WHY JENNIFER GOT SICK

By Anastasia Toufexis

Sitting beside Hillary Clinton at a meeting on Capitol Hill two summers ago, Jennifer Bush cut a heartbreaking figure. The seven-year-old Coral Springs, Florida, girl with big eyes and a perky red bow atop her little Dutch-boy coif seemed a perfect poster child for the Administration's health-care-reform plan. Chronically ill almost from birth, Jennifer had already endured nearly 200 hospitalizations and 40 operations, and her $2 million-plus medical bill had exhausted the family's health-insurance benefits. Not surprisingly, Jennifer became a media darling, appearing on the Today show and on the front page of many newspapers.

Now it appears that Jennifer's suffering may have been much worse than was ever reported. Last week Florida officials arrested Jennifer's seemingly devoted mother Kathleen Bush and charged her with aggravated child abuse and fraud. According to authorities, Bush, 38, deliberately caused her daughter's ailments by dosing her with unprescribed drugs, tampering with her medications and even contaminating her feeding tube with fecal bacteria. As a result, say officials, Jennifer was subjected to dozens of needless operations and invasive procedures. Bush has denied all charges.

What could lead a parent to such shocking behavior? Authorities believe Kathleen Bush suffers from a variant of Munchausen syndrome, a mental disorder that impels people to feign or induce illness in a twisted bid for attention. In Munchausen by proxy, parents may injure their children--smothering them with pillows, injecting them with poisons, mixing blood in their urine--in order to draw praise for their dedicated nursing of their offspring.

Almost as shocking as the charges against Jennifer's mother, however, is the fact that it took more than four years of warnings before state authorities placed the child under protective custody. Nurses at Coral Springs Medical Center began noticing as early as 1991--when Jennifer was just four--that her condition seemed to worsen whenever her mother visited. A formal complaint was filed, and the hospital had her records reviewed by Dr. Eli Newberger, a Munchausen expert at Boston's Children's Hospital. His conclusion: this was a clear case of Munchausen.

The Florida Department of Health and Rehabilitative Services investigated but took no action. "It is a difficult form of abuse to prove," says hrs spokeswoman Michelle Lagos. "It's not like you have broken bones or bruises." The authorities may have been dissuaded by Jennifer's celebrity, as well as by her mother's litigiousness: Bush had sued the Coral Springs Medical Center for conducting tests on her daughter's vomit without parental permission.

State officials reopened the investigation last April, after receiving an anonymous complaint. According to the arrest affidavit, once her mother was informed of the inquiry, Jennifer's condition improved dramatically. In the preceding nine months she had been hospitalized seven times for a total of 83 days. In the nine months afterward she was admitted just once for four days.

--By Anastasia Toufexis. Reported by Ann Blackman/Washington and Tammerlin Drummond/Miami

With reporting by ANN BLACKMAN/WASHINGTON AND TAMMERLIN DRUMMOND/MIAMI