Intended for healthcare professionals

Views & Reviews Review of the Week

Gone to pie

BMJ 2009; 339 doi: (Published 29 September 2009) Cite this as: BMJ 2009;339:b3889
  1. John Quin, consultant physician, Royal Sussex County Hospital, Brighton
  1. John.Quin{at}

    Doctors are experts in self diagnosis. Does this mean that they may be hypochondriacs par excellence, wonders John Quin, who reviews a study of a select batch of high functioning whiners

    The French philosopher Gilles Deleuze suggested that great artists are a special kind of doctor looking for the hidden codes of their and our neurotic sicknesses. The renowned cultural critic Brian Dillon serves up here a select batch of these high functioning whiners. His magnificently tortured tragicomic nine are James Boswell, Charlotte Brontë, Charles Darwin, Florence Nightingale, the hyperdelusional German judge Daniel Paul Schreber (BMJ 2008;337:a614, doi:10.1136/bmj.a614), Marcel Proust, Glenn Gould, Andy Warhol, and Alice James, sister of Henry. The last of these memorably referred to her episodes of psychosomatic illness as “going to pie.”

    Dillon acknowledges that as a character type the hypochondriac is “pretty disreputable, a malingering drain on one’s capacity for patience and empathy, at worst a parasite on scarce health care resources.” However, he strikes a note of caution: “We behave . . . as if the boundary between sensible vigilance . . . and pathological preoccupation or fear were …

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