Munchausen by Internet Breeds a Generation of Fakers

"Some of them had such bad migraines they had to be on Social Security disability," says Hamilton. "Others had them from head traumas from accidents. Many had been on drugs for years with no relief."

After their encounter with the fake poster, the group never recovered. It split into factions of believers and doubters, its spirit of trust and caring broken.

An even more bizarre case involved the 1997 duping of a Web-based fan club for the musical Rent. Many of the members had met while waiting on line for tickets in New York, and for them the club became a support network. Catherine Skidmore, a 26-year-old technology consultant in New York, was one of those taken in a student claiming to suffer from a fatal liver and nerve disease.

"She showed up once with an IV shunt taped in her arm," Skidmore recalled. "And she'd go to the cast members and try to get sympathy." In this way, the woman was able to meet and have dinner with Rent stars Anthony Rapp and Gwen Stewart. When she returned to Chicago, the group started getting e-mail from a "friend" of the woman's. The messages were full of medical jargon and day-by-day accounts of the "sick" person's condition as she slipped into a coma. "I had lost a friend who didn't tell me she was dying," says Skidmore. "So I wrote to her and said I didn't want her to be alone."

Skidmore and others in the group prayed, sent messages, and bought tickets to fly to Chicago. But whenever they were about to leave, the friend, who refused to give the name of the hospital, would write that Rachel had miraculously recovered.

Eventually, these Lazarus-like revivals aroused suspicion. Group members uncovered the hoax by calling all the hospitals in Chicago. Rapp's boyfriend, Josh Safran, was one of the fraud detectors. "I can't believe the lengths she went to. Her e-mails were very medically proficient. And everybody's lives were so messed up. It was total drama." Although Safran was skeptical early on, he hesitated to mention his doubts. "If she turned out to be sick after this, we were horrible people."

The people who perpetrate these hoaxes don't usually consider the ways they're harming others. One former Munchausen patient, a 40-year-old computer technician on the West Coast, used to hurt herself and pretend she'd been the victim of an attack or accident. "I called them 'scenarios,'" she explains. "When I'd do something to attract the paramedics and police, I got an adrenaline rush. I believe I got addicted to it. At the time, it didn't occur to me I was hurting anyone but myself."

For those who do not want to be victimized by such folks, however sick they may or may not be, Dr. Feldman has developed a series of cues for online detection. Some warning signs are posts that copy textbook material or other online sites verbatim, and a series of dramatic declines followed by miraculous recoveries. Be suspicious when the person makes fantastic claims, he says, resists telephone contact, or complains that the group is not supportive enough. Be very suspicious if a "friend" or family member posts for the sick person—displaying the same writing style and spelling errors.

The treatment for the support-group fakers is psychotherapy. The treatment for their victims is...another support group. Victims of Factitious Liars already has 42 members who post regularly about their own victimization and brainstorm about how to get publicity and funding to treat Munchausen. Cohen and Grabb are hoping to make a documentary on the Munchausen phenomenon and have recently received a substantial contribution from an individual donor.

Paradoxically, one of the issues Cohen and Grabb must confront is that a member on their own site could be lying. "Look for inconsistencies in the story over time," Cohen advises her group. "If you become suspicious, e-mail me and let me know. For the most part, we have to take what people say at face value. But let's all be aware that we could get used and get emotionally attached to someone who is an online liar."

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