Prologue

August 1, 2006                                                                        Greenville, Ohio

In a book-lined conference room upstairs at the courthouse in Darke County, Ohio, Tammy Fourman leafs through the police reports about her son’s death. Long and lean at 31, Fourman is dressed in a T-shirt and jeans because she’s on her way to work, second shift at the Whirlpool assembly plant just outside of town.

A few empty chairs away, ruddy and robust in a suit and tie, sits investigator Craig Prenger, who kept the case alive for six years while he looked for the clue that would point him to a single suspect. He winces when Fourman stops to read his notes on a talk with her brother-in-law, who’d said it was surely Tammy herself who shook her son so hard his bones broke and his brain bled.

The files are public record now. The case is closed. Daniel Crow, Jr. died of Menkes disease, a rare genetic disorder that causes brittle bones and cranial bleeding. The parents had been telling the truth all along: Neither of them had shaken their baby.

The truth cannot undo the devastation to Fourman’s family, though. During the years she and her husband stood accused, Tammy Fourman lost four children:  two to Menkes Disease, which is always fatal, and two to social services, which placed her other children into foster and then adoptive homes.

“If somebody had listened to us in the first place, it would have saved everybody a lot of trouble,” she sighs. “But they just kept insisting we’d been beating on Daniel the whole time he was with us.”

Though I wouldn’t call them lucky, Tammy and Daniel enjoyed a number of circumstances that set them apart from most families whose children have been misdiagnosed with Shaken Baby Syndrome (SBS).

First, they were both home with the infant the morning Daniel Jr.’s seizures started. Even under repeated and intensive questioning, their stories matched, and neither could name a time when the other was out of earshot with the baby. Prenger insists he could find no reason to charge one parent over the other.

Not that he didn’t try. He interviewed family members, neighbors, friends, co-workers, anyone who was willing to talk with him.  His findings:  “Nobody said they’d seen either of them being anything but caring with both children.”

At the same time, though, “All these doctors were telling us it was clearly abuse,” Prenger says, “People were clamoring for a conviction.” The District Attorney’s office was in the headlines throughout the next election, while a local attorney pressed a suit for failure to prosecute “the worst case of child abuse” in the history of the county. Daniel Jr. had arrived at the hospital with 15 broken bones and bleeding inside his skull, but no bruising or other signs of impact. It was, as the child-abuse experts reported, a classic case of SBS.

If either Tammy or Daniel had been alone with the infant that morning, Prenger confirms, the county would have charged that parent. “The doctors were telling us all along that the perpetrator had to be the person who was there when the problems started. I just couldn’t pinpoint that event.” He couldn’t name both of them, he explains, since it seemed so unlikely they were both guilty. How could the prosecutor argue it in court?

Prenger’s ethics and stubbornness kept both Tammy and Daniel out of jail despite the accusations. Tammy had another baby, who was taken from her hours after his birth. When she became pregnant again, she fled to Indiana so as not to lose custody, later followed by Daniel. Then their next son Logan developed the same symptoms that had afflicted Daniel Jr. six years earlier, and Tammy and Daniel met the men who would eventually exonerate them, the doctors who kept their minds open when faced with a case that others dismissed as obvious abuse.

When her baby boy Logan started “curling up and twitching” one afternoon, Tammy brought him to her health clinic, where he had another seizure during the examination by family physician Brandon Connerly. Connerly saw no signs of bruising or anything else that would signal abuse, and Tammy’s concern for her child was clear. He can’t say why he wasn’t convinced by the arguments of colleagues who told him Logan was the victim of a violent shaking. Logan was in and out of the hospital for the rest of his short life, but this time Tammy and Daniel were allowed to be with their son.

As Logan’s condition deteriorated, he spent more time at the children’s hospital in Indianapolis, where geneticist Luis Escobar, like Connerly, didn’t think he was examining a shaken baby. “Any child that has seizures, I think first of a metabolic disorder,” Escobar says. But tests for the most common gene defects all came back negative, and soon Escobar was answering calls from social workers checking up on abuse reports filed by others at the hospital. No, he told them, this was not abuse, although he still couldn’t say what was at the root of the child’s problems.

Then Logan, bald from birth, began to grow hair, kinky-curly hair. “Kinky-hair syndrome” is an informal name for Menkes disease, which Escobar describes as “very rare but so distinctive.” Logan tested positive for Menkes and Escobar contacted authorities in Darke County, suggesting they sample Daniel’s blood. When Daniel was found to share the disorder, the original doctors submitted their opinion that Daniel was likely “a Menkes patient who was also abused.” Skeptical of that diagnosis, the DA closed the case.

Through tremendous personal resilience and unique circumstances, Tammy and Daniel are now living quietly in Indiana, near the Ohio border, raising two sons who have both tested negative for Menkes. Her older children are forever lost to her: the adoptions are final and attempted contact is forbidden. I was able to find Tammy because she’d joined an online Menkes support group, using her real name. She was not hiding from the accusations nor letting them define her:  She was reaching out to the community she felt part of, parents of children with Menkes. She mourns her losses, but she chooses not to focus on the system failure that tore her children from her and for six years branded her publicly as a child-abuser.

I’m less accepting, so I’ve spent years now writing about it.

The book I’m writing tells the true story of Stephanie Olsa, a woman I knew only slightly before she was convicted of shaking an infant in 1997, not long before the “Boston nanny” case made SBS a national story. While researching the medical thinking behind those convictions, I came to doubt first the presumed timing and then the specificity of the symptoms that have defined SBS for the past 30 years. This book also tracks my journey, as I visited courthouses and medical libraries, attended conferences, and interviewed not only experts in the field but also scores of people whose lives have been torn apart one way or another by a diagnosis of SBS.

This tale has no villains:  Child abuse, including infant abuse, is a real and agonizing problem. The professionals who try to protect children from irresponsible, sometimes sociopathic caretakers are doing vital work in an especially difficult arena. Of course they want to do right by the children. And almost always, they do.

The history of SBS in the courts, however, reveals a weak point in our adversarial justice system. Physicians and prosecutors working with a widely accepted but unproven model of SBS have blurred the distinction between medical opinion and legal fact. The different standards and practices of the two disciplines—medicine and law—have allowed a theory to become institutionalized before it was proven. The science of pediatric head injury is now catching up, to reveal that what doctors believed in the late 1970s is not necessarily true. This cycle is common in medicine, and in most other fields as well, though not always with such tragic side-effects.

My book, Shaken: A Diagnosis on Trial, illustrates how benign families are being destroyed and innocent people sent to prison despite the best intentions of everyone involved. I hope that understanding Stephanie’s story can help our society offer better protection for both children and their caretakers.

copyright 2011, Sue Luttner
photos by Sue Luttner

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