ABSTRACT
The physician validates their diagnostic abilities while obtaining a subtle, if vengeful, conclusion—branding the patient with the stigma of a diagnosis of malingering. Malingering can present in seemingly kaleidoscopic variations. A criminal may pretend to be ill to avoid standing for trial, or plead insanity in the act of the crime and malinger the corresponding symptoms in order to escape the death penalty. Once the diagnosis of malingering is established there often is the initial urge to dismiss the malingerer from one's care. Physicians are intrinsically trusting people and would rather have the patient undergo all sorts of extreme testing to make sure of the diagnosis of malingering rather than falsely accusing him or her. When physicians see patients malingering, they become angry and intentionally or inadvertently sabotage the relationship because they feel deceived. The doctor feels betrayed and angry at the patient who is trying to fool and manipulate them.
