All For The Attention

Had a diabetic patient who used to inject himself with insulin in the waiting room. Then we would have to run out there with a gurney and a few techs, throw him on, and race him back into the ER to get some glucose into him. He liked the attention and to skip the line. A few times he would be looking right at the girls working intake. Stare right in the eyes, and Inject himself.

I was not there the one day he took it too far, but it really sucked.

Goofygrrl

Even Pets Get In On The Action

Had a dog come in once with intermittent lameness of the left hindlimb. Had been going on for months and seemed to resolve only to pop up over and over. It wasn't a mild lameness either, the dog would be barely toe touching at times.

Absolutely nothing wrong on physical exam, no neuro issues, radiographs showed jack squat. I eventually sent the dog out for a orthopedic referral and they couldn't find anything specific. They assumed the dog was somehow just repeatedly injuring itself at home when the owner was away.

The owner installed CCTV at home to watch the dog and try and figure out what was causing the trauma only to discover that the dog would happily tear around the house on all four legs during the day, only to start limping the second the owner came home.

As far as we could surmise, the dog must have actually injured itself at one point, and realized that limping got it more attention and treats. Between diagnostics and specialist referral, the owner spent over £2000 just to find out her dog was faking.

Moctor_Drignall

Disgusting

Everyone in my hospital knows the story of the patient who was under the infectious diseases unit. He had a horrible foot ulcer that would not heal, despite every antibiotic the team threw at him. He was on four different antibiotics simultaneously at this point, including being hooked up to a drip with a very strong broad spectrum antibiotic called piptaz.

His wound swabs kept growing strange and unusual bacteria, and he had been in hospital for months. They couldn't quite figure it out. Until a nurse caught him in the bathroom while she was doing medication rounds. He had taken down the dressings and was rubbing his own faeces into the wound.

manlikerealities

How Dare You Make Me Perform My Legal Duty?

Had a patient who was faking an idiopathic bilateral lower extremity paresis (think extreme leg weakness). Turns out he was trying to miss a court date for child/spousal support. His story and physical presentation was inconsistent, without going into needless details. The final straw was attempting to throw himself to the ground while testing ambulation with a walker. That is why we use "gait belts" so I could catch him.

He complained because I foiled his devious plan to blame a fall on worsening symptoms. This happened while I was an intern. The truth is most of my patients are honest, often confused, sometimes scared. In my career this is the only blatant attempt of faking I've encountered. Exaggerated symptoms are another matter entirely.

cmomall1

Don't. Forget. The. BBQ. Sauce.

Right before my shift was over I get an admit of a 9-year old boy with new onset seizures. He and dad get settled into his room and we start hooking up electrodes to his head for an EEG. I explain that we are also video recording so any suspected seizure activity will be seen, along with data from the EEG. I then ask if they have had dinner yet, as kitchen is closing in 5 min. The boy asks for chicken nuggets with BBQ sauce, fries, apple sauce and chocolate milk. I call down to the kitchen to order his meal when the EEG tech says she is finished and we are recording. On cue, he begins to have a "seizure". I stare, dumbfounded, as do the EEG tech and nurse assistant.

The father yells "He's having one now!" in a total panic, not realizing there is no way this is a real seizure. The closest comparison would be as if this boy was doing the dance move from the '80's called The Worm, but lying on his back while doing it. My coworkers and I are trying to hold back laughter, desperately not looking at each other, and I continue to order "Chicken nuggets, apple sauce and chocolate milk." From mid "seizure" this kid yells "Don't! Forget! The! BBQ! Sauce!" That was it. I left quickly and hid in the bathroom laughing my @ss off.

ronsinblush

What The...?

This was about 10 years ago when I was a Pediatrics resident. I had a patient from a juvenile detention center admitted for sudden inability to walk or stand. He started peeing brown and it was found he had rhabdomyolysis (severe skeletal muscle breakdown) that was threatening to shut down his kidneys. He had no idea how this happened and claimed he woke up and suddenly couldn't use his legs.

The second night of his admission his mom and sister came to visit. His mom left, but his sister stayed the night in his room. The next morning, I go to his room on rounds to discover this dude boning his "sister" in his hospital bed. Keep in mind this is a Children's Hospital with butterflies on the walls and little kids being pulled in wagons by their parents down the hallways.

Needless to say, all hell broke loose and the truth came out. This "sister" was actually his girlfriend who was implicated in his weapons and drug charges and who he was forbidden by the court to have contact with. The cops came and dragged her away while she screamed and cussed us all out. Stunned parents of other patients looked on in horror.

The guy's rhabdo eventually cleared and he didn't need to go on dialysis. He started to regain strength in his legs. Before discharge, he finally admitted what triggered the muscle breakdown and his leg weakness- he did 1000 leg squats. All to get released from juvie and see his girlfriend.

I presented the case at morning report the next day and called it " The Sore Shank Redemption"

Hareborne1

You've Seen This More Than Once?

Ophthalmologist here.

I just saw a patient about 3 weeks ago who complained about how she's seen about 7 doctors for her problems and every doctor keeps blowing her off. Every doctor she's seen just doesn't listen to her and she's frustrated.

I said, "Okay, you have my undivided attention. Let's see what I can do for you." She says she can't see any bit of light at all in either eye. I already know she's lying because she's cringing from the light but I'm confused because she's doing a really bad job lying and she hasn't asked for anything. She hasn't asked for disability, she hasn't asked for a work excuse, she hasn't asked me for drugs.

I ask if she's seen a neurologist. She says yes. I ask to see their card. She then walks across the room to her purse to look for her wallet. She then pulls a stack of business cards out and reads through each of them to find her neurologist's card and hands it to me.

I then ask her to come with me to the check out desk and back. I don't help her at all. She follows me down the hall, around a couple turns, and then back to her seat in her exam room.

That's very weird. I've had patients pretend to be blind but she's doing such a bad job of it.

So, what to do now? I'm about to be doctor #8 to blow her off. I can call her a liar and confront her. That would probably not end well. I don't want to get sued and I don't want to get bad reviews on Yelp. The last thing I need is for a patient to start screaming at me in earshot of the waiting room.

I take the diplomatic approach and just say, "Well, I don't know why you're completely blind but your eyes look completely normal. We can at least rule that out." She seemed to accept that. I think she just wanted to hear someone say they believe that she's blind... even though she's not...

I discussed this case with many other ophthalmologists and we've come to the conclusion that maybe she just liked playing the sick role. Kind of a Munchhausen or factitious disorder.

seeing_red415

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