Medical history timeline: a tool for doctor visit storytelling

Originally Posted on January 3, 2012

By: Katie McCurdy

This is a follow-up to my last post, in which I described how visualizing one’s own medical symptoms and progress in the form of a timeline (in addition to other visualization formats) might help people better understand what is happening to them – and help them communicate with health care practitioners.

I recently took a print-out of my own medical timeline (which I had created from memory) to a new Doctor I was seeing, hoping that the visualization of my symptoms and medications would help him better understand what I was experiencing and thus better understand how to treat me. The new doctor was Dr. Richard Ash, a medical doctor in NYC who is known for embracing alternative therapies.

med-timeline

As it turned out, he spent less time with the visualization than I had expected. Because he had seen similar complications in the past, he felt confident that he knew what was going on with me before I even had a chance to show him the timeline. I also realized that Doctors and their staff communicate through their own language of scribbles and shorthand, and they wouldn’t necessarily want to take any extra time during an office visit to understand this new visual language.

But this timeline prop was still extremely beneficial, because it helped me tell my story in a chronological manner and it helped me remember all of the details I intended to talk about. For comparison purposes, here’s what usually happens during an office visit with a new doctor (or, for that matter, an office visit with an existing doctor but for a new problem):

I go into a bland, beige room devoid of any personality. It looks like this.

imag0663

Typical exam room: beige-splosion

I sit on a paper-covered table and swing my legs. I look around for a magazine, and I might find a tattered Travel or Highlights for children sitting next to a stack of educational pamphlets (perhaps on the perils of chlamydia or the importance of proper nutrition, depending on the doctor). I stare into the distance. After 10 or 15 minutes, the doctor knocks and comes in the room.

‘So, what brings you here today!?’

At which point I spew forth whatever words and thoughts come to my mind, sometimes aided by a scrap of paper on which I may have written a short list of things like ‘calcium/bones, guts, tingly legs.’ I usually feel a little rushed, conscious that the doctor inevitably has back to back appointments, so I end up abbreviating my story to accommodate him/her. But once I’ve left the office, without fail I realize I forgot to mention a certain symptom, or a certain thought. Sounds inefficient, right?

But this time was different – when I spread the taped-together timeline in front of Dr. Ash and started talking, an ordered and coherent story unfolded and a bigger picture disorder came immediately into focus. I was able to point to certain phases of my history and explain what had been going on at the time. I talked quickly and deliberately, and showed both my timeline and full list of symptoms. The result was a more structured conversation that allowed me to communicate my story more efficiently while saving the doctor from having to listen to five minutes of my rambling.

I suspect I’m not the only person who has a hard time articulating my symptoms, fears, and questions when I’m sitting in a stark white room in a paper smock. We don’t often think about the importance of this moment to our healthcare experience, but it’s usually the only time we have the doctor’s full attention. How empowering it would be for all of us patients to take a little control over this moment and present our stories like expert witnesses.

I’m still feeling energized and inspired by the idea of empowering the masses and will continue pursuing it, while I’m also spending lots of time and energy getting better myself.

Katie has lived for over 20 years with an autoimmune disease called Myasthenia Gravis. She applies her expertise as a User Experience (UX) Designer to help improve healthcare. “I especially am interested in trying to solve problems that are relevant to me as a patient. By finding solutions for my own problems, I hope to improve the lives of other patients like me.” . Follow her blog [sensical], her professional website or on Twitter @katiemccurdy.

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