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A Piece of My Mind
July 18, 2012

Making It From Home to First

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Senior Editor.

Author Affiliation: University of Colorado, Denver (

JAMA. 2012;308(3):245-246. doi:10.1001/jama.2012.7816

Everything goes away.—James Finley, PhD1

“You have terrible arthritis in your fingers,” the orthopedist said immediately after an x-ray image of two hands appeared on his computer screen. Even as a cardiologist I could see that the distal interphalangeal joints of all the fingers were absent the cartilage seen in other joints. “Bone on bone there,” he added, pointing to several places on the image. He had obtained an x-ray because I showed him a small, tender nodule on one finger that I assumed to be a Heberden node, and thus a sign of focal osteoarthritis. As I looked at the image I thought, How could I have severe arthritis of my hands when I can swim, garden, and swing my baby granddaughter around without limitation? I suspected that the orthopedist had mistakenly brought someone else's x-ray up on the screen. But there it was, disappointingly but convincingly visible on the image, my name.

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