On the orientation questions

(Another posting from my time in rehab in Palo Alto, this one originally written up on 12/2. As before, it’s very much a bare-bones posting — there’s a lot about posting to my blog that is still a cognitive mystery to me, thanks to alcohol poisoning.)

In the U.S., medical staff ask patients a series of questions to discover how well the patients are oriented to their contexts — where are you? What city is that in? What state? What year is it? Who is the president of the United States? The governor of the state? And so on.

Early in this inquisition comes a question I now believe to be unreasonable and insulting and which I will now accordingly refuse to answer, even when I know the answer: what is today’s date and day of the week? (On the day on which I am writing up this WordPress posting it is Sunday December 6th. I know this because I now carry a calendar, provided to me by my speech therapist at the rehab center, in which I mark off the days one by one, so I now always know the answer.)

Here’s the problem. The questioner expects the patient to remember the date and weekday for the previous day and then update these by one day. That is, the patient is expected to calculate this information, in the absence of information about these matters: most medical institutions are informational deserts, so calculation is the only avenue available, though no normal person figures out the date and weekday by calculation; instead, this information is provided to us, from many sources.

So … My landline telephone displays the current date (and time). And as soon as I look at my computer, the date and weekday are conveniently displayed, often in several different places. Meanwhile, the daily newspaper displays both pieces of information prominently on its front page. Normal people are awash in the relevant information and would view the idea that they should somehow calculate it from shards of memory as lunatic.

Institutions should be supplying this information for their patients, in the same way that the way normal people are given it: the date and weekday should be prominently displayed in a place visible to everyone, to help orient them in their context.

4 Responses to “On the orientation questions”

  1. Julian Lander Says:

    I couldn’t agree more. I’m only recently retired, and I still have a schedule that varies from day to day, but I occasionally have to think to remember what day it is. And it is by calculation: I generally have an idea what I’m doing today, and I can generally figure out the day of the week from that. Date is harder, but do-able, because math comes easily to me, so I generally know the day/date correspondence for the month.

    And even working people occasionally trip over this, particularly around holidays, when the normal schedule is thrown.

    I agree it’s not an appropriate question if they’re looking for instant recall of a relevant fact. And, I suspect a lot of people don’t know immediately who the governor of their state is, particularly if it’s early in the governor’s term.

  2. kenru Says:

    Except for on a check written in January, everybody should know the actual year, at least. Unfortunately, except for the period between election and inauguration, every American (at least) should know the President. Other than that, I do wonder about all the other universal signifiers of reality, including those two which do have noted exceptions.

  3. Karen Schaffer Says:

    It would be interesting to hear from a professional what they’re actual expectation for that question is. I wonder if an honest, “Well, it’s December but I don’t know the exact day. Maybe the 6th?” might be considered a good response, versus a totally out of touch answer.

  4. Kathryn Burlingham Says:

    Aunt Terry does have a diagnosis of Alzheimer’s but I assure her that NOBODY including medical staffers remembers what day it is.

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