A Tough Case of Mother Love

From The Washington Post:

If you don't belong to a book club, Darin Strauss's bitter and brilliant new novel is reason enough to start one. You can always disband afterward, and in any case your discussion of More Than It Hurts You may be so heated that you'll never talk to those people again. Strauss has packed this gripping story with the whole radio dial of divisive, hot-button issues, chief among them a form of child abuse labeled Munchausen Syndrome by Proxy (MSBP). Identified 30 years ago by a controversial British pediatrician named Roy Meadow, MSBP describes a monstrous set of mothers who rush their children to the hospital after injecting feces into their bloodstream, sickening them with tiny doses of poison or smothering them until they pass out. They perpetrate these and other covert acts of abuse on their own children to experience the vicarious thrill of solicitous medical attention. In the decades since he first raised the alarm about MSBP, Meadow has been censored for professional misconduct and questions have been raised about the prevalence and even the existence of this syndrome, but some doctors and social workers continue to consider it a viable explanation for mysterious, hard-to-diagnose illness when certain warning signs are present.

Dori Goldin, the mother in More Than It Hurts You, presents a textbook case of all those warning signs, and what she and her husband, Josh, endure at the St. Joseph's Medical Center is a nightmare most loving parents don't even know is possible. The novel bursts into action with the words that "snapped Josh's life into before and after." He gets a message at work that his 8-month-old son has been rushed to the emergency room. When he arrives a few minutes later, he hears that Dori had noticed blood in the baby's vomit and taken him to the hospital. The staff had checked him over, assured her that he was fine and sent them home, but in the parking lot the baby lost consciousness and needed to have his heart restarted.

The edges of this chronology are fuzzy and the doctors seem a little confused, but Dori remains amazingly calm. As a phlebotomist, a nurse trained in handling blood, "Dori spoke fluent hospital." She challenges the doctors' treatment of her son, objects to what she claims are unnecessary tests and finally stages a confrontation with the staff that requires the police to intervene. All this makes for a tremendously exciting story, eerily similar to the recent case of the Georgetown parents who took one of their 8-month-old twins to Children's Hospital only to endure accusations of child abuse and to temporarily lose custody of both twins. But Strauss has something more ambitious in mind than merely beating Jodi Picoult to the next ripped-from-the-headlines controversy. The case of this baby's mysterious and recurring illness serves as the starting point from which to examine the health of American culture, which to Strauss looks alarmingly ill.

More here.