What's Best for Corbin? : Michele Beideman says her son has been sick since infancy. Some doctors at UCLA say he'sfine-- she's the one who's ill. While authorities grapple over the case, the boy has been taken away from his family.

TIMES STAFF WRITERS

Michele and Bill Beideman desperately want their baby back. The question is: Should they get him? It has been an agonizing seven months since the Las Vegas mother took her son, Corbin, 2 1/2, to UCLA Medical Center to find out why he was underweight and sickly--and seven months since doctors refused to return him.

A UCLA medical team says the baby is healthy, that it's Michele, 29, who is sick. According to a hospital psychiatrist, Beideman's is a classic case of Munchausen Syndrome by Proxy (MS-P)--a rare psychological disorder in which a mother lies about symptoms in her child, or actually abuses the child to cause the symptoms.

The psychiatrist, Dr. David Charles Beck, says Beideman may have deliberately underfed Corbin and may have given him drugs to suppress his appetite, subjecting him to scores of unnecessary medical tests and treatments.

"We believe that (Michele Beideman) has a very serious psychological disorder that has been very detrimental to Corbin's well-being," Beck said in a letter written jointly with UCLA colleagues.

The Beidemans say it's the psychiatrist who has "lost it"--that he has incorrectly diagnosed her and then used his influence to convince others that he is right. Michele says she is neither sick nor abusive. She says Corbin refused to eat, which is why she took him to UCLA in the first place.

"We have been stripped of all civil rights, decency and pride," says Bill Beideman, who is distraught and overwhelmed by what he calls the "unbridled power of one UCLA psychiatrist and a social services system that is out of control."

Now, a Nevada court has placed Corbin in foster care, his mother has been arrested and is out on bail facing felony child abuse charges, and a divided medical community is grappling over what happened.

No matter who is right--and in Munchausen cases one seldom knows for sure--the saga is bizarre and complex: experienced doctors, courts and a social services system doing what they think is best, and loving parents who say they have done nothing wrong.

And in the middle of it all, a boy too young to tell what really happened.

His parents say that even as an infant, Corbin was sick. He suffered ear, nose and throat infections so frequently that he sometimes seemed to ingest more antibiotics than food. He'd lose weight with each infection, then gain some back again.

When Michele tried to wean him at less than a year, he absolutely refused to eat, she says. "Remember how we danced around the apartment the first time he finished a jar of baby food?" Michele asks Bill during an interview in their apartment in Henderson, a Las Vegas suburb.

At 14 months, Corbin weighed about 17 pounds, compared to 23 pounds for an average boy his age. His baffled pediatrician, Dr. Esther Akogyeram, eventually called in a specialist, who agreed with the diagnosis of "failure to thrive--"a vague medical term to describe a child who is undernourished and not growing normally. But neither doctor could find the cause.

After trying various medically supervised feeding therapies, the doctors suggested that the Beidemans take Corbin to UCLA for evaluation.

From the day after she arrived in October, 1991, Michele says she realized that doctors suspected she was the reason her baby was sick. Monitors were assigned to watch her and she says she was not allowed to feed Corbin herself. She also says Beck conducted a videotaped interview in which she believes he "slanted his questions" so her answers would fit his diagnosis.

UCLA health experts, however, paint a different portrait of mother and child.

Hospital officials refuse to discuss the case with The Times, citing confidentiality. But in letters to Nevada authorities and in court testimony, they describe Michele Beideman as having the symptoms of Munchausen Syndrome by Proxy--named after the Austrian baron Munchausen, legendary for his outrageous lies.

Mothers with this condition (it affects women primarily) repeatedly take their children to doctors to find out what's wrong. But the doctors can find no physiological cause for the child's symptoms, which can include bleeding, seizures, vomiting, diarrhea, fevers or rashes. (Few doctors suspect the mother is the cause, but if a doctor does get suspicious, the mother changes doctors.)

MS-P mothers sometimes give their children laxatives, stimulants or drugs, or inject them with feces and other foreign matter to induce illnesses.

But, according to scientific research, these mothers never seem like what they are. They are usually viewed as devoted and caring parents who are simply trying to get help for their inexplicably sick children. They are typically intelligent and friendly with medical personnel, which makes it easier for them to hide their abuse.

Those were among "behavioral warning signs" that Beck says he noticed when concerned nurses and physicians asked him to consult on Corbin's case soon after the child arrived at UCLA.

Beck, one of the few MS-P experts in the country, has diagnosed 16 cases and has been tapped to study the disorder by the American Academy of Child and Adolescent Psychiatry.

In documents sent to Clark County Juvenile Protective Services in Nevada--copies of which were obtained by The Times--Beck and his medical team say their examinations showed Corbin to be a "completely healthy and normal" child who has no problems eating when given the chance. They say they can find no medical reason for Corbin's failure to gain weight.

The toddler is very small for his age, the team concluded, because his mother may have chronically underfed him, according to court records.

The UCLA experts also believe Michele may have over-reported Corbin's food intake to his Las Vegas pediatricians, who then repeatedly tested him to find out why he was eating a lot but not gaining weight. She may have also falsely reported rashes and other allergic reactions to oral medicine, they say.

And they say it is "quite possible" that Michele secretly gave Corbin drugs to suppress the baby's appetite, since caffeine was found in his urine on Oct. 31, 11 days into his month-long stay at UCLA; Beideman and her lawyer contend that the caffeine came from chocolate Halloween candy that Corbin ate at the hospital.

In court testimony, Beck says he partly bases his MS-P diagnosis on the fact that, in a videotape interview he conducted with Beideman at UCLA, he saw "virtually every major behavioral warning sign . . . described in the literature."

He noted her "striking interest" in the medical profession (she had wanted to be a pharmacist) and her use of medical jargon; her close relationships with Corbin's doctors in Las Vegas, and her vigilance regarding her son's care.

Asked in court what motivates a mother with MS-P, Beck said he didn't presume to know what Beideman was thinking but "it seemed as though Michele obtained a kind of identity . . . that it was as though (she) was famous for having a child with serious medical problems that the doctors could not figure out what was the matter."

When Beideman realized UCLA fingers were pointing in her direction, she phoned her husband, crying, "What should I do?"?

"Get the hell out of there with Corbin," her husband said.

But doctors wouldn't let Corbin leave with her. UCLA officials told Beideman that they had notified Nevada authorities of possible child abuse. So, when Corbin was discharged from UCLA on Nov. 18, he left in the custody of a Clark County, Nev., social services worker.

Because MS-P is considered a form of child abuse, physicians who suspect it are required by law to report the case to social services agencies. Typically, the child is removed from the home and placed in foster care if the judge feels there is sufficient evidence to support the diagnosis.

There have been only about 200 documented cases of MS-P recorded in the United States since the disorder was first identified in 1977, and 10% of those children died.

The number of reported MS-P cases is low possibly because the syndrome is so hard to diagnose, experts believe.

Diagnosis of MS-P generally occurs when the mother is caught in the act of causing the symptoms, or when the child seems to improve as a result of being removed from the mother's care.

The UCLA team recommended that Corbin be placed in a protected environment, that his mother not be allowed to visit him at mealtimes, that she undergo a thorough psychological evaluation and "obtain . . . treatment by a psychologist or psychiatrist familiar with MS-P."

"I would hope that she would get help and be able to accept what happened and show that she truly, truly had come to terms with what was occurring," Beck said in his court testimony.

Michele and Bill Beideman have seemingly logical explanations for every allegation leveled at them. Bob Gaston, the Beidemans' attorney, calls it "highly unfortunate" for Michele that some of her personal characteristics happen to be the same as those of a Munchausen mother. "They are also the characteristics of millions of other mothers who have no severe emotional problems at all," he says.

"If they cared about children, as they claim, they could not do this to any child," says Bill Beideman, an electrician. "Our baby was ripped from parents and a sister who adore him and sent to strange foster homes. That is something I can never ever forgive."

In his testimony, Beck describes Bill Beideman as the classic case of the unsuspecting husband in the Munchausen scenario. These fathers are typically uninvolved in their child's day-to-day care, are stumped by their child's sickness and simply follow their wives' cues. In her interview with Beck, Michele described her husband as "passive."

According to medical literature on the disorder, MS-P mothers are so cagily convincing in their fakery that even their own husbands don't realize the child's symptoms are induced.

Experts say that other children in the same family might not be affected.

Courtney, the Beidemans' 6-year-old daughter, is healthy and remains with her parents. Michele shares custody of her 12-year-old son, Kevin, from a previous marriage. After Michele's divorce from Dale Tracy, she was investigated by the state of Florida on an allegation of child abuse after her son showed up at school with a bruise on his head. But no charges were filed.

Tracy, who lives in Brooksville, Fla., says his ex-wife loves her children.

"I would say she is very caring. But it was kind of like she was in her own world and if you tried to suggest something to her that didn't agree with her, all hell breaks loose," he says.

"Michele is a very domineering person. She has to be in control. What she says goes," says Tracy, 33. "She's so bright--she can tell you what you want to hear."

Jacque Phillips, a friend of Michele Beideman for five years, describes her as a loving mother.

"I would leave my granddaughter with her with no fear because I trust her . . . she's never done anything but love her kids."

Beideman supporters--including several doctors--are appalled by the succession of events in this case.

Dr. Russell Hart, a Las Vegas psychologist, says that he is "unequivocally convinced" that Michele does not have MS-P. He has been in practice 20 years, has treated five cases of MS-P, and says that the family should be reunited.

Hart says Michele came to him after she left UCLA, asked him to determine if she really had MS-P, and to cure her if she did have it so that she could get her baby back.

"She was very open and voluntary in seeking treatment, if indeed I thought she had the syndrome," Hart recalls. He finds it "unfortunate" that the court was not convinced by his opinion--submitted to the court in a letter--nor that of Dr. Nathan Roitman, the Las Vegas psychiatrist who was paid by the court to evaluate Michele Beideman.

In a written report, Roitman stated: "I cannot conclude that the diagnosis of Munchausen's Syndrome by Proxy is valid."

Instead, says Roitman--who says he is not a MS-P expert--Corbin's health problems appear to stem from a "parent/child problem" caused by anxiety in Michele. Roitman says Michele needs therapy but that the child should definitely be returned to his parents.

Also supporting Michele is Dr. William Sears, a respected San Clemente pediatrician who has written 15 books on child care. He heard about the Beidemans from a mutual acquaintance.

This is definitely a case of "when in doubt, take him out," says Sears, referring to the current climate of zealous child protection by social services agencies. But the authorities went a little bit too far in this case, asserts Sears.

"Dr. Beck may be a victim of his own expertise," Sears says. "He has already diagnosed about 15 cases of this very rare syndrome and he may have a tendency to look for it where it doesn't exist."

Experts in MS-P unrelated to the Beideman case say that disagreements between medical specialists--and protracted custody battles in court--are typical in the diagnosis of MS-P.

Dr. Marc Feldman, a Munchausen Syndrome expert based in Birmingham, Ala., points out that "mothers with MS-P typically go to great extremes to marshal support" from previous doctors who will say she does not have the syndrome. "They will typically get the family pediatrician to say this is a model parent. It is a very emotional issue for the mother, the father and the whole health-care team."

Dr. Herb Schreier, chief of psychiatry at Children's Hospital in Oakland and author of an upcoming book on MS-P, thinks it highly unlikely that someone of Beck's expertise in the field could mistakenly diagnose MS-P.

All the experts agree that the accepted way to find out if a child is being abused by a Munchausen mother is to remove the child to see if the child's symptoms go away.

That is exactly what Beck recommended and what has been done.

The Beidemans and their partisans say the baby has had just as many infections while in foster care, that he has gained and lost weight as he usually does.

The opposing side says in letters and testimony that Corbin has had only "normal childhood illnesses" while in foster care, that he exhibits a healthy appetite, and that he is gaining weight at a more rapid rate than when he lived at home.

The juvenile court wants Beideman to see a mental health professional who believes she does have MS-P and who will work with her to cure it. Then she will get her baby back, the judge has said.

But MS-P experts say there is no known effective treatment for these mothers, since so little scientific research has been done. The focus of research so far has been on diagnosis of the mother and protection of the child.

"The problem," says Dr. Bernard B. Kahan, assistant professor of psychiatry and pediatrics at Emory University in Atlanta, "is that no (psychiatrists) have been able to get access to enough of these people in one place to do a formal study . . . We don't know what they are and so we don't know how to treat them."

He says one of the biggest problems is that courts order therapy, but they are ordering treatment that has yet to be proven to help anyone. Perhaps because so little is known about how to help these mothers, experts like Kahan say, they are often prosecuted as felons.

Meanwhile, the Beidemans worry about the upcoming date in district court to answer charges of felony child abuse--stemming from MS-P.

Although treatment for MS-P does require psychiatric help, MS-P expert Feldman says arrest is also appropriate.

"We have to acknowledge this as a form of child abuse . . . . It has to be reported under the laws in every state.

"But the way I would approach these women is not just from a legal perspective. I think the best approach is for the pediatrician who makes the diagnosis to approach the mother with a psychiatrist as well. The following should be said to the mother: 'We recognize a severe problem. The problem isn't a medical one that involves your child. The problem is a psychiatric one that involves you . . . We are going to report it. But we want you to know you're not in this alone.' "When you think about what these children undergo--sometimes 300 clinic visits and procedures" to find out the root of their ailments, he says, "it would be hard to justify not arresting the mother."

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