CRIMES AGAINST NURTURE

CLAIMING A RARE DISORDER MADE JAN BROOKS AN UNFIT MOTHER, THE STATE TOOK HER DAUGHTER AWAY. THE DIAGNOSIS WOULDN'T STAND.

Jan Brooks was bustling about her new Mesa apartment, preparing for her daughter Ashley to come home from the hospital. It was June 9, 1993, and in a few days, Ashley would be 18 months old.

Happy days like this one had been rare for Brooks, who had moved from the Bronx with Ashley the year before. Since they'd arrived, Ashley had been in and out of hospitals and doctors' offices; the toddler refused to eat, and her weight dipped precariously. To make matters worse, Ashley had had croup and frequent ear infections. Surgery was required to repair a hernia.

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But now, after a month at Maricopa Medical Center, the county's public hospital, the little girl had recovered from her latest ear infection, gained some weight and was ready to be released. With the help of social-service volunteers, Brooks--who'd fallen into a succession of doomed roommate situations--had found and furnished an apartment. A church had stocked it with essentials, and hospital staff had found a pharmacy within walking distance; someone had even arranged a taxi ride home.

Ashley's discharge would also end the animosity that Brooks had encountered at the hospital. Ever since Ashley had been admitted this time, the staff had treated Brooks like a leper. In hushed tones, one of the friendlier nurses told Brooks to get herself a lawyer. Brooks didn't know what that meant, but she did know that Dr. Mary Rimsza, Ashley's latest doctor and the head of pediatrics at the hospital, wouldn't speak to her at all.

More ominous, Child Protective Services had been suggesting that Brooks relinquish custody of her daughter to the state. Social workers said Brooks' living situation was inadequate, and they were worried because Ashley's weight kept fluctuating.

But Brooks was confident that all of that was behind her. She and the CPS workers had devised a plan by which she could keep Ashley; it involved getting the apartment and continuing supervision with CPS.

Finally, the call came from Maricopa Medical Center: Come and get your daughter!

Brooks rushed to the supermarket to pick up food for Ashley. But when she returned to her apartment, her euphoria was shattered.

"There was a CPS notice on the door saying, 'Don't go pick up your daughter. CPS has her in custody,'" Brooks recalls. "They didn't even put it in an envelope," she says as she pulls the wrinkled Temporary Custody Notice from her files.

Unbeknownst to Brooks, for weeks, staff at the county hospital had been making veiled references in Ashley's medical records to their suspicion that Brooks was somehow preventing her daughter from getting proper nutrition.

On June 9, 1993, just 13 days after taking responsibility for Ashley's care, Dr. Rimsza transformed the veiled references into her official diagnosis: Ashley Brooks was a victim of Munchausen Syndrome by Proxy, a rare and bizarre condition in which a parent injures a child to get attention from medical professionals.

It would take four months for Jan Brooks to get Ashley back.

Laura Knaperak and Barbara Hopkins are not doctors, but neither believed that Jan Brooks was trying to harm her daughter. And as it turned out, they were correct.

Providence smiled on Brooks when Knaperak, who at the time was executive assistant for the Arizona Consortium for Children With Chronic Illness, and Hopkins, a pediatric nurse and ACCCI president, became aware of Brooks' case. The two women stood by Brooks, and, in doing so, may have saved Ashley from becoming a ward of the state.

Brooks looks like the girl next door, but she isn't. She was born and raised in England. When her troubles with Ashley peaked, she was barely 30, alone and poor in a strange city, in a strange country. Nobody could explain why her baby was so sick, so the doctors decided it was her fault.

Hopkins sighs at the recollection of Brooks' plight. "This woman had nobody," she says. "She didn't have a single soul, except for us. I really believe that she would not have her child back if it were not for us."

Knaperak, who is now a Republican state representative from Tempe, recalls Brooks' travails with the doctors and the state with equal incredulity.

"People will think in the back of their minds, 'There's got to be more to this. There's no way this could happen.' I hear that all the time. Well, there isn't more to it. I was there. I saw it," says Knaperak.

Hopkins and Knaperak helped Brooks unravel the red tape that had ensnared and snatched away her child. They counseled her through the depression that accompanied the ordeal.

Brooks says, "I didn't even know what Munchausen by Proxy was, and I had to read about it, and I thought, 'Boy, if I'm this person, I'm really screwed up.' I mean, they have you believing you're this person."

Munchausen Syndrome by Proxy has been the topic of a made-for-TV movie, a segment of 20/20, an episode of L.A. Law and at least one true-crime paperback. And still, most people haven't heard of it.

It's a weird psychological condition with an exotic name and tragic implications. Munchausen Syndrome, which was first officially diagnosed in the 1950s, is a condition in which people injure themselves to get attention from medical personnel. The condition is named for Baron Karl Friedrich Hieronymus von Munchausen, an 18th-century hunter and soldier renowned for his outlandish travel tales.

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