Subjective versus objective

There is a reason that medical notes start with a subjective section about what the patient says in their own words.  Then we purposefully separate out that story from what we label as objective facts. 

The objective facts are usually pretty standard.


General appearance

Head and neck





Sometimes additional exams if you are gyn or neuro.

Then labs.

Then special studies.

It’s all very objective.  Numbers.  Things we can measure.

If we repeat the measurement there may be slight variation, but for the most part these things are relatively objective, repeatable, and everyone agrees on them.

We can separate this out from the story that someone is telling about the facts, which we call the subjective part of the medical note.

This could include whatever the patient states, whether we have any way of knowing if it is indeed true or not true.

We can use this skill in our own lives.

Let’s say for instance a patient had a fasting glucose of 200.

Now, if this was my fasting glucose, I’d be pretty unhappy.  I’m guessing if it was your fasting glucose, you too would be pretty unhappy. 

However, there are many patients who would be either completely indifferent or actually thrilled that their fasting glucose was “only” 200.  I have many patients who would be happy with this number. 

So the objective data is what everyone can agree on.

If everyone in the whole world agrees on it, that’s a fact.

If not, then it likely has some subjective component to it and it’s just a thought, a narrative, a belief.

When  you can start to see SO much of the world around you as just a narrative, just a story someone is telling themselves, it really starts to shift the way you see things.  It’s like having magical secret X ray classes. 

I want you to take a look at your own life and write down all of your thoughts.  Just do a thought download, or journaling, about everything you can think of that is bothering you right now.

Then go through with a pen and circle the things that are indisuputable facts.  There are typically very few things.   Then only the circled items go in the objective section of the note.  Everything else is a story we are telling ourselves over and over again. 

Let’s look at your story.