‘A History of the Present Illness’ by Louise Aronson

I’ve got a couple of friends who are nurses and doctors. Two have them have worked in the emergency department of a major city hospital in Melbourne. They have the BEST dinner party stories.

I wonder if Louise Aronson, a doctor and an author, wrote A History of the Present Illness at the prompting of her friends? Maybe not – her collection of interlinked short stories are a brilliant mix of the delicate, hard-hitting, personal and coolly remote – not dinner party conversation fodder at all.

Before the recent, terrible event in Sandy Hook in the US, Obama’s reforms to the American health system were filtering through to the news broadcast in Australia. Gun control may take over policy debate within the forseeable future however the issues in the existing healthcare system will still be festering away. When I look at pop-culture takes on the US healthcare system that have influenced (and to a certain extent informed) me over the past decade it comes down to three things – Mike Moore’s documentary, Sicko; Lionel Schriver’s novel, So Much For That (and an accompanying author talk that I attended); and my guilty television pleasure, Grey’s Anatomy. So I’m hardly qualified for judging whether Aronson’s collection of stories are a fair reflection of US healthcare. Instead, I put judgement aside and enjoyed each story for what it was – a heartfelt snapshot of men, women and children in the neighborhoods, hospitals and nursing homes of San Francisco.

All of the sixteen stories are little lessons in compassion with Aronson swinging the reader from the perspective of doctor, to patient, to on-looking family member. Some stories are told in the first person, others in the third. Some are lush, detailed and sentimental whilst others are stark, clinical. Despite the obvious changes in creative writing style between the stories, there are subtle links between each and the overall result is impressive.

There are no weak spots in this collection. From the first story, a man talking about his day-in-day-out visits with his wife who is in a nursing home after suffering a stroke –

“It’s much like caring for a baby, he explains to his daughter, except without the sweet smells, without the hope.”

– to the heart-wrenching story of a little girl with a bed-wetting problem and a young man dying without family by his side –

“The nursing notes in his chart said that Jake’s family never visited… It was impossible to look at Jake’s torso and not think plague and curse and infestation and death. But it was equally impossible to imagine how people could stop seeing, touching, and loving their son.”

I started the last story in the collection not realising that it is the author’s story. It offers some nice insights into her work as both a doctor and as an author and how each role informs the other.

“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.”

4/5 A memorable collection of stories.

My copy of A History of the Present Illness was courtesy of Bloomsbury via NetGalley.

The obvious thing to match this book with was some kind of typical hospital food – jelly, anyone? I actually LOVE jelly and think it’s just as much for grown-ups as it is for kids. I was tempted by this stunning Raspberry and Mint Jelly and this pretty recipe for Strawberries in Jelly but in the end I couldn’t go past this – Gin and Tonic Jelly with Macerated Fruits – more likely found at a dinner party than on a hospital tray.


7 responses

  1. US healthcare (and healthcare legislation) truly is a terrible thing. It costs obscene amounts of money (with insurance) for the simplest of procedures and/or preventative healthcare. I get a bit depressed when I think about how much we pay for how little coverage it affords. You can go broke just by visiting the hospital for two hours. And doctors really do have they best stories, I heard a disgusting, fascinating one the other day that involved a man and a battery.

    • It’s incredibly distressing that when people are at their most vulnerable they can’t always get help. In Australia we have both private and public healthcare – private for elective procedures and public for everything else. For example, my son broke his arm two years ago and it was fixed at the Children’s Hospital and cost nothing.

      • Currently we only have private insurance, theoretically that is about to change somewhat. Here’s an example that’ll make you cringe (well, maybe, unless you have extra money floating around everywhere): when Finn was about 2 he had some blood in his diaper, it was Sunday so the doctor told us to go ahead and take him to the hospital just to check. We did, they looked at the diaper, said that’s not enough to worry and sent us home. The end. The bill came to nearly 4000 after insurance (3800 AUD). I wanted to cry, I think I actually might have. And don’t get me started on how much it can cost to have a baby.

      • Medical bankruptcy. Eventually if your income falls below a certain point, you can file for government assisted healthcare. It should work better now that they’re going to make refusing to cover pre-existing conditions illegal.

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