I’ve assessed the patient, we’ve made a plan, and they’re being discharged from clinic. Now I’m at the computer writing my note, deciding how the story will be told. The thing is, I have a conflict of interest. I want to be the hero, the one who asked just the right question and guided the patient to the appropriate treatment.

At a minimum, I don’t want to sound dumb.

I’ve been trained to get good grades, earn praise. On rounds as a trainee, to describe physical findings and construct a thoughtful differential diagnosis to professors and fellow students. Now when it’s just me documenting the truth in the medical record, how can I resist? I confess to claiming I asked a question which in fact I forgot to ask. I confess to omitting from the record a comment that doesn’t fit well enough with the diagnosis I made.

I want my story to be smart. But the real story has a far more interesting tension between the categories we wish to fit people into and the messy details of their experiences and needs and priorities.