文档介绍：INVISIBLE TO THE EYE RICHARD B. GUNDERMAN, MD, PhD
M and M (and M)
Medicine is all about telling and lis- Every story can be told multiple cal residency program might intro-
tening to stories. In the typical pa- ways. In choosing how to tell it, we duce a more thorough discussion of
tient-physician encounter, the pa- reveal a great deal about the filters plications such as
tient tells the physician a story. through which it has passed. What bleeding into its curriculum. Sec-
From the physician’s point of view, elements strike us as most impor- ond is the issue of the first resident’s
that story should supply two key tant? What details do we exclude as performance at the time of the eval-
pieces in a larger diagnostic puzzle, irrelevant? How does our sense of uation. Why did he fail to recognize
a plaint and history of the the story’s moral, our purpose in the bleeding? Was he overworked,
present illness. The plaint telling it, shape the way it is told? In with too many other patients to
is a one-sentence summary of the the following paragraphs, we hear look after to devote adequate time
problem that led the patient to seek the same story twice, once from the to this one? Was he tired and there-
medical attention, to which the his- perspective of a morbidity and fore not as sharp as he should have
tory of the present illness adds a mortality conference