The hospital's records give a quite different story to that taken in the 1990s. With claimant lawyers then estimating that any victorious families in the publicly-funded lawsuit might each have three million reasons to believe that MMR caused their child's autism, "E" put aside her past accounts, and signed him up as a vaccine victim. Her son's development had been normal until he received MMR, she said. Then he lost speech, eye contact and play. He became "quite distressed, with fever, his eyes were fixed and his pupils dilated and was not well for days," she said.
"From 2000 onwards," the judge continued this account, "M's parents, and in particular his mother, have given increasingly vivid accounts of an extreme reaction to the injection experienced by M. There are descriptions of M screaming after having the injection, followed by six hours of convulsions, screaming and projectile vomiting." In one note, recorded in an "auditory processing assessment report" dated 31st October 2002, E alleged that, following MMR, M had remained in "a persistent vegetative state for six months."
Hospital found constipation
She also now complained that - from the time of his vaccination - "M" had suffered from "autistic enterocolitis". This is a novel condition, not accepted by medical opinion, masterfully discovered by Wakefield for the (long-since-failed) lawsuit, that cost the taxpayer £26.2 million in payments to lawyers and doctors, of which he got more than £435,000. For ten years, the boy suffered a "severe gut disorder", "E" said, although nowhere could the court find any record of such a problem, and the Royal Free only noted constipation.
"M's" medical records were comprehensive, reporting minor ailments, and the court did not believe that no notes would have been kept if such longstanding serious issues had been real. And many other problems were later reported by the mother that were unsupported by documentary evidence. These included loss of sensation in "M's" hands and feet, adverse effects of "electromagnetic energies", apparent brain seizures, meningitis, "leaky gut syndrome", Lyme disease, uncontrollable sneezing, a shut-down of his urinary system, "tumours" in his gums, chronic blood poisoning, bilateral deafness, uncontrollable temperatures, a "black shadow sitting on his left sinuses", stabbing pains in his groin, rheumatoid arthritis, heavy metal poisoning and "black gunge oozing from every orifice".
As I have said, I wondered if the mother was mad. And that was almost the point of the court case. Founded upon her claim that her son was an MMR victim, she had embarked upon an odyssey of often costly remedies and responses, ranging from wrapping electrical equipment in his room with tin foil, through cranial osteopathy, reflexology, oxygen chamber sessions for six hours at a time, and dosing him with handfuls of pills.
"By this point, according to a list prepared by E and A," Baker reports, "the range of biomedical interventions being supplied to M included a probiotic, six vitamin supplements, four mineral supplements, five trace elements, fatty acids, amino acids, enzymes and a range of homeopathic remedies."
I am named in the judgment, but I knew nothing of the court case. Had I done so, I might well have assisted. The picture painted so far could fit thousands of parents, particularly in the United States. Hardly a month passes without the wealthy Wakefield appearing at conferences dominated by quack remedy merchants and crowded with mother warriors who - wrongly blaming themselves for having their children vaccinated - are uniquely vulnerable prey.
But "E's" story becomes darker than her MMR deception, which Baker said "lies at the heart of this case". And it does not require condemnation of potions and pills that the less exploitable might think of as nuts. The hearing turned on the mother's character, which the judge found controlling, manipulative and duplicitous. "In 35 years of family law and in the Court of Protection, dealing with many hundreds of families," he said, "I have rarely, if ever, come across someone who is so difficult."
This was also the position of the unnamed local authority, whose managers brought this mother to trial. Four years ago, "E" had persuaded a district judge to make her "M's" legal "deputy", giving her all-but total control of his affairs. And, even before that coup, she had embarked upon another odyssey: of pathological conflict with his carers.
The authority's submission was that "E" was a case of "factitious disorder imposed on others" (previously known as "Munchausen"s syndrome by proxy"). The case before the court was that the fraudulent MMR injury was a concoction by the mother to get attention for herself, and that the quack remedies were instruments of control.
"To date, such abnormal behaviours have been most commonly described in mothers who have care of dependent children," the court heard from Dr Alison Beck, a consultant forensic psychologist at the Royal Maudsley hospital, London, and Dr Gwen Adshead, consultant forensic psychiatrist at Broadmoor hospital, Berkshire, "but they have also been seen in nurses and in those who have care of the elderly and other vulnerable adults."
Baker weighed the consultants' testimony, but also used his senses as he watched what he described as "M's" "performance". Appearing without legal representation, but assisted by her husband, seated behind her with two Wakefield mothers, she had initially hoped to rely on no less than 91 witnesses, including a high court judge and an MP. Then she expected to call another 48 from those she criticised, for a barrage of cross-examination.
She was scrupulously polite, raising a hand before speaking, but the court was not impressed by her antics. "E has dominated this hearing in a way quite unlike any other case in my professional experience," the judge said. "I have no doubts that E adores her son and her daughter, and that she has devoted much of her life to her children and, in particular, to getting the most that can be achieved for her son. Her devotion is not, however, selfless. On more than one occasion she said that this case was about her and, although she was quick to retract that comment, when I pointed out that it was actually about M, there was no doubt that she felt she was the main focus of the inquiry. She was the centre of attention and, in my judgment, at times obviously enjoying the experience."
But what struck me more vividly was "E's" conspiracy theories: another favourite of mother warriors and Wakefield mothers. There was an MMR conspiracy, through which thousands of doctors and scientists (and, more recently, journalists) concealed horrific alleged injuries to children. There was a legal conspiracy, through which judges denied fairness. And there was a local government conspiracy, by which hard-pressed social workers wanted to remove autistic children from their parents.
"E's" allegations of multiple conspiracies are a fantasy," said Baker. "I merely observe that, if the parents' assertion about conspiracies is correct, it would amount to gross misfeasance in public office and the biggest scandal in public care and social care in modern times."
Teeth meant for Wakefield
Although not a criminal case, a litany of misbehaviour runs from page to page in the judgment. "E" subjected her son to unnecessary tests and interventions "and/or lied" about purported illnesses. She behaved in a "devious and destructive" way towards professionals. She denied her son the chance to develop more independence. She allowed the pain and suffering of a dental abscess to go untreated for a year, then planned to send the lost teeth to Wakefield. She made false allegations against social workers, and vexatiously complained to regulators.
In the end, Baker ruled that, not only did she have factious disorder, but a bunch of other disorders as well: "narcissistic personality disorder", "histrionic personality disorder" and elements of "emotionally unstable personality disorder". Her legal deputyship status was revoked. "M" would receive a vaccine if a GP advised it. And the mother was told to demonstrate a "fundamental change of attitude", or face "permanent steps" to restrict her involvement in the future of her much-loved son.
A more devastating appraisal you could hardly lay your hands on. Here was a reputation quashed like few others. And I had merely thought that her son's autism plus Wakefield had so stripped her of trust in almost anyone but charlatans that she had been driven off the rails and round the bend.