November 13, 2012
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Pseudo-awesome
Secondary gain: And external usually incidental advantage resulting from a disease process.
Usually people get secondary gain in the form of attention from other individuals, days off work, rest, gifts, etc. If you have the flu, people often try to make you feel better and thus provide secondary gain.
Sometimes people actually pretend to be ill in order to get attention, or days off work, or disability or whatever. This is where our story begins.
If you have ever seen a seizure it is a terrifying experience. Though there are a wide variety of seizures, grand mal are both the most common and visually the most terrifying. A person collapses to the ground, their entire body stiffens, then this is followed by rhythmic jerking while the body is unconscious. This is often accompanied by tongue biting, incontinence, and periods of apnea (breath holding). Also (and this is important), after grand mal seizures there is a period of confusion, disorientation, and exhaustion immediately after seizures called the “post ictal” phase. After a seizure, you don’t just wake up and feel completely better, your brain just pressed the reset button, it takes a while to reboot.
However, there is an entity known as Pseudo seizures. These are when a person demonstrates seizure-like activity without the actual neurological brain firings seen in epileptic seizures. There are a wide variety of causes for these, the most frustrating (and seemingly the most commonly seen in the ER) are pseudoseizures for secondary gain.
Yep, some patients actually just pretend to have seizures so they can come into the ER and have people feel sorry for them. Now, don’t get me wrong, all pseudo-seizures are not willfully caused by patients, but let me give you an example from one of my nurses.
My nurse: Yeah, she’s having another whatever you want to call that.
Friend in room: “Can you get the seizure pads? She’s having a seizure”
Patient: <Moves arms back and fourth randomly in a poor representation of a pretend seizure>
My nurse: <Walks into the room> “Yeaaaaah. We don’t need to do that right now, she’s fine.
Friend in room: “Why not?!”
My nurse: “She’s fine. She’s not having a seizure.”
Patient: ”Yes I am, this is a real seizure.”
My nurse: <sighs and walks out>
Comments (5)
You should write a TV show.
@Roadkill_Spatula - Whenever I watched Scrubs it would often hit a little too close to home
from watching medical TV shows, I’d like to ask if there is such a thing as a seizure that can be isolated to a certain part of the body rather than the whole thing. I once saw a show in which a little kid experienced a seizure just in their leg…don’t know if that is realistic or not.
@blonde_vampire - Yes that can happen, and yes it is possible to have a seizure and still be conscious. There are a wide variety of seizures. ”Partial focal” seizures are just one type that can cause an effect like that.
Now here is a whole cup of fucked up. When I was a kid, I used to make myself have severe asthma attacks (not difficult since my mother was a chain smoker), so my mother would take me to the ER… where I hoped the docs and nurses would see the bruises from my mother beating the eff out of me and call CPS. Sadly, the medical staff were most concerned with my breathing issues and never noticed the bruises.