I think my wife is faking her “chronic illness,” and more advice from dear

Dear Prudence is Slate’s advice column. Submit questions here. (It’s anonymous!)

Dear Prudence,

My wife (“Laura”) and I have been together for 10 years and we’ve mostly had a good relationship until the past couple of years. Laura is a hypochondriac. In the beginning, it was really minor and barely noticeable—she insisted any cold she got was actually pneumonia or an upset stomach was appendicitis. As time went on, she became convinced she was suffering from an undiagnosed illness and after years of seeing doctors and getting tested, a doctor diagnosed her with a syndrome that mostly consists of a collection of symptoms with no other cause, no test to confirm the diagnosis, and no treatment except lifestyle and diet changes. I had hoped by getting a diagnosis her hypochondria would calm down.

It has not and I fear it is getting worse and turning into Munchausen syndrome. It was brought to my attention recently that Laura may have written into this column about an incident that happened a few weeks ago where she was vomiting and I wouldn’t take her to the hospital and prevented an ambulance from coming to get her. In the letter, she changed some identifying information—but the other details matched an incident that happened between us. My concern with the letter was her presentation of her diagnosis with medical terms derived from the CT scan and not the actual diagnosis the ER doc gave her, as well as leaving out key information, such as the questionable leftover chicken she had eaten earlier that day and the UTI she was diagnosed with earlier in the week and was supposed to be taking antibiotics for. She wrote that she was diagnosed with “acute colitis, cystitis, and a kidney infection”, however, except for alluding to her UTI moving into her kidneys, the doctor told her that she likely had food poisoning (acute colitis) and needed stronger antibiotics for her UTI because of the slight bladder and kidney inflammation (cystitis). He gave her new antibiotics for the UTI and when I went to throw away the old ones when we got home, I noticed that they were much fuller than they should be and asked her if she’d been taking them. She said that she may have missed a “couple of doses” but there were a lot of pills remaining.

I’m really scared that she is trying to make herself sick. If she did write the letter, then I am also scared that she is trying to get public validation and sympathy and that she may continue to escalate. I’ve alluded previously that this is all in her head and it did not go well so I hesitate to ask her outright but I need to do something. I don’t want her to hurt herself and I want her to get the help she needs. Should I try to talk to her therapist about my fears? I know he can’t break doctor-patient confidentiality but can family members tell them about their fears so they can do some probing? Should I mention my fears to her physician? Her family? Even before this incident, I knew some sort of intervention needed to happen as we have nearly $10,000 in medical debt from her various tests and medical visits. Her health is more important than the money, but if this is Munchausen and it can be fixed by therapy, then I’d prefer that than to keep adding to our debt.

—In Love With a Hypochondriac,

Dear In Love,

Well this complicates things… Sorry for telling her to leave you. I don’t know what a therapist or doctor will do with the information you provide, but it can’t hurt to share your concerns with them as well as a couple of trusted family members. I will add that, whether she made herself sick or not, she was actually sick and you should have helped her get to the hospital. If your suspicions are true, I hope she can get help but in the meantime, you should make it a priority to respond to her very real illness and suffering, despite your belief about its origins.

Dear Prudence,

My brother-in-law loves Hawaii and frequently talks to my husband and me about traveling there. While Hawaii sounds amazing, we dislike traveling with other people and have always deflected. Recently, my brother-in-law told me he wants to plan a week-long trip to Hawaii with just my husband as a Christmas gift and will be contacting me to ask about dates. I know this will not go over well with my husband but do not know how to reject the offer without hurting my brother-in-law’s feelings. Not only is that way too extravagant of a Christmas gift, but my husband gets easily annoyed by the brother-in-law and prefers to adventure alone. Why can’t he just buy my husband some socks for Christmas? Or get him the gift of space?

—Burnt Out

Dear Burnt Out,

This is his brother! Not a co-worker or neighbor. He should know better. But he doesn’t. Unfortunately, you have to ruin the surprise, tell your…