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Saturday, March 31st 2007

The Patient Who Won't Talk, The Patient Who Won't Be Quiet

The directive interview is beaten into your head when you’re first learning to do a patient history. You ask pointed, direct questions in a pretty standard order.

That is lovely until you get to the patient who doesn’t feel like elaborating.

Yeah, I’ve Seen A Lot of Patients Who Apply Lipstick While In The Hospital Bed

I shouldn’t be so hard. I’m pretty tight lipped myself.

So I probably have more sympathy for the “non-elaborators” than for those on the other end of the spectrum. This is the patient with just crazy tangential thought. He starts off talking about his back pain and the next thing you know the stats from his junior year in high school playing tailback or about the time he bit into a piece of rotten fruit when he was nine years old.

For those who stumble across this post: which do you think is the most difficult to deal with for an inexperienced medical student?