Truth Is Stranger Than Factitious

Virtually all physicians have learned that some of their patients sometimes deviate from their recommended therapies. Physicians also know — uneasily — that some people become patients because they surreptitiously administer pharmacologic agents to themselves or otherwise abuse their bodies. The list of factitious diseases thus produced is long and continues to grow in proportion to the availability of potent pharmacologic agents to those in our self-medicating society who seek relief or presumptive personal gain from real or imagined ills. Anecdotes and case reports abound, revealing puzzling fevers of unknown origin due to thermometer manipulation, debilitating diarrhea due to cathartics, . . .