It's up to doctors and nurses to know when a patient is in pain, and exactly what to do to handle. More importantly, they need to know what to do when a patient isn't exactly telling the truth. Just ask these doctors.
Doctors on Reddit share what they did when they caught a patient faking their symptoms. Content has been edited for clarity.
"My sister is a pediatric audiologist and this is my favorite story of hers.
Apparently, sometime in elementary school (usually the early grades), a ton of kids like to fake hearing loss. Like not just 'Oh, I can’t hear the teacher. Full on faking it, like wanting to get hearing aids, etc.
Anyway, she explained to me that based on the way she plays the tones, you can usually tell if someone is faking. Especially when they just pretend they can’t hear anything. But it’s not 100%, obviously, because hearing loss patterns can be really weird.
However, she’s caught a number of kids simply by saying, 'Okay, so I’m going to play [a random number] of tones and they’ll go in both ears. I want you to say ‘yes’ if you hear it and ‘no’ if you don’t.'”
"When I was doing my EMT clinicals (I was 17, still in high school), we had a guy who called 911 reporting crippling back pain. It was immediately obvious when we got there that he was faking a back injury. We did an evaluation and gave him some over the counter painkillers, but he asked to be carried to the hospital. The whole way there, he begged for something stronger to ease his pain.
After a while, the medic said 'Okay sir, unfortunately, we don’t carry morphine on the bus, but I’ll give you an alternative that we use sometimes. It’s called Normalsaline.'
He hooked up an iv, and within a few minutes, the guy was totally fine, telling the medic that it was good stuff and he was feeling much better.
Later, I went back and asked the medic what he had given the patient - I had never heard of it before. He laughed and said 'good ole Normalsaline.'
Normal saline. He had just given him saline."
"I once had a patient with 'appendicitis.' Every time I prodded him (to check whether he actually had it or not), it would pain in different spots. Soon, it got to a point that wherever I prodded him, he screamed like a stuck pig.
I mean... that's a dead giveaway sign that someone's a faker."
"My wife is a nurse and used to work on an adult unit (now works in NICU). She said there used to be narcotics seekers that would come in stating they were in the worst pain they had ever felt, and they needed pain medication for it. Often, they would be asking for a specific one.
After leaving the room to talk with the doctor and getting the appropriate perception filled (or denied), my wife would return to the room to give the patient their medicine. Most of the time, she would often find the patient soundly sleeping in their bed. Someone who was in 10/10 pain 15 minutes earlier is now just taking a nap. A lot of the doctors would tell her to just spill out the medicine, and give the patient some saline, then send them on their way."
"I'm a nurse on a floor that deals with a lot of chronic and acute pain patients.
The most recent instance was this lady from a few weeks ago that was apparently splitting the Oxycodone we were giving her in half in her mouth. Then, when the nurse's backs were turned, she would stuff it in a pill jar. A night nurse caught her in the act and all of her belongings had to be searched. We found 20 half tablets of Oxycodone she had been stashing. She told us she was 'saving them for her family in case they need them because it's just so hard to get an Oxycodone prescription these days.'
I had her a few days after that, and she was having some abdominal pain (STAT x-ray showed only gas. She just really needed to pass gas). But she was screaming, claiming it was a 10, and making a huge freaking scene. She DEMANDED Dilaudid through her IV, and she wanted it to be pushed fast. Huge red flag right there. She wanted the high, not the relief. The doctor straight up said he wouldn't give her Dilaudid because she was already on so many opiates. She then demanded Lorazepam, still through her IV of course. Doc was like fine whatever, just one time and only a low-end dose.
I was flushing her IV with normal saline first (to make sure her IV was patent) and she leans back and is like 'Oh my god, that's so much better already.'
Hadn't even given her the Lorazepam yet."
"My aunt works as a geriatric nurse and there are many people faking to be dead just to mess with the nurses. One day, an old man who regularly faked his death was laying in his bed 'dead.' My aunt was sick of this. She complained and told him that he was scaring the new nurses and staff.
He still didn't move, so she started shouting a bit. A few minutes later while she was still talking to him, another nurse walked up touched his arm, and said, 'He's cold. I think he isn't faking this time.'
Turns out he was actually dead."
"We had a lady with dementia who would fake seizures and faint all the time. We aren't sure why, but she would do it whenever she was told she couldn't do something (which was probably the reason why she was on an orthopedic ward with a broken hip).
She would be so good at presenting seizures that doctors administered medications to her, which of course did nothing but make her drowsy.
One time when she fainted, we did a controlled fall gently lowering her to the ground and moved her purse out of the way. This caused her to wake up, and start telling us off for moving her bag.
Another time she put her hand to her head and did a super dramatic swoon.
When she wasn't being a human opossum, she was a lot of fun as a patient and strangely very good as a hip patient since she wanted to walk on day one after surgery, even though her dives to the floor broke three of our staff who hurt themselves trying to catch her."
"When I worked at an Apple Store, we had people come in and get caught stealing all the darn time. And this one dude pretended to pass out.
Even peed himself just to sell the act.
But, our loss prevention team is legally required to detain the person and call paramedics to assess them. So they do. And the most jaded, crusty, road-weary paramedic shows up and is like 'oh... a seizure just when he’s caught stealing? How convenient! I got a test for that. Roll up his sleeve.'
He pulls out this comically scary-looking syringe and says, 'I have got to take a big blood sample and some optical fluid samples. It could be a stroke.'
Totally lying. Just to scare the dude.
Guy makes an almost instant recovery, miraculously. How coincidental!
The paramedic then screams at the dude that he could be out saving an actual life but he’s here around with his dumb self who just doesn’t want to go to jail.
Funniest thing I've ever seen."
"I had a patient in my emergency room many years ago who was in a really low-speed motor vehicle accident. The police told me he just mounted the curb and stopped on a picket fence. He looked fine physically but claimed he couldn’t move his legs. He had normal reflexes but said he was insensate and couldn’t move anything below the waist.
He was pretty impressive. We all knew he was putting it on to avoid the cells, but he did need an MRI and that wouldn’t be available until the morning.
I caught him smirking as I was explaining this all to him, but my hands were tied. The cops were livid but stayed by his bedside as he was under arrest.
So I went off and saw another couple of patients, then came back when he was asleep and jabbed him right in the sole of his foot with a needle. Both legs shot up off the bed and he cried out!
So I said, 'He can go to the cells,' and walked out without turning around to look at the explosion."
"I worked in the emergency room with this one doctor, and one day we had a guy come in 'unresponsive' with his girlfriend. Per the girlfriend, they had both eaten a weed brownie and then when they didn't feel anything ate two more (big mistake). She was hysterical and convinced he was dying. She kept wanting us to send him to surgery (and do what??). The dude would not respond to anything but was absolutely fine. The doctor ordered like two lines of saline iv, turned to me, and said 'We'll see if he's dedicated to this bit enough to pee himself.'
Sure enough, half an hour later my man is up and at 'em and sprinting to the restroom.
Another time I was working in a rural emergency room and this lady comes in with her husband complaining of abdominal pain. The doctor swears he's seen her before and I pull up her prescription history. She's one of those people who just bounce around trying to get an opiate script from anyone. We hit her with a general medicine combo, but lo and behold it's 'not even touching the pain and I have a very high pain tolerance.' Sure you do sweetie.
'My friend told me that a medicine works, Dilaudid or something?' Sure she did.
'I think it's because I haven't pooped in like a week.' Lady, what?
The doctor goes, 'Well we can't give you any Dilaudid because that would make your constipation worse, but if it doesn't get any better we can try a manual disimpaction.' Silence.
Her husband chimes in with, 'Oh no she doesn't like anything in her butt believe me.'
She took a trip to the bathroom and was magically better. Had me rolling. If you're trying to game the system, don't use constipation as your go-to, try a kidney stone or something. I think that's the only thing I've ever seen work.
Another time, this dude came in claiming a history of kidney stones with symptoms consistent with kidney stone presentation. In a patient like that, you hit them with the pain medication first because kidney stones are indeed tortuously painful, so that's what we did. Ultrasound and CT both come back negative for calculus. My doctor was livid but to his credit, the dude was a great actor."
"I was doing a ride-along with paramedics, and one patient was complaining of severe shortness of breath. She was struggling to breathe and has a preexisting muscle condition which is flaring, so she was struggling to walk and will need to be carried to the ambulance. Fine, cool.
We then have to wait while patient goes into her bedroom, then climbs onto her desk and out of the window onto the flat roof to have a smoke before we leave.
"I worked at a local hospital, and one day we had a young adult patient come in for seizures. Their mom was always with them and had been during a few other hospitalizations. The neurologist ordered an EEG which is where wires are attached to your scalp and such to monitor brain waves. During the middle of their EEG, the neurologist walked in, looked at the screen, and turned to the patient, and asked them to have a seizure. I immediately stopped what I was doing because that was such an impossible request.
But lo and behold, my patient went into a seizure. The doctor smacked them on the hand and told them to stop. The patient was a bit surprised but stopped. He then asked them to have another seizure. To my shock, the patient went into another 'seizure.' The doctor smacked them on the hand again, and told the patient to stop because he knew they were faking it.
Apparently, the mother and patient duo had been taking turns pulling the same seizure scheme to get narcotic pain medication. They had done it at hospitals within the same system. The doctor was able to see their medical records and realized they had been hospital hopping. The patient was promptly discharged and I don't know what happened to them afterward, but they were hopefully arrested."
"I'm a former volunteer EMT. One night, I got a call for a suicide attempt. Get there and this woman (early 20s) was 'unconscious' on a couch, her roommates nearby. On the table next to the couch was a cup of water next to opened bottles of Advil and melatonin. There were signs that a number of pills had been crushed and added to the water. It was still nearly full. We attempt to rouse her, but she isn't working with us and after a brief grunt and twitch from an arm pinch (don't remember if we did or if we were allowed to do sternum rubs), she would return to being limp.
We tell her that we know she's not unconscious, and would really appreciate it if she would just work with us. Nothing.
So we follow procedure and call one of our roaming paramedics to the scene (our truck that day was two full-time EMT's and me as a trainee). He gets there and comes to the same conclusion. He asks her to help us out and work with us. Nothing.
So we follow the procedure and package her up and start taking her to the hospital. The paramedic says that since he's going to start an IV.
'Oops. I missed the vein,' he said to her. 'You know, I could just keep on missing the whole trip to the hospital... or you could just work with us here.'
She proceeds to crack open her eyes the slightest bit for a few seconds, then goes back to her bit. The paramedic gives up and leaves it at that. A few minutes later, we get to the hospital and turn her over. She's the nurses' problem now.
We do our usual routine of paperwork and cleaning the stretcher. As we leave, we pass by her bay and see a nurse but no girl. We ask the nurse what's up.
She responded, 'Oh, she's up and going to the bathroom. She seemed to be faking and wasn't cooperating with us, so we let her know that if she remained 'unconscious' they were going to have to cath her.'
It was a miracle of miracles, she had a near instant recovery."
"Earlier this year, my dad started having crippling back pains out nowhere one night.
He thought it was just a pulled back, aches, and pains of getting old. It didn't go away with any over the counter pain medicine, didn't go away with heating pads, didn't go away or even get reduced with anything. The pain had him, a 67-year-old man and retired military officer and combat veteran, in tears. He realized it probably wasn't just a pulled or twisted muscle, it was probably something serious.
He tried going to an Urgent Care clinic, they told him point-blank they don't treat back pain, and to see a Primary Care doctor. They considered all back pain complaints to be narcotics-seeking behavior.
He goes to an emergency room. They don't even bother with a scan or x-ray, they just give him a shot of morphine while there. After that, they refuse to give him any more pain medication and send him on his way with a referral to see a primary care doctor. They tell him it's just a sprained or pulled back, just a bad one.
He sees a primary care doctor. The doctor doesn't bother to run a scan or X-ray, he just hears back pain and says it's a pulled back. Refuses to give any pain medicine and sets him up with a referral to a physical therapist.
The pain gets so crippling he can't walk, he can't get out of bed. He calls 911.
This time, because he can't walk, they bother to take an X-ray.
His L1 vertebrae were almost completely gone. He had cancer, which had metastasized, spread to his bones, had compromised his vertebrae. The pain he was feeling was cancer pain, and the pain of a back messed up because he was literally missing vertebrae.
He's in a nursing home now, with weeks or months to live, he never left the hospital after that.
However, we'll all remember how NOBODY took it seriously when he said he had severe back pain, that they all thought he was just seeking some substances.
He was dying of cancer, and they just thought he was looking to get high."
"I'm the son of a nurse who covered triage in A&E, and my mom has seen it all.
One story that stuck with me was when she was working the graveyard shift over Christmas Eve. A known narcotics user was brought in claiming, she needed whatever substance she was after. She kept faking fainting spells.
My mother did the 'arm drop test' whereby you hold someone’s arm over their face and drop it. If they move it away from hitting them full-frontal in the face, they’re clearly faking it. My mother did this a couple of times with this woman and then declared 'she’s totally faking' only for the supposedly unconscious woman to protest she wasn’t."
"One of the biggest signs is when someone is shaking violently on the floor and you call their name, they say they're having a seizure, and go back to shaking.
Another sign is when someone is resting quietly in bed and they rate their pain 12/10. You give them a shot of Dilaudid and their first question is when can I get another shot.
We have people who are in and out of the hospital frequently. We call them frequent fliers. At the hospital I used to work at, there was a patient who would intentionally not take their heart medication so they would go a-fib w/rvr, which almost always gets you admitted. They cycled through all of the hospitalists because they would refuse to admit her. They would get some sucker who didn't know any better and bam! IV pain meds.
Every time you walked in the room, they would start yelling out about how much pain they were in and when they could get more. They would get a new doctor who would discontinue the IV pain meds. I once won $20 on a bet with one of them that they would leave AMA as soon as they found out their IV pain meds were no longer happening. That patient left AMA three times in one week because we would stop giving them IV pain meds. In my opinion, unless someone has had recent surgery, has been in a massive trauma, or has chest tubes or other invasive LDAs, a patient should not have IV pain meds, but I'm not in charge."
"I am a former EMT. Patients will fake passing out all of the time. A simple test is to raise their hand directly over their face and drop it. If they were truly unconscious, their hand will fall and smack their face. If they're faking, their hand will fall away from their face purposefully because who in their right mind would let their hand drop on their nose?
Right hand to God, I did this test once and said out loud 'if he's unconscious, his hand won't move.' as I raised his arm into the air. I'm not even kidding, his hand stayed levitating in the air after I let go. I was fighting back tears."
"We had a man come in who was saying he had a kidney stone. I came in to check him and tried to elicit CVA pain while I had him distracted, and shockingly enough, nothing. I ask him how he knew it was a stone, he said he was diagnosed at a hospital a few counties away. I ask said hospital’s name, he 'doesn’t know.' I order an ultrasound and cat scan, but he says he needs something for the pain. I ask him what usually works, 'I don’t remember the name, but it’s an IV that starts with a d but it only works if it’s put through the IV quickly.' Cool, Ofirmev - IV Tylenol - it is.
About five minutes after the nurse scans it and he realizes he’s not getting Dilaudid, he’s mashing on the call light. Says I gave him the wrong medication, the nurse tells him that no, I, in fact, did not order the wrong medication. He demands to see me, I come in and tell him he’s not getting narcotics unless he has a positive US or CT.
He then decided to leave AMA. I guess he wasn’t a 10/10 anymore after that Tylenol."
"We once had a trashed patient come into the ER, completely unconscious. He would not even respond to a sternal rub (this means it's really bad and they're really under). Apparently, this patient just broke up with his boyfriend and was drinking his sorrows away. We did labs and other stuff, and all of a sudden the patient started having seizures. The thing is, these seizures would only happen when the person who brought him in would talk to his ex-boyfriend over the phone to try to convince him to come to the emergency room.
They kept happening over and over, and eventually, the doctors decided to intubate him. As soon as the tube was placed inside the trachea, the previously 'unconscious' patient immediately pulls it out of his throat with both hands, and immediately went back to his 'unconscious' state. When the ex-boyfriend arrived, he miraculously woke up and they both started crying and apologizing."
"If you're shouting and screaming and rolling about demanding the 'IV medicine' as you have an upset stomach...
This is where IV paracetamol comes in.
Rarely anyone has an allergy to paracetamol. It's an IV. Works as good as a small dose of fentanyl but lasts longer.
If they don't want that then they are likely trying to get the opiate or IV cyclizine.
Either way, we have set ways to manage someone's pain and a stepwise manner unless of course, I can see your leg is missing in which case you get all the good stuff.
I personally will call them out on it, and generally, they get really upset. Then, they are miraculously are able to walk out of the department to the next hospital emergency room.
The only time I gave in was when a 20-year=old female was screaming for painkillers, and I mean screaming like a banshee. Her mom was there, who was also demanding I give her morphine, and her little darling baby isn't a substance seeker as mummy knows best.
Tried all the tricks in the book but after an hour of her screaming I gave in and she got five milligrams of morphine. Ten minutes later, she is well and wants to self-discharge!
I let into her and essentially kicked them out. The mom apparently had no idea and was apologizing the entire time."