So, I am a chronic migraine sufferer (sans sunglasses), and up until about 2 weeks ago I was having about 15 headaches a month, so pain is not a new thing for me. I will get into the migraine thing in another column, as I have some great migraine stories.

Some new pain assessment techniques my colleagues and I have begun to employ are pretty simple – and AWESOME!

First of all, most of these people have never had pain worse than a blister from new shoes, so you have to put it into perspective for them. People with kidney stones or those going through childbirth or broken long bones notwithstanding.

Here is my new one. Granted, I use this on patients I gauge will tell me a 10 even if they are sleeping and talking in their sleep about Care Bears.

“So, how would you rate your pain, on a scale of 0-10, if 0 was no pain and 10 was pain you would have if someone chopped both of your legs off.”

No lie: I do use this. It usually gets an honest response. The key is to say the last phrase sort of quickly and catch them off guard.

Another friend of mine uses his special scale only on those who give him an answer of 10 on the pain scale. His next question is, “A 10, huh? OK, then how would you rate it on a scale of 1 to 1,000?”

Patients look at him quizzically, and then always answer some odd number like, “Umm… 847.” If it was a 10, why wouldn’t it be 1,000? I sense inaccuracy here, people.

What do you mean? Inaccuracy in medicine? The horror!?!

I’m sure all of you have your own Spidey-sense to hunt down the posers out there. It is not uncommon for me to think (sometimes aloud…) “10/10 pain my a–” when departing a patient encounter. I mean, even as a rookie, you get good at sniffing out the bull pretty quick.

All in all, being an emergency physician is not just about making an accurate diagnosis, treatment plan, and disposition, it’s about sniffing out what’s going on underneath, what’s real and what’s not real, the sick and not sick, and no numeric score will ever be able to do that.

Dr. Bundy is an assistant medical director at Baptist Medical Center East in Montgomery, Ala., and a former photojournalist. She not only sings in the car, but also talks to herself, is addicted to diet drinks and shoes, and thinks emergency medicine is the greatest specialty.