The Dark Side - Danielle Steel Page 0,74

She followed him up the stairs to his office, and he opened the promised bottle of wine.

She took a seat in the comfortable chair across from his and he handed her the glass of wine, and she noticed a box of tissues on the table next to her. She handed him the manila envelope with Jaime’s chart in it.

“So what brings you here, my friend?” She saw him looking at her legs and pretended not to notice. She knew he had been divorced twice and was something of a ladies’ man, which was one of the things about him that had put her off, but she liked him as a friend, and respected him as a shrink. And she had the blond, blue-eyed, wholesome kind of girl-next-door looks that appealed to him, and a great figure. But she was there as a doctor, not a date.

“A three-and-a-half-year-old patient. I read her chart again before I came over, to see if anything stuck out, or I missed anything. She’s a bright, happy, normal, active kid. She gets banged up a lot, and has had a lot of minor accidents. Nothing terrifying that suggested child abuse to me, and I know the parents. But she’s had her share of injuries, probably more than her share. Broken wrist, broken arm at a year old, stitches, a bump on the head but no concussion, ten days ago she slipped while running at a pool, cut her chin open, fell into the deep end, and went down like a rock. Her father noticed and got to her just in time. She had twelve stitches in her chin. Today, she got bitten in the face by a German shepherd. It’s a long list. One minor surgery for ear tubes, and almost an appendectomy. Her mother lost a sister to leukemia as a child, so she’s nervous. At her request, I tested my patient for leukemia, negative of course. Now she’s seeing an orthopedic surgeon, wondering if the child has scoliosis—she doesn’t.”

“Shit, it sounds like a lot to me. Stitches twice in ten days?” He looked skeptical.

“Two in a row is unusual, even for her.”

“So what are you trying to figure out. Child abuse?”

“No. More intricate than that. To cut to the chase, my patient’s father thinks his wife may have Munchausen by proxy. His mother suggested it, she’s a licensed, non-practicing psychologist.”

Paul rolled his eyes at that. “God save me from my non-practicing colleagues, who have too much time to think. It’s an interesting diagnosis, though. What do you think about it?”

“I have no idea. I’ve never dealt with it. That’s why I wanted to talk to you. And the child’s mother runs one of the most respected abused-children’s shelters in the city, and had two years of medical school. The parents are highly educated, intelligent, nice people, and they’re crazy about their child. But I have to admit, the kid has gotten hurt a lot. When I try to look at it objectively, I see it too.”

“And you don’t think she’s abusing the kid in a more traditional sense, and the child is protecting her, as most abused children do?”

“Definitely not,” Cathy said as she took a sip of the wine and set it down on the table next to her.

“Interesting case. I have dealt with Munchausen by proxy. It’s a bitch to prove. The people who have it are usually smart and educated, a lot of them have medical training, as the mother does in this case. They lie like dogs and they do it brilliantly, and it’s very hard to pin anything on them and prove it. It all looks accidental, except for the excessive surgeries. The mother may be moving into that phase, if she’s taking her to an orthopedic surgeon.

“The ignorant ones usually kill their kids in more obvious, clumsy ways and wind up in prison for murder. But the children of the smart ones die too, if they go too far. It’s all about the parent getting attention from having a sick kid, either sympathy or they play super-mom, and everyone talks about what great mothers they are, except that they’re either making the kid sick, or putting them in situations where they’ll get hurt. Off the top of my head, just from what you’ve told me, I think it’s a possibility. Is it a sure thing? It almost never is. And most typically, their victims are under six, because they can’t communicate what’s happening to them. They