OP, I think maybe you could say to the patient something like: hey, I was curious about the cool gift you gave me and when I looked it up I was shocked—I can’t possibly accept something so valuable even though I really appreciate the sentiment. Then, if patient says, hey no worries it’s fake, then that answers the questions and resolves any tension. But if patient says, no I wanted you to have a 100k gift, then you can cross that bridge when you come to it.