Factitious Disorder Imposed on Another
My Story of Munchausen Syndrome by Proxy: Urine Injections and Bizarre Medical Treatments
A dark side of childhood
“Munchausen syndrome by proxy [now known as Factitious disorder imposed on another] is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.” — Medline Plus.
I prayed that the pain wouldn’t be as bad as the last time. It was a long needle, and I remember glancing at the yellow and feeling dread. Dr. Simmons’ nurse, or at least she claimed she was a nurse, injected my buttocks with my own urine. I was right to worry. Because it hurt. A lot.
I was usually quiet, but this time I made the mistake of making a noise when the needle went in. Something like a loud whimper or a cry. My mother informed me “That didn’t hurt. You shouldn’t be so dramatic.” I wondered how she knew that the injections were painless, as she had never received one. I felt stupid. I felt small and alone.
I felt I had embarrassed my mother, the doctor, the nurse and myself. I had made a spectacle and I felt deeply ashamed. In 1976 “gaslighting” wasn’t a term in popular use, but later it resonated with me. My mother made me doubt that my experiences were mine at all.
I was eight.
Every Tuesday she took me out of school for the day so that we could go to these appointments. We took the 7 AM train from Wilmington, Delaware to Philadelphia. I hated Philadelphia. It was dirty and smelled like garbage. But it was fascinating to see the tall buildings and walk on the broad sidewalks with people everywhere.
Once, when we were headed toward the tall building where the doctor’s office was, a boy a little older than I shoulder-bumped me . He stopped to glare at me. My mother grabbed me and pulled me toward her. The boy then paused and walked away.
She bent down and whispered in my ear that he was about to hit me and that I shouldn’t make eye contact with other people, especially in Philadelphia. After that, I dreaded the walk from the parking garage to Dr. Simmons’ office almost as much as I dreaded the visits themselves. It felt dangerous.
She used a blender to mix up a thick brown lumpy substance that she made me swallow on the mornings that we went to Philadelphia. Eating it was necessary, she told me, because the urine shots wouldn’t work without it in my system. It needed to contain every food and spice that I might come in contact with in my life, future-proofing my health.
I had to drink a huge amount and it filled the blender almost all the way to the top. I wondered how foods of so many different colors ended up brown. It smelled and tasted bad. The texture was offensive, lumpy and fibrous, as it partially contained foods that were difficult to liquefy.
My mother blended various meats, fruits, grains, oils, beverages, spices, vegetables, milk, chocolate, nuts and seeds, applesauce, yogurt, beans, garlic, raw egg, coffee beans and so on. It was work-intensive and took a long time to get the concoction right, but she didn’t seem to mind. She seemed to even enjoy it.
We had to get up very early so she could have enough time to prepare it before we left for the doctor. We also needed to rush to get to the train station on time. She had to do the blending the morning of the visit, because it the concoction wouldn’t be effective if she did it the night before. At least it was fresh.
I sat at the breakfast table while she presented me with a tall glass that she refilled until I had ingested all of it. I hated it because the smell, the taste, the temperature and the texture. Just smelling it made me feel like throwing up. I had to pause between gulps to try to keep it down. Sometimes after I drank it all, I vomited and she would have to re-do all of her work.
I threw up on the train more than once. That was particularly upsetting and I remember the awful smell, which made me feel like throwing up again. I could see the other passengers looking on, I’m sure in horror, and I can only imagine how they felt having to complete their journey with vomit on the floor.
I dreaded the train rides to Philadelphia. Apart from feeling nauseated the whole way, I hated having the train stop so frequently to let people on or off. That made it all worse. I wanted to get to Dr. Simmons’ office as quickly as possible so if I had to throw up I could run to his bathroom instead of doing it in public. It was a long train ride. I think it took at least an hour to get there. It felt like a very, very long time.
When this happened it seemed odd to me that we didn’t have to turn around and go home because the shots weren’t supposed to work unless I had the goo in my stomach. But my mother always reassured me it would be OK. I was appreciative because I felt ashamed at making such a disgusting mess in public.
We would arrive at Dr. Simmons’ office when it opened and would stay until 4 or 4:30 PM. I remember how long it took because I would look at the clock and count the hours until we could leave. Sometimes it was dark outside when we left.
The window in his examining room had a wonderful view of the ugly city. I would stare outside as I turned my head away while he gave me allergy shots. I didn’t want to see. He gave me so many shots that he would use up all the space on the inside of one forearm, from near the wrist to the inside of my elbow. With no room left, he had to do the same with the other arm. I had injection bubbles all over the inside of my forearms. I think the rule was, if it turned red and bubbled up then I was allergic to whatever food or environmental thing he was testing me for. I seemed to be allergic to everything and my forearms stung by the time he was finished.
One of the most disappointing allergies I was told I had was to chocolate. I loved chocolate and felt a loss at not being able to eat it anymore. Carob was the substitute. I don’t know if it’s been reformulated to be less awful now, but then it was a powdery unpleasant substance that didn’t taste anything like chocolate. Still, my mother made carob brownies and I ate them. But that stopped when Dr. Simmons informed her that I was allergic to gluten. Today there are plenty of gluten-free choices at grocery stores and restaurants, but back then there was nothing. It meant I couldn’t have anything with flour in it. This limited my food choices significantly and my parents policed my food intake closely.
I was constantly hungry and having cravings due to the restrictive diet my mother had me on and I wanted the off-limits carbs. Once when I thought my parents weren’t around, I snuck into the kitchen, opened the cabinet and got a slice of bread. I was trying to be quiet about it, but I wasn’t quiet enough, as my father rushed into the kitchen, shouting, and snatched the bread away. He told me to stay out of the kitchen.
I was told I was allergic to milk, nuts, soy, fish, shellfish, eggs, baked goods, cheese, cats, dogs, mold, pollen and just about everything else I could think of. It didn’t occur to me to challenge this with the information that these things (apart from mild house dust allergy) had never previously caused me any problems, so why were they problematic now?
But I knew it would be futile, because when it came to my health, my parents believed things that went against logic or reason, especially if it was upon a doctor’s advice. My mother seemed pleased and animated when Dr. Simmons told her I was allergic to yet another substance. My father believed what she told him and his role was co-enforcer of whatever the changing rules were for me. He could have stopped all of it. But he didn’t and I resented him for it.
At the recommendation of Dr. Simmons I was required to crawl back and forth a specific number of times from one end to the other of our living room floor. My stomach needed to be touching to the floor while my arms pulled me forward. I can’t remember what the reason was or if there was a reason given at all. I had to do this every day, with my mother’s supervision to make sure I did it and she would count-down the number of times I went from one end of the room to the other.
In addition, per Dr. Simmons’ instructions, I had to wear homemade eyeglasses with one green side and one red. The color was rigged up by taping colored cellophane to the left and right lenses on a pair of sunglasses. I was to read for a certain length of time every day while wearing them.
This was to address a slight turn-in that I still have in my left eye which becomes more pronounced when I’m very tired. I didn’t mind this particular requirement as much as it was much harder for my parents to police. I could get away with wearing the glasses and pretending to read while I daydreamed. It was pretty simple to look at the books and turn pages.
My mother told me early on not to tell anyone about the urine shots or any of the other treatments, explaining that people would think I was crazy if they knew. So I didn’t.
