http://nymag.com/daily/entertainment/2009/07/so_whats_orphans_surprise_endi.html (http://nymag.com/daily/entertainment/2009/07/so_whats_orphans_surprise_endi.html)
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Esther is really a 33-year-old woman who was born with proportional dwarfism which causes her to have the appearance of a child. She also happens to be a former prostitute, who had wealthy pedophiles for clients. The reason why she has her neck covered is because she was once in asylum and she struggled so much in her straitjacket that it left with her deep scars on her neck.