Doctors as lie detectors

His story was perfect, right out of a medical textbook.  He needed pain medication for his unremitting migraine headache, but it was 4 a.m. and as a medical student, I was evaluating him in a West Los Angeles emergency room.

Laying in the ER dark-room, he was convincing with light exacerbating his headache, while his fluorescent maroon high-top tennis shoes glowed in the dark.   The Migraine Clinic was closed, and 40 years ago there were no computers nor access to medical records in the middle of the night.

Do I believe him, or not?  Was he suffering, or searching for a “fix”?

One nurse felt empathy; the other said “he’s lying!”  Yikes.

He got his dose of morphine, but it was a “fix” as we found out later he was lying.

Unfortunately, doctors and nurses must sometimes act as lie detectors to keep people from their addiction and potential overdose.

Trying again, he came back six weeks later with his fluorescent high-tops giving him away on my last day of ER rotation.  Bad luck as we were a bay station for law enforcement so he was arrested.

My takeaway:  Doctors are not good lie detectors!

Gene Uzawa Dorio, M.D.

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