Should we pity the “poor historian” — the individual or family member who can’t give a clear accounting of their illness or symptoms — or embrace them? They have important stories to offer their clinicians, but can’t tell them. Who is really to blame here? And should the term poor historian ever be part of an individual’s permanent record?
Here’s an example of how this works: One warm summer night, when one of us (Steven) was on call, an elderly man came to the emergency department. He was confused and had a fever with shaking chills. After stabilizing the patient, finding out why he became sick was the central priority for the team. To set the diagnostic cart on the right track, a resident physician interviewed the patient’s wife to gain more information about his condition. The conversation wasn’t illuminating: there was only so much information she could convey through her tears.