Auntie Jo's Guide to Faking Neurological (and other) Disorders

Friend, are you feeling bored? Dissatisfied with your life? Vaguely disappointed by everyone and everything? Do you think you ought to be getting more attention from your family and from strangers than you do currently? Do you need a vacation from responsibility for a few days? How about your meals brought to you in bed? Does that sound good?

Well, Friend, do I have an offer for you! In a few easy steps, you can waste tens of thousands of dollars of resources, undergo unnecessary and sometimes unpleasant testing, and contribute to the inefficiency of the American health care system! You'll get all the attention you want and then some! You'll have people waiting on you hand and foot! You'll get visits daily from attractive young men and women! Just read this first:

Auntie Jo's Guide to Faking Neurological (and other) Disorders:

1. Remember to be consistent. If you present to the emergency room with a pronator drift, be sure that that pronator drift either stays the same or improves very slowly over time. Pronator drift testing is a cornerstone of the neurological exam, and drifts don't get better suddenly, only to worsen in a few moments, then improve again.

2. The same goes for unilateral weakness. Keep track of where, exactly, you're supposed to be weak. Having your leg give way and land you on the floor is an excellent dramatic touch, but only if it's the same leg every time. Again: consistency is key!

3. Retrograde amnesia rarely shows up in the absence of head trauma (internal or external) or really, really good drugs. It also rarely presents in a person with no other deficits. Try not to bring out the big gun of amnesia unless you're in danger of being discharged.

4. Beware the CT scan and MRI! They might just show that you have, indeed, no basis for your extremely interesting neurological exam. Watch out for the MRI especially: it's best to avoid being scanned by telling the tech at the last possible minute that you have a pacemaker, artificial joint, or bullet fragments in your body. It doesn't matter if you forgot to include that on your medical history before; you won't have to get scanned for now!

5. Don't forget: Migraines and somatic pain are for amateurs. There are too many non-narcotic options for treatment these days, and too many neurologists who are themselves migraneurs. Go with something more exotic, like the classic ipsilateral/contralateral/whateverlateral "falling out" syndrome.

A quick couple of notes on other disorders:

1. Rheumatoid arthritis generally affects more than one side of the body. Although a good-quality deformity can be achieved in one hand with time and self-harm, it's best to create problems on *both* sides of the body.

2. Blood tests and X-ray results have no place in your concept of reality. Even if radiology reports and test results come back normal time after time, keep insisting that a test you had at some hospital (the name of which you've conveniently forgotten) at some undefined time in the past was indeed positive. It'll create doubt and the need for even more exciting testing.

3. Never, ever admit to having any psychiatric diagnosis. It makes diagnosing your current illness that much easier. Instead, insist that you're fine, just fine: your hospitalization will be dragged out for days (or weeks) that way!

Happy Hospital-Hopping!