In October 2016, the Kowalski family took their daughter Maya to Johns Hopkins Hospital because she was experiencing severe stomach pains. A previous doctor, who was not affiliated with Johns Hopkins Hospital, had diagnosed Maya with CRPS1. However, upon arriving at Johns Hopkins, the medical team did not believe her original diagnosis. This was because Maya had been receiving ketamine treatments in Mexico from the doctor who had diagnosed her. Despite Maya’s mother, Beata, being insistent that the doctors and nurses at Johns Hopkins give her ketamine, the medical team declined ketamine treatment due to concerns over side effects and limited knowledge of efficacy.
Beata’s persistence triggered concerns, which resulted in child protective services being alerted. The doctors and nurses at Johns Hopkins found her character and use of language problematic, describing her as “controlling,” “belligerent,” and “demanding.”
It is worth considering that Beata’s ethnic background (Polish) may have influenced the health professionals’ opinions2. However, it is also possible that Beata’s behaviour stemmed from her role as a mother or her training as a nurse, rather than her ethnic origin. Additionally, her behaviour could be attributed to fear for her daughter’s life, as the doctor had made it clear that without ketamine treatment, Maya would “die a painful death.” Such a dire prognosis would understandably cause any parent to experience fear and anxiety. Beata was solely focused on finding a solution to relieve her daughter’s pain, but the health professionals at John Hopkins misinterpreted her intentions and punished her for it. A social worker named Cathryn Betty became involved in Maya’s case when doctors at the hospital, including herself, suggested that Beata might be suffering from Munchausen by proxy syndrome3.
The social worker presented the case to a judge, which led to a court order that mandated Maya’s 12-week hospital stay without parental visitations. The Kowalski’s attempt to contest the decision backfired. Doctors and nurses, sceptical of Maya’s illness, left her alone for 48 h, hoping she would prove her ability to walk; however, this resulted in her soiling herself, ultimately resulting in her experiencing neglect. In one specific instance, Maya described an encounter with a nurse who came to change her and demanded that she turn onto her side. Maya explained repeatedly that she was unable to do so due to the pain, but the nurse shouted at her and made threats.
There is also a scene where Maya describes someone entering her room while she was alone, undressing her, and touching her inappropriately. This happened without her consent and without any parent or guardian present. As she was a child, Maya’s needs have been disputed. Social work is a profession that supports individuals within the context of their circumstances. Social workers act as change agents, advocates, and champions of social justice. As such, they have a duty of care to protect and safeguard those under their care from harm. Additionally, professionals must avoid causing any further harm. These values are shared globally. However, Maya’s case demonstrates a failure to uphold these values. Despite the allegations against her mother, the hospital neglected Maya and violated her basic human rights as a child. This led to a worsening of her situation, resulting in more trauma and pain. Maya was eventually diagnosed with CRPS and discharged to return home.
This documentary brings to light several important aspects of the social work profession. It exposes the detrimental effects of poor practices within the healthcare system and the consequences of abusing power. It also addresses the genuine fear that many people harbour towards social services and the misconception that social workers merely seek to break families apart and remove children. This documentary should be shared with all social workers, student social workers, and healthcare professionals to raise awareness about these issues and provide guidance on how to avoid such poor practices. It highlights the numerous gaps within the health and care systems that should be responsible for protecting individuals like Maya from harm.
Notes:
- Complex Regional Pain Syndrome.
- Communication styles can differ among cultures, and Eastern European people may be portrayed in the media as angry and aggressive, which may have biased the professionals’ perception.
- This syndrome involves a caregiver deliberately causing or fabricating an illness in a loved one to gain sympathy or attention.