Keeping Faith Read online

  I lean over, my words falling on her face. "I never told you that I'm sorry," I whisper. "For a long time I was so busy with myself that there was no time for you. But I knew you would still be waiting for me, when I was ready." I touch my hand to her cheek. "It's your turn, now. Take your time. When you look over your shoulder--days from now, months from now--well, I'm not going anywhere without you." I close my eyes, listening to the fleeting, occasional whir of the machines feeding into Faith. One piece of equipment picks up its pace, beeping with quick regularity. The nurse looks up, frowns. "Something's going on," she says, reading the printout from the electrocardiogram. "I'd better page Dr. Blumberg."

  She's barely left the room when Faith's eyes fly open. They focus on Kenzie first, then my mother, and finally come to rest on me. Faith opens and closes her mouth, trying to speak.

  The doctor flies into the room, pulling his stethoscope from around his neck. He checks Faith's vital signs, murmuring quietly to her as his hands move over her body. "Don't talk yet, kiddo." He nods to a nurse, and she braces Faith's shoulders while he extracts the endotracheal tube. Faith coughs and gags, and then her voice comes in a sandpaper snap. "Mommy," she rasps, smiling, her bandaged hands coming up to frame my face.

  SIXTEEN

  So lonely 'twas that God himself

  Scarce seemed there to be.

  --Samuel Taylor Coleridge,

  "The Rhyme of the Ancient Mariner"

  December 6, 1999

  Because it is bitterly cold, the snow does not stick to the pavement. It swirls beneath the undercarriage of Mariah's car; it lies down in her path before twisting out of reach of the wheels.

  Mariah keeps her eyes on the road. She concentrates on where she is going, on when she will arrive.

  "Dr. Birch," Malcolm Metz says, "did you interview Faith White this weekend?"

  "I went to the hospital, and I did get to see her, but we didn't speak."

  "Why was that, Doctor?"

  "She couldn't conduct a conversation. She was comatose."

  "Were you able to speak to anyone affiliated with her case?"

  "Yes. I spent some time with a doctor in charge of Faith's medical care, who outlined her symptoms and test results for me."

  "Can you tell us what you learned?"

  "She was admitted for observation due to unexplained bleeding from the hands. Once hospitalized, she developed a high fever, along with febrile convulsions, renal-system failure, and she went into cardiac arrest. This wasn't caused by pulmonary problems, nor does it seem to be a myocardial infarction, myocarditis, or a cardiomyopathy. In short, the doctors are treating the symptoms without necessarily knowing the cause."

  "Could any of these symptoms have been caused by her mother?"

  "I suppose so, under the right circumstances," Birch says. "Of course, in this case, since Mrs. White has not been present at her daughter's bedside since Friday, I'd have to say that the bleeding and the fever are the symptoms most likely produced by her hand. I would have to reserve final judgment until interviewing Faith."

  Metz pauses in front of the witness stand. "In your expert opinion, Dr. Birch, how would you summarize the case of Faith White?"

  "Again, this is hypothetical without a chance to talk to the child herself. But if the interview corroborates my gut feelings, I'd have to say that she's a victim of Munchausen by Proxy. The child is obviously failing, and requires immediate long-term separation from her mother to ensure her mental and physical health. Her father is the obvious alternative--he can provide a supportive, loving, and mentally healthy environment for the girl. Of course, this is all dependent on whether the physicians can patch up the damage that's already been done. But if Faith is a victim of MSP, if she comes out of the coma and is separated from her mother and given constructive psychotherapy, I think her prognosis would be excellent."

  "Thank you, Doctor." Metz glances at Joan. "Your witness."

  Joan braces her hands on the defense table. She is wearing her kick-ass pink suit, as she likes to call it, and feeling confident. "Dr. Birch, are you here at the request of Mr. Metz?"

  "Yes."

  "Has he paid you to be here?"

  "Objection," Metz says. "Asked and answered."

  "Withdrawn. How many years have you been practicing?"

  "Twenty-three."

  "In those twenty-three years, how many patients have you treated?"

  "Oh...five hundred? Six?"

  Joan nods. "I see. Out of those five or six hundred patients, how many have you personally diagnosed with Munchausen Syndrome by Proxy?"

  "Sixty-eight."

  "In each of these sixty-eight cases, did you have a psychiatric interview with the mother?"

  "Yes."

  "In each of these sixty-eight cases, did you have a psychiatric interview with the child?"

  "Yes."

  "Have you had a psychiatric interview with Mariah White?"

  "No."

  "Have you had a psychiatric interview with Faith White?"

  "No. She's in a coma, for God's sake."

  "So you're basing your diagnosis of this case--of this incredibly rare disease--on newspaper articles you've read, and doctors' reports, and seven-year-old records from a psychiatric institution...oh, and on hearsay?"

  "No--"

  "You can't truly diagnose this illness without interviewing Faith and Mariah, can you?"

  The psychiatrist's cheeks flag with color. "I can make a contingent diagnosis. I'm just one step removed."

  Joan arches a brow. "I see. So, you've...contingently diagnosed Mariah White with Munchausen Syndrome by Proxy. Are there any other diagnoses this case might support?"

  "Well, there's always something, Ms. Standish. But having studied this syndrome for years, I'd say it's a likely diagnosis."

  Joan looks at a pad. "Have you ever heard of somatization disorder?"

  "Of course."

  "Could you define it for us?"

  "It's when a child manifests symptoms that are psychologically induced--in other words, he's sick, but it's his mind that's making him sick. Imagine a child who breaks out in hives every time his father has visitation rights; the child is expressing some internal psychological disturbance with physical symptoms. Often it's an unconscious means of getting attention."

  "Have you ever seen clients with somatization disorders?"

  "Many times."

  "It's far less rare than Munchausen by Proxy, then."

  "That's correct."

  "Is it true, doctor, that often the victim of a somatization disorder looks a lot like a victim of MSP?"

  "Yes. In both disorders, the presenting symptoms have no organic etiology--in MSP because they're faked, in somatization disorder because they're psychologically driven."

  "I see. How do you go about diagnosing somatization disorder, Doctor?"

  "You'd interview the parents and the child. And you'd order many medical tests."

  "The same strategy you'd use to diagnose Munchausen Syndrome by Proxy, then."

  "Yes. However, in MSP separation from the parent results in a disappearance of ailments. If the child suffers from somatization disorder, they'll continue."

  Joan smiles. "May I approach the bench?" Judge Rothbottam beckons the attorneys. "Your Honor, can I have a little leeway here? I'd like to bring in a live exhibit."

  Metz frowns at her. "What the hell have you got? A chicken?"

  "You'll see in a second. Your Honor, there's really no other way to make my point."

  "Mr. Metz?" the judge asks.

  "Why not? I'm feeling charitable today."

  After Rothbottam agrees, Joan nods to Kenzie van der Hoven, who walks to the doors at the rear of the courtroom. She summons a bailiff, who enters with Faith in tow.

  Faith is wearing a pink dress a shade lighter than Joan's suit. Her hair is bright and silver, her smile infectious. She waves at Mariah as she approaches, and doesn't seem to see the press snapping shut its collective jaw. With the exception of h