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WHITE PLAINS, N.Y. — On Facebook, Lacey Spears would decry Western medicine, shun fast food and constantly promote new diets for herself and son Garnett.

In mid-January, three days before her 5-year-old son, Garnett, was admitted to the hospital for what would be the last week of his life, she proudly posted a picture of a drum of vegetable broth, stating "Homemade veggie broth. I cook all our greens in veggie broth, made three gallons tonight."

Living in the Fellowship Community in Chestnut Ridge, N.Y., where many residents work on the on-site organic farm, Spears found a community that embraced her stated penchant for healthy living. Like Spears, when their children got sick, several young parents at the Fellowship would send their children off-site to the same pediatrician, Dr. Kenneth Zatz, who shared their interest in holistic as well as traditional medicine.

Katz, a popular pediatrician in nearby Nyack, N.Y., who has been serving Rockland County since 1989, sends his two daughters to the Green Meadow Waldorf School, located on the same campus as the Fellowship.

His private practice is in the same building where his wife works as a holistic chiropractor. He declined to be interviewed, largely because there is an ongoing criminal investigation into Garnett Spears' Jan. 23 death and because of doctor/patient confidentiality rules.

PART ONE: Boy's unexplained death reveals mom's lies
PART TWO: For boy who died, two fathers — one real, one imagined
PART THREE: Red flags in, out of hospital before boy's death
PART FOUR: Before boy's death, a life of sun and sand castles
PART FIVE: Neighbors saw 2 sides to mom of boy who died

Police are pursing medical records from the doctors and hospitals who treated Garnett over the years in Alabama, Florida and New York, as they piece together Garnett's medical history. They are investigating whether Garnett may have been poisoned by salt, and focusing their probe on Lacey Spears, 26, the boy's single mother who they believe may have Munchausen by proxy, a psychiatric disorder where parents harm their children to seek sympathy and support.

Doctors at Maria Fareri Children's Hospital in Valhalla, N.Y., where Garnett was airlifted from Nyack Hospital on Jan. 19, reported the boy had suspiciously high levels of sodium in his body. Police heard from a Fellowship neighbor that Spears had called her from the hospital and asked her to dispose of a feeding bag in her home. Officers later seized the pouch which Spears would use to feed her son through a port in his abdomen. Sources say the confiscated bag contained an extreme concentration of sodium.

The (Westchester County, N.Y.) Journal News was unable to confirm whether Zatz saw Garnett in the days before his final hospitalization, or to determine the nature of his treatments or possible referrals for issues such as his feeding tube. Garnett had the tube since he was a baby.

Dr. Anthony Porto, a professor of pediatric gastroenterology at Yale School of Medicine who treats patients at a hospital in Greenwich, Conn., has said a feeding tube is a temporary measure and it would be highly unusual for a child who was able to eat by mouth to have a gastric feeding tube for years on end. Porto was not involved in Garnett's care.

Spears started bringing Garnett to Zatz's office shortly after she moved to the Fellowship, an alternative-lifestyle community centered on elderly residents, in November 2012. She initially brought Garnett to the Fellowship's on-site veteran physician, Dr. Gerald Karnow, who works out of the campus' medical office and practices "anthroposophical" medicine, blending traditional and homeopathic remedies.

"When she first got here, she didn't know any doctors or anyone in the area," said Matt Uppenbrink, a Fellowship administrator. "I'm sure she went to our doctor here. But she wanted a person who is a pediatrician."

Like Karnow, Zatz offers a holistic approach to medicine, with a personal touch. Parents say Zatz has a casual demeanor with parents and children, despite screaming babies or petulant toddlers.

On his practice's Facebook page, Zatz shares his philosophies on healthy living in an open dialogue with his 637 followers, many of them patients. He decries the overuse of medicines such as Tylenol, Zantac, antibiotics and psychoactive pharmaceuticals, while advocating certain natural foods. He devoted an entire post to juiced vegetables.

In February, the doctor wrote about a six-week detox diet where he and his wife avoided grains, sugar, dairy, nuts, coffee and eggs while eating loads of vegetables and taking herbs and supplements. He also takes a liberal attitude toward parents who choose not to vaccinate their children.

"Of all the vaccines, the HPV vaccine is the most difficult one for me to embrace," he writes on Facebook.

The Centers for Disease Control and Prevention says the human papillomavirus is the most common sexually transmitted infection in the United States. Its website says health effects caused by HPV can be prevented with a vaccine.

Spears espoused a similar aversion to vaccines and unhealthy foods in a June 28, 2012, Facebook post: "No (Garnett) does not watch tv, drink purple kook-aid (sic), eat ice cream or consume sugar of any form... He isn't vaccinated, doesn't follow western medicine ... "

There have been no allegations against Zatz related to the Spears investigation. The fact that police are looking at Munchausen by proxy, however, raises possible questions for all the doctors who saw Garnett.

Physicians, particularly those who treat children, have experience dealing with nervous, overly anxious parents. But nothing prepares them, experts note, for a mother who tells outright lies about a child's health to gain their sympathy and attention.

Mothers with Munchausen by proxy, also called fictitious disorder by proxy, are skilled liars.

They tell doctors long stories of their child's medical history, but often don't have records to back up their claims. They may move frequently or tell a new physician that a previous doctor died, noted Dr. Jose Maldonado in a 2002 paper published in the American Journal of Forensic Psychiatry.

The mother demands extensive testing and treatment, and physicians, motivated by their desire to help what they believe is a genuinely ill child, comply.

"Physicians become the parent's unwilling accomplice, fulfilling the parents pathological wish for sympathy and attention," Maldonado wrote.

Contributing: Jane Lerner, The (Westchester County, N.Y.) Journal News.

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