The book contains an appendix purporting to be a scientific paper ("A Homo-Erotic Obsession, with Religious Overtones: A Clinical Variant of de Clerambault's Syndrome") describing a case study identical to the one around which the narrative is based. The appendix is an invention of McEwan, with its authors – Wenn and Camia – being an anagram of his name. Although fictional, some reviewers took the document to be a factual case, with a review in The New York Times criticizing McEwan for having "simply stuck too close to the facts".[3]
McEwan later submitted the paper to the British Journal of Psychiatry under the name of the paper's fictional writers,[4] but it was not published. Speaking in 1999, McEwan said "I get four or five letters a week, usually from reading groups but sometimes from psychiatrists and scholars, asking if I wrote the appendix."[3]
