Stuff You Should Know - SYSK Selects: How Munchausen Syndrome Works

Episode Date: January 5, 2019

Why would someone fake an illness? Here's an even better question: Why would someone repeatedly make themselves sick? Join Josh and Chuck as they separate the facts from fiction and give you the scoop on Munchausen syndrome. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

Hey everybody, when you're staying at an Airbnb, you might be like me wondering, could my place be an Airbnb? And if it could, what could it earn? So I was pretty surprised to hear about Lauren in Nova Scotia who realized she could Airbnb her cozy backyard treehouse and the extra income helps cover her bills and pays for her travel. So yeah, you might not realize it, but you might have an Airbnb too. Find out what your place could be earning at airbnb.ca. On the podcast, HeyDude the 90s called, David Lasher and Christine Taylor, stars of the

cult classic show, HeyDude, bring you back to the days of slip dresses and choker necklaces. We're going to use HeyDude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. Listen to HeyDude the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Howdy everybody. It's February 1, 2011.

No it's not. It's modern times, but this is a throwback to February 1, 2011 when Josh and I released our episode on Monkhausen Syndrome. Very very fascinating when here everyone. Really really interesting condition and very sad as well, but you should be delighted to learn all about Monkhausen Syndrome today. So I hope you enjoy it. It's a pretty interesting one, and that's why I picked it.

Welcome to Stuff You Should Know from HowStuffWorks.com. Hey and welcome to the podcast. I'm Josh Clark with me as always is Charles W. Chuck Bryant. What makes this stuff you should know, the podcast, that you didn't know? How's it going? It's going great. Your nails are still shiny. I got my first manicure last week, and I went for the clear coat.

And the undercoat. I didn't know this about Chuck, no it's an overcoat. Yeah, it's an overcoat. I didn't know this about Chuck, but he bites his nails. So he has very shiny, well-trimmed, half-nail stubs. Yeah, little bleedy cuticles. It's like you have some sort of like keratin deficiency or something. Let's go with that.

But it's very shiny. So like the keratin you do have is radioactive. Yes. Or I could fake like I have a keratin deficiency. Speaking of faking Chuck, that's just amazing that you said that word. Because we're going to talk about a syndrome wherein people, perfectly healthy people, at least who start out healthy, fake their own illness. Bear with me.

Yeah? Yeah. Okay. Have you seen the movie The Sixth Sense? Yeah. Have you seen the television show The OC? No. You've never seen The OC?

No. I used to be hooked on that show. Really? Oh yeah. Is that why you got rid of TV? One of the reasons? I can't. It's ruining my life.

Right. I can't remember the girl's name in The OC, but she plays the girl in The Sixth Sense who dies and who shows up to Haley Joel Osment's character. Is it Misha Barton? Yes, yes. Really? She was the little girl in that? Yes, she was.

She had a vomit and remember she was like hanging outside of his tent and just scaring the tar out of him? Out of me too. Well yeah, but she turned out to be okay. She's just a little upset that her mom was feeding her pine saw, right? And she eventually dies. She had videotaped herself. I hope everyone's seen The Sixth Sense.

If you haven't, I'm actually not really spoiling it. That's not the big daddy. I could spoil it way worse than this, but she videotapes her mother poisoning her soup with pine saw and her mom is outed for having what's called Munchausen's Biproxy and that's a derivative of what's called Munchausen's Syndrome, right? Munchausen. That's another way to put it. Yeah, they also call it FII, have you heard of that?

Fectitious. Close. Fabricated or induced illness. Where's the other F? Or FII? FII, induced illness. Yeah. My brain didn't function correctly.

But yeah, you were going to say facetious disorder, which is what it is. Facetious. Oh, is it factitious? Yeah. Oh, I feel like a dummy now. I was like, yeah, it is pretty facetious. I remember when I came across the word facetious, I used it in my everyday vocabulary or tried to, but I was reading it in books here or there and never put the two together.

So finally, I'm like, what is that word? And I sounded it out in a facetious, facetious, facetious. I was like, oh, that's facetious. Oh, yeah. No, facetious. Is that what you were thinking? No. Oh, okay.

It's like facet, like the facet of a diamond, I O U S. And this is fastidious. I've been reading this wrong. Okay. No, this is factitious. Factitious. I'm a dummy. Jerry's in there shaking her head.

Should we keep this in? Yeah, I think so. Okay. All right, let's do this. Okay. So this is like Munchausen or as you say at Munchausen syndrome is a really mysterious disorder. People imagine it's extremely rare, but we have no idea how prevalent it is because

one of the hallmark characteristics of Munchausen syndrome is that is dishonesty. Yeah. Right? Like you didn't want to admit you have it. That's the whole point. No. And to define it, it's where somebody who is not ill either fakes an illness or makes himself intentionally ill in order to be able to go seek medical care and or sympathy

and empathy from friends, neighbors, relatives for, you know, having an illness inflicted upon them. Yeah. It's like Fight Club. Remember? Yeah, the tourists. Uh-huh. Ed Norton and Helena Bonham Carter visit support groups for illnesses to get, you know, get

attention and feel a part of a club, I guess. Right. Exactly. And that's actually, there's a new thing called Munchausen by Internet. Yeah, that's a big one. And that's like a new deal where you'd go online to online support groups and feign being sick just to feel like you're fitting in, I guess. Right.

And it is sad. It is sad, but as we'll figure out, Munchausen by Internet is actually kind of a, it provides somewhat less harmful sucker to people who need that, right? So you're still feeding this pathological illness. It's not as dangerous. Mental illness. Sure, I get it. But mentally, it's just as dangerous.

Physically, it's not. Right. So what you want, what you crave, what you need, which is that attention, that sympathy, but you're not having to like inject gasoline to get it. And you're not going to the doctors and you're not running up insurance premiums that shouldn't be there and all that bad stuff that happens with the real Munchausen. Well, let's talk about the history of this. Well, 1951, I think, was when it was first described by Richard Asher in The Lancet.

Right. That's when it first got its name. Oh, okay. I read somewhere that there's like biblical accounts of people like basically doing harm to themselves to get attention. Really? Yeah. Well, I don't want to say it makes sense, but it makes sense that it goes back that long

because what better way if you're very lonely than to get people to feel sorry for you than to like jump in a wheelchair all of a sudden or something? Right. A prehistoric wheelchair. Exactly. Or at least a, yeah. So he named it in The Lancet and he named it after, of course, Baron von Munchausen, who was the 18th century German military man who apparently went off to fight the Russians.

The Turks. The Turks and came back with all these fanciful stories that people thought were largely probably made up to get attention. Right. And there's this Munchausen Appreciation Society who like actually like the guy and like the tales and they've only, they've been able to pin three tales to the actual Baron Munchausen. Oh really? But they, there's whole books of what he supposedly, these tales he's supposedly told.

And then Terry Gilliam got ahold of them. Well, yeah, of course we'll be remiss without saying that former Monty Python alum made that great movie. Did you see it? Yeah, The Adventures of Baron Munchausen. I've not seen it. It was good. It seemed good.

I think it was Uma Thurman's first role, if I'm not mistaken. Was she in it? Yeah. That's very neat. Very young Uma. From The Adventures of Baron Munchausen to Super Mom. My super ex-girlfriend. Yeah.

What was the one where she's a mom though that came out even more recently? I don't know. She's, she's been in a bit of a tailspin lately. We like Uma though. Uma and Oprah. That's a classic bit. We should probably get back to the serious timber. Yes, we should point out that it is not hypochondria because hypochondriacs actually believe that

they're sick. And people with Munchausen Disorder, they know they're not sick. They're trying to pretend that they're sick. Right. There's another, I don't know if you call it a disorder, there's another state of mind that someone can be in called malingering. And that's where you pretend to be sick, either for financial gain or to get out of work, like maybe from arrested development when she had that alter ego who was wheelchair bound

and like raised a bunch of contributions for her. I think everyone's malingered at one point or another if it's to get out of work. Right. I guess even just sending an email like, yeah, that's malingering. Yeah. In fact, the next time I do that, I'm going to just put in the subject line malingering and see if anyone even notices what that means. That's way worse than, or it sounds way worse than playing hooky.

Yeah. You know, malingering. Sounds like you're defrauding somebody. So why would someone do this? Well, there's a lot of reasons. The underlying reason, the underlying part of the disorder is that it's psychological, they believe, right? Right.

It's a part of a personality disorder and there's a number of risk factors that people who have Munchausen syndrome tend to exhibit like they were, they either lost a parent while they were young or they were abandoned by a parent to another big one. They may have had some sort of prolonged childhood illness is one. They... Some are want to be doctors and nurses. Yes. Yes.

They can't maybe couldn't get a job in the medical profession or never wanted to try hard enough because it's kind of hard to do that. Sure. It's easier to just hurt yourself. Fake it before you make it. And then you've got sexual, physical, emotional abuse. And this provides some sort of outlet, it's a really, I guess really the easiest way to understand it is these people who need to be, who need attention, who need to be taken

care of, who just need more than they're willing to ask for overtly have found an easy street between where they are and where they need to be as far as attention goes. Well it's interesting you say that because they do point out passive aggressive personality and a lot of these people if you could just teach them if you need more support and love then you should be able to ask for that but this is like the ultimate and passive aggressive I think. Right, exactly. Exactly.

So when you're addressing Munchausen syndrome you would usually treat it like you would depression or anxiety and just kind of approach it from that route. And I imagine probably as well as using cognitive behavioral therapy where it's like no, no, don't do that anymore. Right. Don't eat that salt. Snap the rubber band on your wrist. Exactly.

Remind yourself. Wrist if you're lucky. What else are we talking about, Chuck? Oh, some more defining characteristics. Usually people who have Munchausen syndrome are young or middle aged although there is a record of a guy who is pretty much a Munchausen patient his whole life he became famous. Oh, yeah. Yeah.

Yeah, we're going to get to him right. That was a hit. Is that the cherry? No, yeah. Hey, everybody. When you're staying at an Airbnb you might be like me wondering could my place be an Airbnb? And if it could what could it earn?

So I was pretty surprised to hear about Lauren in Nova Scotia who realized she could Airbnb her cozy backyard treehouse and the extra income helps cover her bills and pays for her travel. So yeah, you might not realize it, but you might have an Airbnb too. Find out what your place could be earning at airbnb.ca slash host. On the podcast, HeyDude the 90s called David Lasher and Christine Taylor, stars of the cult classic show HeyDude, bring you back to the days of slip dresses and choker necklaces. We're going to use HeyDude as our jumping off point, but we are going to unpack and

dive back into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal?

No, it was hair. Do you remember AOL instant messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to HeyDude the 90s called on the iHeart radio app, Apple podcasts, or wherever you get your podcasts.

And then so what do they do? I mean, how do you feign illness? Well, this is where it gets really interesting because it goes anywhere from just lying, but it's not just a lie. It's usually very specific. They say that any symptom that can't be proven medically is what they'll usually use. And they always say it's very, very specific, like textbook symptom that they clearly read from a book.

So they said, hey, if I say that I'm this, this and this, then I can get this attention. But the problem is if these doctors use these same physician desk references, so they go look up this, this, and this, and they go, oh, well, it's probably this. So I'm going to treat it with nitroglycerin. The problem is if you're faking these three symptoms and the nitroglycerin doesn't have any effect, that you raise some red flags for your physician or nurse. That's a big problem with Munchausen syndrome is that eventually people are going to start to get suspicious.

Right. Right. And you're lying too. So it's not like you can just hide behind your conviction. You're hiding behind a lie, which I think is much more stressful. Well, they'll go even further. I mean, that's just the basic lies told. People will also physically inflict harm upon themselves.

Everything from, well, this isn't really harm on yourself, but like heating up your thermometer. Right. Tampering with stuff. Like Henry and E.T. Yeah. He clearly had Munchausen syndrome. Well, he's trying to get out of school though, so he was really malingering to stay with E.T.

Yeah. But that is something that they will do. Injecting yourself with toxins, tainting your urine samples. Which you could use anything for that. I mean, even like a little salt in your urine will change things. Blood, if you put a little blood in your urine or your stool. Taking medications you shouldn't be taking. Yeah.

Or just poisoning yourself in any way, shape, or form. But apparently injecting is fairly common. And then you said also when you were talking about feigning illness and choosing specific symptoms, they may also take a different route and choose very broad symptoms like chest pain or like nausea or something like that. It could be anything. Yeah. That'll just tie a doctor up for hours if not days.

Which is what they want is more and more attention. Right. It's like, oh, you're going to have to come in tomorrow too. They're probably like sweet. Right. One of the reasons that tying a doctor up is just great is because within those hours this doctor's going to get more and more baffled and order more and more tests. Right.

And one of the, if the doctor's paying attention, he or she would notice that the Munchausen patient is more than happy to do this next test. Like sure, stick that there. Right. Or maybe even suggest it like shouldn't you do this test and stick that there. Those are two characteristics or two symptoms of Munchausen syndrome is that you are very willing if not eager to undergo any and every test that they want to do. Whereas most people are probably, you know, they're like, do you have to do that?

Yeah. Like are you sure is there another thing to do? Right. Right. And then extensive knowledge about tests and procedures and symptoms and the inner workings of a hospital. Those two things should be big red flags if you are a physician and you suspect, you know, you're having kind of trouble dealing with somebody's symptoms.

But not because you're dumb because you're trying everything. Well, yeah. And inconsistency is one thing to look for in your medical history. If they say, well, you're in here for high blood pressure, you were in here last year for low blood pressure. Right. So that's a little weird. Yeah.

Because I think, I would imagine if you're getting what you need and especially if it's like a standard kind of pathological behavior where it builds up and up, like remember when we talked about kleptomania? Yeah. Yeah. Like the urge just builds up and builds up until it becomes irresistible and afterwards there's just catharsis and then the guilt or whatever. I didn't see it anywhere, but if Munchausen syndrome is like that, one would imagine that

you kind of lose touch with your previous lies. Yeah. I would imagine that. And you're not looking at it as a big picture thing like, I'm going to do this for the rest of my life, it's very like, let's do it now and get this done and get this over with. And maybe if they actually sat down and saw their medical history sheet, they'd say, ooh, I need to take this in a different direction. I read an account of a guy who feigned bereavement.

It was called Fectitious Bereavement and he showed up at the hospital and was committed for like four weeks because he was grieving over the car accident death of his wife seven weeks earlier and the heart attack death of his mother three weeks earlier. And then he was interviewed, he was giving a family history and three of his 14 siblings had died young from things like throat cancer and some other accident and another thing. And they started asking this guy more and more questions and he wouldn't produce like a photo of his wife and he wouldn't let anybody talk to his family and they started to get kind of suspicious.

So he finally contacted, found out who his family was, contacted his mother who was alive. His 11 siblings were all doing well. He didn't have 14 and three hadn't died and he was never married. And when they confronted him with this stuff, he just continued to lie and lie and lie. So there's a pathological bent, pathological lying aspect to Munchausen's. Which is called Pseudological Fantastica. While you brought up an important point, not letting family be involved, that's a big tell too.

They say, you know, you should probably bring your husband in and like, oh no, no, no, no. We don't need to involve him. Right. Or he's dead. Yeah, exactly. Yeah. You don't want to talk to him. He's dead.

It's not funny at all. So that's Munchausen's syndrome. There's a high risk of suicide with Munchausen. Probably accidental suicide, I mean, people that go too far by accident or they just come to the end of the road. I hadn't thought about that. I heard coming to the end of the road is terrible. I don't know.

I don't mean it like that. 30 to 70% is what I saw. But I don't know. Maybe it would be accidental suicide. Interesting. I don't even know if there is such a thing. But there's also all sorts of other myriad problems that arise from Munchausen's syndrome. Right.

Like real illness. Like if you're a Munchausen sufferer, happily, you can eventually make yourself like genuinely ill. Yeah. From injecting toxins and stuff. I read another account of a guy who had suffered a number of amputations. Medical amputations. He was missing like pieces of his fingers.

He would have body parts removed. He would have his toes, he forced the doctors to do it. He would cut himself. He kept a little knife and a little bag of liquid feces on him at all times because this thing was to cut and then smear poop on the cut to make sure it got infected. Cut it faster, go seek medical attention, it was far too late, and have his limbs amputated, have his extremities amputated. But apparently the cut and smear is not, he's not the only one doing that.

The cut and smear? That's what I've dubbed it. I was about to say if it has a name. No, I just made up that name. Okay. Well, that's what I'd call it. Cut and smear. Well, clearly one of the biggest problems too is not just the harm you're doing yourself,

but you're tying up doctor's time, you're spending money. If not your money, maybe it's Medicare or whatever insurance carrier you have, it's very wasteful and it's taking up time doctors have to treat real patients when you need to be treated by a mental health professional is what you need. And a lot of these guys too when you're talking about tying up physicians time, they'll go at times when there's different staff, lesser staff, so like weekend nights, holidays, that kind of thing. So when they tie up, because they'll be different people who haven't met them before and aren't

familiar with them. So when they're tying up people's time, they're really tying up their time, you know? No good. So that's traditional Monkhausen, which is bad. But it gets worse. Yeah. Monkhausen by proxy. Right.

20 years after the guy, Richard Asher, Dr. Richard Asher coined the term Munchausen syndrome. Another guy named Roy Meadows coined the term Munchausen syndrome by proxy. And that one is not as recognized, readily recognized as real as Munchausen syndrome. Oh really? Yeah. Did you run into that? Recognize is, what do you mean? Well, I...

Proven? Yeah. Yeah. Scientifically proven. I think the way that I'm seeing it is it's viewed by some as more like, remember the satanic worshipper hysteria of the 80s? It kind of falls in the line with that. Although this is much more established than that is, like the AMA recognizes it, the American

Psychological Association recognizes it. But it's still, it's easily... It's a lot more easily misconstrued than Munchausen syndrome is. Gotcha. It's another person who's being harmed. Yeah. And because they're usually children, right? Well, yeah, this is the deal.

It's usually children, but not always. It's basically you're a caregiver to somebody and you are maybe poisoning them. You maybe are smothering them so they develop breathing problems. There's all sorts of awful, abusive things that you can do to bring your child in. And that's when, I mean, you talk about getting sympathy is when you run into a hospital with your baby saying, my baby is sick. My baby is sick. Or even worse, a dead baby.

Yeah. And that happens sadly all the time. Well, the first two cases that the guy, Roy Meadows, Dr. Roy Meadows, described were... One of them was a dead kid, little 14-month-old Charles, whose mom had been feeding him salt and kept bringing him back to the hospital and doctors had no idea what was going on. And eventually he died. The other one was a little girl, right? Yeah.

Her name was Kay. And she was six and she was admitted 12 times for a urinary tract infection, treated with all kinds of antibiotics and none of them ever worked. And that's obviously the doctors were like, something's going on here. Yeah. Or at least Roy Meadows was. Well, he wrote a study about both of these cases, called it Munchausen Biproxy, and just basically changed everything.

Yeah. And then he took this fairly obscure disease and turned it into this huge, almost hysterical entity. Yeah. One of the problems is, if you are suspected of this, at least in the States, and I think the UK is big on it too, but if you're suspected of this, all a physician has to do is say, you know, call family and children's services or whatever you call it in your county or state, and say, I think I have a Munchausen case here.

Social worker comes, takes your kid and then you go through the hoops to prove that you don't have it. Right. The burden of proof is on the parent who's been accused. Yeah. This is a tricky one. Very. Because we'll talk about this doctor.

Well, we could talk about him right now. Southall? Yeah. Southall and a very controversial guy who conducted some hidden video experiments, surveillance in the 90s, and in hospitals. So what he would do was, he would videotape these parents inflicting harm on their kids for cases that they suspected it was Munchausen. And in the end, he got 33 of these 39 suspected abusers were prosecuted, 23 were diagnosed

with FII, and you think, well, that's awesome, but it's also like you're videotaping someone doing harm to a kid, it was very, very controversial, and this guy has been removed and put back on the list, the GMC General Medical Council, which means you can practice medicine in England. He's been on and off of this thing for years, and I think just this year, he was finally reinstated again. Right. They finally said we're not going to go after this guy anymore. Yeah.

That was the big documentary. Well, he accused these parents publicly of killing their two sons based on a TV documentary he saw. Yeah. Well, the woman was already convicted of killing the sons, and then he was watching the documentary and said, you know, I think the husband, Stephen, was the guy. And then that was that, like a huge inquisition was launched, and like this guy's life was turned up on, you know, upside down, and there were a lot of accusations like that.

I get the feeling from this guy that he was one of those, if you look for it, you're going to find it kind of guys. Right. Think about the prevalence in one hospital that he was able to document, 30, 33? 39 total that he was spying on. Yeah. 33 were prosecuted. He was able to document 33 cases of Munchausen by proxy.

I mean, like that means the prevalence is like probably more than half of the global population suffers from Munchausen by proxy in that case, like if that's the case. You know what I mean? Well, I thought these were special cases he was surveilling now. I don't know. I don't think it was just random. Okay. Well, that would definitely change the ratio.

But still. And thanks for that, but I don't even know what I meant by that. Hey friends, when you're staying at an Airbnb, you might be like me wondering, could my place be an Airbnb? And if it could, what could it earn? So I was pretty surprised to hear about Lisa in Manitoba, who got the idea to Airbnb the backyard guest house over childhood home. Now the extra income helps pay her mortgage.

So yeah, you might not realize it, but you might have an Airbnb too. Find out what your place could be earning at airbnb.ca slash host. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it. And now we're calling on all of our friends to come back and relive it.

It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Is that a cereal? No, it was hair. Do you remember AOL instant messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. There are people also out there who question if Munchaus and Biproxy does exist. Oh, really?

Yeah. There's a lot of accusations that fly at parents of autistic kids. There's a sub-term that's been coined called Asperger's Biproxy. Really? Yeah. And there's a lot of autistic parents who are like, oh yeah, is that what you think? Oh, sir, not saying my kid is sick, like ill with physically ill, but my child has Asperger's? Yeah.

And the physicians are like, no, your kid doesn't. It's you. You're doing this to him. You're suddenly delaying your kid for attention or whatever. Right. Again, if it does exist, clearly the kid needs protection from the parent. This is the parent almost every time he's doing it. I think 98% of the time it's the mom.

But you're also running the risk of taking a kid away from perfectly normal parents. Right. Right? And apparently the other big bone of contention is the people who make this diagnosis almost every time is a pediatrician, not a psychiatrist or a psychologist. All a pediatrician has to do is pick up the phone and say, I think I got a munchausen case here. Get over here.

Right. Get this kid. Wow. Yeah. Well, it's important you said it's 98% of the time it's by the mother and that's what is going on most times. The cases are all sort of the same and there's a woman who's the generally responsible for the stay at home parenting.

Maybe the husband is not very involved in giving them enough attention and one way to stop that in its tracks is to make your baby sick. Yeah. That's what happened with this one lady, Mary Beth Tenning. Between 72 and 85, all nine of her children died and she was very distraught and got lots and lots of sympathy, was arrested in 86 and it turns out that she had smothered her children with a pillow. And they asked the husband and he said, quote, you have to trust your wife, she has her things

to do and as long as she gets them done, you don't ask questions. So that's kind of the typical case of this uninvolved husband, clearly uninvolved husband. That's beyond uninvolved. That's like apathetic. Yeah. Exactly. Almost. That's allegedly apathetic.

Allegedly. And she was convicted for real in 87 and sentenced to 20 years and that's one of the saddest cases I've ever heard. There's another one, Juanita Hoyt, you know, SIDS, Sudden Infant Death Syndrome, still is a medical mystery. But there was a time when they thought that it ran in families and they were hot on the trail of explaining SIDS as like a genetic disorder and it was based on a woman named Juanita Hoyt who had six children die between 1965 and 1971 and her primary physician wrote

a study that kind of made a name for himself as a career as an expert on SIDS based on this woman's experience. And in the 90s, I guess a local prosecutor heard about this story and was suspicious and started digging around and it turned out that this lady had killed her kids, all six of them. That's awful. But not only had killed her kids, had also derailed the investigation of SIDS, also raised a lot of questions of what does it count for SIDS?

Is there such thing as SIDS? Is it all cases of mothers killing their children? There's a lot of questions about what percentage of mysterious infant deaths are related to foul play. Well, and that's just a prime example of all the ramifications that Monkhausen has. Not just on your child, but like diverting the path of medical research. And not only that though, Chuck, again, we keep coming back to, imagine being a parent who lost your kid.

You have no idea how, right? And now other people are accusing you of killing your kid. Okay, so Chuck, if the idea that Monkhausen by proxy does exist, as I said, is endorsed by the AMA and the APA, what are some of the symptoms of it? By proxy? Yeah. One of the things is that the symptoms don't match the test results. One thing is sometimes a caregiver is actually a nurse or works in the healthcare industry.

They could be siblings, the child might have died under weird circumstances. Yeah. It's kind of the same as the adult things. There's a mysterious unexplained symptoms that aren't going away, bizarre medical history. All these things are red flags. And there's also, it's prevalent in healthcare workers. Remember with Monkhausen syndrome, you wanted to be a healthcare worker? Yeah.

In Monkhausen by proxy, you may be a healthcare worker. Yeah. I said that. Oh, you did? Yeah. Okay. Well, you said you know the angels of death? Uh-huh.

That's a type of Monkhausen by proxy. Oh, really? Yeah. Oh, yeah. I guess so. Yeah. People who kill the elderly. There's a doctor.

I think the United Kingdom's most prolific serial killer was a physician who just dispatched his patients. He was treating them, but really killing them. And he killed a lot of people. Wow. Speaking of a lot of things, we can't close without talking about William, how do you pronounce that, Michael Hoy? Yeah.

He is in the Guinness Book of World Records actually because he had 400 operations in 100 different hospitals to the tune of $4 million because it's Britain, it's all subsidized healthcare. Right. So that's a lot of dough going to this one guy. And he didn't have any of these things. He was a Monkhauser. Can I say that?

I think you can. It's not funny because he eventually died. Well, actually he just died in a retirement home, so it doesn't really say that he might have died from any of his treatments. Yeah, I wonder though. Yeah. Was he a Monkhauser cut in smear, cut in smear in Monkhauser? 400 operations.

He was cutting in smear in something. I've got one for you. Let's hear it. Do you remember when we talked about Monkhausen by Internet? Yeah. So there was like this, the first description came in the 90s. Obviously you can't have Monkhausen by Internet before the Internet was around. You'd be very far ahead of your time.

But very, very quickly, right off the bat, there was a huge, well it was first term by the New York Times as a hoax. There was a little 19-year-old spunky, very positive 19-year-old named Casey Swenson who lived in Kansas, and she kept what the New York Times referred to in 2001 as a weblog, right? Yeah. Of her battle with leukemia, which she lost in May 2001. And she had this huge following of people who really genuinely cared and were supportive

of her and were pulling for her and let her know. And then in May 2001, they went to the weblog and found news that Casey had died. And I don't know who exactly got suspicious, but people started looking at Casey's mother, who actually turned out to be Casey. There was no Casey ever. This woman just created this whole fictitious character that had leukemia and who died and received like cards and presents and flowers and condolences for a kid that never existed. You know, if I was going to fake something on the Internet, I would fake that I'm awesome.

Like I would make... What do you think we're doing right now? Well, exactly. I would be like the Walter Minnie style. I would just make up these awesome stories about myself. Yeah. But I mean, this is a real mental disorder. It's not...

I'm not making life that same. Well, you guys should just choose to be awesome instead of sick. Yeah, no. I'm not saying that. No. I don't think that... I sincerely hope no one took it like that. No.

You'd be surprised with these emails. And then lastly, I ran across a case of a double munchausen case. Munchausen and munchausen by proxy in the same mother-daughter duo. The mother used to inject her daughter with their daughter's knowledge with bacteria and had been doing it for so long. The daughter had both kidneys removed and was on full dialysis. So she was in on it too, basically? Yeah.

The mother had munchausen by proxy. And she just had munchausen. And the daughter was both a munchausen... By proxy victim. And a munchausen. A munchausen, yes. All right. So before you send in emails about the X-Files and ER and M&M...

I'm sorry, mama. Yeah, I'll treat them... Here, do your M&M. I'm sorry, mama. That's all I'm doing. M&M had a lyric that said, going through public housing systems, victim of munchausen syndrome, my whole life I was made to believe I was sick when I wasn't. And it was on the X-Files.

They investigated munchausen by proxy. Yeah, I don't remember that one, do you? Yeah, I don't remember that either. I was always into the real plot line arc of the whole series was okay with the smoking man and all that and the, you know, Mulder sister. I liked how they mixed it up, though. But I liked the just stand alone, like there's a shapeshifter in the forest. Right, or Ponce de Leon's men are still living in Florida because they discovered the fountain

and they turned into little invisible weirdos. I didn't watch that show at the time, but the stand alone ones were like Scooby-Doo's. Hint, hint. But I didn't watch that show when it was on for real at all. And then when it went into reruns, Monday through Friday, I watched it the whole series, you know, in a year. So good. Yeah, I love those two.

Those movies were pretty good, too, yeah. That's it for this episode on the X-Files. If you want to learn more about it, type X-Files, was it X-Files, munchausen. Like munchausen. You want to spell it for me? Yeah, it's M-U-N-C-H-A-U-S-E-N. You want to do it again? M-U-N-C-H-A-U-S-E-N.

Munchausen, yes. And I should have done a bell at the first one. Oh, because I missed it. You can type that into the searchbar at HowStuffWorks.com to learn more about this mysterious and extremely fascinating disease. And until then, let's do some listener mail. Josh, this is maybe a weird listener mail to put at the end of this one. Are we doing it on this one?

This is a very, very special listener mail. Okay. And everyone should listen to this one because it's pretty, pretty cool. Are we going to put a drum roll in at all? I think we should at some point. Okay. Doug lives in North Idaho. Doug and I were riding back and forth last week about fishing, trout fishing.

Okay. I don't remember how it started, but it started. And I fish for trout here and there in North Georgia. It's sort of fun. I'm not like the hugest fisherman. And Doug is an avid, I think, fly fisherman. Okay. So we were just kind of chit-chatting and he said that he and his girlfriend, Kena, he

got her hooked on the show and he said, I know you'll never read this and Kena's just making fun of me right now. Right. And I said, you tell Kena to shut it. That's not very nice. And he wrote back and said, she's laughing that we're emailing and you said, shut it. And this is the best thing ever. And he said, but guys, her birthday is February 2nd and I got a plan that I want to hatch.

So right now, as you people are listening, I don't know about right this second, but over the next day on February 2nd, at some point, Doug is in his car, he's with Kena right now. How's it going, Kena? And she's probably going, what's going on here? This is weird. She's, she's laughing nervously. She's laughing nervously.

She's maybe like trying the door handle to see if it's locked. But Doug is actually the one who is nervous because Doug has something very important to say and that is, Kena, he would like you to be his wife. He's asking you to marry him right now. We sort of are, but we're not marrying you. It's actually Doug. And this is, uh, this is a first for us as a marriage proposal right here on the show. Somewhere in Idaho, Kena should hopefully have a ring on her finger at this point.

Don't you think? What do we do with the answers? No. Yeah. I guess we'll hear from Doug. Yeah. We won't break it to people though. I think we should go ahead on the premise that she says yes.

All right. So I mean, what else can we say? I can't believe we just said that. Yeah, Doug, the trout fisherman is marrying Kena and congratulations, Mazel Tov. Again. Right. Yeah. I mean, where do we go from here?

I don't know. It's like, we should probably just like fade out with us wondering. I guess so. Send us an email. Right? Yeah. Stuffpodcasthowstuffworks.com. Holy cow.

For more on this and thousands of other topics, visit howstuffworks.com. To learn more about the podcast, click on the podcast icon in the upper right corner of our homepage. The Howstuffworks iPhone app has arrived. Download it today on iTunes. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and

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