Kaylene Bowen-Wright was sentenced to six years in prison last Friday after years of subjecting her 10-year-old son, Christopher, to invasive medical procedures—including more than a dozen major surgeries within a seven-year span.
Bowen-Wright’s case is considered by medical experts to be a particularly severe case Munchausen syndrome by proxy, in which a person exaggerates or fakes another person’s sickness and pursues unnecessary treatments for it, writes the Washington Post. Over the course of her young son’s life, Bowen-Wright is believed to have taken him to see doctors 323 times at hospitals in Dallas and Houston.
Christopher was placed on oxygen full-time and fitted for a feeding tube—a device that led to “multiple life-threatening blood infections,” wrote the Dallas Star-Telegram in a 2017 article. Christopher occasionally used a wheelchair and was placed in hospice care; at one point his mother once tried to get him on a lung transplant list. None of the procedures were necessary.
But though Christopher’s father tried to convince various authorities since at least 2011 that his son was healthy (collecting evidence that included doctor’s reports), Bowen-Wright wasn’t investigated for abuse until 2016, after several hospitals grew suspicious of her. By then, she had claimed her son was dying of cancer and had used various crowdfunding campaigns to raise thousands of dollars for Christopher’s treatments. She told investigators at the time that she was a full-time caretaker for Christopher, collecting disability and Medicaid for her son.
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Bowen-Wright’s abuse of Christopher is horrific and confounding. We know a 10-year-old boy lost large portions of his childhood to doctor’s visits and risky procedures at the hands of well-intentioned physicians. We know it shouldn’t have happened. But the case is so unusual it’s hard to say with any real confidence exactly how it could have been prevented.
Marc Feldman, a distinguished fellow at the American Psychiatric Association and an expert on Munchausen by proxy, told the Post it takes an average of 14 to 15 months for these kinds of cases to be discovered, noting he’d seen cases where it took up to nine years for authorities to recognize the abuse. This is in part because America’s decentralized medical system “enables perpetrators to bounce from doctor to doctor to avoid suspicion and continue to fabricate stories and diagnoses with each new visit,” the Post writes.
Some 600 to 12,000 cases of Munchausen by proxy happen in the U.S. each year; though it’s unclear Bowen-Wright was ever officially diagnosed with the condition. Medical professionals are also undecided about whether it is a form of mental illness or a type of abuse, Feldman says.
Outside of the medical field, state officials like family court judges and Child Protective Services workers may be largely unfamiliar with what medical abuse looks like. As Feldman told the Star-Telegram in 2017:
“They are used to seeing gross evidence of physical or sexual abuse — bleeding, bruising, broken bones—and don’t seem to respond to the more subtle indications of medical child abuse.”
Feldman said such judges also tend to treat doctors as “gods who are incapable of error, not realizing that these abusive mothers doctor-shop until they find someone who will acquiesce to their demands.”
This was particularly salient in Christopher’s case: in what could be the most tragic facet of this story, his father, Ryan Crawford fought for years to prove Bowen-Wright was actually endangering their son’s welfare. Judges frequently sided with her in child custody battles, with Bowen-Wright effectively using her son’s “illnesses” as a wedge to keep Crawford away:
Though he had court-ordered visitation initially, Crawford said Bowen would frequently cancel at the last minute, claiming Christopher was too sick. She’d tell judges that Crawford didn’t know how to properly care for their seriously ill son, further delaying his visits until he could take court-ordered classes in things like CPR and G-tube care.
Until recently, Crawford’s last visit with his son had been Dec. 7, 2012, when he took the boy’s great-grandmother to Kaylene’s Dallas apartment to see Christopher.
“We went to court two weeks later and Kaylene told the judge that Christopher went into cardiac arrest due to my visit,” Crawford said.
He says at a subsequent hearing, 255th District Family Court Judge Lori Hockett said she was taking away Crawford’s visitations with his son since he refused to believe the boy was dying.
Crawford kept up the fight for custody over Christopher for years, even after Bowen-Wright was arrested and Christopher placed in foster care. He now has full custody of his son, telling the Morning Star in 2017 that despite years of sustained abuse, Christopher has been resilient.
“You would think my son would be so screwed up. Obviously mentally, he’s going to need some counseling,” Crawford said. “But he is so sweet, so nice, so playful. You wouldn’t think that he had gone through all this abuse.”
While the cycle of abuse may have stopped, Crawford made clear there are no winners in this case; it’s unclear how treatable Munchausen by proxy is, and though Bowen-Wright will be permitted to visit Christopher while supervised, the child has effectively lost his mother. Speaking to CBS DFW, Crawford fought back tears after Bowen-Wright’s sentencing.
“It’s difficult to have to go home and tell [Christopher] that his mother is going to prison,” he said, “but his safety is what’s most important.”