Everybody Lies. Especially idiots.

Dr. House is quite right.

EVERYBODY   LIES

Patients usually lie because they are:
* embarrassed
* ill-educated about their health conditions
* scared

Science usually prevails, in the end.  Medical professionals can often coax the truth out of patients, but testing and/or physical symptoms also point to the truth in the end.

Today, let’s meet some of the scared patients I’ve encountered.

15 yr old admitted asthmatic: We’re called to his home for an asthma attack. Opening the door we’re immediately hit by a cloud of marijuana smoke through which we see a few teenagers cowering around corners, avoiding the eyes of the cops on scene.  Upstairs we find the asthmatic kid having a panic attack.
Me:
“So… have you been smoking anything tonight?”
        Kid: wheeze “Ummmm….” wheeze “NO.”  fearful look at firefighters
        Me: skeptical look  “Really? ‘Cause this place reeks of pot.”
We finally get him to admit it once he is on the ambulance away from all cops and firefighters.  My partner explains that we don’t care what he’s done or taken, we don’t report to the cops, but (seriously kid) we need to know, so we can help him feel better.  He asks me not to tell his mom, and I say I won’t, because frankly, she doesn’t need me to.  1o seconds in a room with him and the combo of the smell, his bloodshot eyes, and wheezing will give it away.  Oh, teenagers are so stupid.     *facepalm*

Similarly, I’ve gone into homes with bongs, pipes, and marijuana plants and had very stoned out people deny toking up.  I’ve learned that the key is to ask not “Have you smoked pot today?” but rather “How much?”

Bob was my first “frequent flyer” homeless drunk when I was but a fresh-faced naiive EMT.  Bob swore to me up and down that all he’d had that day was coffee, no alcohol, nope, not him!  He went to the same place every morning for his coffee, and he never missed it.  Had to have that jolt to start the day.  Then he snickered when I said, yeah, I liked my Starbucks, too.  Obviously, he meant his booze.  Then once he let me in on his joke, he pulled his nearly empty pint of vodka out from his waitband (or underwear, I’m not sure which) and took a swig on the ambulance.  When I tried to take it away from him, he tried to punch me.  My partner, a former marine, dealt with him sternly.  He tried the same story at the hospital and managed to clip the RN on her cheekbone when she wrestled the bottle away.  Security restrained him after that.

Mommy Dearest is a patient who still makes my blood boil, the patient who I’m not sure was lying or just telling her version of the truth.  We respond to a “sick person call” (so helpful) to meet police on scene.  Apparently a 6 year old called 911 because his Mommy had the “Irish sickness.” 
So many things wrong with that, already. Open the front door, kid is sitting on the floor surrounded not by Hot Wheels and Elmo toys, but by pills, empty beer cans, and alcohol bottles scattered everywhere.  PD tells us they’re looking for evidence of harder drug use.  The coked out boyfriend is on the couch.  The patient, the boy’s mother, is upstairs dazed and confused, vomiting on herself, crying and apologizing to the room.  She drank on her psych meds, which is a big no-no.  Her main concern though? Don’t take my baby away from me!  Those pills downstairs aren’t hers, of course.  Her boyfriend is very responsible and the boy will be safe staying with her.  She’s been very compliant with her psych meds… this time.  And her boyfriend is getting better with his.  Her son should stay here, not go into DCF (Department of Children & Families) custody. HA!  Right.  Of course her story changed on the way to the hospital.

Drug seekers are a unique category all their own, and a trained eye can spot them a mile away.  It took me about 20 minutes to “diagnos” my first one, on the way to committing her (against her will) to an inpatient rehab & psychiatric program (Section 12).  She gave me a whole sob story which was initially somewhat convincing to a newbie like me.  Then the questions started about my scope of practice as an EMT; could I give out Tylenol?  What about other things that a paramedic gave her once? Di… Di… Dilaudid?  Could I give that out, for example?  Then I started questioning her story and it fell apart, she got hostile, and eventually shut down for the remainder of the ride.

We’re told to suspect every patient of withholding information, whether intentionally or not.  We’re told to take every statement with a grain of salt, essentially to assume that Everybody Lies.

What might you lie about?  Why?
What other important lessons have you learned from tv characters?
Post your comment below.

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