Historians are left forever chasing shadows, painfully aware of their inability to ever reconstruct a dead world in its completeness.
“Tell me about your prior cancer treatment,” I say. “When did you have the surgery and radiation?”
“It wasn’t a surgery,” He tells me emphatically. “It was a biopsy.”
“But the doctor SAID it was a surgery!” chimes in his wife.
“Yes, Dad. You have a long scar on your neck,” adds his son.
“No! They called it a biopsy, NOT a surgery! And it was two years ago.”
“No, dear, it was five years ago.”
“Five? Are you certain? That long ago? And I had radiation before the biopsy.”
“No, Dad, you had the surgery before the radiation treatments, remember? You were still recovering from the radiation when the twins were born. And they are four already.”
“Are you certain?”
“Anyway, Doctor, he’s been losing weight.”
“No, I haven’t!”
“Harold, your clothes are hanging off of you!”
He scowls. Things get worse.
Harold is the type of patient physicians tend to call a “poor historian.” He can’t remember his health history and has difficulty connecting the dots between his symptoms and his illnesses. It is hard to get people like Harold to answer health-related questions in a format that is easy to understand and record.
However, an essay by Dr. Jeffrey Tiemstra puts Harold and patients like him into context for me. In a clever and insightful piece, Dr. Tiemstra reminds us that it is not the patient who is “the historian,” it is the doctor.“The historian sorts and organizes the past, identifying the important and meaningful events from the trivial, and then interprets the story in order to explain the circumstances of the present.” That, I agree, is my task.
It is my job to make sense of the events told by the patient and his family. It is my job to create a record of his prior health so that our team move forward and safely develop a plan to help him.
Fortunately, there is a lot of the information in Harold’s records from the outside hospital. I hope they are complete and accurate. Those documents should help me make sense of what I am hearing from Harold in bits and pieces.
I lean back and listen to the family interact. There is a lot of history in the way they talk to each other. Some days more than others, I need to take my role as historian very seriously.
Bruce Campbell is an otolaryngologist who blogs at Reflections in a Head Mirror.