I have written before about the nature of delusions and how permanent they seem to be in those that suffer them. Every time I come across something to do with such behaviour it reinforces in me that irrationality is the default state for humans and that there is not a lot that can really be done about this.
The following article is a wonderful look at delusions in a general way but it is a much more telling piece than simply a blog about some nutbags.
I saw a patient recently for parasites.
I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite. The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism.
The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem. There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who I saw in clinic who, while we talked, ate a raw garlic clove about every minute.
“Why the garlic?” I asked.
The rest follows here –