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BMJ. 2007 November 10; 335(7627): 997.
PMCID: PMC2072025
Between the Lines

Faking it

Theodore Dalrymple, writer and retired doctor

Sometimes I wake in a sweat having dreamt that my school exam papers have been marked again, and it has been determined that I failed. As a result, my entry to medical school was invalid and the rest of my subsequent career fraudulent. I shall have to begin my life all over again.

This is a common dream, of course, though I am not sure whether in my case it signifies general anxiety or is a manifestation of what the great political print artist James Gillray called “the horrors of digestion.” He who eats late at night must expect to fail his exams repeatedly.

One of the most remarkable books that I have read in recent years is The Adversary by Emmanuel Carrère. It recounts the life of Jean-Claude Romand, a medical student at Lyon who, having failed to turn up for his second year exams, lied to his parents that he had passed them.

He maintained the lie for the next 20 years, passing himself off after his equally fictitious qualification as a doctor working for the World Health Organization in Geneva. He lived with his wife, whom he managed to deceive just as he deceived everyone else, on the French side of the border, going off every day to “work,” that is, to say spending time in the public parts of the WHO building, or in cafes and parks, reading books and newspapers. Sometimes he would claim to have gone to conferences abroad, and would return with jet lag and appropriate presents for the children, but would have spent the time in local hotels. There he would read up on information about the country he was supposed to have visited.

He maintained his expensive lifestyle, commensurate with a WHO salary, by using the savings of his parents and others, acting as an intermediary for lucrative investments in Switzerland.

He kept the lies going for many years but when exposure became inevitable he killed his parents, his wife, and his two children, and then burnt his house down, having taken barbiturates, in an attempt at suicide. He was rescued, however, and survived.

The author manages the difficult trick of evoking compassion for “Dr” Romand, while not minimising his crime in any way. What drove Jean-Claude Romand to such a pass? I think it was the ordinary sin of pride, and because we all commit that sin very often we can enter imaginatively into his predicament.

Once when I was in Argentina a man who had been a famous neurologist was exposed as a fraud, as having no medical qualification whatsoever. He really did attend international conferences, where he would always begin his presentations on abstruse subjects with words to the effect that “You don't have to be a doctor to be a neurologist.” Everyone laughed: how he must have loved to hear scores or hundreds of properly qualified people made a fool of in this way!

After reading Carrère, my dream recurred several times, and for a short time I found myself in a panic anxiously asking, to quote a famous medical student and poet, “Do I wake or sleep?”

He would always begin his presentations on abstruse subjects with words to the effect that “You don't have to be a doctor to be a neurologist”


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