Gregory House, MD, the main character of the Fox TV show House
, isn't like other TV doctors. While they obsess over emergencies, surgeries, and affairs of the heart, House is all about the subtle art of diagnosis. That's no surprise given the inspiration for the series—the New York Times
column "Diagnosis," by Lisa Sanders, MD. In her new book, Every Patient Tells a Story,
Sanders uses puzzling medical cases to illustrate how narrative can help you help your doctor. Here, she shares some pointers: O : How do I know what to tell my doctor? Sanders:
You're telling your story even before you call a physician. You share it with your friends, your mother, your spouse. You tell them about the pain you're feeling—what makes it worse, what makes it better, how it affects your life. Use this info, and then be prepared to answer the questions that doctors ask. O : What kinds of questions? Sanders:
Actually, the first question is one that I find doctors rarely ask, though they should: "Do you have any idea what this is?" Patients usually do have a sense of what is ailing them. So if your doctor doesn't ask, speak up. I had a patient with fever, low blood pressure, sore throat, and maybe diarrhea. I took a good history and did a thorough physical exam. But 48 hours later, all the tests (Lyme disease, various other bacteria, salmonella, etc.) were negative. As I was giving her the results, she said, "Oh, I think this might be dengue fever because I was just in Puerto Rico visiting relatives and everybody in the neighborhood had dengue and felt just like this." Sure enough, that's what she had. Another important question: "Has anything like this ever happened to you before?" Patients often overlook this. If something strange happens to you once, okay, everybody has one freak occurrence. Twice? That's a pattern. O : What happens if your doctor doesn't take the time to listen? Sanders:
If your doctor interrupts before you are through, indicate to her you're not done. We have no idea which detail is going to be useful until we hear them all. When you get a chance, say, "I'd really like to go back to my story. I still have some thoughts about what's going on." You are the expert on your experience, and no one but you can describe your area of expertise: your body. Related: Are you reading your body's signals correctly?