Im-Patient History Form

Patient Information

Patient Name: Andria Kennedy

The same name you ask me to write at the top of every piece of paper you put in front of me. Is this a secret memory test? A double-check that I’m not an imposter attempting to sneak medical care out from under the noses of Big Pharma? (If someone else wants to pay my bills and co-pays, why are you stopping them? I don’t have a problem with it) Your need to prevent a mysterious doppelganger from infiltrating the hallowed halls of Medicine to obtain free healthcare?

Or is this nothing more than your office’s subtle attempt at finding new ways to claim you have no idea how to spell my name? Fifty pages of black ink—block letters printed at the top—but you still feel I should be “Andrea” instead of “Andria.”

Patient Social History

Marital Status: ___ Single _X_ Married ___ Separated ___ Divorced ___ Widowed

There’s no connection between marital state and health (I maintain stress is perfectly natural and necessary for life). You ask this question to fuel your office gossip pool.

“Ooh, look! The sad, tragic lump is no longer checking the ‘Single’ box! She managed to land an unsuspecting husband. Wonder if he knows what a disasterpiece he saddled himself to.”

My change in selection didn’t prompt you to correct my emergency contact information (it’s cool; my parents don’t mind fielding phone calls at 2:00 AM).

And it’s not like my husband feels awkward standing in the corner while you discuss my treatment plans. Or when you congratulate us on our marriage. For the 12th time. In two years.

Use of Alcohol: ___Never ___ Rarely ___ Moderate _X_ Daily

Oh, you meant OVERALL. Not as I was filling out this form. (My bad)

Use of Tobacco: _X_ Never ___ Previously but Quit ___ Current Packs/Day

Use of Drugs: ___ Never _X_ Type/Frequency:

You should know, considering you prescribed them.

What? OH! You meant the illegal kind that no one admits to. But you expect someone to write it down on a legal (is this legal?) document. Good luck with that.

Medical History

List Previous Hospitalizations With Year

Are there human beings in your clinic that can list their hospitalizations on two measly lines? Healthy individuals who don’t have an intimate knowledge of the workings of an ICU or cardiac floor? Aren’t on first-name bases with half the staff of their local hospitals? (Not just the nurses, either; I’m talking assistants and cleaners. I’m a regular prom queen over there)

You know very well my record contains flagged warnings from at least three local hospitals NOT to admit me to their services.

• “Patient refuses to stay in bed.”

• “Patient wanders beyond floor telemetry limits.” (Did you know telemetry units have alarms? It’s like a house arrest ankle bracelet)

• “Patient switches off pump alarms herself.”

• “Patient provides unwanted commentary on her IV catheter placement.” (That twit wasn’t anywhere near a vein, and she knew it)

• “Patient refuses prescribed medication.”

Two lines on the page, and I’m supposed to somehow squeeze a HISTORY of my life in the hospital sector into that space. All the while envying individuals with blanks or room to spare. Must be nice.

List Previous Surgical Procedures With Year

You’re the doctor that cracks jokes about my “constellation of scars.” Remember my last procedure when you admitted you needed to find somewhere else to cut? Because my navel was so full of scar tissue, it refused to tolerate another intrusion? (Hilarious joke, by the way)

Sure, now I get FIVE whole lines, but how is that enough? What about the year I went under the knife THREE times? Five lines won’t even dent the surface!

I pop out organs like a clearance sale. “Everything must GO!”

Here’s a better idea: I’ll write out what I still have, the parts of my body that have never seen a knife. You can create a handy checklist based on that, and we’ll just start crossing things off as we get to them. I won’t have to remember as many dates or multi-syllable words (cholecystectomy? Really?), and you won’t have to listen to me gripe about having to write on the back of your stupid papers.

It’s a win-win.

List Medications You Currently Take

I own a pharmacy.

I know it, and you certainly know it. There’s no cute pill fob at the end of my keys for discrete medication travel. I could take down TSA agents with the pill dispensary I haul around! When I run through the airport, it sounds like I’m smuggling maracas (happy, laughing children everywhere I go). Tim bought us the largest cosmetic tote L.L. Bean sold, and it’s too small to hold our combined toiletries AND my medicine.

That’s right; I need a separate tote for my pills and liquids and bottles.

But I’m supposed to somehow make do with FIVE pathetic lines?!

I have EIGHT shelves in the medicine cabinet devoted to my medications.

Prescriptions, OTC meds, and supplements; better living through chemistry is (in reality) barely surviving.

• Top Shelf: Pain medications that never work (not even when you combine them in a chemistry experiment).

• Second Shelf: Everything designed to get me through the night and (supposedly) sleep.

• Third Shelf: It’s allergy season All. The. Time.

• Fourth Shelf: A thrifty assemblage of narcotics preserved after surgical procedures, squirreled away for days when the pain goes to 451.

• Top Shelf #2: It’s a vitamin extravaganza!

• Second Shelf #2: Hello GI central—make the stomach work, make the stomach behave, make the stomach calm down. (Goddammit, stomach, do SOMETHING!)

• Third Shelf #2: A random assortment of ointments to tackle screaming paresthesia and dysesthesia.

• Fourth Shelf #2: Steroids. Because sometimes steroids really are the answer.

It’s fine, though. I’ll figure out a shorthand way to cram all of those drugs onto FIVE lines. Why worry about understanding? You have this in your system—the system you forget every time you hand me another iteration of this godforsaken form. (Let’s say, for the sake of simplicity, you assume I save extra opioid pills when they’re prescribed)

Have You Ever Had the Following:

Diabetes ___ Yes _X_ No

Hypertension ___ Yes _X_ No

Cancer ___ Yes _X_ No

Stroke ___ Yes _X_ No

Heart Trouble ___ Yes _X_ No

Gout ___ Yes _X_ No

Convulsions ___ Yes _X_ No

Bleeding Problems ___ Yes _X_ No

Acute Infection ___ Yes _X_ No

Venereal Disease ___ Yes _X_ No

Hereditary Defects ___ Yes _X_ No

And that’s the crux of this form, isn’t it? A stretch of “NO” to put me in my place. Nothing else I say matters once someone casts an eye down that column. My problem doesn’t warrant anything important, which dumps me squarely in the UNIMPORTANT part of the clinic.

It’s why you forget how to spell (say) my name. Why you don’t bother to remember my marital status (once the novelty that I could get married wore off). And why you’re constantly horrified when you review the number of times I’ve spent in the hospital. Why you blanch at the scars turning my abdomen into a patchwork quilt. (I’m so cute in a bikini)

I’m that fibromyalgia patient with the laundry list of medications I hand you because I’m fed up with attempting to write tiny enough to fit everything in your form’s minuscule space. You applaud and thank me for the “extra effort,” then toss it aside because I’m uninteresting.

Nothing exciting or dramatic.

Too bad I can’t have a heart attack on command. Or bleed all over the waiting room. Inject a note of trauma (drama?) into your mundane existence.

Just little old me, covering your form with an extensive medical history more appropriate for a corpse.

Yes, for the 100th time, it’s A-N-D-R-I-A.