All in the family

When evaluating a patient, it's always important to take a good history.  A thorough medical history includes information about the present complaint as well as established medical problems, prior surgeries, allergies, medications, and family and social history.  The family history is often abbreviated or omitted, particularly during short clinic visits.  It's an important facet of the patient's medical profile, though, and it can often yield valuable information.

Sometimes the information it yields is less than helpful.

As a fourth-year medical student I once asked an emergency room patient for her family history.  I ran through the most common things, including hypertension, diabetes, cancer, cardiovascular disease, and stroke.

"Lots of people in my family with high blood pressure and diabetes," the young lady told me.  "Not those other things, though."

"OK.  Anything else come to mind?"

"Syphilis runs in my family, too."

Indeed.