Who Is the Poor Historian?

John L. Coulehan, MD
JAMA. 1984;252(2):221. doi:10.1001/jama.1984.03350020023018.
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We cluster in the hall on rounds. A medication nurse pushes her cabinet around us on her way down the hall, while the breakfast lorry closes in from the other direction.

The intern begins his presentation: "Mr Blank is a 52-year-old man who presents with abdominal pain... the patient is a poor historian."

We learn that this sick person "claims" to have a number of symptoms and he is "apparently" taking several medications. The intern adds that the patient's compliance is poor, he doesn't seem to understand his illness, and he is, after all, a "poor historian." Having dispensed with the preliminaries, the house officer moves on to reporting the patient's physical findings and the initial laboratory data. At this point he drops all qualifiers: the magnesium level does not seem to be 2.2, it is 2.2.

Once again, we have left the patient and gone on to his biochemistry


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