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Among the many bizarre and incredible conditions that can develop in human beings, factitious illnesses (of which Munchausen syndrome is the ultimate form) are unequaled. The very mind-set of a physician -- caring, trusting, and eager to help -- is diametrically opposed to that of the patient with a factitious illness -- deceiving, lying, and eagerly undergoing diagnostic and surgical procedures for no apparent reason. The mixture is as natural as oil and water.
Feldman and Ford help us to understand these disorders. There is a natural three-step progression among physicians faced with such a patient. First is the unparalleled
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