A diagnosis records what you have. It usually doesn't record what was happening when it started.
This practice builds that page.
Take one sheet of paper. Draw a line across the middle. Mark the month your symptoms first appeared, as best you can remember. Then mark the month you were diagnosed. The gap between those two marks is often longer than people expect.
Above the line, write what your body was doing. The first change you noticed, even if it seemed too small to mention. Sleep. Appetite. Energy. Pain. Digestion. Skin.
Below the line, write what your life was doing during the same months. A move, a loss, a new job, a caregiving role, a relationship ending, a stretch of short nights. Keep it factual. You are not looking for a cause.
Then add one more row at the bottom: family. Anyone related to you with a similar condition, or with anything the family called "nothing." Dry skin. A nervous stomach. Bad knees. Write the family's words, not a diagnosis.
Look at the page once. Don't draw conclusions from it.
Bring it to the clinician who manages your condition and ask one question:
Is there anything on this page that should be in my chart?
Is there anything on this page that should be in my chart?
This practice is reflective, not medical advice. Do not stop or change prescribed treatment because of what you notice. Bring the page to your clinician.
It goes with last week’s essay, The Diagnosis Was Correct. The Story Was Incomplete.
Practices here are small, specific, and meant to be done, not admired. Subscribing is free, and it's how the next one finds you.
If someone you love is carrying a diagnosis without the story around it, send this to them.
What did you write below the line? Tell me in the comments. I read them.
Dr Shiv Kumar Goel is an internal medicine and functional medicine physician and founder of Prime Vitality Care in San Antonio. Across 25 years in hospitals, intensive care, and functional medicine, he has studied the gap between what medicine can measure and what patients actually live through. He writes Healing the Split and is the author of the forthcoming book The Unread Life.