An Irish schoolteacher who came to a Jerusalem hospital convinced she was about to give birth to the Baby Jesus when in fact she was not even pregnant.
A Canadian tourist who believed he was the Biblical strongman Sampson and tried to tear stone blocks out of the Wailing Wall.
An Austrian man who flew into a rage in his hotel kitchen when staff refused to prepare the the Last Supper for him.
These are just a few examples of what has come to be known as the Jerusalem Syndrome: a well-documented phenomenon where foreign visitors suffer psychotic delusions that they are figures from the Bible or harbingers of the End of Days.
Israel’s health ministry records around 50 cases a year where a tourist’s delusions are so strong that police or mental health professionals are forced to intervene. Many more incidents go undocumented on the streets of Jerusalem’s Old City.
The city’s hospitals are expecting fresh cases as tourists flock to Jerusalem for the Easter weekend and doctors are preparing now-familiar routines of alerting foreign embassies that one their citizens believes he is John the Baptist or King Solomon.
Evidence of the Jerusalem Syndrome dates back to Medieval times and observers throughout the centuries have noted the air of madness that seems to hang over the city.
As J.E. Hanauer, a British traveller and Anglican vicar, wrote in around 1870: “It is an odd fact that many Americans who arrive at Jerusalem are either lunatics or lose their mind thereafter.”
Modern psychiatrists describe the sufferer’s delusions as highly theatrical and very public. They will often rip hotel bed sheets into makeshift togas, deliver impromptu sermons in front of holy sites and go wailing through the streets.
“Their appearance is very dramatic and they use Jerusalem as a stage and deliberately go there to play out their act – an act that they entirely believe to be true,” said Dr Moshe Kalian, the former district psychiatrist of Jerusalem and a leading authority on the syndrome.
Interestingly, the affliction has been recorded among Jews and Christians but not Muslims. A study from 1999 found that “Although Jerusalem is sacred to all three major monotheistic religions….no documentation regarding the syndrome among Muslims was found.”
The majority of those who are hospitalised suffered mental health problems in their own countries and came to Jerusalem deliberately on what they saw as a mission from God.
They are mostly harmless but occasionally sufferers become violent.
Dr Kalian describe a British man who interpreted the ash cloud thrown over Europe by the 2011 eruption of an Icelandic volcano as a sign that world was coming to an end.
Once the ash cloud cleared and air travel resumed he flew to Jerusalem and headed to the Church of the Holy Sepulchre, where Christians believe Jesus was crucified and buried.
In his own mind the plan was clear. He would enter the Church and be killed by Satan, triggering the beginning of the Armageddon. There was just one problem: by the time he arrived the Church’s heavy wooden doors were closed for the night.
The man, whose name was not released under medical confidentiality rules, then took a knife and charged at Israeli police. They shot him in the side and sent him to a psychiatric hospital and he was eventually returned to Britain without charges.
The most contentious point of debate among scholars of Jerusalem Syndrome is what one group of doctors has called Type III cases: people with no history of mental illness who become overwhelmed by the city’s religiosity and temporarily lose their minds.
“The third type of Jerusalem syndrome is perhaps the most fascinating,” wrote the psychiatrists from Kfar Shaul Mental Health Centre, the Jerusalem hospital where most sufferers are treated.
They record 42 cases of people who arrived in Jerusalem as regular tourists, suffered severe psychotic episodes while there, and then recovered completely after leaving the city. Of the 42 individuals, 40 were from what doctors described as “ultra-religious” Protestant families.
Among them was a Swiss lawyer who arrived in Jerusalem as part of a tour of the Mediterranean. He spent a perfectly happy week with friends in Greece before reaching Jerusalem, where he became obsessed with ritual purity and started wearing sheets as a gown and calling out verses from the Bible. Within days he recovered and went on with his group to Egypt, apparently never suffering any mental health problems again.
Dr Kalian and others are sceptical of this “pure” form of the syndrome and argue that the patients are more likely to have had some underlying psychiatric condition. “Jerusalem Syndrome should be regarded as an aggravation of a chronic mental illness and not a transient psychotic episode,” they wrote.
Comparable phenomena have been found in other cities. Stendhal Syndrome describes the breakdowns that art-lovers sometimes suffer in Florence when confronted by the grandeur of Renaissance frescoes.
Japanese tourists in Paris sometimes have manic episodes when they realise a city they have idealized as the most romantic place on earth contains all the rubbish, traffic and overcrowding of any other major urban area. Known as Paris Syndrome, the affliction is thought to be exacerbated by jet lag and the cultural and language barriers in the way of Japanese visitors.
Neither condition, however, is as severe or as frequently observed as Jerusalem Syndrome.
There is something about ancient Jerusalem, a disputed city that is so important to people of three faiths, that attracts – or perhaps even causes – a special kind of madness.