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On November 13, 2008, the Wilfred family gathered to mourn a tragedy.

Three days earlier, mom Leslie Wilfred had called the family from the local hospital in Thomasville, Ga., with devastating news: The twins she had been carrying for the past five months had been stillborn. According to Leslie, each baby had taken one breath just before dying.

“I’ve been in law enforcement for 30 years and...I had never encountered anything like this before.” — Officer Bob Brettel, lead investigator on the Leslie Wilfred case

The grief stricken mother told her husband that the twins had been cremated, and she wanted to come home to plan their funeral. Conducted at the family’s regular church, the service included a letter Leslie had written from the perspective of the twins entitled “A Letter to Our Daddy” and a pair of teddy-bear shaped urns, which held the small children’s ashes. Two framed ultrasound photos of the fetuses were on display, and many of those in attendance even commented that the unborn twins looked just like the children’s father.

But while family members and friends mourned for the two babies whose lives had been cut short, little did they know how tremendously fooled they all had been.

For the twins had not died during childbirth. They had never existed at all.

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In fact, Leslie Wilfred was not capable of getting pregnant, as she had had her tubes tied prior to her marriage to her current and second husband, Chris. The ultrasound photos were of some other woman’s child, lifted from an unknown website, and the Teddy Bear urns were filled with nothing but air.

The entire pregnancy had been a complete fabrication concocted by Leslie – and she knew exactly what she was doing.

“I’ve been in law enforcement for 30 years and have been an investigator for 25 of those years. I’ve investigated everything from homicides to armed thefts,” Officer Bob Brettel, lead investigator on the Leslie Wilfred case at the Thomasville Sheriff’s Department, told FoxNews.com. “I had never encountered anything like this before.”

Soon, Brettel would confirm that Leslie’s actions were the result of two bizarre and astonishing medical conditions known as Munchausen syndrome and Munchausen syndrome by proxy.

Related: Faking it online: Munchausen by Internet

The two syndromes, while quite different, revolve around a similar premise. In both scenarios, an individual purposefully fabricates medical conditions they know to be false in order to garner attention or sympathy. Munchausen syndrome patients tell falsehoods about themselves, but in scenarios of Munchausen by proxy, a caregiver invents medical conditions for his or her children, often inducing symptoms in them to better illustrate the lie. Because the condition extends to unknowing minors, Munchausen by proxy is typically considered a severe form of child abuse.

“With Munchausen by proxy, there’s a mortality rate of 9 to 10 percent among published reports, so it’s the most lethal form of child abuse there is,” Dr. Marc Feldman, a clinical professor of psychiatry and adjunct professor of psychology at the University of Alabama in Tuscaloosa who collaborated on Leslie’s case, told FoxNews.com.

The Wilfreds

Leslie, 37, and Chris, 39, who first met in high school, were married on June 23, 2007. Their marriage brought together four kids from Leslie’s previous relationships and a stepson from Chris’s.

While Leslie’s children were loved and accepted by their mother and new stepfather, Chris’s son Nathan* was treated quite differently.

According to the two parents, Nathan was a very dangerous child. Prone to violent rages in which he would threaten the family, Nathan was seldom allowed to participate in family events and outings, and he was often isolated from his stepbrothers and stepsisters. Friends and community members rarely saw him outside of the house.

The family’s troubles also extended to their other children, two of whom were suffering from illnesses, according to their parents.

Leslie’s then 13-year-old son Charles* had had his gallbladder removed when he was a young child due to what Leslie described as frequent bouts of vomiting. Furthermore, everyone in the family believed that Charles was still in need of a liver transplant. Though the reasons for the procedure remained unclear, Chris was prepared to donate part of his own liver to help save his wife’s son.

A much more serious condition afflicted Leslie’s then 9-year-old daughter Theresa*, who had been told she was dying from leukemia. Leslie took Theresa to supposed chemotherapy treatments, and to help pay for their medical bills, the Wilfred family had placed canisters throughout Thomasville to collect donations.

According to Leslie, the other children suffered from a variety of medical and psychological conditions, and she even maintained that her biracial 11-year-old daughter Brianna* was the result of a rape by a former co-worker – although this was never reported to authorities.

As for the family’s matriarch, most members of the community viewed Leslie as a good parent who frequently participated in school and church events. And despite their tragic ailments, Leslie’s children dressed and behaved appropriately enough, prompting no one to question the Wilfred family’s numerous medical maladies.

It wasn’t until Nathan had a run in with Child Protective Services that Leslie’s fabrications were finally brought to light.

Unraveling the lies

A few weeks prior to the twins’ funeral, police were called to the Wilfred home after Leslie and Chris reported that Nathan had threatened the family with a knife. The incident subsequently prompted an investigation with Child Protective Services, and Leslie was often required to meet with officials involved in Nathan’s case to discuss his outbursts. According to sources at the department, Leslie’s behavior during these appointments seemed just slightly bizarre.

“During this whole period of time when the mother would be talking to his attorney, she made several references about his behavior being responsible for the safety and wellbeing of her unborn twins,” Brettel said.

When CPS heard about the stillbirths, an employee contacted Brettel at the Sheriff’s Department with her suspicions, prompting Brettel to do some preliminary investigations.

What he found blew him away.

“We first checked with the hospital, and there was no record of any of this,” Brettel said. “….The doctor’s name she gave us didn’t exist.”

Brettel’s initial findings eventually led to a cascade of discoveries about Leslie’s lies. Not only had she made up her entire pregnancy, but a search warrant of her computer revealed that Leslie had ordered the Huggable Teddy Bear urns five days prior to the twins’ “deaths,” indicating she had planned to concoct the stillbirth story all along.

Additional seizures of medical records, search warrants and other documents unearthed even more sinister fabrications. Charles had never been in need of a liver transplant, and his gallbladder surgery as a child was immediately called into question.

“The suspicion that could never be proven was that the mother was poisoning him,” Feldman said. “The doctors had their doubts about what was going on, yet she went from doctor to doctor until she found one willing to remove the little boy’s gallbladder.”

Furthermore, there was no evidence to support the claim that Theresa was dying from leukemia. The little girl’s visits to the hospital for chemotherapy treatments had all been elaborate stage plays directed by Leslie, and the donation canisters set up throughout Thomasville to fund Theresa’s medical bills had all been a sham.

Chris’ son Nathan may have suffered worst of all. After searching the Wilfred’s home, officers discovered a small wooden box that had been secured to walls of the linen closet in the master bathroom. Leslie initially claimed the box had been used to house animals, but further investigation revealed that Nathan had been forced to sleep in the box every night, with plastic bands strapped around his arms to prevent him from making noise.

The parents’ explanation for the box was that Nathan was too violent and needed to be constrained during the nighttime hours. But psychiatric analysis of the young boy showed he mostly suffered from post-traumatic stress disorder (PTSD) as a result of being confined to the tiny box every evening.

Dissecting Munchausen syndrome

Overwhelmed by everything he had learned about Leslie and the reality of her children’s situation, Brettel decided to reach out to Dr. Marc Feldman, an international expert in factitious disorder, Munchausen syndrome, Munchausen by proxy and malingering. Feldman explained that patients with Munchausen syndrome knowingly make up illnesses and other medical conditions in order to receive attention from their family and friends.

“It is a diagnosis of people who evolve lifestyles in which they travel from hospital to hospital, getting themselves admitted and subjecting themselves to surgery they don’t need,” Feldman said. “What they have in common is this quest for sympathy – a desperate search and yearning for some kind of identity as a patient or the vicarious identity of a patient.”

Feldman noted that while Munchausen syndrome and Munchausen by proxy are considered psychiatric factitious disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, doctors are wary of considering them a form of mental illness. Since Munchausen by proxy can lead to fatalities in children, Feldman and other psychiatrists try to disassociate the condition with mental health so that perpetrators can be fairly prosecuted in court.

After undergoing an evaluation, doctors noted that Leslie did not exhibit any other symptoms of major mental health issues.

“They did a complete psychiatric assessment of her, and she is not psychiatrically ill in the sense of a major diagnosis like schizophrenia,” Feldman said. “There are no psychiatric excuses for what she did. She has a personality disorder which means she has long-term, self-defeating ways to deal with stress.”

Feldman said that a common misconception about Munchausen syndrome is that it is the same as hypochondria – the obsessive worry that one is suffering from a serious medical condition. However, he said the two conditions are drastically different.

“The difference is the sincerity of the belief of the illness,” Feldman said. “People with hypochondria truly think they’re sick, interpreting aches and pains as indicative of severe illness. They don’t intend to deceive others, they just deceive themselves. With Munchausen, they know they’re lying, and they have often had to engage in considerable planning to deceive. They aren’t delusional; they know they or their children aren’t really sick.”

To explain their actions, many Munchausen patients claim they were abused as children, though Feldman said it’s hard to qualify these statements, given the patients’ extensive history with lying.

Another trend, which was seen in Leslie’s case, is the presence of unquestioning partners. When police asked Chris if he had suspected that Leslie was faking her pregnancy, he said he had no idea that she was lying – even though he had been intimate with his wife during the time she claimed to be pregnant.

“In case after case, you find these very passive husbands,” Feldman said. “They don’t question the lack of insurance bills, because the mother claims she’s handling them. They have very traditional marriages; anything involving children is the woman’s responsibility and work life is his domain.”

Because Munchausen syndrome and Munchausen by proxy are so bizarre, Feldman said that doctors don’t often consider the conditions when diagnosing their patients. If left unchecked, these cases can lead to fatalities, since parents have to follow through on their fabrications of severe illness.

Moving forward

Following a two-and-a-half year investigation, Leslie Wilfred eventually pleaded guilty to several counts of cruelty to children and theft by deception, as a result of the donation canisters she set up throughout the town. She is currently serving an eight-year sentence, which will be followed by 30 years of probation. Chris was convicted of one count of cruelty to children, and both parents have been ordered not to contact their children without explicit permission from the court and other designated agencies.

According to Brettel, he is thankful he was able to intervene when he did, as he believes very real fatalities may have soon occurred in the Wilfred family. Fortunately, the children did not suffer any permanent physical damage, and they are all currently living in foster care. However, the emotional abuse they endured has had a lasting impact.

As for Leslie, Brettel said she never really understood the extent of the pain she caused through her deceptions.

“She was pretty much in denial about doing anything significantly wrong,” Brettel said. “She didn’t think she had done anything to harm her children.”

*Names have been changed to protect the children.