Do you have to let it malinger?


One of our professors in chiropractic med school made it his life’s mission (and a noble one at that) to make sure we knew how to spot a malingerer.  A malingerer is someone who called in sick to work…again.  With another migraine.  Except that she’s not locked in the dark room she claims to be.  Unbeknownst to her employer, she’s got the blinds open and the music on (light and sound are two things of which genuine migraine sufferers are temporarily phobic).

Apparently, malingerers like to visit doctors (of all types).  They want attention and sympathy from anyone and everyone.  They try to score drugs from the MD.  They want the DC to document just how much pain they’re in so they can stay on disability or win that personal injury or worker’s comp settlement.  There are certainly legitimate cases for all of these things, and there are certainly legitimate people who genuinely need them.  That’s not who I’m talking about.

I’m talking about the ones who are faking it.  Or otherwise totally milking it.

Knock on wood; I’ve never received a visit from any of these little gems.  It may be that my price tag is way past the price point of rescue, and they’re likely to see little–if any–compensation or reimbursement.

I almost did.  Someone we know and love told us about someone who just had to come in and see us.  They said this person had been in to see every other doctor, but to no avail.  (That doesn’t intimidate me; it does, however, raise a yellow or orange flag that the person may bounce right on through, ending up dropping out of our care too.  After all, that IS the track record in cases like these.)  The friend even brought the person in our office to make a formal introduction.

She was a nice enough person; I think we could’ve done them some good.  They were all excited to have finally found us.  To which, trying to be a realist without crossing the line into pessimism, I think to myself, we’ll see.

Sure enough, that person didn’t show up.  Couldn’t get out of bed, they said.  Another migraine.  We caved and said, no problem, and scheduled them another appointment.

Another no-show.

I’ve had my share of beloved people I know tell me, “I’ve got to get so-and-so in to see you.”  They go on and on about how this person is AJU (all jacked up) and on a quadrillion different meds.  There are lots of people like that out there, and many of them do genuinely want and need our help; again, those aren’t the people I’m talking about.  It’s not even the “they’ve been to 15 different doctors” bit that gets me.

In fact, I don’t really know at what point I pick up on the fact that there is another force at work here during the conversation.  I mean, it’s not like I’ve seen the people in question before.  I’ve seen people just like them before, though, and a sixth sense kicks in, and the realization hits me: “oohhhhhh.  One of those.”

At some point during the conversation, I can tell that the condition (be it migraines, other pain, or other diseases) has become that person.  As miserable as that person may (or may not) be with their condition, the harsh truth is that they receive more benefit than they sacrifice.  The benefits could be tangible (prescriptions, disability checks, lawsuit settlements, paid sick time), or they could be intangible (attention or sympathy from others, or a certain amount of control or manipulation of those around them).

Or maybe it has become a lifestyle, such as the case with weekly or monthly support group meetings to attend or associations to join.  Maybe it’s the “special” feeling of getting labeled, especially if the condition elicits concern from others, like being in an elite society.  That person has become married to their problem.

Therein lies a problem even bigger than the condition itself.  It’s one thing to accept the hand being dealt you.  It’s OK to look at the bright side and see the silver lining.  It’s quite another to embrace it and make it a part of you.  I know there’s merit to the “if you can’t beat ’em, join ’em” philosophy, but that shouldn’t apply to a physical illness.  It’s OK to be someone with Lupus–but things get murky when you align yourself with the “Lupus Sufferers”.  It’s not that you’re not suffering, it’s that you start to subconsciously believe that the suffering can bring you benefits.

I feel for the lonely housewives whose husbands avoid the family by working all the time–those are the types that try to use symptoms, real or conjured, to get attention.

I also feel for those who think their lives are better off if they impair their brains, drifting into a fog–those are the types that fake or exaggerate a symptom to score narcotics.

And I feel for people whose lives and career paths are so empty and devoid of pleasure that they’d rather spend the day sedentary at home than putting in a productive workday.

I refuse to feel sorry for them in the way they would want me to, however.  My sorrow is coming from a completely different angle.

If the person’s complaints are flat out fake or they’re exaggerating, then they’re simply a loser, and they’re going to get busted sooner or later.  Karma’s a bitch like that.  But the other type is far more vexing to me–the category of people who are genuinely suffering but refuse to get help or to follow through with any information that could help them, because miserable as they may be, they’d rather hang on to their suffering than give up whatever benefit(s) their (real or imagined) suffering brings them.

I’ll never know if our no-show was truly miserable; they never came in to give us the chance to find out.  Those who knew this person said they were on disability.  (There you go.)

Maybe they were genuine.  If they were, then I feel for them that they would put themselves through this much just to elicit sympathy from those around them and collect a measly government check for doing squat.  Such a meaningless life.  No pursuit of knowledge, information, evolution, or self-improvement.  No attempt to advance intellectually, socioeconomically, or anything else.  No real interaction with friends or strangers.  Same TV, same four walls, same as the day, month, and year before.  Yuck.  All for what–people to gush over you to your face and then whisper behind your back?  These people have got to know that their friends and family are sick of hearing about their issues by now.  They’re thinking, FFS, go get help or quit complaining already!

I personally know people who are always complaining about something; much of it was brought on themselves.  Some of it could have even been avoided had they taken my advice years ago.  More of it could be avoided by taking my advice now, but they make poor choices, day after day.  They choose to sit around, eat wrong, and gain weight, which leads to body pains and lack of energy.  They choose to pop pills or visit a second-rate doc in their insurance network instead of trying a good natural protocol that works or paying out of pocket for a good practitioner.  They seem to do everything backwards, opposite of what I tell them.  And they pay for their mistakes.  It’s not that I have a huge ego; it’s just that I study this stuff and I know what I’m talking about.  I’ve done the work for them; all they have to do is listen, take it to heart, and follow through.

But alas…

Now, when I hear people voice their own similar frustrations about those types of people in their own lives, I simply say, “have them call me”.  Of course they never do–I know they won’t.  I sympathize with my friends when they sigh after a long rant about some family member they’re trying to coerce into seeking alternative or complementary help.  I know they’re in the same boat that I am with people I know who haven’t yet let me help them.

So when I either encounter or hear of people like that, I’ll say a quick, genuine “bless your/their heart” but I refuse to give in to any force they try to exert on the people around them.  It’s probably frustrating when I remain objective and logical.  I separate the genuine people from the malingerers of various types by simply taking a goal-oriented, results-driven approach.  With me, the conversation is not going to get stuck on the “poor me” spiel, it’s going to get steered toward, “well, we take care of that kind of thing; when would you like to come in?”

It’s kinda funny how they never do.


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