Some people seem to think that faking unconsciousness is a good idea, either they are mentally ill, drunk, or more commonly, have had some form of argument and have decided to ‘go unconscious’. 

For some reason, benefit offices and rent payment offices are popular places, as are police cells, magistrates courts and at the checkouts of supermarkets.

The easiest, and quickest way to see if someone is faking unconsciousness is to lightly brush your finger against their eyelashes.  If their eyes flicker, then they are almost certainly faking it.  Also if they try to keep their eyes closed when you try to open them, they are definitely faking it.  Another way of checking is to hold their hand over their face, and let it drop.  People tend to be reluctant to let their hand hit them on the nose, and so the hand will instead magically drop to one side.

The other giveaway is that they open their eyes to look at you when they think you aren’t watching them…

But what happens if someone is able to wake up, yet is refusing to?

Let me quickly explain an important part of measuring someone's Glasgow Coma Scale.  The Glasgow Coma Scale is a way of measuring how deep someone's level of unconsciousness is.  (I could just quote the Wikipedia article, but if you want to know what a GCS is, then click the link).  Part of this process of assessment is how they respond to pain.

The official method of applying this pain is to push hard against the upper part of the eye socket.  This does no damage but is apparently painful.

Not to me it isn’t, and not if you are deeply drunk.

So there are other painful stimuli, one of which (my favourite) is the ‘sternal rub’, where you rub the knuckles of your hand against the patient’s breast-bone.  Some lilly-livered people think that this assessment is too close to assault, but I would ask them to consider that if we didn’t get drunks to wake up, we would be forced to undertake invasive medical procedures on them in order to ensure that their airway is clear.  If you can tolerate my sternal rub then there is something seriously wrong with you, and you need emergency treatment – but if you wake up then I have effectively ‘cured’ you.

Either way the assessment is complete.

Of course I did get a broken rib for my troubles when curing an unconscious drunk who had sexually assaulted a female pedestrian.  I also can’t see how one way of causing pain may be assault, but another isn’t.

The moral of this story is simple : Don’t pretend you are unconscious, because we will know – and don’t pretend to be unconscious when you are drunk, because it can get painful for you.

My favourite tale of how to uncover a pretender in a hospital setting was a doctor, who would loudly ask for the ‘brain needle’, to draw off some brain fluid from the unconscious patient via the ear.  Of course, he would continue, the patient needed to be unconscious because otherwise they might flinch and the needle go into the brain itself.  This was normally followed by the patient ‘waking up’ and asking, “Doctor, where am I?”.