As I was putting together the information for the telecourse on history-taking, I had a flashback to my veterinary education years ago. At that time, a fair amount of time was spent on anamnesis. Never heard of it? Well, I bet you’ve heard of one of its opposite’s forms: amnesia. Whereas amnesia refers to forgetting, anamnesia refers to remembering.
Although getting a comprehensive history before establishing a diagnosis and formulating any treatment would seem the obvious way to go, two human factors conspire against it. The first is that much of animal behavioral and veterinary medical education is still deeply entrenched in the problem-oriented approach. The net result is a kind of selective amnesia when it comes to collecting a history. These people see gaining information about anything other than that obviously related to the problem as a waste of time. “Who cares how the owners and animals relate to each each other when the problem is the dog’s barking?” they ask. Meanwhile, some animal owners are often equally problem-oriented, seeing requests for such information as equally useless.
In both cases, compared to the expansive world in which all medical and behavioral problems actually exist, these people look at the the situation through the wrong end of the telescope. Sometimes they’re delighted to discover the value of gaining a bigger view. But other times it frustrates and confuses them because they feel overwhelmed by all that. I can sympathize because, in the short term, there’s no doubt that the problem-oriented method is a much simpler approach. On the other hand, the devil invariably lurks in the details. And when one of those devilish details that dwells in the realm excluded by the problem-oriented approach comes back to haunt us and our animals, the result can be hell.