Posted by: Tony Copperfield28 January 2013
‘Have you tried talking treatments?’ I ask the blubbering mound of emoting jelly, who’s quivering and snivelling her way through my day’s supply of Kleenex.
She fixes me with a look of snot-smeared contempt. ‘Counsellors?’ she snorts. ‘I’ve seen 31 different counsellors.’
Blimey. So what do you conclude about a person who says they’ve seen 31 counsellors? That they need counselling? No. That they’re bonkers? Yes. But it’s not the counselling overdose that’s the clue, it’s the specificity and certainty of the number.
I’ve never actually seen it recorded in the medical literature, nor have I heard it discussed during our informal, caffeinated, ‘Guess what happened in my surgery today’ debriefs. But I think it’s a real syndrome: Hyperbolic Numerical Specificity (HNS).
I could quote other genuine examples I’ve encountered. A woman whose visit request stated, ‘Has vomited 27 times’. A man who told me that he’d experienced 43 headaches in the last six months. Another man who, last hay fever season, told me he’d sneezed 81 times that day and who, next summer, will presumably provide me with a pollen count involving an actual number.
These figures are always stated with the utmost, unshakeable certainty and an expression that conveys the notion I’ll be impressed and moved to action. True, we GPs are always moaning about vague and inaccurate histories, but HNS is the opposite polarity and is just as useless.
Though it isn’t completely. Because it screams out, as clear as a flashing neon signs above the patient’s head, ‘I’m a nutter and you can ignore everything I say because I have no serious organic illness.’
I guarantee this is true. Because every case of HNS seems to resolve without harm to the patient. And I’ve seen it 68 times.