? about auditory hallucinations

I would like to know if anyone has had an experience with a

patient who has a possible major organ pathology who has auditory hallucinations?

The patient was seen by us in a walk in clinic at a summer resort area. No alcohol or drug use, per client . Age about mid 40s to 50's, no medications . Worked full time in sales, so drove 2 or more hours per day

for his job. Denied history of mental illness.

When waiting to be seen (alone in the room) patient was observed talking loudly to the floor and

then ceiling. MD was alerted by staff.

Patient was referred to his MD as he was leaving for home the next day,

MD felt it was more medically based.

Any experience with something like this? We were amazed he could function at work with

all of the driving.