Editor's Comments on 'History Taking Tips from Grandma'

 , May 30, 2018

The wealth of knowledge that precedes attaining a medical degree demands great pause and respect. However, perhaps none of it proves useful if it cannot be translated into patient care by the practicing physician. Hidden among medical school’s onerous biochemistry syllabi and lengthy anatomy texts rest the ironically “unspoken” and “undiscussed” lessons on communicating with patients. Collecting a patient’s “History and Physical Examination,” colloquially called an “H&P,” serves as the fundamental stepping stone for data gathering and analysis of a patient’s presentation. It is within this framework that a physician’s thoughts are gathered. All the doctor must do is ask a series of questions - quite straightforward, it would seem.

But how can we be genuine and empathetic in the process of this interview?

Especially early in training, but even for seasoned physicians, this task is easier said than done. It is admittedly quite unnatural and even uncomfortable to discuss topics such as frequency and quality of diarrhea, substance use, loss of ability to perform activities of daily living, and the like. However, such data, taken together, is crucial to seeing the big picture of a patient. To create space for a patient’s vulnerability, the art of the interview aims to preserve humanity in an occasionally ruthlessly objective and depersonifying field.

Stephanie Wan’s piece “History Taking Tips from Grandma” highlights her journey through the art of the interview in a raw, self-critical reflection of her evolution as a budding physician. Her attitude of learning interviewing skills from textbooks, just as we learn the rest of medical knowledge, hits home to the essence of a medical student mind. The safety net of the robotic “tips and tricks” Wan learned from her texts for her earliest patient encounters readily conjures the awkward feelings perhaps every physician has experienced at some point in their training. [Looking at you, standardized patient encounters]! Wan relives for her readers the “a-ha” moment when she finally takes her nose out of the books and begins to find the humanity in her patients to better relate to them in earnest, turning lovingly to her beloved grandmother, a small town Mauritian shopkeeper who could befriend just about anyone. Wan’s sincerity, openness, and humor sing boldly through every line of her captivating work.

On behalf of myself and the other editors at The Living Hand, thank you, Stephanie, for sharing your courageous, honest, and meaningful piece dedicated to your path towards compassionate patient communication. Your piece brings to light a common intersection we all face in our path to becoming a doctor. I am humbled that you have shared this piece with me and, now, the greater medical humanities community.

Herbert Rosenbaum