Alayna Pretended She Was Sick

Q: You acted like you were sick so people in medical school could guess your illness. Is that right?

A: Yes. It was such a fun job.

I was taking prerequisites for nursing school and my sister was working in the medical school and she told me about the “standardized patient” program.

I worked in the medical school every few weeks acting out a patient scenario for medical students.

Q: It sounds like Seinfeld. Wasn’t there an episode where Kramer had to pretend he was sick? The same kind of thing?

A: It was a little different than Seinfeld. I just watched that clip recently and Kramer went into a room full of doctors and he had gonorrhea.

When I did the job, it was one-on-one. The student would ask me questions and then leave the room. Then I filled out a survey; you graded them on how well they interacted with people.

Then the next person came in. After five people I’d take a break and then have five more.

Q: What kind of “diseases” did you have?

A: Nothing with outward symptoms. Maybe a little limp when I walked in the room.

I played a lot of teenagers. Mostly it was constipation or mood stuff. One time I was a pregnant woman who was smoking. I stuffed a big pillow beneath my shirt for that one.

Usually I played a teenager because I looked young, and in one case I was a teenager with constipation. During the interview, I was trying to act like a teenager so I wasn’t really answering the questions—I would just say, “My stomach hurts.”

For some reason the guy thought I was sexually active and that I just wouldn’t tell him. He was saying, “Tell me—you’re having sex, aren’t you?!”

But I was supposed to be a teenager who never had sex before.

Q: Eek. I wonder what kind of grade they gave him.

A: I don’t think they gave grades—I think it was pass-fail.

Q: What was the setup like? Do all medical schools have something like this?

A: It depends on the school. It think it’s only the bigger medical schools that have a program like this.

This school had a fake office suite with little fake patient exam rooms.

I’m a nurse practitioner and in school we did a version of this but it was less formal. We did it as a class.

Q: I love that you played a teenager.

A: Yeah. I had outfits I saved just for the job. Like things from the JCPenney junior section. I remember I had this neon green shirt with little silver skulls on it, and I would wear purple eye shadow…

The same day the one guy thought I was hiding my sexual activity—that night I went into a bar and one of the other students was there, and he looked shocked. But I told him, “I’m actually an adult.”

Q: How did you know what malady you were going to have on a given day?

A: They’d give me a one-page description and a list of answers to questions we’d be likely to receive.

Q: Were most of the students pretty nice?

A: Most of the time they were really nice. Sometimes they were tongue-tied or nervous.

One time one of the guys got really nervous and he took the fake otoscope from the wall and put it in my ear and was like, “I can’t see anything!” because it was dark—there was no light because it wasn’t a real otoscope.

A voice came over the loudspeaker and it said, “You don’t need to physically touch the patient.”

Q: The loudspeaker? So they were watching you?

A: Yeah, and there was a camera so they could watch it later.

Q: How long were the interviews?

A: They lasted 10-15 minutes. I would have five appointments. I did it every couple of weeks for a year.

They’d hire me for an afternoon. They’d give me snacks. And the pay was really good—like 15 bucks an hour.

Q: Did you meet any of the other pretend-sick patients?

A: Yes, we would take breaks together. It was mostly older, retired people.

Q: Did you date any of the doctors?

A: No. They were totally cute though. The problem was they thought I was a teenager. They’d ask me, “Where do you go to high school?”

Q: It must take a reasonable amount of skill to interview patients effectively.

A: As a doctor, you want to just re-focus people to get the information you need. I think it’s called OLDCARTS: Onset, Location, Duration, Character, Alleviating, Aggravating, Radiation, Temporal pattern, and Severity.

Q: Do you think about these things when you go to the doctor?

A: I do think about having the information from OLDCARTS ready for the provider.

Q: I’ll have to try to remember that the next time I’m sick.