The article notes that:
McEwan made up a medical condition for the stalker and wrote a spoof article from a psychiatric journal explaining the illness and included it in the book.
His description of De Clerambault’s Syndrome fooled reviewers and psychiatrists alike.
In fact, De Clerambault’s Syndrome (where someone has the delusional belief that another person is in love with them) is well known in the medical literature and McEwan’s description is quite accurate.
Nevertheless, his book concludes with what looks like a reprint of an article from the British Review of Psychiatry that describes a case study which the book seems to be based upon.
Although also fiction (the British Review of Psychiatry doesn’t exist), its style is convincing and it’s properly referenced with studies from the real medical literature.
So convincing, in fact, that it fooled several reviewers, including those in top medical journals, into thinking the novel was based on a real case report.
A clue as to why McEwan was able to successfully imitate the medical literature is given in the acknowledgements. He thanks “Ray Dolan, friend and hiking companion, for many years of stimulating discussion”.
Dolan is a professor of neuropsychiatry at the Institute of Cognitive Neuroscience and the Functional Imaging Lab in London.
Interestingly, Dolan also played a key part in Saturday, another of McEwan’s books – which tackles a dramatic day in the life of a neurosurgeon.
As mentioned in an article in the British Medical Journal, McEwan shadowed neurosurgeon Neil Kitchen while researching the book. The article notes the pair were introduced by Dolan.