A 40-year-old woman presented saying a man attacked her earlier in the day. He pulled her legs, kicked her back and cut her with a knife on her arms, legs and chest.
Most of the time, when a woman comes in after being assaulted, she is pretty upset. In this case, my patient was upbeat and pleasant. She didn’t act very worried that she might actually be injured very badly.
When I looked her over carefully to evaluate her for possible injuries, all I saw was multiple superficial abrasions on the insides of both forearms, across her abdominal wall and both breasts. It was clear they were just scratches and not cuts from a knife. It was also clear from their position, shape and symmetry that they were self-inflicted.
I gently confronted her with my impressions but she continued to steadfastly deny she had caused the scratches or that she had any desire to hurt herself. I recommended she go talk to a psychiatrist but she refused. Had I really thought she was a danger to herself, I would have put her on a psychiatric hold and sent he to psychiatry anyway but I felt this was just strange attention-getting behavior, though I could never get her to admit it.
I had the police come and take a report since she continued to state she had been assaulted. I then sent her on her way, leaving me wondering what was really going on.