For some reason which I have been, as yet, unable to discern, those members of the public who are most inclined to attempt malarkey at the hospital choose neurological afflictions as their mode de malarkification.
I am SO TIRED of people who insist--insist!--that there is indeed a brain tumor, right here (points to right temporal lobe), despite the evidence of repeated MRIs to the contrary. I am equally as tired of people who have trouble remembering on which side they ought to be weak. And I've had it up to my moustache with folk who think that squinting is a facial droop.
So, in the interest of having something actually fascinating to deal with, I've come up with a list of things that malingerers shouldn't try, because we've seen them all before.
Numero Uno: SQUINTING IS NOT FACIAL DROOP. Seriously. I have all these fun little tests that I can do to prove it to you, plus: I watch you when you think I'm not watching you. Oh, and I read the charting from your forty previous admissions, so I know what you're likely to try. How many times do I have to say this, anyway?
Number Two: If you're gonna have weakness, make sure it's not distractable.
Number Two, subsection A: If you're gonna fall over, do it on a hard surface once in a while. We have a name for what you're doing: it's astasia-abasia, and it means we know you're bullshitting.
Number Two, subsection B: The same goes for upper extremity weakness. If you pretend to pass out, seize, or otherwise suffer an alteration in your level of consciousness, you bet I'll hold your hand about a foot above your nose and then drop it. If it misses your nose, I know you're faking.
Number Three: Telling me that you're allergic to morphine and "all NSAIDS" will not get you the IV Dilaudid you want. I weep for you, the Walrus said, I deeply sympathize: Dilaudid is the best shit ever in the history of the universe, and I certainly understand why you want it. However, you won't get it. Nor will you get Phenergan IV, or any of the other cool drugs, like Stadol. Here; I'll help you fill out the AMA paperwork.
Numero Quatro: Threatening to sue me won't work. Don't try it. Besides being rude and laughable, it's out of character for your illness for you to be able to holler unslurred words at me.
Number Five: This might bust up the angel-at-the-bedside myth about nurses, but: We Judge By Appearances. If you have no teeth, a heavy backwoods accent, track marks on your neck, and smell like an ashtray, we're going to be very, very cautious about what you're reporting in terms of symptoms.
Number Five, Addendum One: Likewise, if we read in your chart that you're on your fourth revision of a gastric bypass, have recently gotten out of rehab for the third time, and are allergic to morphine and all NSAIDS (see above), we're gonna lock up the narcotics.
Number Five, Addendum Two: In the same vein (no pun intended), we automatically double or treble the amount of alcohol use you admit to. That's why you're getting Librium with your scrambled eggs.
Number Five, Addendum Three: Yes, I will search your bag, your bed, your closet, your pockets, and everyplace else you could hide a stash after your family visits. I know these rooms better than you do, so don't even try.
Thank you for your time. We at Consolidated Research and Healthcare, Inc. know that you have a choice in healthcare providers, and we thank you for choosing us. We hope, wherever your final destination may be, that you have a safe trip. We hope to see you again soon, perhaps even in a sober state.