Despite contradictory opinions, Baron Munchausen was not a liar; he was a master storyteller. He fought the deadly ‘Austro-Russian-Turkish’ war in 1740 with courage, ingenuity and survived to tell the stories, at least that is what the legends claim.
Over time, his stories became more and more eloquent, popular; and at the same time delusional, bordering on to fantasy. He became popular among the visiting royal dignitaries, who would opt to have a dinner with the Baron to listen to his stories.
But it was only in 1785, when Librarian turned author, Rudolph Erich Raspe published a book called “Surprising adventures of Baron Munchausen” did the character of ‘Munchausen’ become popular and iconic. The name ‘Munchausen’ became synonymous with unbelievable but well-knit stories.
This patient was admitted to the cardiology department chest pain. He had a long history of heart disease, and he was just 45. He had two angiograms done in the past and was on a long list of medicines. The long suffering made him reel off the names of complicated cardiac medicines, with the ease of a school kid reciting a poem.
Despite all these treatment, he needed hospital admission every other week and was unable to go to work. His doctors have categorically told him that stenting or bypass surgery was not possible because of the advanced nature of his disease. To add to his woes, his old medical records went missing during a travel by train.
Located diagonally opposite the cardiology block, in theme and distance, sits the pediatric department; heavily populated by mouse and ducks, with first names of Mickey and Donald. The lady brought her 2-year-old son for admission with a problem of passing blood in urine intermittently.
The kid was shown to host of specialists, urologists, pediatricians, nephrologists, but no diagnosis. Surprisingly, she too had lost all the medical records of her son.
Don’t mistake me; Safekeeping of medical records is not the issue I am trying to highlight. We are talking of a rare disease called ‘Munchausen Syndrome’
‘Munchausen syndrome’ is a rare disease where a person exaggerates a non existent or a mild illness with a purpose to gain sympathy and continuing medical care, by creating long and interesting medical stories involving themselves or someone close to them, but making sure that they don’t get harmed by medical procedures.
In the first case a nurse who took a detailed note of the dates of his angiogram found that the first mentioned hospital did not have an angiogram facility at all, while the doctor who apparently did the second angiogram was now working in our own department, which the patient was unaware of. Finally, we found that he didn’t have heart disease at all.
In the case of the kid, on the day of the planned discharge the mother produced a stone, which she claimed to have been passed in urine by her son, turned out to be a granite chip on analysis. Munchausen syndrome patients do not fake illness for any bad intention or wrong motive; they just enjoy the hospital ambience. Medical literature today has scores of such care reports.
Hospitals are not a nice place to be, neither as a patient, nor as a staff, we too know that very well. The touch of a cold stethoscope on the chest, the painful poke of the needle on the arm or a cavernous scanner whirring around the head is scary to many and irritating to most; but enjoyable to the rare ‘Munchausen-ian’.
Medical researchers worldwide are worried that ‘Munchausen syndrome’ incidence is increasing; but on the flip side, more smiling and amicable Munchausens might mean less violence in Indian hospitals!!
(Dr. Tiny Nair, MD, DM, FACC, FRCP(E) is Head, Dept. of Cardiology, PRS Hospital, Kerala and he can be reached at email@example.com )
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