The more we know, the wiser we grow. The principal source of medical enlightenment these days, therefore, is the internet: for by its use, we can all become expert on almost anything within a short time. Knowledge that has taken years of strenuous effort to accumulate is available to us in minutes.
Alas, history demonstrates that any technology that is used for good can also be used for ill. I was looking something up on Medline last week when I came across a paper entitled Munchausen by Internet, in the Southern Medical Journal, by a psychiatrist in Birmingham, Alabama, called Dr Feldman.
In the paper, Dr Feldman describes four of the 21 cases that have already come to his attention. Typically, an internet support group for people suffering from a certain disease is suddenly joined by a newcomer, who claims to be suffering from the disease. He has the most dramatic manifestations of the condition, or even claims to be dying, though life-threatening complications do not prevent him from writing long bulletins about himself. If interest in his case wanes among the other participants, he simply invents new crises to rekindle it.
For example, a person who called herself Barbara and claimed to be suffering from the terminal stages of cystic fibrosis, wrote to a cystic fibrosis internet support group. She (if indeed it was a she) was looked after by her older sister, Amy, and wrote that her dream was to die on the beach. She received a great deal of sympathy from other sufferers. Prayers were offered up for her. A short time afterwards, a message was posted by Amy, to the effect that, sadly, her sister Barbara had died, though fortunately she had been transported to the beach just in time to die there.
Members of the group, however, noticed that the very same spelling errors that had appeared in Barbara's communications, which they had generously attributed to the lack of oxygen reaching her brain, now appeared in Amy's communications. On being questioned, Barbara/Amy admitted that she had made the whole story up, and taunted the other members of the group for being so gullible.
In another case, this time of a mother claiming to have a baby with cystic fibrosis, the support group was divided for a time as to the truth of her story. Some soon spotted the fake, but others took longer to do so. When the baby was alleged to have died, some members offered to send flowers to the hospital, but discovered that no such baby had ever been treated there. Only then was the entire group convinced the original story was nothing but a lie: some were left with feelings of anger, disgust and shame at having been duped in this fashion.
What kind of people mimic suffering in the hope of attracting sympathy and attention, if only temporarily (their eventual exposure as fraudulent being inevitable)? It doesn't take much imagination to understand that they must be rather sad individuals, whose life is lacking in more conventional rewards.
No doubt some people have always sought sympathy by subterfuge, but there seems something more urgent and unscrupulous about our modern thirst for victimhood. Not long after the problem of stalking (in my belief, a real enough and probably growing problem) was given wide publicity in the press and reports emerged in the medical literature of people who falsely claimed to have been stalked. The false claimants wanted the sympathy and attention that the truly stalked had received, but without having gone through the unpleasant experience itself.
Perhaps we are seeing the survival into a secular and materialist age of the old religious idea that true sanctity cannot be achieved except through the voluntary acceptance of suffering. If life itself refuses to send you such suffering, you simply make it up.
Of course, I was in two minds whether to write about Munchausen by internet, because you have only to mention such undesirable conduct nowadays for it to spread. How long can it be, indeed, before there are false claims to have been the victim of someone with Munchausen by internet? What would such a condition be called? Munchausen by Munchausen by internet? The alarming prospect of an infinite regress of false claims opens up.
• Sarah Boseley is away
