Dr. Scott: Hi Wilson, good to see you again. Weren’t you here just a few weeks ago? Right before the election?
Wilson: Yeah, Doctor, you too, but I had to come in before my Obamacare gets cancelled.
Dr. Scott: Okay. So, I see you haven’t recently had a fall or visited a foreign country. What’s the problem today?
Wilson: I have an ache in my Muslim Bone. It starts…
Dr. Scott [interrupting]: Your what?
Wilson: My Muslim Bone. Down here under my left ribs. [Wilson points.] It starts to hurt when I watch the news after dinner and doesn’t really stop until I go to bed.
Dr. Scott: I, um… would you mind if I took a look? The discomfort starts at dinner time?
Wilson: Sure. [Lifts gown.] Especially when they talk about hospitals getting bombed. And those refugees drowning in boats trying to cross to Italy. It just starts throbbing.
Dr. Scott: I don’t feel anything. I’m not quite sure what I can do about this.
Wilson: I was afraid you might say that. I guess you probably won’t be able to do anything about my case of Black Knee either.
Dr. Scott: I have never heard of Black Knee.
Wilson: Doctor Scott, I just can’t tell you, how weak I seem to get. Can hardly stand up. Every time a poor black person in a poor neighborhood — hell, even a rich black person in a rich neighborhood, isn’t that funny — anyway, they get stopped or shot, or stopped and then shot. My right knee, it just gets weak and I have to sit down. Aspirin doesn’t help and crying doesn’t help either.
Dr. Scott: It only hurts after you hear that someone has been shot?
Wilson: Well, that’s the way it used to be. Now it’s in the air. Like the weather. I can feel it coming. My Black Knee starts to twinge. I can tell. The next day or so, another black man gets shot. These days, my knee just seems to hurt all the time. It’s crazy, just crazy. That’s why I’m here. Can’t you do something, Doctor Scott?
Dr. Scott: You know, Wilson, I think… no, I’m pretty sure that your problem is political and not physical. Maybe your pain has to do with voting for the wrong person. You know, sort of a dislocation of your mental joint.
Wilson: What? My mental joint? Are you nuts? What kind of doctor are you? I came here to get relief from my pain and you start talking to me about politics and things that make no sense at all! Where are my clothes? I’m getting dressed and getting the hell out of here! You doctors, you’re all alike.
Dr. Scott: Wilson, I was just trying to point out that your concerns might be…
Wilson: Hey, man — I am the one who knows where my pain comes from! You are the one who is supposed to do something about it. This is my last visit with you! [Wilson stuffs his arm in his jacket and storms from the room.]
[Dr. Scott walks out of the exam room and sits down at the charting station. He scrolls down to F68.12: Factitious disorder with predominantly physical signs and symptoms and enters this as the diagnosis code for Wilson’s visit. Chart closed.]