Listen to your patient ’s story: It’s their diagnosis

Sir William Osler wasn’t exactly wrong when he said, “Listen to your patient, he is telling you the diagnosis.” But he didn’t mean it literally. His patients did not offer up esoteric and complete medical diagnoses on a silver platter. They left him clues in plain language that he listened to carefully in order to make the correct diagnosis. He penned his words in an era when medical information was scarce among non-medical people. There was no Dr. Google, Dr. Oz or Dr. House to educate the public about diseases or medical terminology a century ago. In a way, I think doctors today have to do more filtering of what our patients say to get the medical history straight. For example, Mrs. LaVerdiere made an appointment for nausea some time ago. As soon as I walked into the exam room, she started telling me about how she must have eaten a spoiled crab sandwich on her trip to a coastal fishing village the weekend before. Her conversation was full of theories as to why she was feeling unwell and her husband wasn’t. I finally got her to describe in great detail exactly what she felt, and the gnawing pain that radiated to her back did not fit with a simple case of food poisoning. Her CT scan showed the smallest pancreatic cancer ever diagnosed at Cityside Hospital, and she underwent a Whipple procedure as easily as any routine minor surgery. Mrs. Waller describes ordinary bodily sensations in the most dramatic terms and throws terminology around that rocks me out of my c...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs