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Disease and deception


Chronic headaches were only part of Chris’s troubles. By the age of 15, he’d already endured a short lifetime of misery. The physical abuse he’d suffered at the hands of an estranged father had resulted in a seizure disorder and intractable migraines, on top of his hemophilia. His brother was also diagnosed with AIDS. His stepfather, an alcoholic and deaf mother, refused to support his academic pursuits (he was a fourth year medical student), which forced him to use a skateboard to commute three miles every day. He worked as a drummer and used his earnings to pay his medication.

Chris seemed mature, sensitive and insightful despite the Job-like list of suffering and afflictions. But he was lying—about his migraines, about med school, about everything. “Chris” existed only online, created by a patient with Munchausen by Internet syndrome (MBI). MBI isn’t an official diagnosis. Marc Feldman, a psychologist, introduced MBI to the literature in 2000. He described the case and three other cases and outlined the key features of the 21st century condition.

Munchausen syndrome, also known as factitious disorder in psychiatric nomenclature, is a condition where people pretend, induce or exaggerate the symptoms of illness. MBI patients do this online. By Feldman’s account, a typical MBI patient enters…

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