A Holiday To Hope
By WVFC on August 21, 2009
The weekends have been filled with chart reviews that I have done periodically but have now chosen to do with each annual visit. After all, after 25 years of time with a patient, it is helpful to review anew the past and the story of our time together. This kind of work requires quiet time and often becomes diagnostic as the patient’s memory in the present may no longer be in sync with the story told at that first visit years ago. Initial patient interviews and evaluations lasting two or three hours cannot be integrated in the space of that first consultation. It’s customary that I spend an hour on the weekend for two separate weekends with each chart of a new patient, putting the pieces together of a one thousand piece puzzle that has only a blurred picture on the puzzle box to guide me.
I have clues from each woman’s life stage, clues from the narrative of her life, clues from her symptoms, clues from her physical exam and clues from her goals and choices. But the strange work I do diagnostically begins in the quiet hour when I am alone with her story, and work to understand how she became who she is at this time. I write the story in narrative form in each patient’s chart and it is the writing that distills my thoughts. The next weekend I have the chart with me again, with additional clues from diagnostic tests.
For each woman, the original narrative and this new information generally give me the insight I need to create a plan that will work uniquely for her — to allow her to obtain better health and understand the importance of self care. Medical team building requires that each patient must be the equal partner in her goals for good health care. I have known patients who prefer to just fax their body parts in to the office and have a bit looked over and a blessing made or a treatment prescribed. But, sadly, this does not fit in the work that is done in a medical relationship with me.
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