Nobody Should Believe Me - Revisiting Kowalski Part Three: The Breaking Point

Episode Date: March 5, 2026

In the third part of our Kowalski recap, Andrea walks through the events that led to Maya’s hospitalization and what hospital staff observed in those first days. As doctors quickly became concerned about both Maya’s condition and the unusual treatments she had been receiving, the hospital brought in a child abuse pediatrician and an investigation into possible medical child abuse began.  *** Try out Andrea’s Podcaster Coaching App: https://studio.com/apps/andrea/podcaster Order Andrea’s book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy.  Click here to view our sponsors. Remember that using our codes helps advertisers know you’re listening and helps us keep making the show!   Subscribe on YouTube where we have full episodes and lots of bonus content.  Follow Andrea on Instagram: @andreadunlop Buy Andrea's books here.  For more information and resources on Munchausen by Proxy, please visit MunchausenSupport.com The American Professional Society on the Abuse of Children’s MBP Practice Guidelines can be downloaded here. Learn more about your ad choices. Visit podcastchoices.com/adchoices

True Story Media Fiscally responsible, financial geniuses, monetary magicians. These are things people say about drivers who switch their car insurance to Progressive and save hundreds. Because Progressive offers discounts for paying in full, owning a home, and more. Plus, you can count on their great customer service to help when you need it so your dollar goes a long way. Visit Progressive.com to see if you could save on car insurance. Progressive Casualty Insurance Company and Affiliates, potential savings will vary, not available in all states or situations. At Desjardin, we speak business.

We speak equipment modernization. We're fluent in data digitization and expansion into foreign markets. And we can talk all day about streamlining manufacturing processes. Because at Desjardin business, we speak the same language you do. Business. So join the more than 400,000 Canadian entrepreneurs who already count on us. Contact Desjardin today. We'd love to talk. Business. By the time Maya Kowalski arrived in the ER at Johns Hopkins All Children's in Sarasota, Florida, on October 7, 2016, she was in bad shape.

She was malnourished and hadn't had anything to eat or drink in five days. And in the 10 months that pain specialist Dr. Ashraf Hannah had been seeing her, the 10-year-old hadn't gained a single pound. Maya was receiving quantities of ketamine that were 15 to 100 times the recommended dosage, a total of 55 infusions over the preceding 10 months. She was also receiving opioids, benzodiazepines, and zofran to deal with the nausea from the ketamine. The previous summer at the parents' request, her pediatrician, Dr. Wassenauer, had made a hospital homebound referral saying that Maya could no longer attend school. Dr. Hannah wrote a second referral in September.

When Maya saw Dr. Hannah in his office the day before he sent her to Johns Hopkins All Children's, she rated her quality of life at a zero out of 10. Here's how Jack Kowalski describes the lead-up to October 7th and take care of Maya. She went back to school to laughing and playing. We were just blessed that we finally seen something working. And for a year, it did. Until the night of the hurricane. Conditions were bad an hour ago.

They've gotten worse now as Hurricane Matthew makes its way up the east coast of Florida. Bridges are closed. People have been told wherever you are hunker down. It is too dangerous now to go outside. Maya relapsed. It came back and it was very severe. She started complaining of pain in her tummy and it got to the point where she was screaming and crying and begging for help.

I contacted Biazza at work. Okay, hold on. Let me pull over to the site. And I told her I have to take her into the emergency room. There was a hurricane on the day of Maya's admission, but it was on the opposite coast of Florida. So the Kowalskies didn't actually drive through it to get to the hospital as the film and their counsel depict. And also, they were already on the hospital's campus. Maya and Jack had been staying at the Ronald McDonald House, a charitable organization that provides housing for families of hospitalized children. And what might at first seem like a dramatic embellishment is actually something a bit more instrumental, as Attorney Ethan Shapiro noted in his closing arguments.

You have heard a lot about the hurricane, right? Like, why are the Kualsky so insistent on saying when we went up for a hurricane, we know they were saying it to Ronald McDonald's house? because they know if this is true what Dr. Hahn has said, it's an admission that the ketamine failed. It's an admission that the ketamine failed. So this begs the question. If Jack Kowalski's story of Maya's hospitalization begins with a fiction, where does that fiction end?

2026 is turning into my year of giving keynotes. So I'm going to be traveling around a lot, heading to Chicago, Florida, Nashville, San Diego, and who knows where else. So I decided it was time. for a little luggage upgrade. So I went where I go for all my high-quality essentials. Quince, of course. I'm always finding new categories of things to shop for on quince, and they've added a lot of items to their travel section recently. My brown Italian leather hand-woven tote was a favorite purchase of last year. They also have these very cute quilted totes and duffles and their best-selling hard-shell suitcases in carry-on

and checked sizes. The set is only $229. True story, I was just perusing the same. I was just perusing the site in order to write this ad copy. And on a whim, I ended up buying myself the leather jewelry travel case and a leather cross-body phone case and cardholder in Emerald Green. This happens to me almost every time and honestly, no regrets. So if you are on the go this year, I highly recommend checking out Quince's travel gear. As with everything from Quince, you will be getting the highest quality goods at half the cost because Quince works directly with safe ethical factories and cuts out the middleman. So right now go to quince.com slash believe for free shipping and 365 day returns. That's a full year to wear it and love it. And you will. Now available in Canada too.

Don't keep settling for clothes and luggage that doesn't last. Go to QINCE.com slash believe for free shipping and 365 day returns. Quince.com slash believe. And remember that shopping our sponsors is a great way to support the show. 2026 is turning into my year of giving keynotes. So I'm going to be traveling around a lot, heading to Chicago, Florida, Nashville, San Diego, and who knows where else. So I decided it was time for a little luggage upgrade. So I went where I go for all my high quality essentials. Quince, of course. I'm always finding new categories of things to shop for on Quince, and they've added a lot of items to their travel section recently. My brown Italian leather hand-woven tote was a favorite purchase of last year. They also have these very cute quilted totes and duffles and

their best-selling hard shell suitcases in carry-on and checked sizes. The set is only $229. True story, I was just perusing the site in order to write this ad copy. And on a whim, I ended up buying myself the leather jewelry travel case and a leather cross-body phone case and cardholder in Emerald Green. This happens to me almost every time, and honestly, no regrets. So if you are on the go this year, I highly recommend checking out Quince's travel gear. As with everything from Quince, you will be getting the highest quality goods at half the cost because Quince works directly with safe ethical factories and cuts out the middleman. So right now, go to quince.com slash believe for free shipping and 365 day returns. That's a full year to wear it and love it. And you will.

Now available in Canada, too. Don't keep settling for clothes and luggage that doesn't last. Go to Q-U-I-N-C-E-com-slash-B-Leave for free shipping and 365-day returns. Quince.com slash believe. And remember that shopping our sponsors is a great way to support the show. Counter to the impression given in the film, Jack took Maya to Johns Hopkins All-Chilterns, not after a spontaneous relapse, but at the recommendation of Dr. Ashraf-Hanna,

who'd reached the upper limit of ketamine he was willing to give the malnourished 10-year-old. Jack initially brought Maya to Johns Hopkins all-children's, but Bia Towalski arrived soon after, and she made her wishes well-known to hospital staff. She was belligerent, demanding. She was shouting at her husband. She was not open to any conversation

or nothing was negotiable but her way. She was not concerned about the child's medical condition if she had presented there for abdominal pain, you would want some tests to be done to find out why the child has abdominal pain. That was not her concern. Her concern was merely administering ketamine over and over and over and over and more and more. The ER staff tried to explain to Biata that the 1,500 milligram dose of ketamine she was demanding was not within their standard of care, and that Maya would have to be admitted to the pediatric intensive care unit. Once Maya was transferred to the Picku, Biatta also requested that she be put in a medically induced coma and demanded they give Maya Propofal, a powerful anesthetic before they performed an ultrasound on her.

In addition to the outlandish request for drugs, staff noticed a number of other concerning moments. Here's Pick You nurse practitioner Kelly Thatcher at trial. When mom was in the room, Maya was, she was yelling. She was cussing at us a lot. She was very agitated and angry. Ms. Gowalski was coaching her to behave that way. She wanted her. She said, Maya, you tell him, you tell him how angry you are, Maya. And so it was really hard to get the room to get calmed down. And then there was a very brief point, maybe 10 or 15 minutes during my time caring for Maya,

that Maya, Ms. Gwalski stepped out of the room. And Maya was very pleasant. She was very age-appropriate, like you would think a 10-year-old would behave. was kind. She used kind words. Maya was screaming that she wanted to be sedated and asked for value, which the nurse explained would not help her pain and could not be pushed fast as Maya was requesting. Later, nurse practitioner Kelly Thatcher heard Bia to offer Maya a reward if she was a good girl for her CT scan. Ms. Kowalski said to Maya, she's like, if you're really good, I have a treat for you. And I didn't think anything of it. We use treats all the time and rewards all the time. And we use

treasure box, we use stickers, we use all kinds of rewards and pediatrics. It's very common for us to give rewards. Staff was shocked, however, when they witnessed Biata delivered the reward in question, when she handed Maya a volume. Thatcher clarified that they do not offer benzodiazepines or other controlled substances to pick you patients as rewards. When the hospital continued to decline to administer the large amounts of various drugs Biotta was requesting for her daughter, Bata said something to the staff that stopped them in their tracks. She did state out that we may as well consult hospice, and that way she can have enough medication and let her die because she doesn't serve to live this way. Was that a concerning statement to you as a picky nurse?

Oh, very concerning, very concerning because we deal with death and dying all the time in the pediatric intensive care unit, and I take it very serious. And these children who unfortunately pass away in our care, we have gone through everything for these children, and they have fought a hard battle. pediatric hospice is an incredible service and they take care of children in their last moments of life and Maya was not a terminal patient and hospice is for terminally ill patients so I was very chilled when she said this because there was nothing in Maya's care

that made me think she was at risk of dying. The concerns of the ER and PICU staff were strong enough that they called in a report suspected abuse to the hotline, and this initial report was screened out. Critical care physician Dr. Tepa Sanchez remained deeply concerned about Maya, so she called child abuse pediatrician Dr. Sally Smith to get her advice. It's a moment Dr. Smith remembers well. She called me on a Saturday, and for 32 years I was on call 24-7, 365, unless I was out of

the country, to get those calls. So, you know, I'm talking to her on a Saturday. So I think she probably did give me a little bit of information about the unusual treatment with the high-dose ketamine. And I think they were concerned about not only the mother's behavior, but the child's behavior at that point and had concerns from medical child abuse. And I think, as I recall in terms of the conversation, it was what do we do? And I said, well, what needs to happen is you've got to get every medical record that kid ever had. and review that and see if there's enough evidence to support this. So in the way that the system works,

like our child protection team reviewed every report for Pinellas County every day to see if they met certain criteria where we needed to do a medical evaluation or not. Here's Jack Kowalski in the film describing his interaction with Dr. Sally Smith. She never stated who she was. She just walked in, looked at me, looked at Maya. She came in and she acted like a regular doctor that worked for the hospital. And she started to ask questions. The idea here is that Smith misrepresented herself in order to obtain information that the parents would not have given her if they'd known they were subjects of a child abuse investigation.

This is a common thread in media stories about child abuse pediatricians, the idea that they're sneaky in the way they go about their work. It's true that Jack Kowalski had a brief 10-minute visit with Dr. Sally Smith on October 13th. But it's not plausible that he didn't know who she was. For one thing, Dr. Sally Smith clarified that she always introduces herself. And for another thing, the Kowalskies knew they were being investigated. I asked Dr. Sally Smith about this idea that the Kowalskies didn't know who they were talking to. She knew exactly who I was. There was no question that this was related to the Child Protective Investigation.

Right. The conversation. What do you remember about her during that conversation? I think understandably considering what had been going on for the few days. She even made reference to being tired and not getting sleep and things. She seemed somewhat, I would say, like, agitated or pressured somewhat to me, somewhat animated. And, you know, I approached the history taking in a fairly methodical manner.

and I even put in my report that I would ask a question and perhaps there would be some realm of answering it that would occur, but there was an awful lot of other information that was thrown in and extraneous things, and it was somewhat disjointed. There were, in fact, child abuse investigators and law enforcement in the room while Beata was giving this history. And this is all backed up in Beata's own work. On October 11th, a few days into Maya's hospitalization, Biotto wrote an email to her husband, Jack, that reads, quote, I had another supersized visit from Dr. Smith,

who was sent by CPS to investigate this possible abuse slash neglect case. I spent one and a half hours with her describing Maya's illness from May 2015 till now, and all the doctors involved in Maya's care, end quote. Here's how Jack described this process and take care of Maya. She did a 10-minute interview at most, and shortly after, she walks out. Well, it's true that Jack had a pretty brief visit with Dr. Sally Smith. That visit happened on October 13th, two days after Biazza had a lengthy meeting with Smith and recounted it to Jack. Getting a detailed history from parents is crucial for any pediatric doctor.

Dr. Smith recalls one of these early conversations with Biazza. I think that, you know, beyond that, the past, of going to specialists and all different specialists and everything. I mean, as I recall, she was kind of interested in presenting all of the different doctors that had to see Maya. And, you know, this, again, most of your case, you know, needed the most intensive evaluation and testing and treatment and everything. That conversation, it sounds like, was pretty focused on the events of, like, July

2015 when she had the alleged onset of CRPS. on to... Right. I mean, I think she, as I recall, I think once I got the records, there were exaggerations about medical history prior to May to June of 2015. But most of our discussion was related to when things started, which in her, you know, telling was roughly June 2015. In these early days, Dr. Sally Smith was going through the process of collecting thousands of pages of Maya's medical records from numerous institutions. And as she was working on her

initial report, the Kowalskies were lawyering up. So, yeah, there were five attorneys. I mean, this was a, this was a circus from the legal standpoint right out of the gate. That was part of why it took so long for anything to happen. It was because there were hearings and motions and, you know, Maya had an attorney, Jack had an attorney, mom had an attorney. there was a guardian ad litem attorney, there's a dependency attorney. And, you know, all this, the poor judge is head spinning trying to, you know, sort through what's the best thing for this child. And that's what the judge is trying to decide. Right. Right. And, you know, listening to the evidence that's presented from the child protective investigation side and the dependency attorney and the defense attorney and the experts that the parents might have. And, you know, all those things were going on in this. case and the judge was hearing all this information and then trying to make some kind of a decision about what's best for the child. So they were preparing to go to the shelter hearing. I'm sorry, I think it was on the 14th because I did that report on the 13th. And so they asked me

if I could provide something in writing. Maya had been in the hospital for a little under a week at this point, but there was urgency in this case. I had received probably two, thirds to three quarters of what I eventually got. And I had pulled up a bunch of articles and taken a look at those. I had scanned through a fair amount of the records that I had, but there's only so many hours in the day. So I had a fair amount of information, but there was a lot still to review. I had received it, but not necessarily reviewed everything. But what I had seen to that point was quite alarming in terms of the concern for medical child abuse. And I think one of the things that's important in a case like this is you have to look at the potential risk for the child.

How threatened is their safety? And if a child has an indwelling ivy catheter that goes into a major blood vessel, that's a whole different ballgame than a child who has no kind of access to the internal part of the body. And if the child is getting very unconventional treatment that's potentially very dangerous, that also is something that I would take into consideration at that preliminary moment. You know, if it's a child that doesn't really have those levels of safety concern, then I might be more inclined to say, I'm still looking at the records, I'm concerned, I don't know exactly, you know, where this is going to lead. But in this particular case, and in cases like this, where there's this high level of risk to the child, Then I'm more inclined to say there's significant concern for risk and harm and those kinds of things in this case.

And those parents cannot provide a safe environment for her at this time. One of the things that I came to understand more thoroughly by the time I wrote my final report was that Beata was an infusion nurse. That was her day-to-day job, putting medications through veins. And I think at that point, I already had seen fairly extensive indication that she was accessing that port on a routine basis. Dr. Smith would eventually turn in a much lengthier and more detailed final report. But unlike her initial report, this was not allowed into evidence and remains sealed to this day. During her initial deep dive into Maya's medical history, Dr. Smith also spoke to Dr. Kirkpatrick. Here he is in the film.

As soon as I was made aware that Sally Smith was investigating, I called her immediately. And I explained to her, this is what the diagnosis is. If you want to see the objective evidence, I got it for you. I told her that on the phone. There was a lot of criticism of Dr. Sally Smith in this case for not being an expert on CRPS, But a big part of her job in a case like this is to do a record review. And Maya had seen other doctors with expertise in CRPS, such as Dr. Gatti Revivo at Lurries, who had determined that she didn't have it.

And as Dr. Smith writes in her report, quote, There are specific diagnostic criteria used to diagnose CRPS, and Maya does not meet those diagnostic criteria. Dr. Kirkpatrick calls himself an expert in CRPS, but that's not an objective professional qualification, nor are the vanity license plate on his Mercedes reading CRPS. But I digress. Dr. Kirkpatrick only saw Maya in his office a total of four times, but this didn't impede him from inserting himself into this situation, again from the film.

I told her that if she goes forward with this, it would not only be a catastrophic outcome, for the child, it would be a permanent injury to the whole family. The risks to Maya were very real, but they were not the ones Dr. Kirkpatrick alludes to. Dr. Smith highlighted Maya's indwelling port in particular, writing, quote, this provides a potentially very dangerous portal into Maya's body. Mom reports she's inserting needles into that port on a regular basis and deciding on her own to administer

IV fluid, valium, ketamine, narcotics, immunoglobin, and other medications based on her perception of her daughter's medical condition. She also writes that Biazza portrays her condition as terminal with no hope for a cure. Here's Dr. Kirkpatrick again in the film. This was not the first time I've seen this type of scenario. After a few days at the hospital, they refused to give her ketamine. And without the high-dose ketamine treatment, she had virtually no mobility in her legs at all.

And that's where you get these blood clots forming, which can break off, go to the lungs, and it could be fatal. And I felt it was important that Biata, understood the seriousness of this. So I warned her in all medical probability that Maya would die a slow, painful death. Neither the film nor the plaintiff in this case has ever made any attempt to reconcile the fact

that despite never receiving any additional ketamine after she was successfully weaned off of it during her time at Johns Hopkins All Children's, Maya did not, in fact, die. I run a small business and I have two small children, and that means that my husband and I are in a near constant state of decision fatigue. So the simple question of what should we make for dinners this week

can lead to existential dread. Thank goodness for HelloFresh. All you have to do is go to HelloFresh.com and choose for more than 100 weekly recipes and they will send you fresh pre-portioned ingredients with a quick and easy recipe. But Andrea, you say you still have to make decisions. True, but they make it very easy and fun to choose your recipes,

whether you're looking for meat and potatoes, vegetarian, kid-friendly, diet conscious, they've got it all. You get to skip going to the grocery store and the ingredients that come in your box are the highest quality. Now they include three times the seafood for no upcharge. If you are a steak fanatic like my husband, you can check out their grass-fed steak ribbyes, and you're always going to get fresh seasonal produce like pears, apples, and asparagus. We have never gotten a meal from HelloFresh that wasn't a winner and getting the box each week really takes something off our plates. Get it? Sorry.

So go to HelloFresh.com slash Nobody10 FM to get 10 free meals. and a freeze-willing knife, which is a $144 value on your third box. Offer valid while supplies last. Free meals applied as discount on first box. New subscribers only varies by plan. You can find all of that information at the link in our show notes, and remember that shopping our sponsors helps support the show. A central point of this story from the plaintiff's perspective

is the idea that Maya was kidnapped and falsely imprisoned at Johns Hopkins All Children's. And one of the lawsuit counts deals specifically with the time period between Maya's arrival at the hospital on the 7th and the implementation of the court's shelter order on October 14th. Jack Kowalski claimed on the stand that he was threatened with arrest if they tried to leave against medical advice. But the idea that they wanted to leave is strongly contradicted by documentation in both Biazza and Jack's own words. On October 12th, Biazza wrote an email to Jack where she expresses frustration at being accused of attempting to leave against medical advice and insists that she was not. And here's Jack in an interview with police detectives.

Stephanie Graham. I mean, when we were in a meeting with the doctors one day, and the other one, take my out, sign her out, and I said, hold on, time out. And this wasn't written down, which I was kind of mad about, but I asked the doctors, I said, what's the time frame you talking about? And they explained, I said, that's doable. And was my wife happy with me? What I said? No. Absolutely enough. So you have to, yeah, there's times I'm going to go the other way. Okay. And in the time before the shelter order went into effect,

Johns Hopkins All Children's had actually attempted to transfer Maya to a different hospital, Nemours, which had a specialty pediatric pain clinic that was more equipped to treat Maya, whether she had CRPS, which was the working diagnosis she came in with, or conversion disorder, as multiple other hospitals had diagnosed her with. Here's Dr. Lizgellia Santana Rojas, a pediatric pain specialist from Nemours on the stand. Tell us as near as you can remember what Mrs. Kowalski said to you

and what you explained to her about what you could or could not do with respect to the care of her daughter. I just remember that she mentioned several times that her daughter suffered from complex syndrome pain syndrome and that she wanted her to have an imprifico palm placement and my response to her was that I don't provide that treatment for that condition, but I'll be happy to see her at the outpatient setting in the clinic to make an evaluation

and recommendations, which for complex treatment of pain syndrome, we have a standard program in our clinic where we keep the patients for an average of a month, Monday to Friday, doing physical therapy, occupational therapy, and behavioral therapy every day. She, at the end of the conversation, she agreed with the treatment, and that was it. Dr. Santana Rojas emphasized on the stand that she and her team would need to independently evaluate Maya for CRPS rather than accept it as a working diagnosis, considering the circumstances. And the treatment protocol Dr. Santana Rojas is describing here is the same treatment that multiple other doctors had suggested for Maya,

as this is also the standard of care for conversion disorder. And it was the treatment Maya would end up receiving during her time at Johns Hopkins. So if the CRPS diagnosis was legitimate and Maya needed to be seen by a specialist, why not take the transfer to Nemours? As Dr. Santana Rojas says here, Biotta was once again requesting a specific, extreme intervention, the placement of an intrithecal pump, a surgically implanted device that delivers medication directly into the spinal fluid, often used in cancer patients. Dr. Santana Rojas explained

to Biata that this was not something she used to treat CRPS. The abuse investigation had been opened at this point, but the shelter order had not gone into effect, and there's ample evidence during this period of coordinating medical care with the parents. Biazza and Jack Koewski ultimately declined the offer to transfer to Nemours because they didn't agree with the transfer diagnosis. There was quite a bit of back and force in the courts during Maya's time at Johns Hopkins All Children's. So there were actually three different court orders regarding Biaa's communication with her daughter. The initial shelter order that was issued on 1014, which lasted for almost a month, prohibited contact between Biaa and Maya completely. Harsh as this decision may seem,

this is in accordance with Apsack professional guidelines on investigating Munchausen by proxy abuse. This period is known as the separation test, and it's crucial for determining the true status of a child's condition outside of the influence of their parent. There is much more of a focus on the physical parts of Munchausen by proxy abuse, the unnecessary treatments, medications, and surgeries. But the psychological elements of this abuse are profound, especially when it comes to older children like Maya. On November 10, 2016, a new order was issued, allowing supervised calls and letters with

Biana. Here's a clip from the film. I'm a phone on that because I can't call outside. What do you mean you can't call outside? You are not in a prison and you're not in a Nazi camp. Mom, Mom. Yes. She just has to ask the nurse how to do it.

That's all. On October 18th, a few days after the shelter order went into effect, Maya was given a lengthy evaluation by clinical neuropsychologist Dr. James Lewis, who in this capacity was working as a contractor for the child protection team. Here he is discussing his evaluation in a recorded deposition that was played in court. She was worried about what she perceived as her mother's distress. She's also traumatized by hearing what she believed that she heard that she had a 50-50 chance of dying as a result of some of these treatments. She also felt really badly about hearing how much money her parents were spending.

All three of those things were causing her worry or depression. Dr. Lewis emphasized that he had worked with many children suffering from pain disorders, and that the doctors who had administered all of these heavy-duty drugs to Maya, Kirkpatrick, Kintu, and Hannah, did not approach her treatment in a multidisciplinary way or require that she see a psychologist. He also noted that Maya did not appear to be in any pain with any of the tests he performed, which was notable given that she was well in her way to being weaned off of her pain medications by this point. Dr. Lewis's report notes that Maya appears to be intellectually gifted

and that her cognitive abilities were likely to improve as she continued to stay off of narcotics and dissociative drugs like ketamine. Maya told him that her mom and the doctor in Tampa, presumably Kirkpatrick, had told her that she had CRPS because of her asthma attacks and that she really didn't want to have it anymore, and she didn't want to go back on all those pills and the ketamine. Maya told Dr. Lewis that she didn't feel she could tell her mom this because she didn't want her mom to be any more upset than she already was. She said she wanted to tell her dad and hoped that her mom could get some help. Maya was also worried about how much money her treatments were costing her family and was under the impression that the ketamine coma procedure had cost $50,000, in addition to the

$10,000 her parents had paid for the infusion with Dr. Kirkpatrick. Dr. Lewis notes that Maya's diagnosis of CRPS needs to be re-evaluated by a practitioner that doesn't have a financial stake in making an affirmative diagnosis, and Maya should return to normal school as soon as she was able. Speaking of psychological evaluations, according to attorney Deborah Salisbury in the film, Beata had a psychological exam done, and the findings were that she did not have Munchausen syndrome by proxy. Importantly, the psychologist the Gwalski's hired to evaluate Biazza, Dr. Toshana Duncan, did a very minimal record review. She didn't review records from Lurie Children's or Tampa General or speak to any other doctors besides Hannah and Kirkpatrick.

Yet nonetheless, she wrote in her report that factitious disorder by proxy may be safely rolled out. And this would hardly be the first instance of a perpetrator being cleared by a psych evaluation. Munchausen by proxy is abuse. There either is evidence of it or there is not. So Dr. Duncan's report is frankly moot. So what's happening with Jack Kowalski during all of this? Here's attorney Deborah Salisbury, who represented Jack in the dependency case, and take care of Maya. So did they want Jack to turn on the other?

I would assume that they did. That would have made their case easier. He said that you would choose his kids to own his life. That's what he's supposed to say. If you say otherwise, it will be held against you. That is the only correct answer. I can't speak to Jack's motivations, but the tensions between him and Biotto were clearly escalating during this time,

which they do depict in the film. Instead of embracing each other, it just, there was a blowup. Our family was falling apart. Viata was focused on Maya's care. If my daughter requests to speak with me, I want to be able to speak with her. But my approach was not to cause any more tension between the hospital and our family. Jack originally told doctors at Johns Hopkins that it was mainly Biotta who handled Maya's care. But Dr. Sally Smith's record review told a different story.

Since he had been the parent who took her to, I think at least half of these unconventional treatments, I mean, I didn't really know what the dynamic was there and what his level of complicity might be and, you know, that kind of thing. Encountered his framing later on, Jack didn't appear to. to find the allegations against Biazza so outlandish. Here he is again with Detective Stephanie Graham. When nobody else was in the room but my own staff, she had to go through it. When mom would walk in the room, she's in soul.

I heard that many times. There's no other explanation. I noticed it too with myself, you know, and then my mom from home from work. And all of a sudden she's back. There'll be changes. To your home, your guys are doing well. No complaints about pain.

No, no complaints about that. Jesus' name. And at one point, Detective Graham gets even more direct and asked Jack if he's ever heard of Munchausen by proxy. He says he has. So when you heard this term, you saw it, did anybody explain to you what it was? I looked it up.

Where did you look at? My phone. WebMD? Or some other? I just typed in. What do you recall it's saying about Munchausen by proxy? For what it says? it was almost textbook of what we went through.

Over the three months that she was hospitalized at Johns Hopkins All Children's and was weaned from her meds, Maya showed continuous improvement in both her pain and overall function. But according to a court deposition from Biazza's brother Peter, while all of this was happening, her younger brother Kyle had taken a sudden turn. Why did you have to take Kyle to a hospital in Fort Myers? A very good question, so.

Basically, Kyle would complain on the pain quote over. But I observed, Kyle was playing all day under his father's supervision. He was not complaining on anything. Beata is coming from work. Kaya has a pain over screaming pain over. And remember discussions with Bata asking where he want to go. So we decided we're going to go to the Fort Myers and we're going to gather two separate cars in case one of us needs to stay in the Fort Myers with the caria coast.

You're claiming that in 2016 Kyle had some pain. You didn't necessarily observe him to be in pain, but Bayada thought that Kyle was in pain. So you guys got into a car and went down south to Fort Myers to get Kyle some healthcare? With his father approval because Jack was at the time. Okay, so you had Mr. Kowalski's approval to take Kyle down to Fort Myers, right? Yes, sir. What did you observe about Kyle's pain complaints? So, Kyle acted very strangely. Jack had the table outside his garage on the chair.

He was sitting, and Kyle was playing with the Maya schoolmate. Her name is Julia. They were dancing like a kid. And the Atomai system came after all day, and Kyle is the quote, pain all over. Do you know what year this was? It was between the time that Maya was locked up and before they had a passing way. Okay.

So at some point while Maya was at Johns Hopkins All Children's Hospital and before your sister's passing, Kyle began to complain of pain all over. Is that correct? Yes, sir. And why did you decide to go down to Fort Myers, which is pretty far south of Sarasoga? rather than just going to Sarasota hospitals. They were discussing with Kyle, and Kyle afraid that if he goes to the Jab Hopkins, he is going to be also stripped off like Maya from both parents. Kyle afraid that he will not see the parents anymore like Maya. The CRPS and police investigations carried on through the rest of the fall and through the holidays.

And by early 2017, as Deborah Salasbury recounts and take care of Maya, everything was about to come to a head. It never made any sense to me why she was denied giving her child that hug. And I can tell you as we left the courthouse that day, that Biotta was devastated, devastated. And the one thing that I know to this day is none of us can get that hug back now. That hug is gone. That's next time on Nobody Should Believe Me. Nobody Should Believe Me is executive produced written and hosted by me, Andrea Dunlop.

Our co-executive producer is Mariah Gossett. Our editor is Greta Stromquist, research and fact-checking by Aaron Ajai, additional research by Jessa V. Randall. Our production manager is Nola Karmouche. Music from Blue Dot Sessions, Sound Snap, and Slipstream.