Social Work; Essays on the Meeting Ground of Doctor and Social WorkerCabot, Richard C. (Richard Clarke)
Science
Social Work; Essays on the Meeting Ground of Doctor and Social Worker
Cabot, Richard C. (Richard Clarke)
Charities, Medical; Friendly visiting; Medical social work -- United States; Social service
As the history-taker traces out the symptoms of the patient's illness
after finding an answer to this first question, _Why to-day?_ two
opposite habits of mind must be employed, one passive, the other active.
We must be sure that the patient shall feel that he has had a good
listener, that his troubles have really been appreciated. But if we are
constantly putting in questions, as we certainly must later, the patient
does not feel that he has been listened to. We desire first of all to
get his own story in his own words, passively. We may not necessarily
write down a single word of it. But I have found that the patient's own
way of expressing the nature of his troubles is often important and
characteristic. It helps to prevent our histories from looking too much
alike, which is their commonest fault. Hence we should get into them
somewhere a phrase or several phrases reported passively in the
patient's own words; if possible a phrase in which he describes his
"presenting symptom," the thing of which he chiefly complains.
But the second stage in the process of taking a patient's history is the
most important. In this part we should be active, not passive. We must
attack our task with a tool in our hand, _a mental tool fitted to rake
out of the mass of confused ideas in his mind certain significant
facts_. That rake is a logical schedule of questions which you use upon
him actively, not passively, and by using which you get answers either
negative or positive. Whenever you think well, you _think with a
schedule_ of that kind in your mind. If you pack a trunk well, you pack
it using a list, a schedule of the things that ought to go into that
trunk. Our printed social face-card helps us to think and question with
a schedule before us, to think in an orderly way, without forgetting our
items, and thus to select what we need out of the mass of disorderly
facts in the patient's memory.
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