Medical professionals are skilled at diagnosing patients, but their diagnostic skills go beyond real symptoms; they’re also adept at spotting fakers.
And they encounter some very strange sights and “symptoms”: “seizures” that seem to strike right when a person is asked to pay at a restaurant, “sudden paralysis” that sets in when doctors appear unwilling to prescribe someone painkillers for his less serious complaints, or the “blind” man walking out of the hospital, getting into his car and driving away.
Here are 42 stories of people “faking it”–and not getting away with it.
42. Defining Arm Test
I had a patient who was supposedly comatose but was giving a few mixed signs when it came to making a definitive judgment. There is a test called a drop arm test, where you raise the patient’s arm over their head and drop it. A non-comatose patient will move their arm on their own to avoid hitting themselves in the face. But I had a different idea.
With the nurse in the room, I said, “Okay. Our defining test. If his arm stays straight up unassisted, he is comatose.” I let go of his arm and it stayed totally upright. The guy did himself in. I told him shortly after that the gig was up and he had no medical reason to be admitted.
41. The Picked Up Kidney Stone
My mom had a patient who said she had passed kidney stones at home and needed painkillers. The lady actually brought in the kidney stones as proof.
Well, patients don’t usually do this and the stones were way bigger than people can pass on their own. My mom sent them to the lab and they came back as “geological origin.” The A.K.A “crazy lady” picked up small stones from outside to try to get medicine.
40. Dine And Dash Injury
I was called to a bar for a seizure. The waitress says she delivered his bill, and he suddenly went to the floor having a seizure. I look over at him and he’s laying there flopping his arms and legs around, as he looks us right in the eye and screams over and over, “I’m having a seizure!!”
We then told him to stand up, so we can take him to the ambulance. He does and starts walking to the door. We tell him to hold up, gotta pay your bill first. The man was he mad at us. The waitress tells us he does this all the time. Well, not today. He still took a ride to the hospital, though. The hospital has good egg salad sandwiches.
39. An Early Christmas Miracle
I had a patient fake having a stroke. Even received the clot-buster medication, went through all the CTs and MRIs, the whole shebang. Faked the one-sided weakness, severe speech, and language deficits. Didn’t help that her speech/language errors were grossly inconsistent. And that she kept forgetting which side was supposed to be her weaker side when working with PT/OT. Or that she was caught Googling aphasia symptoms on her phone (despite being completely unable to read simple words at the evaluation).
She was trying to get on disability. And wouldn’t you know it, as soon as she was told workman’s comp won’t pay and that she would not be able to drive for an indefinite amount of time (after just having such a severe stroke, after all) the next day her speech and language symptoms were completely resolved. A Christmas miracle in July.
38. Warming Up
I got called for an unconscious intoxicated girl at a bar. I got her to the ambulance, and she shouts: “I’m having a seizure!!!” and starts waving her arms around. I told her that “people who have seizures generally don’t announce it first.”
Well, her response was that I was being very judgmental and she was getting ready just “in case” she had a seizure and that she instead had to stretch. Oh well…
37. In Three, Two, One…
We get called to a 13-year-old having a first-time seizure. We get on the scene, and the entire family is freaking out, except for the father. I walk into the room where the kid was – OBVIOUS FAKER. I turn to dad and have him go outside into the hallway; I tell him the boy is faking, and I ask if anything unusual happened today. The father tells me he found a substance in the kid’s room, and he was getting on to him about it when the kid started “seizing.” He asked if we could take him to the hospital “just to be safe.” I said no problem. We pick the kid up and put him on the stretcher, and as we head outside to the ambulance, he exhibits more behavior that shows he’s faking. I bring the kid in and give a patient report to the internal medicine doctor and the nurse, and I say the kid is “faking his seizure activity.” The doctor had a problem with that, saying “You can’t possibly tell that he’s faking.” I assure him that, yes, the kid is faking.
I explain the situation that led up to him faking, and that I could prove it. The doctor says, “I’d like to see that.” The nurse knows exactly what’s going on and what I wanted to do; he’s all for it! So I say to the kid, “Bob (I don’t remember his name), we need a urine sample from you, and we need you to wake up to do it. If you don’t wake up, we’re going to shove a tube into your manhood, run it all the way into your bladder, and take a urine sample from you. Please, just wake up and give us a sample.” Nothing from the kid. “Okay, Bob, if you don’t wake up in 10 seconds, we’re going to start prepping you to get the tube shoved into your manhood. Ten, nine, eight, seven, six, five, four, three…” and miraculously his eyes opened. He then closed his eyes, started blinking, looked around the room, and said, “What happened?” The nurse was laughing, and the doctor was a little pissed.
36. Mission Failed
We get called to a local Waffle House for a seizure. We walk in to find a man lying on the floor, not moving, but breathing. We start talking to the waitress, asking what had happened. While talking to her, we occasionally look down at the patient, and find him with one eye barely cracked open, watching us; when he sees us looking at him, he closes his eye. This happens a few times. Then the cops show up and find out what’s going on.
One of the officers asks the waitress, “Did he (patient) eat here?” “Yes, he did.” “How much is his bill?” “Fourteen dollars.” At this point, the officers roll the patient over and find his wallet; the guy has a $20 bill in it. One of the officers takes out the $20, gives it to the waitress, and tells her, “Keep the change.” You could see the anger in the patient’s face when he realizes he’s not getting out of paying his bill. He ended up faking a seizure on the way to the hospital (I’m not about to explain how I know it was fake, because I’m not going to give anyone ANY info on how to fake a seizure).
35. Congrats! It’s Water!
I had a woman come into triage in labor and delivery. We ruled her out for breaking her water. She was mad that she wasn’t going to get induced and be delivered. So after I left the room, she flooded the bed, the floor and herself with tap water.
Literally gallons and gallons of water, it was leaking out from under the door. So much water. It was like that scene in Coneheads. She said it was her water breaking. Again, I quickly ruled her out and told her she needed to go home. She subsequently peed the bed before leaving.
34. All For The Show
I was in prison healthcare and every morning the prisoners would get a chance to move freely around the prison to go to their workplace, or visit us if they are on daily meds or something. Often if people are unwell, they will come to healthcare and get a sick note so they can get a day off work without being penalized. Well, one day about 30-40 guys turned up at our healthcare window complaining of headaches, stomach aches, and a few claiming to have vomited, although no confirmation from any of the officers.
The strangest part was that every single one of them was from the same prison wing, so we put in a security report saying that we were worried something fishy was going on. It turned out that one of the guys in that wing had family appearing on the Jeremy Kyle Show (UK’s version of Jerry Springer) and all the guys wanted to stay in their cells and watch it! However, their cunning ruse to skip work turned out to be unnecessary as one of the officers on the wing had recorded it for them and played it back during their social time.
33. Fake Pregnancy
I had a patient fake a ruptured ectopic pregnancy to get narcotics. She says she was diagnosed with an ectopic at another hospital and given medication to end it. She came into our hospital in extreme abdominal pain, rolling around, yelling, had genital bleeding, the whole nine yards. I gave her a bunch of pain medication so we could get an ultrasound. Ultrasound showed nothing. The urine pregnancy test showed nothing. Beta HCG was 0.
Turns out she was conveniently on her period which made the whole thing very convincing. Got records from the other hospital; the patient had been there yesterday but was not pregnant for them, nor was she diagnosed with an ectopic pregnancy. Definitely was a “wow she just made up this entire thing.” We had a lovely conversation about all the results. She ended up screaming at me, threatening to sue me for all I’m worth and stormed out. Joke’s on her; I’m worth -$200K of student loan debt.
32. The Mom’s Crazy Move For Money
I had a mother come in and INSIST that her child had Silver-Russell syndrome. You can go read on it. It’s not that easy to fake, as it’s a bunch of metabolic conditions mixed with congenital abnormalities. The kid was small, but not that small (around 6th percentile). He didn’t weight much (5th percentile). All of this, with a right arm length 2 cm more than the left side, were borderline criteria for Silver-Russell. We did genetic testing, which came back negative, but 30% of cases are negative. So the deciding factor was one of the “soft” criteria of hypoglycemia. Once she heard about this (she printed out 30-40 articles on the disease), she came back with the kid in a coma. But when the kid was in the hospital, he was never hypoglycemic.
He went home, and came back in a coma a few weeks later. Again, as soon as he was eating normally at the hospital, he was never hypoglycemic. She starved her child into comas repeatedly for the diagnosis of Silver-Russell. She was also a “bougon”: people who live off welfare and make a game out of it. By the way, she was in a wheelchair when at the hospital. Once I had enough of her lies and walked into the room after only knocking once. She was walking around normally and jumped into the wheelchair as soon as she saw me. I believe it was for money since in Canada/Quebec, you get money when your child has a genetic disability. God, if it was legal, I would have slapped some sense into that woman.
31. The Needles Didn’t Cooperate
My mom had a “frequent flyer” at the emergency room she worked at. This lady was constantly in unimaginable pain over everything. She got a splinter in her finger and that constituted a 10 on the pain scale, and she needed painkillers to deal with it. She was a known substance abuser as well. She had been caught stealing needles and shoving them up under her huge sweaty rolls.
The only reason my mom found out was because she came back in to place the EKG pads, and to do so, she had to lift her chest up to place the pad. When she did, the needles rolled out. From that point on, they had to have a member of security watching her any time a nurse or doctor left the room. She also had a massive arrest record and there were times the cops would bring her to the ER instead of an ambulance.
30. She Forgot To Close Her Eyes
A patient comes in saying she has terrible abdominal pain: 10/10. I say okay…and start to examine her. She immediately starts screaming the moment I touch her belly. But look, I’ve seen patients in terrible pain, and nobody has ever yelled in pain with their eyes open. She wasn’t even tensing or anything.
It was a really sad case though; she has a history of coming in saying she’s pregnant when the urine and blood test are clearly negative. In one case she even tried to steal a pregnant patient’s urine (she got caught pretty fast). She was on psych follow-up, not sure what the diagnosis was but my guess would have been Munchhausen’s. Anyway, we sent her home without pain medicine.
29. A Slip In The Bathroom
We get called to a fall in the women’s bathroom at Walmart. We walk in, and the manager is freaking. We go into the bathroom to find a female face up on the floor – I’m guessing she weighs at least 350 lbs; there were two friends of hers standing in there with her. I ask her what happened; she says she slipped on a puddle and fell, hurting her back. I look all over the bathroom floor; there’s NO water on the floor. I ask the manager AND the patient’s friends, “Do you see water on the floor?” They all said no. I then tell the patient, “There’s no water on the floor, ma’am.” She says, “I’m lying on top of it.” We’re going to have to roll her to her side in order to get a backboard under her and pick her up; I explain that to her. As we roll her to her side, I check her back for any obvious injuries; I then check her clothing AND the floor she was lying on – nothing was wet. I have the manager (who was grinning from ear to ear at this point) and the patient’s friends look. “Do you see water on the floor? Are her clothes wet?” They all said no. We then roll the patient onto the board, pick her up, and place her on a stretcher.
At this point, I tell the patient, “I’m going to be writing up paperwork for this call and your treatment. Part of what is going to be written up is the fact that you said you slipped on a wet floor, and that no water was found either on the floor or soaked into your clothing. This is standard; I have to write up what I’m told in addition to what I see. What you need to understand is this: if you happen to decide to take Walmart to court, they can request a copy of my run report, and it’s going to show what you said and what I found. They can also summon me to testify, and if they do, I’m going to tell them what you told me and what I saw, the manager saw, and what your friends saw. That being said, do you want to keep dragging this out and go to the hospital, or do you want to just get up from my stretcher and be done with it?” She chose to get up and leave.
28. A Fantastic Weekend
When I wanted to be a physical therapist, I volunteered at one of my local clinics. We had a lady who claimed she was in excruciating pain. She couldn’t walk more than five feet without literally screaming in pain in the clinic. She couldn’t even move her toes without yelling profanities. She kept talking about how her medicines ran out and needed more. She also started talking about how her whole family thought she was an addict, but she swore she wasn’t. I started feeling for her a little; she seemed nice and like she was going through some mess.
But then once the doctor walked out of the room, her and I got to talking about music. I told her my uncle was in a bluegrass band and she mentioned how much she LOVED bluegrass. She loved it so much that the prior weekend, she and her husband spent 14 hours at a festival. She was tired was carrying chairs around and dancing. And they were traveling to go to another one the day after her appointment. When I asked her if she had any pain during the festival, she said “Oh, none at all. It was a fantastic weekend” and then realized she gave herself up and got really quiet.
27. The Blind Driver
We have a patient at our primary care clinic who claims to be blind. He always comes in with sunglasses and a white cane. We were always suspicious though. Something definitely seemed off.
One day, someone followed him out of the building. He walked through our nearly empty parking lot, and down the street a little way to a car parked out of view of the clinic. He folded up his cane, got into the driver’s seat, merged into traffic and drove away.
26. Her Choking Acts
A woman who was eating her breakfast (a slice of bread) had a fight with her husband and felt something stuck in her throat and started to claim she was suffocating. Her first care physician called fake news but asked us EMTs to have a look at her. We make a laryngoscopy and there was nothing there, not in her throat, not in the back of the tongue, not in the larynx nothing that made her present these symptoms. But her husband, who was mad at her before, was now worried sick, loving and attentive of her.
We told her and showed her the video of the laryngoscopy, and she insisted she felt she was choking, so we handed her to endoscopy for a full endoscopy and nothing, the slice of bread was gone, figures… After a whole day in the hospital, I guess she just fed up and started feeling normal again, and she went to keep blackmailing her husband forever and ever until the end of time.
25. “Stop That!”
I’ve seen patients faking seizures, but one guy took it to the next level. Arms and legs shaking, not the head or torso. It looked more like a rain dance than a seizure. He was talking through it!
The neuro doctor happened to be close by and came into the room when we called for him. He said, “Stop that!” The patient replied, “I can’t!” The doc put his hands on the patient’s legs, hard and firm, and said, “STOP.” The patient immediately stopped.
24. Don’t Let Her In
A family was grieving in the room due to a patient not expected to survive the day. A niece of the patient, easily in her 30s, started screaming like she was being killed and fell to the floor. She started “convulsing” but her family completely ignored her.
Finally, she was loaded up to the ER. The family asked if the hospital was going to pay for her expenses, and when they said no, the girl “miraculously” shot up and acted like she couldn’t remember what happened. The family left her there and asked the desk not to let her back in.
23. The Very Important Question
As a resident, I had a patient who had a blood clotting disorder, but who was also addicted to IV pain meds. He figured out how to get admitted for an extensive workup due to a possible blood clot in the lung, and wanted IV pain meds for his “chest pain.” He came in all the time, but it was very difficult to block the admission because he actually did have a risk of this problem. He never took his blood thinner correctly and his symptoms always bought him a couple of days at least while we ruled out a clot and got his blood levels where they are supposed to be. But it meant he had accumulated over 30 high-resolution CT chest scans over his life, which is not good for you. In fact, it’s downright lethal. I had one question I would ask people who tended to come in complaining of every serious-sounding symptom they could think of: “Does it ever hurt behind your eyes when you pee?”
I was very salty at that point; this guy was a nightmare when he ended up in your service and it really bothered me that he was admitting himself with a likely fake lung tumor just to get a day’s worth of IV pain meds and Benadryl. With him, I started asking the “pain behind your eyes when you pee” question like it was extremely important, and he’d quickly answered yes. I acted like it was an extremely serious condition that warranted evaluation. I consider it one of my greatest achievements in residency, that one day he showed up in the ER with “pain behind my eyes when I pee” as his chief complaint. Then one day, I overheard a colleague talking about this crazy dude who came in demanding to be admitted because he had excruciating urination-related eye pain. Made my day.
22. “Thanks For Coming To Rescue My Wallet”
Paramedic here. A guy called 911 from a restaurant claiming he had a migraine and was unable to see properly. He was two blocks from a hospital. We arrive and he was out in the sunlight waving at us. Thanked us politely for “coming to the rescue” and sat in the ambulance chatting up a storm and making inappropriate jokes.
The chef came out and asked for his information. The guy conveniently didn’t have any information on him but promised to come back and tap his “pin” in the debit machine. We knew the guy was full of it, but couldn’t do anything. I’d prefer if he just said: “I ate a meal I couldn’t afford and I’m addicted to painkillers; can you please take me to the ER?”
21. Magical Glasses
I commonly have young kids who really want glasses because some of their friends have them. They’ll come in acting like they can barely see the big E on the chart.
I change some lenses in front of their eyes, give them a little encouragement that they can see better, and they can magically read 20/20 with little to no prescription. They’re not big fans when I tell them they don’t really need glasses.
20. It’s A Miracle
My husband is a firefighter and EMT and he told me about a time where they were called for a man seizing. When they got there a guy was lying face up on the floor not moving and then started faking a seizure.
They stood there saying things like “Oh wow. This is a bad one. But if they did X behavior then we should really be worried!” and the patient would suddenly start doing X behavior. Apparently, this went on for a while until he miraculously woke up in the ambulance asking for opiates.
19. Oh, Love
I was working in an antenatal clinic when a fifteen-year-old girl, her fifteen-year-old boyfriend, and his mother came in for an initial appointment. The first appointment always involves sourcing as much historical information as possible, setting up an initial plan, and then checking that the baby’s heartbeat is tracking as expected. The family was very friendly and the pregnancy was obviously unplanned. His family had taken the young girl in and she looked very uncomfortable. The boy was daunted, but doing his best to be involved.
When we got to check the heartbeat, I wasn’t able to find anything. The midwife with me couldn’t either. We were concerned she may have miscarried, so we brought in the most experienced midwife to check. We had been treating this as a purely medical issue, until both the supervising midwife and I took a step back and noticed that while the boy and his mother were distraught, the girl was looking more ashamed than anything else. It was the first indication that something wasn’t right. As a group, they all went up to see the doctors in another building. The next morning, I found out that after an hour with the doctors, she confessed that she had made it all up so she could move to Australia with her boyfriend.
18. The Robbing Team
My wife is a district nurse and she drives to people’s homes to change dressings, give medications, etc. Her job has her dealing with many people such as lawbreaker members and people on home detention. She had one not long ago that was extremely talkative, almost like he didn’t want her to leave the house. He went through every bump and scratch asking if it might be infected.
Finally, when she left, she got back to the car and noticed the back window had been smashed in. It didn’t take a genius to figure out what happened. She went back to the house and saw the same guy with a friend and her stolen goods. She called the police and waited for them.
17. A Sudden Paralysis
When I was a resident, I had a patient in clinic that was doing that roundabout thing patients do when they want narcotics but aren’t going to directly ask for them. She would hint at having arthritis pain that “just doesn’t seem to get better except that one time she took Lortab” and that “you know, her friend gave her a Percocet once and it helped a lot” (nevermind the fact that this lady was 100% functional despite “debilitating pain.” At the end of the clinic visit, when I offered a physical therapy referral and stronger NSAIDs (the actual treatment for osteoarthritis), she suddenly sat straight up, looked me in the eye, and said, “Doctor, I don’t know how…but I’m totally paralyzed.”
Seriously. She pretended that all of a sudden, everything other than her mouth was totally paralyzed. She made us send her to the ER (but not before she had my nurse unwrap a peppermint and literally put it on her tongue because “her blood sugar felt low”). We had to lift this nutcase into a wheelchair (during which we could all feel her shifting and repositioning…not something a paralyzed person would do) and roll her to the ER to be evaluated for “sudden paralysis.” While in the ER, she suggested to the ER doc that maybe Lortab would fix her paralysis, and when the ER doc rightly refused this treatment, she got out of the stretcher and walked out.
16. It Was Magical
I think the most annoying faker was this woman who would just stay in bed all day. She wouldn’t even try to get up. She actually liked being catheterized. She would also take notes while talking to nurses, doctors, and other allied health professionals while claiming to be a lawyer. She did some clerical work for a law firm, I later found out. She always needed pain medication (legit) and would get them on the dot (every six hours). She would complain constantly and be very irritating.
Then I got a social worker involved, who said that she had to leave the hospital soon. Since she was not able to walk or complete any activities of daily living, she must be transferred to a nursing home as soon as possible. She magically got out of bed and began to walk with a walker. With a little bit of help (not even intensive rehab), she was walking and doing everything herself within a week. Two weeks later, she went home. What a medical marvel!
15. What’s Missing?
I worked in the ICU and one day, we responded to a stroke on a surgical floor. It was a 60ish-year-old woman who complained of “not feeling right,” extremity weakness, and slurred speech. We started a neuro exam and asked her to hold up her arms. We had to physically hold them up for her because they’d just flop down. We tried asking her some questions, but she kept her eyes tightly closed and just mumbled random words. So we started suspecting that she was pulling our leg. That’s when we decided to have some fun. Fakers hate when you ignore them because they’re attention-seeking. But how do you get attention when you’re faking a stroke? Well, the team was talking amongst ourselves, loudly saying, “Maybe she took something! Let’s go through her purse.”
We started opening stuff and finding unidentified pills. When we asked each other what they were, we heard, ever so quietly, “Gabapentin…Lortab…” Guess who perked up? Little Susie Stroke had one eye open, watching us rummage through her belongings and was helping us identify her meds. We decided to call it done, took all her meds to the pharmacy to hold, and started walking out. Well, we took one last look in the room, and there she was, sitting up in bed and scrounging through her bag to see what was missing. What a miracle!
14. The Troublesome Toe
One day, I have several patients to see. I’m informed that my priority patient is an elderly woman who came into the hospital with severe chest pain. I haul to the coronary care united to assess her, start the exam, and ask her about her chest pain. “Hmm? Oh, I’m not having any more chest pain. But let me tell you about this toe here on my right foot, just giving me fits; it started in October and I thought it might be a change in the weather…” She literally faked a heart attack so she could get admitted to the hospital because she wanted someone to look at her toe.
They’d already run tests on her before I arrived, and everything was negative, but she was ancient and had chest pain. At this particular hospital, we got a lot of “this patient is totally stable, but we fear litigation, so let’s admit them to a critical care unit” patients. If you came in with chest pain, if you were in any sort of respiratory distress (even if it was completely resolved in the ER), if you had sniffles and lactic acid of 2, to CCU you went.
13. “It Was All A Joke”
I am a firefighter and we have quite a few calls about people faking medical problems. The most obvious call that I have ever been on when someone was faking was a woman that looked to be in her twenties acting SUPER belligerent. The first call we had was at about 1 pm. We arrived at the scene to this woman having “seizures” but we could easily tell she wasn’t because she was making direct eye contact when we were talking to her and she was even responding to our questions while she was having one of her episodes. We never come out and say you are faking, but we do ask if you are pretending to have seizures and if you say no then we do our best to try to make you go to the hospital. Well, her family and her said that they will just keep her home and watch her and if it happened anymore they would just take her to the hospital themselves. We had another call from the same address about three hours later for the same thing. “Female having seizures.” So we arrive at the scene again. We’re kind of angry since she woke us up for having pretend seizures again. When we walked back into the house, she was laying on the floor again flopping around like a fish in a sea of all different kinds of bottles. This time she gets an attitude with us when we ask her if she was really having a seizure, and we weren’t having any of it. My captain got on the radio and called to have a deputy come out and assist us with dealing with the crazy wasted lady.
Next thing you know, when the deputy pulled up in the driveway a few minutes later she was up running around, screaming at everyone because she said that we aren’t giving her all the medications that we are supposed to give her. So long story short, she was told she could either go with the deputy to jail or she could go with the ambulance. She said that she would rather go with the ambulance. When we got the stretcher brought inside for her, she started saying that it was all a joke and that we needed to get off her property, but she then got into one of the paramedic’s face and started swearing at her, so we all got a hold of her and put her on the stretcher and then strapped her down with all the straps that we had just to keep her still. The deputy said that we better take her to the hospital just to get checked out, so that is what we did, and she screamed and cursed at the paramedics all the way there.
12. A Need For Narcs
ER doctor here. Had the worst person in the world with fake seizures that could only be cured by Dilaudid (the most potent opiate that can be administered in the hospital IV, usually). Seizures aren’t treated by opiates. This lady was insufferable, and she knew all the rules. She would make sure her enabling husband (IQ 50) came in, so she had a driver and could thus get narcotics. If we didn’t give narcs he would shut that place down screaming and threatening. She would also spy on the parking lot to see which doctors were working because of Dilaudid. Well, one day I had it. She had brought her son (IQ normal) to the ER (he had a learner’s permit, she reassured me) and she started fake seizing and screaming. I just let her go. Then she got threatening, so I called security, and I was the first person to ever get her removed.
She then proceeds to walk out the doors with her son and not fifteen minutes later, she is back in the ER as a trauma, full collar, backboard and all. She says she’s going to sue me, that she went outside, had a seizure, fell, and is in more pain. Dilaudid, Dilaudid, Dilaudid. So I stop her right there and walk to security around the corner and look at the security tape. She very clearly looked around, made sure no one was looking, then gently laid down in a mangled position. In the video, it looked like her son said, “Forget this,” and he literally walks away and walks several miles home. I went and cleared her from her c-collar and backboard after calling the police. They came and didn’t do anything. She was back two days later.
I once had a patient who claimed to have intractable back pain, was “not able to walk” (despite having an intact neurological exam), was moaning and groaning to an extent that was completely unreasonable, and was otherwise extremely dramatic and pretending to be completely handicapped. He had been on workers’ comp for a good year at that point and claimed his back pain made it impossible to work. I started making some small talk about sports-related injuries in the waiting room, then asked if he played any sports. He replied that he played hockey.
I steered the conversation away towards something else, then casually asked him if he had been playing this winter. “Yeah, I played yesterday in the rec league and we won!” I documented the comment and sent it to the workers’ comp board on the spot. Of course, I didn’t mention it to him. He didn’t even notice what he’d said.
10. Picking Up His What?
The patient was a man with a fistula (hole from the skin to organ) that had copious output, created by the man picking at an incision site. He had a controlled substance alert, and was continuing to request his oxy every four hours on the dot (which I gave because abdominal wounds are painful), and also requesting IV Dilaudid. When I told him that I wasn’t going to be giving him the IV Dilaudid, he was very upset and tried to manipulate me into changing my mind, but I didn’t cave.
Later, I entered the room to see him happily picking at and extruding his own bowels. The ostomy bag that was catching the output was completely filled with blood. The first thing he requested when I entered was the IV Dilaudid. Probably one of the grossest things I’ve ever seen in the hospital.
9. Oh Deer
We had a patient come in on a worker’s comp case with severe injuries to the chest. He states that while working in a grocery store parking lot, a female deer spots him from a distance and decides she wants him. Once she gets close to him, she kicks him in the chest several times and then headbutts his kneecaps in. Once he’s on the ground, she stomps on his chest and head.
He wakes up several hours later and immediately comes to us. Not only was his story completely ridiculous but he didn’t have a single mark on his body. No bruising, no swelling, no broken bones. Just nothing. He rated the pain at a 10/10 without a single scratch on his body. Needless to say, he got his claim denied.
8. That Will Do The Trick
When I worked in a halfway house, there was a girl I found unconscious in the hallway (she was new). I called an ambulance and when the paramedic arrived, she took one look at the girl and I sighed. She recognized her and started calling her by her name and checking to see if she was breathing, etc. She then took out a pencil out of her top pocket and held it over index fingernail. She only applied a little bit of pressure before the girl yelled.
The girl immediately got up and swore at both of us and went to her room. The paramedic told me she does crap like this all the time. The pencil trick was a cool thing to learn though. I tried it on my self when the paramedic left and it really hurt!
7. Missing Court Session
I had a patient come in with uncontrolled diabetes. He was type 1. His BSL was really high. A couple of days and it was back under control and he was ready to be discharged when they went out of control again. Those patterns continued.
About 7 am one morning, his girlfriend fronts me needing a note for the judge. He was supposed to be in court at 8 am. He’d been eating wild amounts of food to try to get out of going to court, then wanted us to fix the situation with one-hour notice. We did nothing. He went home at about 11 am.
6. Let’s Talk About Football
We got a call to a guy’s place at 2:00 am. The guy complains about pain in his finger, holding his hand up. We drive him to the hospital, and the whole time he talked about football, never once complaining about pain.
We get to the hospital, and suddenly, the pain is unbearable. He said he went to the hospital two weeks ago and was given Dilaudid and said that he should get it again. I dropped him off and drove back to the station. Highly doubt he was given anything that night.
5. The “High Profile” Case
I am an X-ray tech, and when I was a student these two people came in, a man who was pushing a woman in a wheelchair with an ankle boot. They both looked like junkies. Anyway, they came in with a prescription for an ankle x-ray. They ask if she has to take off the boot and I said yes because obviously it would superimpose on the anatomy. She all of a sudden she starts crying saying that it was too painful — no tears. The man said she broke her ankle in three places some time ago and her ankle becomes curved when she takes the boot off. Okay, dude… Ankle x-rays are easy; take off your shoes and socks, three views, boom, done. But no says she cannot get on the exam table and she needs people to hold her ankle together.
We literally had four x-ray techs working this “high profile” case. One to hold the digital cassette, one to hold her ankle in place. One to hold THE CHAIR we HAD to put her ankle on, and one to push the button to shoot. We did this all while she was screaming in pain and she even said: “Kill me pleaseee!!!” The funny thing? All the x-rays showed no abnormal findings. No old fractures, no screws or plates of any past surgeries–literally a perfect intact ankle. They wanted painkillers for sure. They looked like addicts and had a plan to get more. So annoying.
4. Inflicting Pain Solution
A 30-year-old male patient was unconscious and completely unresponsive for over six hours. This guy was totally dedicated to his act. I approached it as a stroke, but when the blood pressure, ECG, reflexes, pupils, etc are all normal…
I start checking the pain sensation. He opened his eyes and groaned and I asked him to tell me his name. The moment I press his Achilles’ tendon, he shoots up, states his name, and declared himself cured.
3. Special Medication Treatment
A young adult woman comes in with a seizure-like activity. We run multiple tests, CT scans, and MRIs that come back clean. We put her on a 24-hour VEEG machine. She reportedly has hundreds of seizures throughout the night with full-body convulsions, drooling, upper body contractions, and won’t respond to verbal stimuli. She wakes up and acts confused. She screams for pain meds when she’s not having seizures, but refuses everything they offer to her. Tylenol – nope. Percocet – nope. Lidoderm patch – nope. She wanted opiates.
After 24 hours and thousands of dollars worth of tests, the doctors had no choice but to send her home. She gets frustrated and starts seizing again, while the doctor explains that she’s faking it. The security ended up escorting her out.
2. Gathering Hospital Opinions
Working a busy trauma ED when a guy walks up and screams he needs to be seen immediately. They take him and he tells everyone he was in a car accident but didn’t go to the hospital because he was worried about his friend. They perform some X-rays of him and see that his bladder is super bright. It’s filled with the iodine contrast agent they inject into your veins when you get a CT scan.
So, we confront our patient about why he didn’t tell us he already went to another hospital, and he launches into a ramble about concussions and exhibited several other medication-seeking behaviors. He decided to leave but not before asking the nurse directions to the nearest hospital.
1. It’s Always Chest Pain
I worked as a nurse on a cardiac floor. Chest pain was the biggest thing people would use to substance seek, because if nitro isn’t working, we also give oxygen and morphine while turning it into an emergency situation. We even have an acronym for it. MONA: Morphine, oxygen, nitroglycerin, aspirin. All are interventions for a heart attack. When you have a heart attack, your cardiac tissue releases these markers. Kind of distress signal. We can pick these up on a blood test. Sometimes a heart attack can be seen on an EKG.
If a patient had a history of negative tests and/or multiple admissions and all their vitals were normal and I suspected they were faking it, I would ask them if it hurt when I put my hand on their chest. They would always say yes, and then I could happily inform them that this likely wasn’t cardiac but muscular pain since heart attacks won’t cause pain when your chest is touched. I would suggest a warm compress and some Tylenol and their pain was always mysteriously gone within seconds of my announcing that it couldn’t possibly be related to your heart. After a while, you do get very used to the signs and symptoms of people actually having a heart attack. There’s just no faking that level of panic or the look on their faces.