5/15. Oooh that's a toughie. It's either:
• 12 or 13 year old kid was having "seizures," would have another every time the ER tried to discharge her, magically woke up when her father proposed getting ice cream with no recollection of what happened. Video EEG was negative of course.
• Old lady pretending to be catatonic, was helping us transfer her from wheelchair to bed (i.e. was not limp) and when we held her hand over her face and let go she dropped it to her side (if she were truly out it would have smacked her)
A lot of pain fakers are obvious too but pain is a bit more gray area while the above have objective findings.
6/15. My partner at work is an Administrator with an ED Nursing background. She was called in to the ED one night last year to deal with a patient who was complaining of severe headaches and nosebleeds but was refusing to go for any kind of examination in favor of being admitted. They are pretty sure at this point that she is drug seeking as she refused to even lie in the bed. My friend left the room and was standing a few feet outside the patient's glass bay talking with the Charge Nurse when she noticed the patient turn around and hunch over. She subtly stopped the conversation so they could observe.
The patient turned around with more blood on her nose and blood on her fingers from where she had been reaching into her underwear and smearing period blood all over her face to fake a nosebleed.
7/15. I'm an audiologist, and it's fairly common to have people fake a hearing loss. With adults, it's commonly for worker's compensation/benefits. Children do it for attention or to get out of school for a day.
They are fairly easy to spot...patients will come in, conversing with me very normally, but the audiogram will show a profound hearing loss. We all have our tricks to get them to slip - I like to lower my mic volume to a normal range and mention that they dropped something when they're in the booth, they instinctively reach for it, forgetting that they shouldn't have heard it because of their "loss." We can also do an auditory brainstem response, bypassing the need for patient responses. A Stenger Test can identify those fakers that only have a "hearing loss" in one ear.
My favorite is when testing kids that are clearly faking, part of the test requires me to have them repeat words. So I present them at a normal volume and the kids are REEEAAALLLYY straining to hear them, then I slip in funny words like "buttcrack" and watch to see them smile because they clearly heard it.