A case is presented which demonstrates the lurid medical history, the dramatic but shifting symptoms, the wandering life in search of hospital admission, and the painful procedures typical of this syndrome. The thesis is presented that such patients have the psychology of the impostor—that is, the intense anxiety about feelings of inferiority and genital defects which is defended against by assuming another identity. But in these particular patients this psychology takes a masochistic form in which the feared inadequacies are felt to be genuinely present. Some evidence of additional reversal is presented in the patient's wish to be the physician. Because of the unreliability of these patients' histories, genetic data contributes little to this psychological formulation.