The God-Complex of Child Abuse Pediatricians: a Book Review of “They Took the Kids Last Night”

“The law on the books is not the law in practice.” Those who practice law know that Diane Redleaf’s statement is true. In They Took the Kids Last Night, Redleaf shares the stories of six families who were accused of abuse or neglect after seeking medical treatment for their child’s injury. They were blameless, but the system still subjected them to a months-long battle to protect their family.

Sure, the law appears to require the State to jump through numerous hoops before removing children from their families. But in practice, things work much differently. In practice, families can be forever changed because of just one opinion: that of a child abuse pediatrician.

The world got a glimpse of how the child abuse pediatrician to DCS to prison pipeline works, through the televised trial of Maya Kowalski. No one was arrested in the case, but Jack and Beata could have been, based solely on the “diagnosis” from Dr. Sally Smith.

If a child abuse pediatrician concludes that a parent has either abused or neglected his/her child, the child can be removed from the parent’s care, and the parent can be criminally prosecuted for the abuse or neglect.

As Redleaf demonstrates in her book, an unsuspecting parent who brings her child into the hospital for treatment of an injury can suddenly find herself in the middle of a child abuse investigation. Head injuries are labeled as “abusive head trauma.” Unexplained fractures are considered abuse until proven otherwise. And mystery illnesses or a parent’s disagreement with a doctor’s treatment plan leads to a “diagnosis” of Munchausen’s Syndrome by Proxy.

Like JHACH in Maya’s case, children’s hospitals all over the country contract with child welfare agencies. These contracts require a child abuse pediatrician to be consulted and a report made to DCS in every situation where an infant or toddler has an unexplained head injury or a fractured bone.

Redleaf’s book explores the following questions:

• How can a doctor know with certainty what caused a fracture?

• Why would a child abuse pediatrician know more than a doctor specializing in treatment of the child’s injuries?

• Force is force; does a particular amount of force differentiate an abusive injury from a non-abusive one?

The simple answer is that a doctor cannot know with certainty what caused a fracture. A child abuse pediatrician would not know more than a doctor specializing in treatment of that child’s injuries. And no, a particular amount of force does not differentiate abuse from non-abuse. Yet child abuse pediatricians will claim they can know all these things.

Redleaf’s book details the uphill battle families face when the “abuser” label is applied by a child abuse pediatrician. The six families profiled in the book involved different circumstances, but they lead the reader to one conclusion: change in the system is needed. Fortunately, Redleaf concludes the book with suggestions for reform.

Maya Kowalski’s trial put these issues into the national spotlight. JHACH is in Florida, but this is not a Florida problem. These kinds of cases are occurring all over the country. If interested in finding out more about the issue, read Redleaf’s book.