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Opinions of Monday, 19 February 2018

Columnist: Kojo Tordjo

Take it out, I’m not pregnant - The tales of a lying patient

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“It’s a basic truth of the human condition that everybody lies. The only variable is about WHAT (emphasis mine). I don’t ask why patients lie, I just assume they all do” Dr. Gregory House, in HOUSE, M.D

Often, most patients walk to the hospital, limping in pain and distress only to lie through their teeth and (or) withhold very essential diagnostic information without an iota of thought about the fact that those lies or half-truths can jeopardize their already dwindling health status.

So deft at it as though it’s a hobby, they lie about everything from duration on their malady, to any home or self-interventions they had tried before reporting.

Whereas patient’s lack of candor about their medical condition is attributable to a number of reasons, such as fear of being judged, blamed or disliked, a good number of them also lie because they consider health workers as ‘super humans’. Despite the lies, we should be able to predict what’s wrong with them at a glance. After all we know everything.

They assume we are a bunch of highly skilled magicians, trained to just look at people and tell what is wrong with them and administer magic potions (drugs) more potent than the potions of Zeddicus Zul Zorander in the age-old legend of Seeker to heal their ailments. Unfortunately, it doesn’t work that way.

Inferring from my little experience and observations, patients lie most when the issue is about their sexuality or abuse of substances. Also younger patients tend to lie more than the middle aged and the aged when it comes to disclosing very vital health information.

While at it, what most of us forget is that, diagnosing and treating a patient involves a constellation of events and processes and that, one lie can initiate a cascade of negative outcomes.

You let me tell you a story,

“Doctor, take it out, I’m not pregnant” those were the words of the 24-year-old banker who was once a patient of one of my bosses, Dr. “name withheld”.

Dr. “name withheld” is a general practitioner whose clinical and surgical skills are near perfect. He could not miss the tinniest capillary vessel in the human body in the surgical theater let alone miss a spot diagnosis.

Due to his exceptional clinical acumen and love for details, one is always pushed into paying rapt attention whenever he was on the floor of a case discussion - you have a great deal of learning to do.

He narrated a story to buttress a seemingly controversial point he made about patients who lie or give out false information to their health care providers.

It was about a 24-year-old banker who once walked into his consulting room, dressed in an elegant blue-black suit, nails neatly fixed artificially with a Toyota car key hanging on her ring finger. A well-informed patient so to speak.
After she was welcomed, she sat down starring at Dr. “name withheld” waiting for the ‘magic’ to begin.

Her presenting complaints were mild intermittent lower abdominal pains and fatigue of three (3) days duration.

After further interrogations and direct questioning, he (Dr.) had a provisional diagnosis in mind and as usual requested for a few laboratory investigations with a Pregnancy Test included.

When the laboratory requisition form was handed to her, she went outside, took her time and perused it as though it were a balance sheet.

Quickly, she returned to the consulting room, face frowned and she posited, “Doctor, Me I am not pregnant, take it out” pointing to the Pregnancy Test.

See, one popular but controversial caveat all medics are told in the course of training or practice is that never trust a woman who says she is not pregnant. With that in mind Dr. “name withheld” tried calming her down to explain things to her again, but she won’t listen.

She succeeded, the pregnancy test was removed and she proceeded to the laboratory.

When she came back her results were reviewed and treatment was commenced.
Upon discharge, he (Dr.) gave her his number to call in case she doesn’t feel well after taking the medications (though that is against the professional codes of conduct), she also took it.

Barely 24 hours after the discharge, a strange number called Dr. “name withheld”, it was the banker. Apparently she had started bleeding per vaginam with associated severe lower abdominal pains after starting the pills that were prescribed earlier.

The doctor, thinking his drug had caused the problem asked for directions and drove all the way to meet the lady and brought her to the hospital. I guess you are wondering why a doctor will do all that innit? (That was obviously out of benevolence and sacrifice).

At the hospital a pelvic ultrasound was taken and it was revealed she had a ruptured right adnexal ectopic pregnancy and she was bleeding gradually into the abdominal cavity which means she could have died in a short period from extreme blood loss.

“An ectopic pregnancy is pregnancy in which the fertilized egg implants somewhere other than the uterus, such as in one of the fallopian tubes” WebMD.
Immediately, she was rushed to the operating theater for an emergency surgery and blood transfusion to save her ‘poor’ life.

When she recovered after the surgery, she narrated a truer version of her story.

She took an emergency contraceptive pill, so to her there was no way she could get pregnant because the pill had never failed her and to cap it all, she ignorantly added she did the pregnancy test herself two(2) week ago and it was negative.

The doctor asked why she didn’t say all that initially despite being asked and she responded “I am sorry Doctor”
The rest is history.

My concluding remarks:

Dear patient (bearing in mind anybody can be a patient),
Never under any circumstance lie about your medical condition, it is deleterious and you can die.

When you visit the hospital be truthful as much possible to avoid being unfortunately misdiagnosed and given a wrong treatment.

Note that, just as in ICT, Economics or Finance, GIGO (Garbage In, Garbage Out) is also applicable in medical practice, when you give out false history or misinform your Doctor or Nurse, you go home with false diagnosis and false medications and that can harm or kill you. You will become a vegetable.

Thank you for reading. Share and Keep your critique coming.

The writer is a Clinician and a Public Health Enthusiast