If something smells fishy...

Whilst on a clinical placement in an inpatient setting, I, together with my supervisor, assessed and treated a patient who had vestibular symptoms. Symptoms reported included dizziness, spontaneous nystagmus (usually in the middle of the night) and nausea. Assessments and investigations done by the neuro (medical) team could not ascertain a diagnosis or cause of the symptoms, and the patient’s mother was becoming somewhat frustrated and worried, almost catastrophising, making it increasingly difficult to reassure her.
In out physio assessment and treatment, we noticed that the patient’s symptoms did not always correlate with findings of our examination. Yes, the patient showed vestibular dysfunction, but some tests that should (according to reports of what brings about his symptoms) have elicited some of his symptoms. I also noticed that the patient’s account of their symptoms also depended on whether their mother was in the room with us or not.
We established that there was some vestibular involvement, so proceeded to treat with desensitizing exercises. We also discussed our concerns with the medical team, who revealed that they had similar concerns and referred the patient for a psych consult.
From this I learnt that if you feel something is not quite right, it is best to consult with other members of the team, as they may have noticed similar things, or they may be able to explain to you why something was noticeable. I took this experience and applied it to a couple of other situations where I felt that I person’s social situation may be influencing their medical presentation.