Wendy Scott

Wendy Scott (born 1948 in Wemyss, Scotland is considered one of the most notable cases of Munchausen syndrome on record, in part because of the severity of her condition and in part because she is a rare case of complete recovery from the syndrome, which many doctors consider untreatable.

A noted expert on cases of this type, Dr. Marc Feldman, a former vice chairman of the department of psychiatry at the University of Alabama at Birmingham, and coauthor of "", has referred to her as "the most extreme case I've ever heard of,", and has stated that "when it comes to number of hospitalizations and number of countries, I've never heard of someone even close... Considering all the surgery and complications she has had, it is remarkable that she survived." She was also described in a 2004 article by Robert Fulford of The National Post as holding the title of "Munchausen queen of the world".

But her survival and remarkable recovery from Munchausen syndrome made her a symbol of bravery in that she was one of the very few people willing to speak openly from first-hand knowledge about behavior that most patients are too ashamed even to admit. Few doctors have had the chance to talk to Munchausen patients about the condition, because they generally go into some sort of seclusion when they are found out. But Dr. Feldman said that among patients who seek treatment for the syndrome, psychotherapy can sometimes help, and Scott's willingness to discuss her condition may have helped others seek treatment.

Childhood and onset

Ms. Scott's childhood, like that of many Munchausen patients, was extremely difficult and lacking in healthy, nurturing experiences. According to statements she made, she was sexually abused, her mother was distant and unaffectionate, and she repeatedly ran away from home. One of her few pleasant experiences was having her appendix out, when she was about 16. "A nurse would come in the morning and plump up the pillows and say, 'How are you today, Wendy?' " Miss Scott recalled. "It was just little things like that, asking how was your pain, how was your night." This demonstration of kindness and concern appears to have had a profound impact on her, perhaps because it had been previously lacking in her life.

Soon after the appendicitis hospitalization, she left home and took various jobs over a period of several years. One of the occupations which made a strong impression on her was that of a hotel maid, in which she said she resented "cleaning up everybody else's muck and being expected to act cheerful 24 hours a day." This again led to feelings of neglect and isolation.

At one point in the course of this employment, she went to a nearby hospital with complaints of a stomach ache, and spent several days there being tended to. The care and attention she received "recharged my batteries," she said.

Over the next year or so, she tried this a few more times, at different hospitals. Getting similar results and compfort, she soon began hitchhiking from town to town, trying to get into the hospital. Ultimately, Scott, by her own count, became a patient at more than 600 hospitals, sometimes being released from one in the morning and getting herself admitted to another in the evening. Her descriptions of agonizing stomach problems were so convincing that many doctors resorted to surgery to help her - over 40 in all, but nearly all of them unnecessary. She did not want surgery, but stated that she went along with it because it meant that she would be allowed to spend more time in the hospital.

Discovery and reactions

But she found that the people who had treated her so kindly could turn against her when learned more about her motivations. One surgeon stormed up to her bed, scolded her in front of the rest of the ward and ordered her to get out. At a few hospitals, employees snapped her picture to warn others about her.

She often ran away whenever she was caught. A few times she fled with stitches still in place, and removed them herself later. Twice, she was jailed, charged with stealing lodging and food by checking into the hospital needlessly.

Looking back, she said, she knew that what she was doing was wrong, and might have asked for psychiatric help, "if somebody had said, 'I know what you're doing but I don't know why.' " But, she said, "It was always approached in a confrontational way. The barriers go up." Thus, she could not make herself stop and was not close to anyone during those years who could reinforce her belief that she was behaving in an inappropriate manner. "I didn't have friends," she said. "I didn't want anybody. If I had friends, they might find out what I was doing."

Recovery and role as an advocate

After 12 years, two things finally helped her recover. The first was an operation that went wrong, and left her ill and suffering from severe infections and complications that took her months to recover from. "I realized that if I kept doing this, I might die," she said. The second step in her recovery was a kitten, left to her by someone in a shelter she was living in. She realized that if she went into the hospital, no one would take care of it.

in late 1996, she contacted Dr. Feldman, who has a Web site about Munchausen syndrome, and offered to participate in any studies he might be conducting. But Dr. Feldman thought she might be able to help other patients, and he put her in touch with them by e-mail. "A number said she made a decisive difference," he said. "Not so much what she said, but that nobody's case is as severe as hers and yet she recovered."

Death

Her history made it difficult for her to get doctors there to take her seriously when she truly became ill in 1999. Although she had suffered abdominal pain and other symptoms for a year and a half, few tests were ordered and no diagnosis was made in London. On a visit to the United States that summer, she called Dr. Feldman, who urged her to come to Birmingham, where doctors discovered a large mass in her intestine that turned out to be intestinal cancer in the form of an inoperable malignant tumor. She continued to deteriorate until her death on October 14, 1999 at the Trinity Hospice in Clapham, London.

References

* [http://query.nytimes.com/gst/fullpage.html?res=9F02EED8113FF933A15754C0A96F958260 "A Great Pretender Now Faces the Truth of Illness", New York Times, July 20, 1999]
* [http://news.bbc.co.uk/1/hi/health/485320.stm "Woman who 'cried wolf' dies of cancer", BBC News, October 25, 1999]
* [http://www.munchausen.com/ Dr. Marc Feldman's Munchausen Syndrome, Malingering, Factitious Disorder, & Munchausen by Proxy Page]

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