A Review by Georgie Lewis

As a reader of memoir where does one separate the voyeur from the concerned and curious observer? Is there a separation? Whatever the motivation, readers continue to buy memoirs in droves. This past year has provided plenty of titillation, insight, intrigue, or simply comfort in the knowledge that there are lives out there that are markedly more creepy than our own. Augusten Burroughs's superb memoir Running with Scissors and his follow-up, Dry, and the just released Los Angeles Diaries by James Brown, to name a few, are the most recent in a long line of memoirs reflecting a childhood scarred by the mental illness of a parent.

And now Julie Gregory enters the fray with her extraordinary book Sickened: The Memoir of a Munchausen by Proxy Childhood. Munchausen by proxy (MBP) is an insidious form of child abuse, and Gregory is the first to document this condition from the eyes of a victim. The term, coined by Dr Roy Meadow in 1977, describes a behavior in which a caretaker (most often the mother) fabricates or induces illness in an otherwise healthy child to meet their own needs for attention and sympathy. Approximately 10% of MBP cases are fatal and more than 25% involve more than one child.

Julie Gregory's mother insisted, to all who would listen, that her child was sick, that there was something wrong with her heart, her gastrointestinal tract, and that Julie needed open heart surgery. When one doctor could find nothing wrong with Julie after a battery of tests, another doctor was sought, and then another. Symptoms were rehearsed:

"How do you act when you are sick, Julie? Show me." I slouch on the end of the table, limbs dangling. I hang my tongue out and my bottom lip falls away from teeth like a National Geographic pygmy with a lip plate in.

"That's right. Now what do you think the doctor is going to say if he comes in here and you're sitting up and all smiling? Do you think he's going to believe me that you're sick? You've got to show him how sick you are outside the doctors office. We've got to get to the bottom of this thing so Mommy can get some rest."

Symptoms were also created through systematic starvation — under the guise of Julie's "allergies" — and poisoning. Little white pills brought on migraines. Shockingly, Julie's favorite treat as a toddler — the one she devours on her mom's advice — is a brand new book of matches.

One of the most horrifying holds the mother has over the child in this set-up is that the child continues to want her approval, and complies with the idea that the child is sick. So strong is the belief that mother knows best the child can often give birth to psychosomatic symptoms. The mother, in her delusional quest for the truth, continually tests the child's loyalty causing him or her to become a co-conspirator.

Like most abusers, Gregory's mother had a traumatic and sadistic childhood. The result, as Gregory's memoir traces, was to inflict this bizarre torture upon her daughter — all the more perverse because it is in the name of healing.

Gregory's childhood in Southern Ohio is laid out for the reader in seamless and poetic prose. A graduate of psychiatry from Sheffield University in London, and now a spokesperson for the victims of this form of abuse, Gregory captures the sometimes bucolic pleasures as well as the sometimes horrific isolation that her rural family home provided. Her shock at discovering her mother is the perpetrator of her pain is heartbreaking as are her eventual resolutions of how to finally take control of her life. That Gregory survived her abuse and can continue to see her mother for all her beauty as well as her psychosis is remarkable. That she records it all in a hypnotic, compelling, and necessarily humane manner is testament to a wise and wonderful woman.