History taking is a most important process and must be rehearsed well. A patient who has not met the surgeon before is coming to explain about his or her problem and putting total trust in the surgeon's ability to sort this. The patient will be very apprehensive. No matter how efficient and skilled the surgeon is, he or she must make the patient feel confident. The surgeon's appearance and demeanor must exude professionalism. A hand-shake, a smile, a pleasant introduction and a caring gesture will make the remainder of contact with the patient much easier and more pleasant.
One's initial approach might have to be modified according to the patient, for example children, the very elderly and infirm, patients who are poor of hearing and patients who are mentally impaired all need different approaches. The surgeon must also take account of any accompanying relative or friend. It is very important, however, to ensure that the accompanying relative does not dominate the consultation.
The history should then be elicited in a rehearsed way as outlined in Table 2.1.
Part I of this text is concerned with basic principles, and so a detailed section on surgical history is not appropriate. Details relating to the specifics of history taking are given in Chapter 22. The sections below highlight certain basic points.
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