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Weaponizing Illness — A Story That Names What Most Therapists Won't

TL;DR. A short fictional vignette anchored in DSM-5 V300.19 (Factitious Disorder Imposed on Another, formerly "Munchausen by Proxy") and WHO ICD-11 6D52 (Caregiver-Fabricated Illness in a Child). The pattern: a child's "sudden illnesses" arriving within 48 hours of every exchange weekend, with no contemporaneous outside-clinician record. Most pediatricians receive zero training on FDIA. The school nurse's log is often the most accurate documentary witness. Naming is the precondition for changing it.

Author: Alan Markson · Last reviewed: 2026-05-15 · License: CC BY 4.0 Originally published at antialienate.com/blog/weaponizing-illness-fiction.

One

She knew the call would come. She always did. Wednesday morning, 7:43 a.m. — the message from her ex landed exactly when it always did. Sophie's been throwing up all night. We're going to keep her home. She probably can't make the exchange today.

She read it twice. Three times. The pediatric appointment from Tuesday — the one Sophie had been excited about, where the doctor had written no acute findings, child appears well, eating and sleeping normally — was already in the file. She knew. The doctor had told her: Sophie is healthy. Tuesday was 16 hours ago.

She sent the brief reply she had practiced. Understood. I'll plan to make it up next weekend per the order. Please send a photo of the medical record if she's seen today. Hope she's better soon.

She didn't send what she felt. She was learning, slowly, that the messages she didn't send were also evidence.

Two

By Friday, Sophie was — according to her ex — fully recovered. They had been to the pharmacy. They had stayed home all day Wednesday. They had ordered a special soup. By Sunday, she would be ready for school.

The pharmacy receipt never arrived. The medical-record photo never arrived. Sophie's school attendance, when she finally got the records months later, showed Sophie present on Thursday and Friday.

She added it to the folder. Date. Time. Nothing-said is also a record.

Three

The school nurse was a woman named Mrs. Tanaka who had been at the school for nineteen years. When the child psychiatrist's office finally subpoenaed the school's nursing log — eighteen months into the case — Mrs. Tanaka's handwritten entries told a story that the pediatrician's notes hadn't.

Sophie complained of stomach pain at 9:14. Sent her to the office. Reached mother by phone. Mother says please send Sophie home for the day. Sophie ate her snack happily before mother arrived to collect her at 9:48.

It happened seventeen times in the year. Always within 48 hours of an upcoming exchange weekend. Always Sophie's mother who picked her up. Sophie was never seen by an outside doctor. The complaints stopped completely the week Sophie's father had a documented business trip — when there was no upcoming exchange to disrupt.

Mrs. Tanaka's log was the document that, three years later, the family-court judge read first.

Four

The judge was named Hayes. He had been on the family bench for eleven years. He had read enough cases that he had stopped being surprised by patterns. He was, however, occasionally surprised by documentation.

The mother's lawyer argued that Sophie's many illnesses showed the child needed stability — she gets sick when there's stress, your honor, the back-and-forth is harming her. The father's lawyer slid two folders across the bench: the pediatrician's nineteen-month run of no acute findings, and the school nurse's seventeen-incident log with the exchange-weekend correlation chart attached.

Judge Hayes asked a single question. Counselor, your client has consistently kept the child home from contact based on illness. Is there a single contemporaneous outside-clinician record finding the child unwell on any of these dates? The mother's lawyer did not have an answer.

The DSM-5 code was V300.19. The ICD-11 code was 6D52. Neither had been written into Sophie's chart. But the pattern, finally documented, had a name even when no clinician had supplied it.

That was the day Sophie's father got her back.

What the story is naming

This is fiction. The clinical anchors are not.

  • DSM-5 V300.19 — Factitious Disorder Imposed on Another (formerly Munchausen by Proxy)
  • WHO ICD-11 6D52 — Caregiver-Fabricated Illness in a Child
  • DSM-5 V995.51 — Child Psychological Abuse (the broader frame)
  • Roesler & Jenny (2009) — Medical Child Abuse — the framework used in pediatric forensic assessment today
  • Sanders & Bursch (2002) — Munchausen by Proxy: A Survey of Pediatric Forensic Issues
  • Baker (2007) — illness-fabrication included among the 17 strategies of parental alienation

Why this often goes unnamed

Most pediatricians receive zero hours of training on factitious disorder imposed on another or its parental-alienation overlap. The DSM-5 codes exist. The training does not. The result is what Sophie's pediatrician did for nineteen months: see a child who was well, accept the parent's account, and write neither finding into a way that the family court could later use.

The school nurse is often the most accurate documentary witness. School nursing logs are contemporaneous, time-stamped, and not seen by the alienating parent. Subpoena them.

The documentation moves (for parents reading this)

  • Send the brief, factual reply when illness-cancellations arrive. Document the cancellation in your folder. Date, time, what was said.
  • Request the contemporaneous medical record politely after every illness-cancellation. "Please send a photo of the medical record so I can keep her files updated." Most alienators won't send one because there isn't one.
  • Subpoena school nursing logs at the right stage. The pattern often lives there.
  • Build the correlation chart — illness-incidents vs. upcoming exchange dates. The chart is what Judge Hayes saw.
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Citations

  • DSM-5 V300.19 — Factitious Disorder Imposed on Another. American Psychiatric Association.
  • WHO ICD-11 6D52 — Caregiver-Fabricated Illness in a Child.
  • DSM-5 V995.51 — Child Psychological Abuse.
  • Roesler, T. A., & Jenny, C. (2009). Medical Child Abuse: Beyond Munchausen Syndrome by Proxy. American Academy of Pediatrics.
  • Sanders, M. J., & Bursch, B. (2002). Forensic assessment of illness falsification, Munchausen by Proxy, and factitious disorder, NOS. Child Maltreatment, 7(2), 112–124.
  • Baker, A. J. L. (2007). Adult Children of Parental Alienation Syndrome.

Disclaimer

Educational fiction. Not clinical or legal advice. The story is illustrative; specific cases require evaluation by qualified pediatric forensic clinicians and family-law counsel.

Author byline: Alan Markson · License: CC BY 4.0 · Originally published at antialienate.com.