Title: The History of the Present Illness
Author: Louise Aronson
Published: Bloomsbury USA January 2013
Synopsis: A History of the Present Illness takes readers into overlooked lives in the neighborhoods, hospitals, and nursing homes of San Francisco, offering a deeply humane and incisive portrait of health and illness in America today. An elderly Chinese immigrant sacrifices his demented wife’s well-being to his son’s authority. A busy Latina physician’s eldest daughter’s need for more attention has disastrous consequences. A young veteran’s injuries become a metaphor for the rest of his life. A gay doctor learns very different lessons about family from his life and his work, and a psychiatrist who advocates for the underserved may herself be crazy. Together, these honest and compassionate stories introduce a striking new literary voice and provide a view of what it means to be a doctor and a patient unlike anything we’ve read before.
Status: Read from January 13 to 14, 2013 — I own a copy {Courtesy Bloomsbury/Netgalley}
My Thoughts:
“In medicine, the ‘history of the present illness’, or HPI, is the critical first portion of the medical note that describes the onset, duration, character, context, and severity of the illness. Basically, it’s the story, and without it, you can’t understand what’s going on with your patient.”
A History of the Present Illness is an extraordinary collection of peripherally linked vignettes that explore the current practice and experience of health care in America.
Insightful, honest and compassionate, Aronson, an accomplished practicing physician overlays truth with fiction to illustrate the plight of her colleagues, patients and families as they navigate bureaucracy and illness. Clinical objectivity blurs with humane compassion, triumph with heartbreak in stories of complex, emotional and medical crisis.
There are sixteen stories that cross the boundaries of race, age and gender. Each give a glimpse into the lives of ordinary people within the health care system. Patients like Rodney Brown whose leg aches even though he left it in the desert sand of Afghanistan (After) and doctors like Robert who witness the obscenity of slow death and and are expected to do nothing (Giving Good Death). I found ‘An Amercian Problem’ almost unbearably sad, it is an indictment of a society who has relinquished the care of its most vulnerable members in favour of balancing the budget, and ‘Soup or Sex?’ an incredibly touching portrait of a young man fighting with uncommon bravery to be more than his disease. All of the anecdotes are affecting however, inspiring hope and admiration as often as anger and disgust.
A History of The Present Illness is a remarkable read, quietly attesting to the triumphs and failures of the American health care system. Forget what you think you know of medicine from watching Grey’s Anatomy or General Hospital. In real life, caring for people is much messier than either show can portray.
Available to Purchase
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Just a note: There was a problem with the formatting of my Kindle ARC edition that I hope is not present in the finished version. Aside from broken sentences, there were no clear separators between the stories and I was thrown a number of times by suddenly finding myself in the midst of a new story. The formatting issues also made ‘Blurred Boundary Disorder’ particularly difficult to read.
Book’d Out 
The reality of serious illness and trauma can be very distressing. I have no doubt that true stories of this could be extraordinarily moving. I’m glad to hear that at least some vignettes are uplifting.
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