Middle aged internists probably remember writing expansive, progress notes during their residency training: detailed SOAP notes, with long differential diagnoses- complete with arguments supporting one diagnosis or another. The exercise had intellectual value- but took so much time, and paper!
My thinking about SOAP notes changed after reading a renowned cardiologist’s consultation note on a patient with chest pain: This patient has viral pericarditis- recommend indomethacin now. He got to the heart of the matter in one sentence.
Good poets (the ones I like) do the same thing: they pack meaning into a few words:
Barn Burnt Down. Now I can see the moon. (Masahide, 17th century)
Of course, it takes a lot of training, thinking, and imagination to get to the heart of the matter- whether you are a cardiologist, or a poet.
–Dean Gianakos, MD, FACP
Dean Gianakos, MD, FACP, practices and teaches general internal medicine in the Lynchburg Family Medicine Residency and Geriatrics Fellowship, Lynchburg, VA. He frequently writes and lectures on the patient-physician relationship, end-of-life care, and the medical humanities.
