Many visits to doctors and hospitals culminate in a diagnosis of CRPS (complex regional pain syndrome). The only effective treatment is large doses of ketamine, combined with physical therapy. A knowledgeable specialist doctor puts Maya on the road to recovery, but she has a relapse during a hurricane. She is in agony, and her parents take her to the emergency room of a Johns Hopkins childrens' hospital.
It only gets worse for the family. The hospital doctors and nurses are unfamiliar with CRPS, and are unwilling to give the child huge doses of ketamine. They suspect Munchausen's by proxy, which occurs when a disturbed parent convinces their healthy child that the child has medical issues.
So, the child remains in the hospital, and suffers, and her condition does not improve. They contact Child Protective Services, which in their state of Florida is outsourced to a private company called Suncoast, and their overworked doctor advocate, Sally Smith. Smith's cursory investigation soon results in a court order that removes custody of Maya from her parents. Beata's assertive efforts to help Maya estrange Beata from the hospital and Dr. Smith.
After 90 days and continued courtroom setbacks, Beata commits suicide. This has the effect Beata desired; the child is returned to the custody of the surviving parent, Jack, but the court orders she is forbidden to receive ketamine.
With therapy, Maya gradually improves, but she is joyless. Beata's obsessive documentation of her interactions with Smith and the hospital allows the Kowalskis to sue Smith, Suncoast, and Johns Hopkins, but justice is slow since the hospital's lawyers are effective at postponing a trial.
How others will see it. The documentary was a breakout hit on Netflix, reaching their Top 10. Whether the buzz will last is another matter, but today at imdb.com it has a very high user rating of 7.9 out of 10. The user vote total of 3.7K is middling, but the film has not been streaming for long.
User reviews note the obvious: there are problems with health care and social services in the U.S. All viewers get it that, no matter how much pain the Kowalskis endured, they are but one family out of a vast number who have been wronged by "The System", whether that system consists of hospitals, courtrooms, or the Sally Smiths of the world.
How I felt about it. Some things are much larger than the grade of a movie. So, the first question is, what went wrong here? Problems abound. From the point of view of the doctors and nurses, the huge of doses of ketamine Maya had received in prior care was unorthodox and dangerous. Maya's mother, Beata, was combative with hospital employees, and from that a false conclusion (a misdiagnosis) was made of Munchausen's by proxy. The mother was wrongly separated from the child, and the child was denied the most promising treatment, doses of ketamine as recommended by her specialist physician. Hospitals and judges seem to serve their own interests over that of Maya.
But the biggest problem is Dr. Sally Smith. She has enormous responsibility. It seems that every child admitted to the Johns Hopkins All Childrens Hospital with any sign of abuse is assigned to Dr. Smith, whose salary is paid for by a private company contracting with the state of Florida. The private company wants to make money, so Dr. Smith does not have a team supporting her. She does not have time for more than a cursory investigation, relying heavily on what doctors and nurses, who have known the Kowalskis only for a short while, tell her about the patient.
Dr. Smith is the bad guy, but she is likely overworked. If she was employed by the state, instead of by a state contractor, would she make better decisions? Possibly.
We recognize that Maya is representative of countless children who have received incorrect care from hospitals, and whose parents have falsely been accused of abuse. Many of those families are less sympathetic to the public than Maya's. After all, she is a beautiful and well-behaved white girl who has lost her mother, and has an ideal father. We do not belittle the genuine suffering of the Kowalskis, but there are so many others without a Netflix documentary to highlight their tragedy.