I talked with a frustrated ER buddy of mine.
His frustration stemmed from patients lying to him.
Now please don’t take this the wrong way. The vast majority of my patients come in with honest problems an effuse more truth than I would ever want to know (oh, by the way doc, just though you should know I have a tattoo of Orko from He-Man around my anus. Yeah, the 80’s were a hell of a decade). But, every once in a while you get a feeling that a patient is not completely forthcoming with the truth.
I had a nice young woman come in complaining of abdominal pain. She was… um… sturdy. Sturdy and planetary in shape and mass. Let’s just nickname her Luna. Her significant other, lets call him Smilie McSunshinePants, closely accompanied her with his overbearing and odd behavior.
So Luna and Smilie come in, and she refuses to answer questions other than saying she has abdominal pain. Everything else I ask is answered “no.”
I specifically ask if there is any chance she could be pregnant? No, of course not.
So I push part of her acreage of abdomen and feel a large mass.
Hmm, how odd, I think to myself as the truth trickles into my mind.
So I let myself out of the room and come back to the room with the portable ultrasound machine.
The patient immediately stands up and announces she MUST go to the bathroom to blow her nose. I try to explain but she was a powerful force of womanly motivation and I had the same chance of stopping her as a mosquito against a rhino, so I let her go to the bathroom. Smilie subsequently left the room as well.
I later ambushed her and she confessed she was just over 9 months pregnant and her water broke. However, Smilie was not around when she got pregnant so she did not want him to find out that he might not be the father. So she had been lying to him (and me) about the whole “not pregnant” thing.
I informed her the truth was coming out. In fact, the truth was probably crowning.
Now that might be an extreme case, but quite often people come in with varying chronic pain complaints which are always difficult. I would much rather give someone who is faking an illness drugs, than withhold medication from someone who honestly needs pain medicine.
As an ER doc we all hate getting burned by someone trying to score drugs.
Maybe if we just had a lie detector in the ER, what do you think?