The mothers accused of poisoning their kids

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Two women are accused of poisoning their own children at the same hospital. They say it tore their lives apart.

It was springtime in 2014 in a regional town just outside Sydney when Alison* noticed her son was unsteady on his feet.

He’d had headaches and been vomiting for a few days, but a local GP told her it was just a bug.

Then, he asked her an odd question that made her worried: “Mum, why are you cooking scrambled eggs in my head?”

Soon after, Liam* collapsed. As Alison raced down the highway to the local hospital, his face began to turn grey.

A trained nurse, she slammed an EpiPen into his thigh. As she pulled up at the hospital, a security guard scooped the boy into his arms.

Doctors didn’t know what was happening. Liam had brittle asthma, a particularly intense form of the condition. They thought an asthma attack might have sent him into cardiac arrest.

Soon, a helicopter whisked Liam and Alison to Westmead Children’s Hospital, in the geographic heart of Sydney, so he could be treated in intensive care.

While Alison and Liam entered together, they would leave separately. It was the beginning of a story that would see Alison lose her home, her children and her sanity, until she sat in a criminal court accused of an almost unfathomable crime.

The blood sample

Down at Westmead, doctors performed a spinal tap to reduce some of the pressure in Liam’s head. He responded quickly to treatment for his asthma. The crisis was over, but the hospital stay was just beginning.

Alison remembers doctors telling her they thought the high doses of steroids her son was on to treat his asthma had caused a build-up of pressure in his brain. It would be a slow process, but they wanted to wean him off them. She agreed.

But it wasn’t straightforward. Liam would start feeling better but then rapidly decline, getting fevers with a soaring heart rate and plunging blood pressure. Twice, he was sent back to intensive care.

Liam had already been in ICU 16 times before this latest episode.(ABC RN: Emma Machan)

A month into his admission, Liam was feeling better, well enough to be playing video games in his bed on the ward.

He was playing with another child when a woman entered the room.

She said she was a child protection worker with the NSW agency now called the Department of Communities and Justice. “You need to come with me,” she told Alison.

Exhausted and dishevelled from the month-long hospital stay, Alison followed her to a small room a few levels up. Another woman introduced herself as a senior constable with NSW Police.

For just over an hour, the pair probed Alison on her life: her kids’ relationship with their father, her employment history, her son’s medical history, and their stay at the hospital.

Tape of this questioning would later be played in the District Court.

Alison voiced her frustration with the difficulties of weaning her son off steroids. She’d threatened to take him home that week.

And then, she added, there’s the E. coli.

Earlier, she’d been told a blood culture taken from her son had grown bacteria found in the human gut — a sign that he had an infection or his blood culture had been contaminated.

“It’s like a vicious cycle in here. You come in for one thing, you pick up bugs, the medications do something wrong to you,” she groused.

The interview ended. An hour later, they told her Liam was being taken into the care of the state.

Alison asked to see the doctors’ report this decision was based on but was denied; instead, it was read to her.

Over the six minutes it took the child protection worker to read those 800 words, it slowly became clear what, or rather who, doctors wanted to protect Liam from.

An infectious diseases specialist thought the most likely explanation for Liam’s fevers and the E. coli in his blood culture was that faecal or decaying material — poo — had been injected into his IV line.

And it was pretty clear to everyone who the main suspect was — it was Alison.

Alison was indignant. She argued she was a good mum and there was no proof she’d done anything wrong.

The childcare worker didn’t budge: “A professor is telling us it’s a life-threatening situation, and we can’t ignore that.”

Over the course of the 20-minute meeting, Alison kept trying to argue back. “I appreciate you guys want to protect a child. That’s fine, but not a child who’s not at risk.”

“He is at risk,” the police officer replied.

“Not from me, he’s not,” she said.

They searched her bag, then security walked Alison directly out of the hospital building.

It was nearly 10pm, her phone was almost out of battery, and she had nowhere to go. She was not allowed to return home to her other children.

Illustration of woman being escorted by security out of hospital.
Alison was unable to return home to her other children.(ABC RN: Emma Machan)

When authorities interviewed Liam that night, he asked to see his mum six times. They reassured him he’d see her soon. But they wouldn’t lay eyes on each other for another seven months.

A relative in Sydney came and picked Alison up.

“I just cried all night, I couldn’t sleep,” Alison says. “And that’s where my — our — whole lives got destroyed.”

The professor

When Alison had met the doctor who wrote that report the week before, he was just another man in a white coat involved in her son’s care. She didn’t know he would change the course of her life.

Professor David Isaacs was a paediatrician and infectious diseases specialist with more than 30 years experience, a clinical professor at the University of Sydney. He was well known and well respected: he’d advocated publicly for better treatment of young refugees after working at the Nauru offshore immigration detention centre.

Liam’s doctors at Westmead had asked Professor Isaacs to help them figure out why Liam kept experiencing the strange fevers. When he’d spent 10 minutes talking with Alison, she’d told him her ex-husband had moved out and she was struggling as a single mum with her four young kids.

Then Isaacs had learned of the positive blood culture. He was worried. He couldn’t find a medical explanation for the E. coli, like an infection, and the antibiotics Liam was taking should have dealt with it.

He would later tell a court he discussed the blood test result with colleagues, including the respiratory physician weaning Liam off the steroids.

Professor Isaacs grew to suspect someone was deliberately injecting contaminants into Liam’s blood.

Against the wishes of the respiratory doctor, Professor Isaacs picked up the phone to the hospital’s child protection unit. As a doctor, he had a legal obligation to sound the alarm, he told his colleague.

At a meeting of doctors, caseworkers and police, Professor Isaacs argued that Liam would die if this was allowed to continue. The meeting was also told nurses had overheard Liam asking his mother what she was putting in his cannula and complaining that she was poisoning him.

Alison was separated from her son, and her other kids, the following day.

The controversial disorder

A mother injecting her own son with poo sounds like a grotesque nightmare, but Professor Isaacs knew that it wasn’t unthinkable. Injection with a contaminant is the rarest, darkest end of a spectrum of behaviour that was once called Munchausen syndrome by proxy, or Munchausen’s for short.

The term was born in a 1977 article in The Lancet. The author was British paediatrician Sir Roy Meadow, who described how some children’s mysterious illnesses were actually caused by their mother. Meadow later speculated that the women were trying to use their sick child to capture doctors’ attention.

The term caught on, and panic only grew when another British paediatrician covertly captured horrifying videotape of mothers suffocating their kids in hospital when they weren’t being watched.

A health worker herself, Alison immediately understood what she was being accused of. Her son hadn’t had a temperature in days, she told the investigators. She asked: “If I was some crazy Munchie, wouldn’t I be injecting him every day?”

Around the 2000s, the Munchausen’s label came under sharper scrutiny. Critics pointed out that the syndrome was imprecise, its empirical foundations shaky, and that it had never been recognised as a mental disorder.

A profile of the Munchausen’s Mum had developed in the literature. But it shared many of the traits of good, harmless parents: perpetrators never left their child’s bedside, were prone to doctor-shopping, and had strong medical knowledge (many were healthcare workers themselves).

Though there were disagreements about what to call it and how to understand it, nobody disputed that sometimes mothers did invent illnesses or make their children sick.

In Australia, mothers have been convicted for poisoning their children with cancer treatment drugs and epilepsy medication — and, prior to Alison being accused, at least one mother had already been convicted of injecting her child with excrement.

A lot of the children in cases like these have existing underlying health issues. Some psychiatrists say the behaviour can begin with a desire to get the attention of doctors — a sort of disturbing cry for help.

Today, “factitious disorder imposed on another” is a recognised psychiatric disorder, though Australian paediatricians prefer to talk about “fabricated or induced illness by a carer”, shifting attention from the caregiver’s personality and motivations to the impacts of their behaviour on the child.

Whatever its name, it is “arguably the most confronting condition a paediatrician ever has to manage”, Professor Isaacs wrote in a 2015 journal article. In fact, he wrote, it’s so confronting that some doctors can’t see it and others fail to do anything even when they suspect it. He wrote: “In the last 25 years, at least three children died at the hands of their mother in our tertiary children’s hospital, as good doctors failed to act on their suspicions.”

Professor Isaacs urged his colleagues to notify authorities — even where they fear they don’t have enough proof. “Paediatricians should know that the Children’s Court will act to protect children on a lesser level of proof than is needed for a prosecution in the criminal court,” he wrote.

“The main consideration should be the danger of harm, not the level of evidence.”

But what if the doctors get it wrong?

Helen Hayward-Brown, a medical anthropologist, claims this happens regularly. Since she started investigating false accusations of Munchausen syndrome by proxy as part of a PhD in the 1990s, she claims she’s heard from more than 100 women in Australia and New Zealand who say they’ve been falsely accused of making their children sick, including both of the women in this story.

Hearing their stories motivated her to become a kind of activist on the issue. Her husband retrained as a lawyer to assist women in this position (including, at one point, one of the women in this story).

Dr Hayward-Brown says often upon close examination the medical evidence reveals something else is going on — perhaps test results have been overlooked, the wrong medication has been administered, or the child has a rare medical condition that’s been misunderstood.

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