Family History

When it comes to getting a patient's family history, older patients often say that they don't know because the generation above them “never talked about things like arthritis and didn’t really go to see doctors about stuff like that.” Their parents and grandparents never talked about joint pain, and even if they did, it may have been vaguely referred to as “rheumatism.” It is almost as if an entire generation of people from the 1920s to the 1970s were told to just be quiet about any aches and pains they had in their body, and to keep their head down and keep working through it.

I met an 80-year-old patient the other day who grew up in another country and washed laundry by hand her entire life. She was a housewife who raised several kids, cooked, cleaned, and labored at home for decades. When I asked her about joint pain, she initially said that she didn’t have any, but then later said “of course I have joint pain, I’m just old and arthritic.” It didn’t occur to her that joint pain should be anything abnormal, whereas to other people who are her age or even younger, pain is not accepted as a symptom that is benign and natural.

What makes some patients curious about investigating their joint symptoms and what makes other patients accepting of what they’re experiencing?