I like to joke around (obviously) and as such, sometimes I end up joking around with patients, sort of as a way to try to bond with them. Sometimes I get worried though that I went too far....
When I was rotating in the ER as an intern, a patient came in with a really bad headache. It sounded like a migraine, but my attending was rightfully worried about a subarachnoid bleed. We did the CT and it was negative. But his clinical suspicion was high enough that he wanted to do a lumbar puncture.
For those of you who haven't experienced this firsthand, during an LP you basically stick a HUGE needle into the back until you hit the spinal fluid. The attending let me run the needle, but even though I was sticking it exactly where he told me at the exact angle he said, I kept hitting bone. It was really frustrating, but more than that, the patient was in excruciating pain. Every time I pushed the needle deeper, he would SCREAM. I felt terrible.
Finally after like 30 minutes and trying a different needle, we got it. The one good thing was that the pain in his back took his mind off the pain in his head. He was pretty nice about it. He said to me, "Now do I get to do one on you?"
About half an hour later, the results of the tap came back: normal.
I went into the patient's room and for some reason, I decided to say: "Well, it turns out we have to do it again."
Of course, I followed that immediately by: "Just kidding! It was normal!"
He laughed but I remember I was a little sorry I joked around like that afterwards. It seems like the sort of thing you could get sued for if you do it with the wrong person. I only did it because I had been treating this guy for hours and I felt like we had a "relationship." In fact, when we discharged him, he said to me, "Thank you. God bless you."
So I don't think I did a bad thing. I mean it's not like I said, "You have a huge brain tumor. Kidding!" But I still felt uneasy about it.
"I'm afraid that arm's going to have to come off. Did I say arm? I meant wet bathing suit."