On Family History
Orwa Aboud MD., PhD*
Department of Neurology and Neurological Surgery, University of California, Davis, California, USA
*Corresponding Author: Orwa Aboud, Department of Neurology and Neurological Surgery, University of California, Davis, California, USA
Received: 19 April 2023; Accepted: 03 May 2023; Published: 19 May 2023
Citation: Orwa Aboud. On Family History. Archives of Clinical and Medical Case Reports. 7 (2023): 210-211.View / Download Pdf Share at Facebook
While I was a Neurology resident, I was asked to see an elderly man for a concern of a “stroke” that was revealed on imaging. On my way to see this patient, my mind was going about what was still pending for the rest of my day. I always believed that there is at least one thing interesting in every patient’s interview. I have to admit that this interview has stuck in my mind since then! As I am approaching his bed, I saw a man with strong facial expressions, but behind that you could appreciate a very kind person trying to tolerate his pain while reiterating his history one more time:
What brought you to the hospital?
It was a stormy night last weekend you know doc…
My dog was having a seizure outside.
I ran out of the house to get him, I slipped on the stairs.
You know, I broke my hip.
Any history of diseases in your family?
I am not sure how to answer that question!
What do you mean?
My mother died giving birth to me.
Sorry to hear that, what about your father?
He died in a car crash while he was driving to meet me at the airport.
When was that?
That is when I came back from the war overseas after being away for 2 years!
Did you see him?
Not while alive.
Do you have any kids?
Yes, used to.
Yes, my wife and I had twins, a boy and a girl.
What happened to them?
They passed away in a car accident while going on a “double date” with a boy and a girl sibling. All four died in that accident!
What about your wife?
She died a couple of years ago, of cancer!
With whom do you live now?
Alone, I mean with my dog and I am happy that he is doing well after he recovered from that seizure…
After going through patient’s past medical history, surgical history, social history etc. I don’t think that I was able to associate his current complaint with a cause from his history beside the rare association between bone fractures and strokes, nor was I able to associate his life-long history of misfortune with a familial disorder. However, you can argue that this is helpful in understanding the patient’s perspective on life in general and on his current medical condition in particular. This will help you understand why he was still happy to be in the hospital as long as his dog was doing ok. While the history and physical examination may seem to have diminished in importance under the specter of technological advances, time constraints and ever increasing electronic medical records (EMR) requirements, the history and physical are still very important components in understanding etiology, prioritizing workup, and reaching a diagnosis. While we spend less and less “face” time with our patients, one can argue that we are losing the human aspect of medicine—understanding the patient holistically.
That reminded me of the following quote from the Count of Monte Cristo by Alexandre Dumas in his letter to Maximilian: “There is neither happiness nor misery in the world; there is only the comparison of one state with another, nothing more. He who has felt the deepest grief is best able to experience supreme happiness.” I believe that our duty is not only to teach but also to learn from our patients. Not only will patient care be enriched, but so will our lives.