Monday, February 18, 2013

The importance of your Narrative of your sickness

Doctors are supposed to get a narrative of your illness when you are first seen.  There are things that can be revealed by how and when your symptoms came about that can not be revealed by tests or examination.  I wish I had known this when I first became ill.

After the initial evaluation determined that I was not dying quickly and we could all take a breath I was lucky that the first doctor that was in charge of my care took the time to get a narrative of what and when things had happened.  Since then I have seen ten other doctors over the past three years for various problems that where outside the prevue of my main doctors specialty and even a second opinion at a world renowned hospital.  Few of these doctors took the time to get a narrative.

There seems to be a new boiler plate theme to appointments now.  The doctors appear to be checking off boxes on a checklist as opposed to actually getting the story of how you became ill and what may actually be the problem.  If the doctor will not listen to your story and interrupts you do not be afraid to speak up and advocate for yourself.  Now this is not a license to be douche bag, if you treat your doctor like crap your concerns will definitely not be addresses.  Ask open ended questions like "does that explain my toe pain, shortness of breathe and headaches?" and in my experience it helps if you come off as though you are stupid and really need it explained to you.

If the doctor can not explain what causes your symptoms that is a warning sign.  If the doctor will not admit that he can not explain some of your symptoms get up and leave and tell them you would like to not be charged for the appointment.  There is one great exception to this, if you have a rare disease and you are seeing a doctor that has written a text book about your disease it might pay not piss him off but barring that if they will not be honest with you there is no point in seeing that doctor again.