Asking Questions II: Tricks for Improving Patient Recall

Uttering a word is like striking a note on the keyboard of the imagination.

–Ludwig Wittgenstein

Throughout the diagnostic interview, your patient’s memory will be both your ally and your enemy. Even when the desired information is not threatening in any way, be prepared for major inaccuracies and frustration if the events described occurred more than a few months ago. Nonetheless, we’ve all had the in-training experience of watching an excellent teacher elicit large quantities of historical information from a patient for whom we could barely determine age and sex. How do they do it? Here are some tricks of the trade.

ANCHOR QUESTIONS TO MEMORABLE EVENTS

Researchers have found that most people forget dates of events that occurred more than 10 days in the past (Azar 1997). Instead, we remember the distant past in relation to memorable events or periods (Sudman and Bradburn 1987), such as major transitions (graduations and birthdays), holidays, accidents or illnesses, major purchases (a house or a car), seasonal events (“the great blizzard of ′78”), or public events (such as the O. J. Simpson trial or Princess Diana’s death).

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