What Brought You to The Hospital Today?

In 1971, when my father was a young medical student, he was working with patients at a county hospital in Houston. One day, a woman came in complaining of swollen feet and my dad was in charge of figuring out what was wrong with her.

“So,” my dad began, “what brought you to the hospital today?”

The woman looked right at him and said, “the bus.”

She was not trying to be a smart-ass. She was merely answering my dad’s question. So he tried again. “Well, why did you come to the hospital?”

“My feet are swollen,” she said.

“Any other problems?” he asked.

“Nope,” she replied.

He was a new medical student, but he knew there must be other issues. So, he turned to his textbooks and spent hours looking up all of the reasons that feet can swell. Then he went back to the woman. “Have you been short of breath?” he asked.

“Yes!” she said.

“Do you have a cough?” he asked.

“Yes!” she said.

“Do you have to sleep sitting up? he asked.

“Yes!” she said.

It was then that my dad knew that the woman had heart failure. So he asked her, “have you ever been treated for heart failure?”

“Yes!” she said.

Eventually, as he asked more and more questions about her medical history, my dad found out that the woman had a host of other problems. She was not forthcoming with any of her answers, but when he asked the right questions, he found out critical information that helped him successfully treat her.

It was a good lesson for him as a medical student. The woman had a litany of symptoms. “But,” my dad always says, when he tells this story, “she didn’t tell me any of that when she got to the hospital! She said there was nothing else wrong, but there was!”

Until he asked enough questions, he knew nothing of this woman’s life, except that she had to take the bus to get to the hospital for critical care. He didn’t know her medical history, and moreover, he didn’t know any of her other history either. He didn’t know what job she did or whether she was caring for multiple children on her own or if she was at risk of losing her housing.

All she told him was that her feet were swollen.

My dad told me this story many times growing up. As a child, I thought the moral of the story was that you should tell a doctor everything when you go to the hospital.

But as an adult, I know that’s not really the moral of this story.

I asked my dad about it the other day. “The woman with the swollen feet taught me that I have to ask the right questions,” he said. “I couldn’t just ask ‘what’s wrong’ and then diagnose her. I had to learn how to ask questions as a medical student.”

Because here’s the thing: we don’t know everyone’s story. We can’t.

When I see someone at the grocery store who gruffly and quickly passes me pushing a cart, I might think that person is impolite.

But maybe he’s just lost his job.

When I’m jaywalking a bit, and someone lays on their horn, I might think that person is really uptight.

But maybe her daughter was hit by a car once.

When I’m walking through the building to get to my doctor’s office, and the man in front of me doesn’t hold the door, I may think that person is a jerk.

But maybe he’s going to get some test results that could reveal if the cancer has spread.

I mean, maybe all these people have no excuses. Maybe they never really learned to be warm or polite or compassionate. Maybe they are all just terrible people.

But maybe that person in the supermarket or on the street or at the doctor’s office actually has a story that helps to explain his or her actions. All I can see is the bumped cart or honked horn or slammed door – just like all my dad could see was his patient’s swollen feet.

But that’s not the whole story.

I get it – we can’t ask everyone their story, and honestly, it would be weird if we did. (Can you imagine? “Excuse me, I notice you bumped into me and didn’t say anything. Are you having any problems with your spouse or children that you’d like to share?”) But damn, I often wish that people knew my story. Because there are times when I’ve been up since four am and am just about ready to break from all of the demands on my time and energy and I show up to the grocery store and just cannot smile at the woman blocking the aisle as she takes forever to decide on the type of pasta sauce she wants.

I’m sure, in that moment, that woman looks at me and thinks, “what is wrong with her?”

And you know what? Some days, there is something wrong with me. Something so deep and so intense that even if she asked I wouldn’t be able to fully articulate it.

Some days, all you can see are swollen feet.

But that’s never the whole story.