Hey, You Never Know

Part of my job involves asking patients some questions they may find strange or unusual. This includes asking them if they are suicidal, if they ever see or hear things that no on else around them sees or hears, if they believe anyone is following them or out to hurt them, and if they abuse any drugs. Not all patients I see endorse any of these things and some look at me like I'm crazy or will laugh when I ask the questions. This is understandable because to them, it does seem a bit unusual. However, I learned a long time ago, never to assume I know the answers to these questions.

The case I learned this on happened many years ago when I was interviewing a 70-year-old woman as part of a neuropsychological evaluation. We came to the part of the interview where I normally ask about substance abuse and I remember saying to myself "There is no way that this sweet old lady abuses drugs and she is just going to get insulted if I ask." So I didn't ask. One of the reasons I usually always ask this question is because drug abuse can affect cognitive functioning, which is the main thing I assess. So later in the day, when reviewing records, I found reference to substance abuse. With this in hand, I mentioned it to the sweet old lady who turned to me and said "Oh yes. Every night I light up a marijuana joint and smoke it before I go to sleep." Go figure. Since that day, I learned to never make assumptions.