Most clinical AI demos feature the tidy post-op patient with weeks of longitudinal data. The clinic-reality majority are first visits: no history in the system, a single verbal complaint, and roughly 60–70% with no surgical need. This post is about what iRehab calls the pre-visit Brief — the short, structured summary that lands on the physician's screen before the patient sits down — and why its central design constraint is that the patient cannot answer 'is it tendon or nerve?'