Balance in the Workplace: Liar, Liar Pants on Fire
I was in a car wreck two weeks ago-hit broadside in the rear passenger door where two of my girls were sitting. The policeman insisted an EMT check out my girls then shared, "The lady in the other car wants the paramedic to look at her ankle. It's really swollen, but I don't know that it has anything to do with this accident." The EMT examined my daughters and informed me what to watch for. If additional care was required, he suggested a nearby urgent care would be a wiser choice than waiting in the hospital ER. Rolling his eyes, he added, "I tried to get that lady to go there, but she insists on going to Baptist ER."
Their message about the passenger in the other vehicle couldn't have been clearer: "She's taking the insurance to the cleaners." It happens. People are dishonest and in the process make skeptics of us all. I've been there. I've worked in pain clinics and industrial rehab clinics. I've seen the malingerers and I've had to fight off the skepticism.
Until I was the victim of that skepticism. I went to the ER in horrific pain that began in my low back then radiated into my right anterior thigh after a sneeze. During my eval, I did everything but say, "Hey doc, I have a herniated disc. Please give me an epidural." His treatment plan was to D/C with OTC Tylenol. I declined and requested an injection, hoping he would clue into the possibility of an epidural. Instead he gave me a narcotic injection. Within 24 hours I had the beginnings of foot drop. In 48 hours my right ankle had 0/5 strength with a Trendelenburg gait to boot. I got my epidural but to no avail. I went into emergency surgery at 9 weeks gestation.
Later I requested my ER records and found the ER doc hadn't documented my complaint of radiating anterior thigh pain, but he did state that I was med seeking. I'm not sure he listened to anything I said. He heard what he wanted to hear based upon the outcome he already knew to be true. One problem: he was wrong.
One of the balancing acts we have as therapists is when to believe a client. Sometimes it is a fine line, especially when we are talking about a subjective symptom like pain. We have to make sure our past history with malingerers doesn't take precedence over our client's medical history. If you have to err, err on the side of compassion-just in case your client really is genuine.
Until next time,
Janey