Do you call somebody out for lying? What if the person is doing so dramatically? As in, it is grossly obvious that she is not telling the truth? Do you let them continue? Or do you bait them with questions to see how far their deceit will go?

At a function the other day, the neighbor from down the way said something odd. The content of her comment was rather unimportant. What matters is that she, for whatever reasons may have been, stated something that I know to be untrue. She was relating what she something she claimed occurred in her life to what I had just explained her and there is no doubt that what she said was untrue. This is not the first occassion this sort of occurrence has happen and will surely not be the last. I know that I will have ample people lie to me, whether knowingly or simply through omission, but that should not be the case with people I consider friends or colleagues. I am undeniably aware that I will have patients lie to me, they will be embarassed about how the household object ended up their rectum and will tell me that they fell on it or they will come up with some other clever excuse for why whatever is wrong with them is not their fault. But, at that point, we all know it is a lie, right? What I think is most interesting about the lying patient situation is that between both patients and physicians it is commonly held that, depending on the patient you are taking a history from, a non-trivial amount of what is said to doctors is steeped in falsehood. This probably leads to a larger conversation more appropriate for another time, but why do people do that? I can see not telling your significant other, your parents, your coworkers about doing something foolish and requiring a visit to a physician if you risk becoming the butt of jokes. But, at least in the US, there is a long tradition of confidentiality between healthcare providers and patients. Beyond tradition, it is legally codified, we risk criminal penalties by disclosing personal health information beyond what the legal releases that the patient has agreed to. Are patients worried that their drug, sexual or personal history will become public? Or are they just so chronically conditioned to lie that they do not know what else to do?

Back to our original subject. Her lie was egregious. At least if there were some subjectivity to it, I could think that she misinterpreted what happened. But that is surely not the case. And, this is not the first time that I have suspected her of being untruthful. Could my mistrust of her honesty informed my opinion of what she said in this occasion? Absolutely. Did it? Most definitely not. The situations in the past were inconclusive. I thought she was being dishonest, but I had no definitive evidence. Now, I knew that she was not telling me the truth.

I let her continue with her story, though it burned me deep inside to have to listen to somebody who was being blatantly dishonest with me, and I said nothing more to her about that topic. I moved on and talked about something else.

Should I have called her out on it? Would it have done any good? I think it would have only harmed our friendship, our professional relationship. But do I really want to be conversing with somebody that I know will only end up lying to me? It is one thing if I do it solely for professional purposes, but that is not where the situation came up.

I have hypothesized reasons why she is so frequently untruthful and I am acutely curious as to the reasons. I do not see myself asking her why she lies so much, but every time I hear her say something that sounds like it might not be the truth, it makes me want to ask her. The lies she tells so frequently match up with content of what we are currently talking about, it seems that she is just trying to fit in, to have something to say to the content of everybody else’s conversations. What she does not realize is that people would like her just fine, and in fact would be much happier talking to her, if she were to just tell the truth. We do not care if her life has been boring, we do not care if she does not always have something interesting to say, most people just want to hear what people honestly think, what has actually happened to them. Anything other than that and you are doing a disservice to those listening to you and to yourself.