Thread by @iceman_ex

I think it may be worth talking a little bit about “faking” from a medical perspective. (1/n)

https://twitter.com/damndrosetweets/status/1196804341753139200

There are several ways of looking at “faking”

1. The body experiencing symptoms of pain, or disease, that don’t represent any actual ongoing physical harm. What we call “psychosomatic” symptoms
2. People pretending to be ill for personal gain.

So the former.

Psychosomatic symptoms- people having pain, hyperventilation, blackouts, or other phenomena, which when investigated cannot be associated with a physical illness.

Many of these symptoms would come under the classification of “dissociative” symptoms (3/n)

Dissociative disorders are a complex and poorly understood series of illnesses, often associated with past physical or mental trauma, that can manifest as profound physical symptoms under times of extreme stress or emotional upset. (4/n)

In other words:

The body is experiencing real pain in itself.

They are real symptoms to the person, and need to be managed as such. The person is not “faking”- they have no control over their symptoms. (5/n)

This brings us to the latter- people who are creating symptoms for personal gain. The classic stereotype for this is drug-seekers, who will pretend they have pain to get more drugs, right?

Sadly drug addiction is also a disease y’all, with real symptoms.

One of the symptoms of withdrawal is severe pain. This can manifest as total body pain, gut cramps, and a profound sympathetic response including hyperventilating.

Sadly they’re not faking that for their next “hit”. They have a biological addiction that needs treatment.

Note:

In this discussion I haven’t mentioned any prejudgement by an observer witnessing symptoms.

YOU CANNOT TELL WHETHER SYMPTOMS ARE REAL OR FAKE, WITHOUT PERFORMING A COMPLETE MEDICAL HISTORY, EXAMINATION, AND APPROPRIATE INVESTIGATIONS.

Which brings us finally, to the few remaining patients who are genuinely making up symptoms for personal gain.

To be honest, if I wanted to get away from hard parts of my life, a hospital is the last place I’d come to... but I can see why some people would...

You’d come to hospital looking for a listening ear, a safe space, some food and drink.

I don’t think you’d want to be judged as “faking”. You’d like to be listened to.

In my entire career I’ve seen this a handful of times- usually homeless people around Christmas.

Once I saw it in a woman who turned out to be a victim of domestic violence.

Being in hospital allowed her to be safe, and finally tell her story.

TLDR:

Amusing video.
The joke is misjudged however as everyone comes to hospital seeking help- and they should get that help.

Let’s use this video as a chance to highlight this and just generally be better healthcare providers.