Eighth grade typing has been a long time ago. I don’t type much because the longest part of my notes turn out to be the history of present illness section and summary. I dictate on my office desktop using Dragon medical after I finish up with the patient. The review of systems and physical examination sections are templates and again I use Dragon medical to dictate the abnormal portions over the normals, also done on my office desktop.
However at the beginning of the visit, when I take my Chromebook into the examination room, in essence a thin client mimicking my dual monitored desktop, the history of present illness, review of systems, physical examination, assessment and plan sections are empty.
After the patient and I review the graphs of the weight, body mass index and blood pressures displayed on the large TV we do the shared mutual documentation of the past medical family and social histories, medication allergies and medications. Every finger tap on my Chromebook shows up instantaneously and easily viewed.
At this point I feel most vulnerable, and yet I think the patient feels most in control. I am willing to show how fallible and fat fingered of a typist in exchange for being directed by my patient to get all of the information correct. My embarrassment is trivial compared to my patient opening his deepest fears to me during the office visit, but somehow when vulnerability meets vulnerability a shared human weakness is acknowledged but not verbalized. We are two imperfect souls working on a mutual goal but somehow the shared discomfiture works.