Munchhausen Syndrome and Munchhausen Syndrome by Proxy



I reached home just as dawn was breaking. Had Angela been raped? It was possible. Some people don't show a lot of emotion, even in situations like these. Maybe shock prevented her from acting bent out of shape. But Angela's past behavior led me to believe that this rape scenario may have been fabricated. She was one of those people who constantly visited the emergency room. She always had the flu, headaches, and terrible menstrual cramps, in addition to a variety of odd symptoms that required tests to figure out if there was anything serious going on. By the time I had interpreted for her for several months, I would cringe any time the nurse ended the visit by saying, "If you have any of these symptoms, come back in."

Sure enough, Angela would show up just a few days later with one of the symptoms on the list that she hadn't already exploited. Some would say Angela was a hypochondriac, but I was beginning to think she was exhibiting Munchausen's Syndrome, a psychological disorder in which people will fake or cause diseases and injuries to get attention. Some people view this behavior as a minor psychological disorder, but the lying, manipulation, and extreme self-centeredness are trademarks of a more serious psychopathology. Could this be Angela's real problem? Was this sweet thing really a psychopath? I didn't know, but I wasn't going to lose sleep over it; in fact, I was looking forward to a good night's sleep that night to make up for staying with Angela until she left the hospital at sunrise.

Unfortunately, this was not to be. At midnight , my pager went off again. This time the call came from D.C. General Hospital .

"We have the victim of a sexual assault." Good God, what was going on in this town?

I was at D.C. General in twenty minutes; it was much closer to my house than the other hospitals. As I walked into the emergency room, I muttered to myself, "I bet it's Angela."

And it was.

I had to shake my head to make sure I wasn't seeing things, but there she was again, this time already in her hospital gown waiting for the doctor to come in.

"Angela! What happened? You got raped again?" I believe I must have sounded a tiny bit incredulous.

Angela didn't bat an eye. "Yeah. Can you believe it?"

I really, really wanted to say "No, I don't believe it" this time. But the interpreter Code of Ethics does not permit this. I was here to facilitate communications, not to judge and interfere with the proceedings.

"Wow! Two nights in a row! Gosh, you have some bad luck!"

Angela nodded solemnly. "Yeah, really bad luck."

The doctor came in.

Angela told pretty much the same story as the night before.

The police investigator took his notes. Said he was sorry. Gave her a phone number.

The nurse patted her on the shoulder.

Angela didn't get a sandwich at DC General, but she got some crackers.

I got the start of my education in Munchausen's Syndrome and its cousin, Munchausen's Syndrome by Proxy (when the psychopath's children are abused and even killed). What I was to learn from inside the medical system about this mostly female version of psychopathology was not only fascinating, but frightening. These women know how to work the doctors within medical institutions. The physicians who should have known about Munchausen's (in both of its forms) seemed to be clueless when it came knocking on their office door. The doctors often played right into these women's hands, oblivious to their manipulations, and even became unwitting accomplices to child abuse and homicide.