So this is a lot more than going to the doctor to complain about some vague pain just so that someone will listen to you long enough for you to transition into an anecdote about your cats. Karol was repeatedly tearing open her own backside. And when picking at her wounds was no longer sufficient, she began actively creating them.
"I started stealing needles from the hospital. I would inject infectious material into my body."
"Infectious materials" is the fancy book-learnin' name for shit. The kind that comes from a butt.
Like the Trainspotting toilet scene and drug scene combined.
"The process was basically something like this: Collect some shit in a little container. Mix with water to make it watery. Fill a syringe. Use a needle to inject into the area I wanted to cause an abscess in."
Eventually, Karol switched from feces to saliva. Not because injecting feces into your own body can damage your organs or even kill you (it can, and happily will!), but because it smelled bad. That was her sole objection. At this point, "faking it" becomes nebulous -- she was doing it for attention, but it was making her legitimately and incredibly sick.
We were as shocked as you to learn that cramming literal shit into your bloodstream might have ill effects.