From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,talk.abortion
Subject: Re: - A Startling Article
Date: 5 Feb 2000 08:35:25 GMT

In <7B4B77FB97CB2203.46F0159C829B289C.3DE09F0B54BBE411@lp.airnews.net>
jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox) writes:

>Patients will frequently exaggerate some symptoms and deny others,
>report they have been taking medications they have not, deny taking
>other medications they have, lie about drug use, drinking, smoking,
>and sexual activity, and about their reasons for seeking care.
>Possible incentives could include avoiding reprimands for their
>behavior, embarrassment, and believing they will get better or
>speedier care.


   I always think of a woman I saw in Long Beach, CA with fever of
unknown origin, in the ICU.  Very ill.  No improvement on antibiotics,
no cultures growing, no obvious site of infection, and no travel
history.  Except she lied about the last, not wanting it to be known
that she'd recently return from Liberia, due to (justified)
embarrassment at being a world traveler and bon-vivant on MediCal (what
California calls their Medicaid).  Some nameless resident did a thick
smear on her blood for not very good reasons, and caught the problem.
She damn near died of cerebral malaria, treated too late, anyway.  It
was lucky for her she had enough cortex left a few weeks later to be
able to `fess up.

From: jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox)
Newsgroups: sci.med,talk.abortion
Subject: Re: - A Startling Article
Date: Sat, 05 Feb 2000 16:39:06 GMT

On 5 Feb 2000 08:35:25 GMT, sbharris@ix.netcom.com(Steven B. Harris)
>
>   I always think of a woman I saw in Long Beach, CA with fever of
>unknown origin, in the ICU.  Very ill.  No improvement on antibiotics,
>no cultures growing, no obvious cite of infection, and no travel
>history.  Except she lied about the last, not wanting it to be known
>that she'd recently return from Liberia, due to (justified)
>embarrassment at being a world traveler and bon-vivant on MediCal (what
>California calls their Medicaid).  Some nameless resident did a thick
>smear on her blood for not very good reasons, and caught the problem.
>She damn near died of cerebral malaria, treated too late, anyway.  It
>was lucky for her she had enough cortex left a few weeks later to be
>able to `fess up.

We had a mother lie about her infant's fever, thinking it would get
her seen quicker in the emergency room.  Little did she know that,
since the infant was a neonate, it would be subjected to blood tests,
bladder catheterization, and lumbar puncture.  When she found this
out, she confessed, and was reported to CPS for child endangerment.

I had a man (back in medical school when I still had to deal with
adult patients, who, by the way, lie about themselves more than
parents lie about their children) who swore up and down that he never
had anal sex.  He had been given antibiotic cream for the sores on his
anus by a VA doc, and they just weren't getting better.  The man had
the most obvious case of genital herpes on his anus, and on rectal
exam his anus was so lax I damn near felt like I could put my arm all
the way in up to the elbow.  He confessed that he did have anal sex.
Had he told the VA doctors that, they may have recognized herpes
instead of misdiagnosing a bacterial infection and having him suffer
for a week on inappropriate therapy.

I have seen mothers who lie about antibiotics they gave to their
children without a prescription (which can be deadly), lie about their
habit of smoking around their children, and call an ambulance and make
up something that sounds life-threatening so they can get a free ride
to the ER for what amounts to a clinic visit.

--
Jonathan R. Fox, M.D.

From: jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox)
Newsgroups: sci.med,talk.abortion
Subject: Re: - A Startling Article
Date: Sun, 06 Feb 2000 00:10:16 GMT

On Sat, 05 Feb 2000 13:07:52 -0500, TheVindicator
<TheVindicator@bellsouth.net> wrote:

>"Jonathan R. Fox" wrote:
>
>> (skip)
>> We had a mother lie about her infant's fever, thinking it would get
>> her seen quicker in the emergency room.  Little did she know that,
>> since the infant was a neonate, it would be subjected to blood tests,
>> bladder catheterization, and lumbar puncture.  When she found this
>> out, she confessed, and was reported to CPS for child endangerment.
>
>Not to take away from your report, but do you think the medical folks
>who reported this woman would have reported a doctor who had done
>something equally as *bad*?

I can't speak for others, but I sure would have.

--
Jonathan R. Fox, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,talk.abortion
Subject: Re: - A Startling Article
Date: 6 Feb 2000 13:45:29 GMT

In <87j18m$k9e$1@bob.news.rcn.net> "Wayne" <wlogsdon@erols.com> writes:

>Physicians often ask arrogant questions that might get one punched in the
>nose in polite society.  Ask a question that is none of your business and
>you are begging to get lied to.


   But it is the doctor's business.  We don't have time, nor
particularly enough idle or prurient interest, to spend the huge amount
of time and money which is necessary on the job to ask personal
questions that only satisfy our idle curiosity about our patient's
habits, and do nothing to get the medical job down.  We've seen it all
enough to be semi-bored by most pecidillos.*  When the patient comes to
us with the problem, (s)he ackowledges by doing so, that the
information in his life necessary to solve the problem is the business
of the person he brought the problem to.  What does he think he's
getting, palm reading?


  * Okay, I did once have a medical professional tell me of a patient
years gone by, who showed him proudly a gluteal tatoo of a fox chasing
a rabbit down a hole, with just the rabbit's hindquarters visible out
of the hole.  You may guess which hole.  No, it didn't help with
diagnosis.  However, what I say above is, by and large, still true.