Wednesday, March 24, 2010

The Sob Story Patient Pelosi Missed

The other evening, a lady came to the ER seeking to use her God-given right to healthcare and her Medicaid "insurance" to get some pain pills.

While in the busy waiting room, she managed to position herself in front of the triage nurse and have a "seizure". Of course, it's poor form to leave a "flopper" in the waiting room floor, so she was placed into a room ahead of other patients.

Once in the room, I walked by and glanced in long enough to make an assessment that she was faking (I didn't really need to break stride to do this). We let her flop around a while until she got tired of it and finally stopped.

When I went into the room to see her a while later, the story was that she called her doctor and he just couldn't work her into his busy schedule that day, so he told her to go up to the ER to get a Rx for pain pills until he could see her the following week. I asked why he just didn't call a few pills in to the pharmacy for her, but she couldn't figure out an answer for that one.

Almost on cue, she began to "seize" again. It was a thing of beauty. She did the "reverse worm" all the way down the stretcher and out onto the floor. I grabbed her trapezius on one side, and the nurse grabbed her trapezius on the other and we hauled her back onto the stretcher.

When she heard me give the order for a catheter and a drug screen, she began to "un-seize" quickly. She claimed to be taking several seizure meds faithfully, and just needed her pain pills refilled.

Her labs returned negative for any of the seizure meds she claimed to be taking.....and positive for all 6 of the items on the drug screen!

When I went back to talk to her, she was furious that her neck was really sore from where we had pinched her (she was supposedly seizing at the time and shouldn't have been aware of this). When confronted with her lab findings, she was enraged. There was NO WAY that any of it was correct. Maybe some cold medicine had turned the cocaine screen positive, or possibly some vitamin supplements turned the amphetamine screen positive etc.

When I told her that I wouldn't write a script for any pain pills and she could hit the road, I expected a fight. Instead, she turned very gentle and friendly and handed me a form that was clutched between her nicotine stained fingers.

It was a disability form, PRE-filled out stating that I had witnessed her having seizures!!!

I love my job!!


  1. How do you do it? I couldn't take that on a daily basis, I don't think.

  2. Dang that Debbie Peel. Did she sign your name to it too? Maybe she waited until you were at least out in the hallway...

  3. PeggyU,
    Fake Seizures are one of the perks of ER/Urgent care, ranks right up there with Cheerleader Physicals...

  4. Can you legally make a note on her electronic hospital chart that she does fake seizures? Can you report her to the disability place? Is there a state run centralized database for fakers like this, so no matter what ED she shows up in, they will flag her as a fake?

  5. Oh yeah. I just found out. The adult "free healthcare" does not start until 2014. And you cannot put your child under age 26 on your health insurance until 90 days from now, and you can only do that at your normal insurance enrollment AFTER 90 days from now. So, right now, there is no "free healthcare", though the taxes and fees started immediately.

  6. I wish we could take all the people who are really sick and need to see a doctor often and hate it and all the people who really want to be sick and fake things and then mix them together and divide up the sickness so that the people who want it can have it and the people who would rather live a fun healthy productive life can have that. I would gladly trade my month of April that has at least 2 doctor appointments ever week with someone who wants them. I just don't get it. If they are so desperate for atttention or something to do or whatever can't they just get a hobby?

    Is there no way to document her faked seizures so someone else doesn't have to order all the blood tests and find the same results when she does this again? Sounds expensive to repeat tests like that especially when there is no reason to have them done in the first place.

    The way you tell a story really makes me laugh (but feel sad that you have to deal with this for real). I loved this line especially "Of course, it's poor form to leave a "flopper" in the waiting room floor, so she was placed into a room ahead of other patients".

  7. I documented the "pseudo-seizures" (the proper medical term for "big fat faking flopper") in her chart.

    I love it when patients actually list "pseudoseizures" as a diagnosis!!

    Sometimes, I wonder if they were wrong in Medical School, because I was taught that it required functioning neurons in order to seize.

  8. Good holy cheesecakes. The shyte you put up with.

  9. Submitted for your review and comments: a <a href=">timeline </a>for the transformation of the health care system.

    I look at this and it looks like they bait the hook with goodies early on ... and then they start ratcheting up the taxes and taking things away (mostly from Medicare patients). What it doesn't say here, and I wouldn't expect it to given that this list was assembled by Republicans, is whether those benefits taken from Medicare are provided to the elderly via another route ... or if they are simply being denied coverage, period. Private insurance companies get shat on all over the place. Analysis of what these individual items will do to your business, please? If you see where this may improve your situations, please mention that as well!

  10. Sorry ... screwed up on the HTML tag. Damned quotation marks ... Please forgive. Here it is again.

    That's what happens when you're too lazy to use the Preview.

  11. oooh. I am having a seizure. Did you see that? Here is another seizure. Now do you see my seizure?

    (The animated video on you tube is funny as hell, if anyone hasn't seen it yet.)

    Pattie, RN

  12. Pattie, that video is a good one, have you seen "firefighter vs cop medical call" got that yesterday from paramedic friend.