Repeatedly, we reviewers of medical records note distortions between immediate recall of an injury and successive changes in the description of said event.
Some perceive this as malingering, or at best, an attempt to inflate the value of a legitimate injury.
While exaggeration can be used for financial gain, the phenomenon of false memories is common to us all. Equally, a traumatic memory may be suppressed and forgotten, only to arise unexpectedly when the proper cueing occurs. This is seen with true Posttraumatic Stress Disorder. A patient burned at work functions well at home and around town, until driving past the place of their injury. Memories flood and incapacitate them.
When my children share memories of their childhood, they most vividly recall the negative events that stand out as an aberration. This would be more palatable if they equally recalled the care and love we had shown them on a regular basis, but it is not so. Daily and expected comfort and support, sadly, is not memorable. Pain and loss are more likely to be imprinted or suppressed in their developing psyche.
Within the context of an accident, the injured party must describe the event repeatedly for EMS, the ER, family, their personal physician, subsequent medical specialists, and their attorney.
If patients recover from their injury, eventually their support system will slowly fade away. They no longer need home health or mobility aids, their physicians see them less frequently, and their physical therapy eventually ends. Their family expects a return to normalcy.
But the patient may not have returned to their normal state. And that, to an injured person, is unacceptable. A new physician may hear a different rendition of the original accident, one that serves to impress upon the specialist the heinous nature of the injury.
The most accurate recall, in my experience, is in the emergency room, barring a head injury or loss of consciousness. When the description changes over time, our duty to the truth requires a methodical review of the medical records. In this way, we can often pinpoint the deviation in recall, allowing those who represent the patient to measure the accuracy of the event, and the reliability of their client’s memories. AMA
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