Recently, I saw a middle-aged ex-smoker with throat pain. The standard Medical History carefully characterized the pain’s location, duration and character. He thoughtfully answered all of the questions. Soon, I understood where and when he hurt and what he needed to do to make the pain go away. He allowed that as long as he spoke quietly, he felt fine and could stay pain-free.
That did not alleviate his concerns, however.
To do that, he had to tell me about his calling as a Pentecostal minister. He expressed some of the joy he had experienced from years spent shouting, singing, imploring, cajoling and inspiring. The pain, he said, made it impossible for him to continue. He could still teach and counsel, but his days at the pulpit appeared to be over.
I do not know if we can solve the problem, but we set a plan in motion that addresses not only the pain, but the context in which the pain occurs. Perhaps, someday, he will return to the pulpit.
A wonderful essay by The Cheerful Oncologist explores the importance of eliciting the patient’s Social History; he shares his insights into how hearing patients’ stories can be both a delightful and a critical exercise. Spending the moments needed to gather the Social History gives the care provider new insights, clues, and treatment options.
