dialogue at the doctor's - present perfect vs past simple

[Verona_82]

Hello,

In one of my books there's a dialogue that reads:

Doctor: It's been a long time since your last visit.
Patient: Yes, I ____ any medical problems for a long time. I can't remember the last time I saw a doctor.
D: What's wrong with you?
P: This morning I woke up with terrible earache.

Although the authors want me to use the Present Perfect, I'm wondering if the Past Simple (didn't have) would be a possible alternative here too, as the period of time when the patient had no health problems is over and thus it can be seen as a finished period of time (finished on the morning when he woke up with an ache).

Thank you in advance.

[Raymott]

Hello,

In one of my books there's a dialogue that reads:

Doctor: It's been a long time since your last visit.
Patient: Yes, I ____ any medical problems for a long time. I can't remember the last time I saw a doctor.
D: What's wrong with you?
P: This morning I woke up with terrible earache.

Although the authors want me to use the Present Perfect, I'm wondering if the Past Simple (didn't have) would be a possible alternative here too, as the period of time when the patient had no health problems is over and thus it can be seen as a finished period of time (finished on the morning when he woke up with an ache).

Thank you in advance.

Since one regular poster has absented himself from the group recently over this very matter of grammar, you'll probably find that almost everyone prefers the present perfect.
Some Americans will use the simple past in the context, so we may have new members who would assert the simple past as just as good here, though I hope not.

No, the "until this morning" is implicit. If you'd been sick for two weeks, you might say, "I didn't have any problems for a long time. Then two weeks ago, I started getting ..." This would be a correct usage of the simple past.

Similarly the doctor doesn't say, "It was a long time since your last visit" even though that time has already finished, since the current visit is in progress.
You're allowed to include changes in the immediately recent past and still use the present perfect. "I've just finished ...", "I've just arrived ..."

[Verona_82]

Got it. Thank you.

[Rover_KE]

I would say 'Yes, I haven't had any medical problems for a long time'.

Rover

[konungursvia]

Agreed, the simple past simply isn't right here as it sounds like an isolated incident, not a continuous state.

[Barb_D]

But since the person now has a problem, I don't see how the present perfect can work at all!

I haven't had any problems.
Today, I do. -- I see a disconnect with present perfect.

I feel it needs to be "hadn't had" or the simple past -- from the last time I saw you until this new problem developed works as the defined time frame for simple past.

[konungursvia]

I agree there are cases when that would be called for Barb. If the speaker wanted to focus on the change of state using aspect. For example, it might be imaginable for the patient to say this:

"I haven't had any medical problems for ages -- or rather, I didn't, until today."

So no one is grievously wrong here. It's just that the information about the earache comes later, so in the sentence with the blank, the simple past doesn't seem to fit without further information.

[Barb_D]

I completely agree that if the information about the earache were not there -- if she saw her doctor at the park or the movie theater -- present perfect is the way to go.

[konungursvia]

Yep. But it's debatable that a fact or detail learnt after the sentence is uttered, a number of sentences after, could go back in time and affect its grammar.

[Barb_D]

Why are you still arguing with me when I said I agreed?

Regardless, the person who said it knew about the current state of the earache. He or she doesn't have to go back and revise what is known. He (she) has perfect knowledge of the situation.

And regardless of THAT, people are rarely grammatically careful in spontaneous utterances.