Raj vs Reality

When you ask Raj how he's doing, he will always say he's fine. When he fell and broke his nose in July 2009, he told the EMTs they didn't need to treat him . . . he simply wanted a white plate to bleed on. Part of it is his mental perception - he doesn't notice anything wrong, so he assumes the status quo - and the the other part is the progression of Mild Cognitive Impairment - diminished ability to feel/recognize pain.

Similarly, when you ask whether he's taking his meds, he will always confirm that he is, since he sees no difference between taking a pill once/month vs once/day; If he remembers EVER taking a dose, he's "compliant" in his estimation; So, when the doctors in his Sleep Consult asked whether Raj was using his C-PAP at night to treat his sleep apnea, he answered in the affirmative. He just chuckled when they downloaded the activity from the card in the machine to reveal using it 4 nights out of the last 180. So now we need to get him using the C-PAP again before they can explore narcolepsy, because poor sleep at night (averages 60 events of losing consciousness per hour) means nodding off during the day.