I've often wondered why patients bother to lie to their doctors. We have seen just about everything in the book as well as most things not in the book.
There's not much that phases me anymore and when someone has done something really stupid or embarrassing, I tend not to judge them, but when they lie (and trust me, a doctor tends to know when a patient is blowing smoke) that just down right annoys me...
If you get shot or stabbed in the middle of the night and come into casualties in a drunken stupor, we are not going to buy your story that you were selling bibles door to door and some heathen attacked you unprovoked and unexpectedly because you have nothing but goodness in your heart.
If come in with a foreign body stuck in your rectum, we are not going to believe that you were naked because you were on your way to the shower and en route accidentally slipped and fell onto it!
If you have half a steak stuck in your oesophagus, we are not going to believe that you only took a small bite and that it must have somehow expanded because of all the water you drank to try and wash it down.
Medicine is evidence based, so if the evidence is there, we'll believe what the evidence shows us.
I had this patient who complained of severe earache. I had a look and saw mostly wax, but peaking out from behind the wax I saw something which didn't look entirely normal. I actually thought it kind of looked like the leg of on insect - those things can get anywhere. I told myself it may just be a hair coated in wax, but I was not convinced, so I had no choice but to syringe the ear. Now, I absolutely hate syringing ears. When I was a 4th year medical student, we went on an "ENT camp" which basically entailed us syringing the ears of underprivileged patients for three days straight. It was horrible. I saw (and smelt) things there that I never want to see (or smell) again. But obviously I had to do it.
So I syringe and a whole lot of wax comes out. Then I look in her ear again and see what looks like tissue paper or cotton wool. So I ask if she had put an ear bud or something into her ear and she says no, she didn't put anything in her ear. Yeah right, I think. I syringe again and more wax comes out. Then, I syringe and out comes a blob of cotton wool coated in wax. I pick it up and show it to her.
She says she doesn't know how that got in there.