Cult of One: The Manipulation of Munchausen by Proxy

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[00:00:30] This podcast is for informational purposes only and should not be considered legal, medical, or mental health advice. The views and opinions expressed do not necessarily reflect the official policy or position of the podcast and are not intended to malign any religion, group, club, organization, business, individual, anyone, or anything.

[00:00:54] I'm Sarah Edmondson.

[00:00:56] And I'm Anthony Nippy Ames. And this is A Little Bit Culty.

[00:01:00] Cult's are commonplace now. From fandoms to fads, we're examining them all. We look at what happens when things that seem like a great thing at first go bad.

[00:01:08] Every week we chat with survivors, experts, and whistleblowers for real culty stories told directly by the people who lived through them. Because we want you to learn a few things that we've had to learn the hard way.

[00:01:19] For example, if you think you're too smart to get sucked into something culty, you might be prime recruitment material. And who knows? You could already be in a cult.

[00:01:27] If you're not aware of your programming, you're probably being programmed. So keep listening to find out.

[00:01:33] We'll talk about all sorts of topics on the show, but be aware, this podcast might contain stories that could be alarming to some of our listeners. So please check our show notes for more detailed descriptions and take care of yourself.

[00:01:45] Subscribe to our Patreon for Thursday bonus episodes, Q&A, and all sorts of exclusive content. That's patreon.com slash a little bit culty.

[00:01:52] Welcome to season seven of A Little Bit Culty.

[00:02:11] Normally when you ask someone to define a cult, they talk about a leader, usually a charismatic leader, with a group of followers.

[00:02:18] Today's guest asks you to picture the opposite.

[00:02:20] We're talking to author and podcaster Andrea Dunlop about Munchausen by Proxy, aka the Cult of One.

[00:02:26] Yes, and we'll leave Andrea to explain the subject in depth. But Munchausen by Proxy is a form of mental illness and child abuse where a caregiver, typically a parent, induces or fabricates symptoms in their child to make them appear sicker than they actually are.

[00:02:40] The disorder has made it into the mainstream with the Maya Kowalski case and the story of Gypsy Rose, which was adapted into a documentary and Hulu limited series, The Act.

[00:02:50] Andrea is an expert on the topic of Munchausen by Proxy abuse, witnessing it firsthand in her family.

[00:02:55] She hosts the podcast, Nobody Should Believe Me, which investigates Munchausen by Proxy cases.

[00:03:01] She's also an accomplished writer with four fiction books under her belt and a nonfiction book, The Mother Next Door, Medicine, Deception, and Munchausen by Proxy, releasing next year.

[00:03:11] Andrea joined us for a two-part interview to dive deep into Munchausen by Proxy.

[00:03:15] In this part one, we explore this very unique type of abuse, its recent coverage in the news, including the Maya Kowalski court case, and how it could forever impact the medical system.

[00:03:25] And, as always, a content warning before we dive in.

[00:03:28] This episode touches on themes of child abuse, so listen with care.

[00:03:48] Welcome, Andrea to Little Bit Culty.

[00:03:50] Oh, thank you guys so much for having me.

[00:03:53] I feel like this has been in the works for a long time, and I've just been really looking forward to it.

[00:03:57] Yes.

[00:03:58] It's an honor.

[00:03:58] Absolutely.

[00:03:59] We got caught in our summer plans a little bit.

[00:04:01] Yeah, we would have had you sooner, but we had to take a break.

[00:04:04] Well, fortunately, today is not.

[00:04:06] It was, I originally thought today was going to be my daughter's first day of school, but she's a kindergartener, so she actually starts next week.

[00:04:12] So, thankfully, I don't have those back-to-back, because I was like, well, that's a lot in the morning.

[00:04:16] Our little one ace is also in kindergarten now, so we've got kids the same age.

[00:04:20] Oh, my gosh.

[00:04:21] That's right.

[00:04:21] Big day, big week.

[00:04:22] But we're in Georgia, so we started like three weeks ago.

[00:04:26] Oh, okay.

[00:04:27] Yeah.

[00:04:27] Yeah, she starts next Monday, so yeah, it's a huge change.

[00:04:31] I'm a little in my feels about it, I have to say.

[00:04:34] Yeah.

[00:04:34] I bet.

[00:04:35] Yeah, it is.

[00:04:36] I bet.

[00:04:36] It's definitely in my feels.

[00:04:38] In my feels, yeah.

[00:04:39] I have to say, I've been very in my feels, researching your content and reading your book, and it's one of those things where I felt, I think I told you this when we connected a few weeks ago,

[00:04:50] part of me was like, okay, I get it, I don't need to read the whole book, I get it, but then I also, because I was feeling so upset by what I was reading, and then also I felt like I had to finish it, because I was so, and it wasn't from a rubbernecking point of view, it was more like, I want to understand this.

[00:05:05] I was very gripped by, like, not, like, I had actually heard of Munchausen by Proxy, our audience may not have.

[00:05:11] Should we start with that?

[00:05:12] Just getting a little.

[00:05:13] Yeah, we know you don't want to get too into the family dynamics, but it is the catalyst for why you're here, and what was it?

[00:05:20] If you could just summarize that experience and what led you on your journey.

[00:05:25] In the nuttiest of shells, it could be the most compressed.

[00:05:28] Yeah, absolutely.

[00:05:30] So, yeah, so I do have a personal history with this.

[00:05:34] My sister, I strongly believe, is a perpetrator.

[00:05:39] She's been investigated twice, and the first investigation caused just a massive rift in my family, and was, yeah, and left her estranged, her and my nephew, who was her one child at the time, estranged from me and the rest of my family.

[00:05:56] So it was a big event in my life, and of course, you two understand how those types of things can lead you down an entire path, as it turns out, in your career.

[00:06:06] So for a long time, I didn't want to talk about it, didn't want to write about it, didn't want to do anything about it.

[00:06:14] Really tried to just heal and move forward with my life as best I could.

[00:06:20] And then I'm a writer.

[00:06:22] I'm a novelist.

[00:06:23] That was my background before I came to podcasting.

[00:06:26] So things will eventually make their way into your work.

[00:06:31] And sure enough, I wrote a novel that was strongly based on my family's history, and that came out in 2019.

[00:06:39] And at that time, I connected with a wonderful expert called Dr. Mark Feldman, who is one of the best-known voices on Munchausen by Proxy.

[00:06:47] He's a psychiatrist, professor of psychiatry.

[00:06:50] He's been working on this issue for 35 years.

[00:06:52] And we became good friends, and he really got me involved on the advocacy side.

[00:06:58] I joined the American Professional Society on the Abuse of Children's Munchausen by Proxy Committee.

[00:07:03] And that is where I met Detective Mike Weber, who is a frequent guest on the podcast, and my co-author on the book.

[00:07:10] And I met a bunch of other folks who have just really been tirelessly working to move this issue forward and move awareness of this abuse, do research on this abuse.

[00:07:22] In Mike's case, you know, be on the law enforcement side and actually try to hold perpetrators accountable and help kids.

[00:07:29] And I was a huge podcast junkie going in, so I loved podcasts and was sort of interested in trying out the medium.

[00:07:37] And when I started hearing all these stories, I thought, well, this is a podcast.

[00:07:41] Kind of, Sarah, for some of the reasons that you were talking about.

[00:07:43] Like, it is, you know, it is a fascinating phenomenon for the reason that I think cults or serial killers or anything is just, you sort of think it's so sort of outside of most people's experience.

[00:07:59] And I think there is just a really interesting, to get to the why.

[00:08:03] And I also just am very, you know, obviously on the show we really focus on how this affects families, how it affects the people involved, and really try and zero in on that human experience.

[00:08:15] So that's what led me here.

[00:08:17] And that was not the nutshelliest of nutshells, but it was my best attempt.

[00:08:21] I'm not kidding, keeping things short.

[00:08:23] That's why I'm both a novelist and talk for a living.

[00:08:26] Well, that translates well for podcasts.

[00:08:29] But there certainly are some parallels that I'm hearing there.

[00:08:31] You know, I think if you give you permission to give yourself a little bit more credit, you know, because as Sarah and I have done this, people have reached out because we're putting language to it.

[00:08:41] And there's certainly red flags.

[00:08:43] And oftentimes, like when people look at cults or they look at something like Munchausen by proxy, they think, oh, that'll never happen.

[00:08:49] And they're observing, right?

[00:08:51] And then as, you know, you hear more stories, you know, it's more a case of how hasn't it happened, you know, in a lot of these cases.

[00:08:59] And so it's always great to see the parallels and support someone who's doing similar work and putting language to it.

[00:09:06] Yes.

[00:09:07] With that said.

[00:09:08] Yeah.

[00:09:08] I mean, I will say when you first reached out, I was like, you know, obviously our podcast has a wide lane, a little bit culty.

[00:09:14] And I was like, okay, well, there may be a little bit of a reach, you know, I'm sure they're overlapped.

[00:09:19] But I had no idea how much of a culty element there was to the disorder.

[00:09:24] Can you just give our listeners, like when people are like, what, sorry, Munchausen what?

[00:09:27] Like how do you, what's the nutshell there?

[00:09:29] If you could just bring our listeners up.

[00:09:30] Yeah, absolutely.

[00:09:31] Absolutely.

[00:09:32] So we've sort of settled on, I these days prefer the term Munchausen by proxy abuse.

[00:09:38] Because Munchausen by proxy encompasses two things.

[00:09:43] And then it can also sort of encompass a wide net of things, as you will have seen when you read the book.

[00:09:48] So Munchausen by proxy refers to the act of medical child abuse.

[00:09:52] So that is when a parent induces, feigns, or exaggerates an illness in their child for the purposes of, you know, attention, sympathy, that kind of thing.

[00:10:04] And it also refers to, Munchausen by proxy is also used to refer to the psychopathology of factitious disorder imposed on another, which it describes the mental state of the perpetrator.

[00:10:14] The reason these days I prefer Munchausen by proxy abuse is as we're getting to know so many more of these stories and as so many survivors are coming forward.

[00:10:26] So one of the best things that's happened because of the show and also just because of, you know, the efforts of my colleagues is that we are hearing from so many more people.

[00:10:36] And I established a nonprofit right in the beginning before I launched the show because I had a sense that I would probably be hearing from a lot of people and wanted to have something to send them.

[00:10:47] Because, you know, really part of the impetus for this was when my family was going through it, other than Mark Feldman's work and his website, there was nothing.

[00:10:57] I mean, we could not find any resources.

[00:10:59] We couldn't find any information.

[00:11:00] You could sort of find basic definitions.

[00:11:02] And Mark has had written several books on it.

[00:11:05] But I mean, there was no I was like, there's no support groups.

[00:11:08] There's no resources.

[00:11:09] There's no there's no person you can call and be like, what do I do?

[00:11:12] And so I thought, well, that's a thing I can help establish and just connect people with these amazing folks on the committee who are willing to talk to people.

[00:11:19] And so I founded Munchausen Support.

[00:11:22] And now I have a bunch of other colleagues, many of whom have been on the show who work with me there and I and who've sort of taken over the day to day of that.

[00:11:30] So one of the things we do is support groups for survivors.

[00:11:34] And what we are hearing so much from people is that this abuse, even though obviously the medical piece is very central, and that's the piece that's been talked about the most, it really spills out into these other forms of abuse.

[00:11:47] So there's a lot of educational abuse.

[00:11:49] Parents often take their kids out of school or limit their schooling or give them, you know, educational plans that they don't need that separate them from other kids.

[00:11:59] And that's one of the cultiest elements of this abuse is the isolation, right?

[00:12:04] Absolutely.

[00:12:04] This really overwhelming need for the perpetrator to control everything about the child's life.

[00:12:13] So that really spills over into the educational realm.

[00:12:16] And they're often saying that they have learning disabilities that they don't really have, that they're on the autism spectrum, that they have ADHD that they need to be medicated for.

[00:12:25] So you see a lot of these, and there's a great deal of emotional abuse, right, too.

[00:12:29] So sort of saying who they can and can't see and really keeping them out of really every aspect of having a normal life for a kid, right?

[00:12:38] They're limiting who they can be friends with.

[00:12:40] You know, anybody that starts to question the mom gets cut out.

[00:12:42] Shunning.

[00:12:43] Yeah, exactly.

[00:12:44] So I think, you know, Munchausen by proxy abuse is my preferred term because it's really more descriptive of the whole picture.

[00:12:52] And I think really, obviously, the medical stuff is, you know, the most likely to be life-threatening.

[00:12:59] But the impacts, the psychological and emotional impacts of these other pieces of it really are quite serious as well.

[00:13:07] Well, since you just brought it up, it's such a clear model.

[00:13:10] We would look at the bite model from Stephen Hass in a fair bit.

[00:13:12] You just brought up information control, you know, controlling the environment, isolation.

[00:13:18] Obviously, there's a lot of us versus them mentality.

[00:13:21] Tell us about the other culty dynamics that you see, and we'll get into some of the stories.

[00:13:25] Yeah.

[00:13:25] And, you know, at this point, I have done a lot of interviews with cult podcasts, actually, because this is such a strong thing.

[00:13:32] And I will tell you that when I was reading, so my first task when I joined the committee was to just read all of the literature that I could get my hands on, right?

[00:13:41] Read all of the research that my colleagues on that committee had done.

[00:13:44] And when I was reading some of the research, that came up as when children are taken out of this environment or, you know, if they're even for adult survivors, they have to go through essentially cult deprogramming.

[00:13:59] And when those references to cults came up in the literature, that like a huge light went on in my brain because I was like, yes, you were just talking about Nippy putting language to things, right?

[00:14:11] It's so helpful to have something that feels descriptive of your experience.

[00:14:15] And I just thought, that's what it is.

[00:14:18] It's a cult.

[00:14:19] It's a cult of one.

[00:14:21] And I was in the cult for a while, right?

[00:14:24] Like, I mean, there was a long period of my life where I didn't question my sister.

[00:14:30] And, you know, her deceptive behaviors go, you know, again, not to get too much into that, but like her deceptive behaviors go way back.

[00:14:36] And so there was sort of a period of being in it and then a period of questioning in and then a period of being out of it.

[00:14:41] So I can sort of see those dynamics.

[00:14:43] And so, you know, the biggest thing that comes up in all these cases is that the perpetrators burn through relationships because they will get very, very close to people.

[00:14:53] They will pull people in, especially the perpetrators.

[00:14:57] And they're not all like this.

[00:14:58] We've covered a perpetrator who was not like this, but especially the ones who are quite charismatic, quite charming, quite intelligent.

[00:15:04] They will really pull people in.

[00:15:05] And, of course, people are, you know, lovely, big-hearted, empathetic people are attracted to wanting to help a parent with a sick child, right?

[00:15:14] I mean, there's nothing that pulls on people's heartstrings quite like that.

[00:15:17] And so people get pulled in.

[00:15:19] And then anyone who starts to question, that person becomes the enemy.

[00:15:25] And the retribution is quite extreme, right?

[00:15:31] So for us, that meant getting completely cut out of her life and her children's lives.

[00:15:36] It was, you helped me to my parents.

[00:15:38] You know, you helped me sue this hospital for, quote, falsely accusing me or you don't get to see your grandchild anymore.

[00:15:44] And that really goes to every, that goes to doctors, right?

[00:15:47] If doctors start questioning them, if doctors report them, then that doctor is, you know, we see this in a bunch of cases.

[00:15:52] We've seen this in the lawsuit with the Kowalski case.

[00:15:54] Like, oh, that doctor has kidnapped my child and they're evil and they're conspiring with other doctors to, you know, make me look guilty.

[00:16:01] And it's just this really intense conspiratorial type of thinking where, yeah, everyone is out to get us.

[00:16:09] I mean, in this case, me, right?

[00:16:10] Because it's sort of centered around one person.

[00:16:12] And they really like people.

[00:16:15] I think the other thing is that people make what seem from the outside like completely baffling decisions.

[00:16:24] And I think for the people that there are often people who stick by perpetrators, certainly this is the case in my family and in most cases I've seen, there are husbands, family members, friends that will stick by doctors in some cases that will stick by that perpetrator no matter what evidence they are presented with.

[00:16:42] It does not matter what you put in front.

[00:16:44] You can put video evidence in front of that person.

[00:16:46] You can say, okay, how do you explain this 10-year-long pattern of things that don't make any sense?

[00:16:53] And they will find some explanation, right?

[00:16:55] And so to me, that is intensely culty dynamic.

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[00:17:36] Now let's get back to a little bit culty, shall we?

[00:17:40] The coercive aspect of this is particularly sadistic because you have a mom, damsel in distress, right?

[00:17:48] Bringing their child, right?

[00:17:51] And if you question it, you are in a position where you're not being, you're actually killing my child as a subtext, right?

[00:17:58] And obviously you don't want that.

[00:18:00] But that's often not subtext.

[00:18:02] I mean, that's often just what they say.

[00:18:03] Like, my child will die if you don't give them, for instance, you know, a 50X dose of ketamine.

[00:18:10] You know, in the Kowalski case, right?

[00:18:12] That is what she was saying.

[00:18:12] Like, well, I might as well put her in hospice if you're not going to give her this massive dose of ketamine.

[00:18:16] That's what Beata Kowalski said in the...

[00:18:18] Right.

[00:18:19] Yes.

[00:18:19] Yeah, I was just touching on putting language to that coercive aspect.

[00:18:22] Who wants to be in the position of being a perpetrator?

[00:18:25] Yeah.

[00:18:25] Well, that's...

[00:18:26] You come in as a compassionate person and now you're the perpetrator or something.

[00:18:30] That's a tough one to like press on and keep questioning.

[00:18:33] Also, the leverage trust, right?

[00:18:35] Like if we look at leverage trust with cults, the leverage trust, doctors are trusting moms who are often the primary caregiver who come in, say, my kid is blah, blah, blah.

[00:18:43] They have these symptoms, blah, blah, blah.

[00:18:44] And to go like, oh, do you really...

[00:18:46] Does that really happening?

[00:18:48] Like if a doctor did that to me as a mom, I'd be so bad.

[00:18:51] Yeah.

[00:18:52] It's a lot to push back on, right?

[00:18:54] Yeah.

[00:18:54] Yeah.

[00:18:54] It is.

[00:18:55] And I think people don't understand the degree to which...

[00:19:00] And I find usually people, especially people who have kids and who have been to the doctor with them a bunch, can usually kind of reframe this pretty quickly.

[00:19:07] But I think people don't understand sometimes how dependent pediatric doctors are on the reports of a parent, right?

[00:19:17] And so one of the things that comes up the most in these cases, I mean, that is like the doctors in these cases are often extremely traumatized also because their trust has been broken and they have been used to harm a child.

[00:19:32] I mean, that is incredibly traumatic for them to go through.

[00:19:35] And actually, one of the really identified barriers to this abuse getting reported is that doctors don't want to...

[00:19:45] It's not even about reporting necessarily, although they don't want to report.

[00:19:49] That puts them in a terrible position.

[00:19:50] And I will talk about the Kowalski case because I think it is the single most important thing for people to be aware of right now because this is a huge threat to doctors' ability to report abuse at the moment.

[00:20:00] But, you know, doctors really don't want to be in that position.

[00:20:03] It really is so antithetical to their training, right?

[00:20:06] They're told to trust patients and parents, you know, in pediatrics.

[00:20:11] And so especially with very young children, right, you can't ask them about their symptoms.

[00:20:15] And then when you get into older kids, you know, in these abuse situations, those kids are often being really, really intensely coached at home on what to say.

[00:20:22] So it really puts doctors in a horrible position.

[00:20:25] And there's all kinds of dynamics that go on there with that relationship because, you know, number one, as you said, Nippy, like,

[00:20:32] who wants to accuse a parent of lying about their kid being sick?

[00:20:36] Literally no one.

[00:20:38] And then secondly, like, there's some ego involved, right, for doctors.

[00:20:42] Like, they don't, as you guys well know, right, like, people are embarrassed when they have been fooled.

[00:20:48] Like, nobody wants to think, you know, it's like that saying, like, people don't join a cult, right?

[00:20:53] They join an organization or they join a church or they join, like, a self-improvement.

[00:20:58] You know, it's like if they knew what they were getting into, they wouldn't just opt into it.

[00:21:02] So it's like people don't want to admit that they're the frog being boiled in water.

[00:21:06] That feels terrible.

[00:21:07] So for doctors, especially if you're, you know, if you're going to, like, which often perpetrators do seek these doctors out.

[00:21:13] They go to the Mayo Clinic or the Cleveland Clinic.

[00:21:16] If they're seeing a doctor that is just, like, the best in their field, they're the, you know, expert in this one rare condition.

[00:21:23] And, like, doctors don't want to admit they've been fooled either.

[00:21:25] So there are a lot of barriers to even getting to that place of reporting.

[00:21:30] So with the Kowalski case, to just give it in a quick nutshell, and we covered this in the third season of the show and we continue to update because this is very much still happening.

[00:21:38] The case has just gone to appeal.

[00:21:40] But it was a very tragic situation where a mother died by suicide during a police investigation.

[00:21:49] So she had a 10-year-old child, Maya.

[00:21:53] There was a Netflix film made about the case that was really a PR vehicle for the family's lawsuit, unfortunately, called Take Care of Maya.

[00:22:02] And that really left out any elements about the abuse.

[00:22:06] So she brought her child to Johns Hopkins All Children's in Florida and was insisting that she needed a massive, massive dose of ketamine.

[00:22:16] If people are not familiar with how ketamine is being used, they might have heard about it in the Matthew Perry case.

[00:22:21] Five people, including a doctor, I think maybe two doctors, were arrested in the Matthew Perry case for being part of how this adult man was getting these massive doses of ketamine.

[00:22:31] And then in the Maya Kowalski case, the doctors who refused to give her a massive dose of ketamine when she came into the hospital got sued.

[00:22:38] And the family got a $220 million judgment in Florida in their civil trial.

[00:22:46] It was essentially a medical kidnapping case.

[00:22:48] So medical kidnapping, for those who are lucky enough to not have brushed up against this conspiracy theory, is the idea that doctors are falsely accusing parents of abuse in order to snatch their children away from them because reasons.

[00:23:05] Just for fun, for profit, because they didn't like the parent, you know, what have you.

[00:23:11] So it's like Darvo for Munchausen.

[00:23:13] Exactly.

[00:23:13] Yeah? Okay.

[00:23:14] Exactly.

[00:23:14] Yes. And that was another one where I came across that term and I was like, oh my God, the big light went on.

[00:23:19] So yeah, it's really wild, but it's really catching on and fortunately has been supported by quite large media outlets.

[00:23:28] Mike Hixenbog, who was originally with the Houston Chronicle, but he did a big series that unfortunately included my sister about parents who'd been falsely accused of abuse.

[00:23:37] And I can tell you, I looked into a bunch of these cases and both Munchausen by proxy cases and sort of, you know, bone fracture cases, abusive head trauma cases.

[00:23:46] And none of these appear to have been false accusations from what I could tell.

[00:23:50] So it's really a huge problem.

[00:23:52] And the Kowalski case in particular, because it's such a massive judgment and also involves a wrongful death claim, right?

[00:23:57] So they also sort of blamed the hospital's actions for Beata's suicide.

[00:24:03] And it exposes just a huge, I mean, if the judgment stands, which it's gone to appeal, I'm hopeful that it may get overturned or have to go to a new trial.

[00:24:12] If it stands, it will really, it really undermines protections for mandated reporters.

[00:24:18] So in every state in the country, medical professionals are mandated reporters.

[00:24:21] So that means that they are subject to charges, to criminal charges, if they don't report when they have a reasonable suspicion of abuse.

[00:24:30] Or, you know, if they just sort of send a child home.

[00:24:34] And there was a case in Colorado, the Olivia Gantt case, where they did suspect Munchausen by proxy abuse.

[00:24:39] They did not report and the child died.

[00:24:41] And the grandparents ended up suing the hospital for a much, much smaller sum of money, it's worth noting, than the Kowalskis sued this hospital for.

[00:24:48] So if this case goes through, you have basically then completely undermined protections for mandated reporters.

[00:24:55] So the deal is, you report, we're going to hold you criminally accountable if you don't report, but you can't be taken to court by someone who is angry that you reported, right?

[00:25:04] You can't, like, that's the deal, right?

[00:25:06] It has to be the deal.

[00:25:07] Otherwise, you can't tell people to, oh, it's a crime if you don't report, but you can be sued.

[00:25:10] There's no incentive.

[00:25:11] Right.

[00:25:12] So all of these doctors got sued.

[00:25:14] Their reputations were trashed.

[00:25:15] Dr. Sally Smith, who was the child abuse pediatrician, was made the villain of a Netflix film, has been subject to death threats and harassment.

[00:25:22] And her family's gotten harassed.

[00:25:23] It's horrific.

[00:25:23] And it's just awful.

[00:25:24] And I am, after spending probably too many hours of my life watching the entire trial, reading thousands of pages from six years of, you know, that this litigation's been going on,

[00:25:34] I am a very strong opinion that these doctors saved this child's life.

[00:25:38] Like, this was not heading in a good direction.

[00:25:40] The mother was telling the doctors in the hospital, if you do not give her this ketamine, this massive dose of ketamine that I'm asking for, then I will take her and put her in hospice care because she might as well die.

[00:25:54] And that is a very scary thing.

[00:25:57] They had every reason to believe, you know, this child had a port.

[00:26:00] Her mother was injecting drugs in her port at home.

[00:26:03] The mother was an infusion nurse.

[00:26:04] There's every reason to believe that this was a possible mortality situation if this child was allowed to leave the hospital under those circumstances.

[00:26:13] And to watch these doctors be so villainized, have to go through this, is awful.

[00:26:18] And it sets a horrible precedent.

[00:26:20] So I think this has really sort of, it's captivated sort of a sector of people and then it's kind of flown under the radar.

[00:26:27] And unfortunately, I'm the only person who's really reported it thoroughly.

[00:26:31] The rest was just sort of following the trial and sort of keeping up with a lot of the narrative that the film set.

[00:26:36] So it's a whole mess.

[00:26:39] That's awful.

[00:26:39] To recap, we have a perpetrator who's able to expose a loophole in our medical system and our legal system and then profit from it.

[00:26:49] Yes.

[00:26:50] I mean, in this case, it's the father of the child who's the surviving parent.

[00:26:55] However, having again done extensive research into this, he's an interesting case because the fathers in these cases tend to kind of fall in a couple of different buckets, right?

[00:27:05] So if there's a father present, sometimes there isn't.

[00:27:07] Sometimes the mother doesn't have a relationship with them.

[00:27:10] In some cases, their children are adopted.

[00:27:13] I've seen that less, but there is a big case I'm looking at where that's the dynamic.

[00:27:16] So there just is no father present.

[00:27:18] Sometimes the father is absent because of work, like it's a dad in the military or they have a job that just takes them on the road for months at a time.

[00:27:26] And then, you know, so sometimes the father is just kind of out of the picture and the mom's just doing her thing.

[00:27:31] And I say mom because it's like 96% female perpetrators of this abuse.

[00:27:35] It's sometimes you have a protective dad who steps in and sees what's happening and when they're confronted with evidence does the right thing.

[00:27:41] And those dads, unfortunately, end up in hell because then they end up in these prolonged custody battles.

[00:27:47] You know, you have dads like Ryan Crawford, who I covered in the first season, who he wasn't married to the perpetrator, but he realized what was happening.

[00:27:55] And, I mean, ended up just fighting and fighting and fighting to get anybody to do anything about it.

[00:28:01] And he finally did prevail and she ended up going to prison and he got custody of his son.

[00:28:05] But, I mean, just to see what these dads are up against when they do come to a realization, you see sort of, not that I empathize with dads who continue to enable the abuse or participate in it.

[00:28:16] I obviously don't.

[00:28:17] But you see why people get dissuaded, right?

[00:28:19] Like that's what you're going to end up, you know, in this horrible court battle where the mom is going to accuse you of X, Y, Z and really do anything she can to sort of discredit you.

[00:28:29] So, and then you have dads that really, you know, anywhere along the spectrum from tacitly enable to actually participate.

[00:28:39] And, you know, who just will support the perpetrator no matter what.

[00:28:42] Jack Kowalski, the dad in that case, who was the, you know, engineer of this lawsuit, who drug his kids through this horrible public, you know, lawsuit that consumed years and years of their life.

[00:28:53] He, I believe, was really a collaborator.

[00:28:56] I mean, he was taking her to like half of her doctor's appointments because in the year leading up to the hospitalization in question, she had this alleged pain disorder.

[00:29:05] This, to me, was very clearly a fake diagnosis that her mother was pursuing.

[00:29:09] She went to this strange shady doctor, Dr. Kirkpatrick, who runs a like all cash ketamine clinic.

[00:29:16] She got 55 infusions of ketamine in this, you know, tiny nine to 10 year old girl.

[00:29:23] She had 55 infusions of ketamine in the year leading up and including a ketamine coma where she was taken to Mexico and put in a coma and given continuous infusions of ketamine.

[00:29:34] Her parents were told this has a 50% chance of death by the doctor who performed that procedure.

[00:29:41] And so her father went along with all of these things.

[00:29:44] So in that case, I'm like, you're, you're not, this goes beyond enabling.

[00:29:48] Right.

[00:29:49] And then, you know, and then once his wife died, he pretty much turned around and waged this lawsuit shortly thereafter.

[00:29:56] So I think just huge opportunists.

[00:29:58] So, you know, the dads can sort of fit any mold.

[00:30:01] They can be really the protector of the kids and really kind of save the day.

[00:30:05] They can get shut out for various, you know, Gypsy Rose case that was, you know, he was extremely young when Gypsy was born.

[00:30:10] He was like 17, Rod Lantern.

[00:30:12] He was like 17 when Gypsy was born.

[00:30:14] The mom was so manipulative in course of this.

[00:30:17] She sort of cut him out.

[00:30:18] And I think he feels very guilty and wishes he had sort of intervened more.

[00:30:23] And obviously I wish he had too, but I think that's sort of a, you know, he was so young.

[00:30:28] He thought she was taking care of this sick child.

[00:30:30] He really believed it.

[00:30:31] He wasn't really involved in the day to day.

[00:30:33] So dads can get really shut out like that.

[00:30:35] So it really runs the gamut.

[00:30:37] But yeah, Jack Kowalski is, Jack Kowalski is a sort of a singular character, I will say.

[00:30:43] Yeah.

[00:30:45] For more background on what brought us here, check out Sarah's page turning memoir.

[00:30:49] It's called Scarred, the true story of how I escaped NXIVM, the cult that bound my life.

[00:30:53] It's available on Amazon, Audible, and at most bookstores.

[00:30:56] Highly recommend, of course, because she's my wife.

[00:30:58] And now a brief message from our Little Bit Culti sponsors.

[00:31:02] Remember, when you support our sponsors, you support our podcast.

[00:31:12] Break time's over, people.

[00:31:14] Let's get back to this episode of A Little Bit Culti.

[00:31:16] It's a good one.

[00:31:17] Just a thought as you were, and I try not to interrupt because you have obviously so much knowledge in this area.

[00:31:22] Probably too much for your own good.

[00:31:24] But just thinking about like something you said earlier about, you know, how people will not, they won't wake up even amidst hard data in front of them.

[00:31:33] And that was definitely a very frustrating point in your book.

[00:31:35] One of the cases where Mike Weber is like, you know, this, this, this, and this, and just can't see it.

[00:31:40] And it reminds me a lot of the people who are still loyal to Keith Raniere and NXIVM and how even in the trial in the face of all the data and like, well, of course, the FBI just fabricated that evidence that it can't be true.

[00:31:51] You know, and it points to this other connection, which I hadn't really made until you were talking about the betrayal that we felt when we realized what we'd been duped, you know, and you start to go back to like, but what about this moment?

[00:32:04] Like, was that not real?

[00:32:05] And I was thinking about, you know, like the moment, you know, yeah.

[00:32:08] Like when you touched your sister's belly and felt a kick and that was a, I think the proper terms alleged fake pregnancy.

[00:32:15] Should we say that for legal reasons or?

[00:32:17] No, I'm quite comfortable saying that was a fake pregnancy.

[00:32:21] Yeah, no, I, no.

[00:32:22] For sure, for sure.

[00:32:24] There's way too much.

[00:32:25] I mean, I, there's way too much corroborating.

[00:32:28] You know, I've spoken to the man who was her partner at the time about how she, you know, she, she brought in an ultrasound picture with someone else's name on it.

[00:32:35] I mean, there's just, there's no, yeah, fake pregnancy.

[00:32:38] Yes.

[00:32:39] But back to like the betrayal of recognizing, you know, for any of the people that were around these perpetrators, like, wait, how did I miss this?

[00:32:47] Like, what were the red flags that I missed?

[00:32:49] And I guess that was something I was trying to make the correlation to.

[00:32:52] Like, when people are around these perpetrators, they tend to overlook red flags because they want to trust the mother, right?

[00:32:57] And they want to believe that people are good and that's our natural inclination.

[00:33:01] What are some of the red flags that maybe you miss knowing what you know now or that people tend to miss in these cases?

[00:33:08] Yeah, that's a great question.

[00:33:10] And it really is so similar, I think, to the cult comparison because it is this sort of gradual buildup over time, right?

[00:33:19] Especially when you're in a perpetrator's life long term, as I was, right?

[00:33:23] You grew up with that person.

[00:33:24] So you sort of start seeing some troubling behavior here and there in, you know, high school and in our 20s.

[00:33:30] And then it just sort of escalates and escalates until you have that kind of record scratch moment of what are we doing here?

[00:33:37] And I think the thing that puts people over the edge is sort of different for everyone, right?

[00:33:42] That's going to look different for everyone.

[00:33:44] I think for me, when I look back at the things, I mean, the fake pregnancy was the biggest thing that I sort of ignored and moved past.

[00:33:53] And for all those reasons, I mean, I think it's really, I think sometimes we look at ourselves as though we're these rational, logical beings that are just taking in the evidence and deciding accordingly.

[00:34:02] And like, that's not how human beings work.

[00:34:05] That's not how any human beings work.

[00:34:07] You know, we make decisions based on, I think, on emotions more than anything, right?

[00:34:12] It's like if you look at how people relate to anything, like politics or, you know, anything that we think we're sort of like collecting all this evidence and making a decision.

[00:34:20] You know, we have that analytical part of ourselves.

[00:34:22] But I think especially with our closest relationships, you know, someone who's become a mentor or a good friend or, you know, your sibling, obviously, you know, a family member.

[00:34:32] Like you are going to put the most loving spin on that possible.

[00:34:36] And I think there was there was this reluctance to make it into a pattern, I think, when I look back on it.

[00:34:43] Right. So it's like I was sort of seeing like, OK, well, there was this weird thing she did in high school.

[00:34:47] And that was just one thing isolated.

[00:34:49] And there's other weird thing.

[00:34:50] And there's other thing.

[00:34:51] And there was this pregnancy.

[00:34:52] But like this was like a troubled patch in her life.

[00:34:55] And we're just going to isolate it and like not look at it as a pattern of behavior that's escalating over time.

[00:35:00] You just because you don't want to draw those dots.

[00:35:02] Because if you start to connect those dots, then what does it say about that person?

[00:35:07] And, you know, I think there's there's almost this sort of buried knowledge that you have that like the minute that you really look at it, you're going to lose this relationship.

[00:35:19] You know, you're going to lose this family, like whether that's, you know, NXIVM is the family or my actual family.

[00:35:26] And I remember, I mean, the day that my parents, you know, for me, the day that, again, sort of the and I think this is where as a wordsmith person, as a person who loves language, this is where I thought I could be helpful.

[00:35:38] Right. Is putting words to this.

[00:35:40] Is putting these parallels together.

[00:35:41] Helping people put these parallels together.

[00:35:43] Looking at more than one case.

[00:35:45] Looking at a bunch of cases side by side.

[00:35:47] Not just having the Gypsy Rose Blanchard case be the monolith that everyone thinks of when they have, you know, and think of my child's by proxy.

[00:35:53] But like looking at how strong these parallels are, because, you know, really when my parents came home, they met with their family doctor and our longtime family doctor who knew all of us really well.

[00:36:03] And they described what was happening with my nephew.

[00:36:06] And she gave them that terminology of my child's by proxy.

[00:36:09] And when they came home, I was living with them at the time because I just moved back from New York.

[00:36:13] And when they came home and sat down with me and explained what she'd said, I mean, it was like my life broke in two pieces.

[00:36:19] That was like.

[00:36:20] I was going to say it's heartbreaking.

[00:36:22] Yeah.

[00:36:22] Yeah.

[00:36:22] Yeah.

[00:36:23] It was the before and after, you know, it was like, oh, we're never going to come back from this.

[00:36:28] I think even then I knew I was like, this revelation is going to destroy our family.

[00:36:34] Like she will never forgive us.

[00:36:37] And still, I mean, we went forward because how can you not, you know, like how can you not when you know that that's that a baby is in danger?

[00:36:46] I mean, it's like, I don't understand how people make that deal with themselves.

[00:36:50] I understand how they get really deep into it.

[00:36:53] But it's sort of like, I mean, I think to your point, it's like when you're talking about, oh, the FBI is fabricating evidence against Keith Raniere.

[00:37:00] It's like people have to get further and further into a conspiratorial mindset to explain why this is not the thing that it is.

[00:37:11] Right. And I think like, and sure enough, you know, watching my brother-in-law and his parents stand by her, you know, for over a decade now, it's all the doctors are in conspiracy against her.

[00:37:22] And her sister's out to get her and her parents and this and that and this and that.

[00:37:26] Oh, these people just have so much influence and blah, blah, blah.

[00:37:28] And it's like, that's not, that doesn't make any sense at all.

[00:37:31] It doesn't make sense on any level.

[00:37:33] But it is like, I think you just have a group of people where they're all just sort of reinforcing each other and telling each other the same story.

[00:37:41] You know, my colleagues on the ABSEC committee have put together kind of a good, just like solid bullet pointed list of these.

[00:37:47] But I think what I want people to understand, because I think sometimes people get this confused with and even doctors, right?

[00:37:54] Like when they're reporting a suspicion of abuse, it's like report a suspicion and then there's an investigation and that reveals what is going on there.

[00:38:01] Right. It's not like the report is not the beginning and ending of anything.

[00:38:04] They don't like CPS doesn't swoop in and snatch the children up the minute a doctor says something like it is quite the opposite.

[00:38:11] These it takes, you know, months and months and months to sort of, you know, look at what's going on in these cases in particular.

[00:38:18] You know, some of these things can look like an anxious mom who is really genuinely worried that there's something going on with her child.

[00:38:25] And sort of, you know, like a hypochondriac type who's like every sniffle that they have, they bring her in or they're, you know, if someone is suffering from, you know, postpartum depression or even postpartum psychosis can like bring on, you know, I think there's something wrong with my child.

[00:38:39] Those are very separate from my child's and my proxy abuse.

[00:38:42] My child's and my proxy abuse is intentional deception.

[00:38:45] So the mother knows and understands that these things are not real.

[00:38:49] They understand that they're doing it right.

[00:38:51] They're not feeding their child and then they're coming in and reporting that their child is spitting up or what have you.

[00:38:56] That's a really common one.

[00:38:57] So I think that's the that's the hallmark is like intentional deception around medical things.

[00:39:03] So certainly if you're very close with someone and you know that they have a history of lying about their own health, that certainly is a big warning sign that they made.

[00:39:14] And again, it's not a one to one.

[00:39:15] Not every perpetrator has that history, though many, many of them do of like Munchausen behaviors, which is when someone, you know, feigns, exaggerates or induces illness in themselves for those same purposes of attention and sympathy.

[00:39:27] If someone has that history, that's certainly a red flag.

[00:39:30] You know, if someone just has a history of really pathological deception, that also is a red flag.

[00:39:37] Like if things sort of start not lining up with their child.

[00:39:40] Right.

[00:39:41] And so what I also want people to understand is this isn't subtle.

[00:39:44] Right.

[00:39:44] It's not like, oh, the kid is goes to the doctor, you know, maybe a little more than a healthy child.

[00:39:51] When you look at these cases, like I had a doctor explain this to me that was like a nice visual for me.

[00:39:57] So when you're looking at like the medical records for these cases, if you look at like one of my kids, right, that thankfully, blessedly, like has not had any serious health complications at all.

[00:40:07] So you look at just like a six year old child who, you know, has had just well child visits and like an ER visit here and there for like a high fever or a bonk something or whatever, you know, just sort of a regular.

[00:40:18] Then you have like a, you know, a medical file that's like a couple inches thick.

[00:40:21] And then you look at like a child that has like leukemia or a childhood cancer or something like that.

[00:40:28] And they're they have a big stack.

[00:40:30] Right.

[00:40:30] So it's like 10 times the size of a healthy child.

[00:40:33] And then you look at one of these cases and it's like five times the size of a kid that would have like if you look at their medical records, it's like five times the size of a kid that has leukemia.

[00:40:43] Right.

[00:40:43] So it's like the doctor visits are constant.

[00:40:47] It's really everything everywhere all the time.

[00:40:50] Like it's it's a constant thing.

[00:40:52] So it's like it's not oh, this it's just it's not a subtle thing.

[00:40:57] So it's it's a whole bunch of things also that don't make sense together.

[00:41:01] Right.

[00:41:01] So it's not like, oh, this child has one illness and here are the symptoms and it sort of fits into this thing.

[00:41:10] It's they have this and this and this and this and none of these things make sense together.

[00:41:15] And they're the biggest medical mystery that any of these doctors have ever seen.

[00:41:19] And they have the most rare disorder and the most rare presentation of it.

[00:41:24] And there's only one doctor in the entire world that can understand it.

[00:41:28] And I think that that's kind of part of the appeal for perpetrators.

[00:41:30] And that was present in the Kowalski case where so basically that she had this alleged pain disorder that was that was, you know, extremely rare.

[00:41:38] And then her presentation of it didn't fit because she had the most rare presentation of it.

[00:41:42] And it was at once the most extreme where she needed these really extreme treatments like the ketamine coma.

[00:41:47] And at the same time, it was the most subtle.

[00:41:50] So you could have like good days and bad days where one day, miraculously, she would look like a normal child.

[00:41:55] And then the next day she would be in horrible debilitating pain.

[00:41:57] So it's those kind of things where it's like if you're around the person a lot, if you're around the child a lot, it is going to be obvious that something is wrong.

[00:42:06] And when I talk to people in these cases, I really try to talk to people who were around the kids a lot, who are family members, you know, who really were involved in those dynamics.

[00:42:18] Because number one, I think that's the piece of the story that needs to be told, right?

[00:42:22] Again, not just listing all of the medical horrors, all of the surgeries, all of the, you know, ghastly pieces of the abuse, but really talking to people about the dynamics and what they saw.

[00:42:30] And it's like most often there may be like one or two true believers, but even they, again, like even the way they talk about it, it's like they're really having to go, you know, all over the place with explaining why this child really had this thing.

[00:42:44] But most people are like something was wrong.

[00:42:48] Like they were saying their child was really sick, but then I would see their child like, you know, bouncing all over the place.

[00:42:54] And they said their child was in a wheelchair, but we never saw the wheelchair.

[00:42:58] It was only when, you know, they were taking them out to this, that, and the other thing.

[00:43:01] And so most of the time, like teachers, family members, close friends, you know, church congregation members will observe that these things are not matching up.

[00:43:13] Do you like what you hear on A Little Bit Culty?

[00:43:15] Then please do give us a rating, a review, and subscribe on iTunes, Spotify, or wherever you listen.

[00:43:21] Or even better, share this episode with someone who you think needs to hear it.

[00:43:25] Maybe they're in a cult.

[00:43:26] Maybe they're a little bit susceptible.

[00:43:28] Just share the love.

[00:43:30] Thanks.

[00:43:32] There's so much information in this conversation.

[00:43:34] I'm so glad we could split it into two episodes.

[00:43:37] Yeah, there's a lot to process here about the complexity of Munchausen by proxy.

[00:43:41] Even saying the name so many times is complex.

[00:43:44] So it can be hard to identify and challenge cases in the medical system.

[00:43:47] I know.

[00:43:48] And we're seeing so much out there in the zeitgeist right now about dismantling cults of one of all different types, as Andrea calls them, playing out in real time.

[00:43:57] Stay tuned for next week's episode where we cover Andrea's new book on how Munchausen by proxy abuse is impacting the medical community.

[00:44:04] And in the meantime, if you'd like to learn more, check out Andrea's podcast, Nobody Should Believe Me, on your listening platform of choice.

[00:44:11] It is so well produced and every episode is utterly fascinating.

[00:44:15] Thank you for listening, everyone.

[00:44:35] A Little Bit Culty is a Trace 120 production.

[00:44:38] Executive produced by Sarah Edmondson and Anthony Nippy Ames in collaboration with Amphibian Media.

[00:44:43] Our co-creator is Jess Temple-Tardy.

[00:44:45] Audio engineering by Red Cayman Studios.

[00:44:48] And our writing and research is done by Emma Diehl and Kristen Reeder.

[00:44:51] Our theme song, Cultivated, is by the artists John Bryant and Nigel Aslan.