separates from the uterus, a condition that can cause preterm labor or fetal death. Susan said that a teenager at a water park had knocked her down, an event Susan’s mother confirms. But DeVine says Susan also told her and a nurse that she had jumped on a trampoline for twenty minutes. (Susan denies this.) “I was shocked,” DeVine told me. DeVine wondered if Susan meant to induce early labor, and her suspicions would only worsen with time.

Susan was put on bed rest, though according to trial testimony, she did not comply. She walked around the hospital and even chose to walk DeVine to her car when she came to visit. Susan says she was depressed and wonders who wouldn’t have been under similar circumstances. “I was stuck in a hospital without my oldest child, who I am going to go home to, and I’m going to give birth to this other baby that’s not going to be mine,” she told me. “It’s gonna be given to somebody else, and I’m putting all this work into this.”

When Amy was born, three months early, she weighed one pound eleven ounces. Susan took pity on the tiny creature she saw in the neonatal intensive care unit. Ultimately, she decided to keep the baby. Patricia, who says she didn’t want to enable Susan’s bad choices, told Susan she’d have to move out of the house. Soon Susan, Heather, and tiny Amy were living in a house in Iowa so small, Susan jokes, it could have been illuminated by a single night-light.

DeVine was heartbroken and disturbed. Birth mothers had broken agreements with her before. They had not, however, shown such instability. (According to DeVine, Susan also told her that she had consented to a do not resuscitate order for Amy, which nurses said wasn’t true.) DeVine wrote a letter to Iowa’s Department of Human Services warning that Susan might be a danger to her child. In February 2003 the state took Susan’s children away and conducted an investigation.

Pages: 1 2 3 4  next »