"Funny how you always remember right at the end!"
A bit rubbish as advertising slogans* go but true nonetheless.
Take Mrs Antrobus. Please...
No, seriously, Mrs A has been getting breathless for around six weeks. Her own Doc has been plying her with all the appropriate meds for this, inhalers, antibiotics (twice), steroids, and yet she has managed to not get better at all. In fact today she is much worse. Her own Doc is on hols so enter Dr J.
When I get to the house I can almost hear her gasping for breath from the front door as her daughter lets me in. She has spent most of this week stuck in a chair in the living room, too breathless to do much more than sit. From the sound of her chest I think she may well have pneumonia. She's not in the first flush of youth, and has been a smoker for four decades and fears the worst. She may be right. Whatever the case she needs to go to the Hospital for now to get properly investigated and to start treatment.
So I call the Medical Assessment Unit, and arrange for her daughter to run her in. Then I sit down to write the letter. She's never been breathless before, had only one operation not relevant to her current presentation, and no, she has never needed regular medication.
Except.... "well, there was this node they took out of my chest when I was very young. Tuberculous they said it was. Oh and I had Double Pneumonia when I was eighteen moths old. "
So suddenly Mrs A has a respiratory history after all, that was not in her records and has had to be added to "the letter" as a hasty p.s.
No wonder hospital medics think we are all useless.
* If you need to know what for ask a grown up / a Brit.