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 4 of 4)

In October 2005 Child Protective Services in Texas received its first complaint about Susan’s behavior. Over the course of the investigation, which continued until February 2007, more than a dozen people called the hotline, questioning the constant medical treatment the girls were receiving. But since federal law restricts access to records and because Susan went to numerous hospitals, it was difficult to put the pieces together.

Soon after the initial call came in, a CPS investigator, Katherine Jones, visited Susan. At their first meeting, Susan painted a portrait of a very fragile family. Amy had breathing problems, cystic fibrosis, and a broken leg, and a doctor was concerned that she may have osteoporosis caused by the steroids she was taking for her bronchial treatments. Susan expressed concern that Beth might have cystic fibrosis as well and insisted she was also suffering from a seizure disorder, cerebral palsy, and hearing loss. In addition, according to Cox’s testimony about the medical records, Susan requested that doctors surgically implant a feeding tube into Beth’s stomach called a gastronomy button, or G-button, which helps a person who has trouble eating. The food is then administered directly into the stomach, bypassing the throat and esophagus. Doctors agreed to the surgery and also performed a fundoplication, in which the lower portion of the esophagus is wrapped around the top of the stomach so that even though the patient may feel nauseated, she cannot vomit.

After the surgery, Beth was prescribed a wheelchair. Then Susan started reporting more concerns about Beth’s seizures. From late 2005 through 2006, Beth was put on anti-seizure medications, which can affect alertness, IQ, and breathing. By September 2006 Beth had been diagnosed as having cerebral palsy, seizures, and developmental delay. In December 2006, when Cook Children’s Hospital hooked Beth up to an EEG to measure seizure activity, Susan was asked to hit a call button so that doctors could correlate her observations with Beth’s brain wave patterns. Susan pushed the button five times. Doctors saw one abnormal reading that could have been caused by Beth’s antiseizure medication but no definite seizures.

While Jones requested and gathered records from more than twenty physicians, clinics, and hospitals, Beth’s and Amy’s level of care escalated. An investigator claimed that the two girls each had eight to twelve hours of home health care nursing every day. One of Beth’s nurses, Jodina Bowers, testified during the trial that she didn’t think the girls needed much medical care. Bowers was concerned when she attended a doctor’s appointment for Beth and heard Susan misreport a previous doctor’s conclusions. Sometimes when Bowers would return after a weekend off, the remaining dosages of phenobarbital weren’t consistent with the scheduled amounts. This would be alarming, since unsupervised variations in dosage could lead to seizures. Once, she testified, when she asked about the discrepancy, Susan said that it wasn’t anybody’s business. Though Bowers said that her assignment was to attend to the children’s medical problems—and testified that she may have witnessed Beth having a slight seizure—she mostly compared her work at the Hyde household to a babysitter’s.

By late 2006 Susan, who was now working as a paramedic at Cook Children’s, was telling doctors that Beth had symptoms consistent with cystic fibrosis. The results of her two sweat tests were high. But oddly, they were dramatically different. The first test was elevated; the second read so far off the scale the human body could not have been the sole source of the chloride. (Susan says she was not present during the tests, as she was working at the time, though she did work at the same hospital where the tests were performed.)

Roughly a year and a half after Texas CPS received its first complaint on Susan Hyde, Jones was still contacting people and gathering information about the case. But she knew she had to make a decision: She was told that Amy was being assessed for G-button surgery as well. (Susan says that although she was watching Amy to make sure she gained weight, she never considered G-button surgery for her.) In March 2007 CPS took the girls. “They just called and told me that they had taken the kids already,” Susan said. “I was pretty distraught. And of course I called my attorney right away to get over to the house.”

For the state’s case, the medical moment of truth had arrived. Soon after the girls were taken into custody, Beth, now three years old, complained of a sore throat, and the foster care provider took her to see Kimberly Sweet, a pediatrician with Baylor Family Medical Center at Ellis County. Based on the list of medications in Beth’s file, Sweet testified that she was expecting a sickly child. But Beth walked around the office and had no problem talking and following commands. The foster care provider said Beth ate well by mouth several times a day. She hadn’t had any seizures other than an episode that may have simply been an attempt to vomit after experiencing acid reflux. A later evaluation reported that she had normal hearing. Beth did appear to have some visual and fine-motor-skill delays and, perhaps, mild cerebral palsy, but she was otherwise a healthy girl.

Within weeks of Beth’s first visit, Sweet ordered the G-button removed. She requested discontinuation of the wheelchair. She weaned Beth off the medications, including the antiseizure meds phenobarbital and Klonopin. By the time of the June 2008 custody trial, the only medications she was prescribing were Prevacid for acid reflux and Claritin for allergies.

Sweet also saw Amy. The four-year-old’s oxygen levels were normal, and she had no signs of respiratory distress. Sweet eventually discontinued the breathing treatments and all other medications except Claritin. Sweet kept seven-year-old Heather, who considered herself “the healthy one,” on Adderall for ADHD.

But the most astonishing moment for the doctors was when they repeated the sweat tests on Amy and Beth, this time certain that Susan was not present. Both results were normal.

Susan and her mother had mixed emotions about the news. “I was happy they didn’t have cystic fibrosis,” Susan told me. “But in the same sense, what did they have that whole time?”

“My first comment,” says Patricia, “was ‘Oh, my God, they’re going to live long lives.’ And my next comment was ‘Oh, my God, this is bad for Susan.’”

She was right. When Susan’s 2008 custody trial began, DFPS lawyer Sara Ruth Spector had amassed more than twenty boxes of documents. Cox testified, “The escalation among the three children is where I was most concerned and why I thought this was the worst [case] that I had seen.”

Susan had her defenders. Her sister testified that she had once seen Beth have a seizure. Patricia said that her daughter didn’t mean to hurt the children. “I believe that she had exaggerated and falsified—I mean, exaggerated some medical history,” Patricia testified. “I don’t think she intentionally did it. . . . I believe she’s very ill. I’m not sure she realizes that she’s done this.” A psychiatrist told the jury he believed Susan was bipolar and that her disorder could have caused her strange behavior. He didn’t believe she was a factitious disorder by proxy perpetrator, and he said he had seen improvement since he gave her medication to address her bipolar condition.

During her defense, Susan said that she hoped to treat her bipolar illness and get her children back. But her testimony likely didn’t impress the jury. She pleaded the Fifth when asked if she had ever given false medical histories of her children to health care providers. She pleaded the Fifth when asked if she had ever witnessed Beth having a seizure. When asked how she would explain Beth’s and Amy’s anomalous sweat tests, she again pleaded the Fifth. Spector raised the question of whether Susan had Munchausen syndrome, in addition to Munchausen by proxy. Doctors testified about Susan’s own medical history, which included a mysterious stab wound to her abdomen.

Reflecting on the verdict, Susan told me, “It would have been a long shot to get the kids to come straight home with me. But by all means they should have ended up at my parents’ house.” In the end, however, the jury gave the Department of Family and Protective Services custody of Heather and Beth; Amy was released to her biological father.

Susan and her mother were dumbfounded. They tried to imagine a life without the girls. No more bedtime songs. No more birthday parties. Heather, Susan later said, would surely try to “keep our spirit alive” in Beth. “But they will brainwash them. I can’t imagine the things they’re telling them about us.”

Susan believes to this day that she didn’t harm her girls with unnecessary medical treatments. If doctors were so concerned about the health of her children, she said, they could have changed the plan of care. They didn’t, and Susan and her mother believe that if CPS had just waited, the investigators would have seen that in Susan’s care the girls were already on the fast track to healthy lives. Before CPS took the girls into foster care, in March 2007, Amy was going to be taken off her breathing treatments. Beth’s G-button was going to be removed after the flu season. “Those were the biggest mutilations that you did,” Patricia said.

“It’s not mutilation, though!” Susan said.

“But the prosecutor said to the jury that you mutilated them.”

“I know, but it’s not mutilation!” Susan said. “I didn’t hold a gun to that doctor’s head! I didn’t do the procedure!”

For the moment, Susan was adamant, her conviction strong. She was not going to take all the blame. “I think they’re responsible for what they do, but they didn’t back what they did,” she said of the doctors. “Now they want to turn it all back on me and say, ‘It’s all your fault’? Wrong.”

She had been sick, she admitted, and now she was getting better. She discussed the appeal she has filed and her hopes that she will get her kids back once she has gotten her bipolar disorder under control. “Of course I want my kids,” she said. “But I don’t want them to come home with me, because I can’t take care of them right now. I know I have my own limitations that need to be dealt with.” Until then, she thinks her children belong with her parents.

“I will have to be in counseling at some point in time for the rest of my life,” she said as a tear rolled down her face. “I understand and accept that. It’s an illness. But for somebody to sit back and say that it can’t be treated? They’re so wrong. Just about anything can be treated.”

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