Monday, March 25, 2013

At fault

When I see back pain patients who were involved in motor vehicle accidents,one thing I find interesting is that the patient is virtually NEVER the person at fault, or so they say. I can think of a few reasons for this:

1) The patient is lying.

2) The person who is not at fault for the accident is more likely to develop fake/semi-fake pain due to the possibility of litigation. (They are all in litigation.) Or maybe the pain is real, but they have no motivation to try to get better.

3) I do think there is a higher likelihood of getting hurt in a car accident when you're not the one at fault. Like of all the severe brain or spinal cord injury patients, when there were two people in the car, the passenger was much more likely to be the injured one. I think the person who is causing the accident might brace themself or something because they see it coming.

12 comments:

  1. Hasn't it been shown that bracing yourself before an accident is actually bad? I remember reading something about drunk people being more likely to survive a car accident because they are more "relaxed" and don't tense up. Not sure if it was a scientific article though :P

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  2. Having been in a few accidents in which the other person is at fault, I have to say I am more likely to seek medical attention when there is someone else at fault. If I strain my back/neck/whatever gardening, I just put up with it. If my back hurts because someone rear-ended me, I will get it treated. Not that I have EVER had an accident in litigation, even though I have been in three in which the other party was cited by the police as being at fault. None the less, I feel like I need to document it (by visiting the doctor) in case it becomes a prolonged thing. Thankfully, it never has.

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  3. You probably don't see many gun shot wounds, but the person shot was always just "walkin' down the street when 'some dude' shot me." The victim was never, ever doing anything wrong, either. (We have to find 'some dude' because he is causin' a lot of mayhem.) The victims never file for damages as the cases are usually criminal, which is another reason you don't see them. Finally, the patient who is shot often has an alternative source of pain relief. Tricia

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    1. I can attest to this; when I did my elective in Chicago, everyone was sitting on their porch minding their own business when they were shot (this was, actually, occasionally true)

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    2. I've seen tons of gunshot wounds. I'm in PM&R! And yeah, the person who got shot was never doing anything wrong. They were just minding their own business, with a big wad of cash in their pocket that they were going to, um, donate to the church....

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  4. I believe this has been studied and that passengers are more likely than drivers to suffer whiplash injury. I have heard the same theory that drivers are more likely to appreciate signs immediately preceding a collision so they can brace for impact. However, I do not have the reference so when I find it (or find myself proven wrong), I will post here if no one else does so first.

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    1. It makes sense. I frequently hold my head tightly when I see a car behind that doesn't seem to be braking (eventually they do). In this case, I won't get (bad) whiplash. But usually this happens too fast for me to warn the passenger. Think of a dog in your car - my poor animal flies around every time I brake, even when I think I am braking gently.

      I think the drunken relaxed thing is more or comparing equal injuries, like falling out of a window or flying through the windshield. To me, whiplash is a different type on injury.

      Of course, I could totally be wrong. But that's what it seems to me.

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  5. I was once responsible for a car accident -- I had just come off a long shift at work, was tired, and advanced into an intersection when I didn't have the right of way. Although no one was seriously injured, both cars involved were heavily damaged.

    It remains one of the most humiliating experiences of my life. While I never denied responsibility to my doctors, I never understood why it was so important for them to ask whose fault it was, and it pained me to have to answer that question every time it was asked. But I was definitely tempted to lie to them because it was so difficult to talk about.

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    1. About a year ago, I scratched a car pulling out of a tight parking spot, and I was SO embarrassed. When I talked to the insurance company, they were so nice to me though. I was shocked and relieved.

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  6. Anon: I think, but I don't know (Fizzy?), that the reason the docs asked you who was at fault was for the reasons that Fizzy listed in her post. The person not at fault often has secondary gains in NOT getting better; specifically, more money, or no longer being able to work due to the accident. Since you were at fault, you are probably more motivated to recover and to put it behind you. It puts a different perspective on your injuries and recovery. But, I imagine it was very difficult for you to have to answer that question repeatedly. Tricia

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    1. The question always came up in the "small talk" portion of the appointment, so while I can't be sure why the question was asked, the docs/nurses gave me the impression that it was being asked more out of curiosity than anything else.

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  7. As a person who was in a car accident and suffers from chronic pain I always feel shameful when I mention "car accident" and "back pain". Once those words come out of my mouth people automatically roll their eyes and want to blow me off. My accident happened two years ago and I was partially responsible. I got in the car with a friend who had been drinking and when he flipped the car on 95 I was ejected 40 ft. After five days in a coma I awoke to find I had a grade 5 liver lac, large pneumothorax, brain injury, and my head and chest were ripped open, and serious road rash, among other things. I was in shock so they kept me in a coma while my body fought serious fevers. My wrist was fractured and I didn't notice for over a month.

    After moving from the ICU to Tele, then to the rehab hospital I realized I really wanted to go home. I was able to go home with the help of home are nurses and PTs. After the pain in my back didn't subside my pain doctor said the nerves were damaged during the accident. After countless trials of PT, OT, injections, etc I have found a healthy balance of pain medication and rhizotomies every four months. I would do anything to change what happened and would take my old body over the one that gives up on me with no warning. Not all of us with back pain from an accident are malingering, nor do we want to live dependent on medication and surgery. I will, however, take any form of relief and anything that helps me live a close to normal life.

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