Dear Annie:

My adult son, "Nick," has been hospitalized more than a dozen times and treated in emergency rooms nearly 100 times over the past 18 years. He has shot himself, stabbed himself in the liver (both "accidental") and has had innumerable bouts of undiagnosed pain and illness.

Several years ago, Nick admitted that most of his accidents, surgeries and hospital visits had been unnecessary. He said he enjoyed being able to fool doctors. Several doctors suspected Nick was intentionally injuring himself.

Nick is now in the hospital with esophageal ulcers due to vomiting and coughing. I have seen this before and am sure it is self-inflicted.

If Nick knew I was attempting to contact his doctor, he would never speak to me again. I am so worried he will one day accidentally kill himself. What can I do?

－A Brokenhearted Mother

Dear Mother:

It sounds as if Nick suffers from Munchausen syndrome, a type of mental illness in which a person deliberately creates or exaggerates physical symptoms in order to get sympathy and attention. It is extremely difficult to treat, and you are right to be concerned. Yes, you should talk to his doctor. Nick needs to see a psychotherapist, and the entire family might benefit from counseling to learn how best to deal with this.