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A real history

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Sometimes, taking a history can be a more historical experience than you first expected. I was recently reminded of one of my first patients as a house officer – my first real solo emergency. He was in his eighties and paper-white, with a bloom of blood on his pillow. Experienced enough to know that he would need a big cannula, but not experienced enough to place the line confidently, my hand was doing a good impression of an Ibiza DJ’s as I approached his arm. Too green even to brazen it out, and desperately concentrating on not setting him up for the ‘little prick with a needle’ gag, I warned him it might hurt.

He looked at me steadily for a few disconcerting seconds. My hand was dangling a ridiculous grey cannula just above his forearm, and continuing to party like it was 1999.

‘Hurt, you say?’

‘Maybe just a bit.’ The cannula stepped its tempo up to become a grey blur.

‘Hmm.’ He frowned. Then suddenly he smiled and beckoned me to lean in closer. ‘When you say “hurt”, I don’t think you know what this means. I was a pilot. I am Polish, but I managed to escape Poland. I came to this country and they gave me a plane. The Nazis shot my plane down, and they caught me. I think they were less gentle with me than you will be.’

I can’t remember how many unsuccessful attempts I had, before finally getting a vein that wouldn’t collapse. He didn’t complain once. He was kindness itself when I finally fluked one in. Over the next few weeks, we talked a few more times on the ward, and he always had the same quiet, unworried dignity.

I met another war veteran recently. He had the same stoicism, and again it was a privilege to learn his history.

Dr Nick Ramscar is a GP in Bracknell, Berkshire

Readers' comments (2)

  • A thorough case history needs to include a human element surely? Nice post, Nick.

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  • We've all met patients like this. Thanks for reminding me! They are so humbling.

    A beautifully written piece.

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