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A Piece of My Mind
December 26, 2012

Warning Shot

Author Affiliations

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

Author Affiliation: Department of Medicine, Stamford Hospital, Stamford, Connecticut (memaldonado@msn.com).

JAMA. 2012;308(24):2575-2576. doi:10.1001/jama.2012.128365

The first warning shot: The physician keeps coming into the examination room where we're waiting for him to give us the next steps in this journey that has taken us to unexpected places. And he keeps leaving, saying, “I’m sorry, I’ll be right back.” It feels odd. As a primary care physician, I constantly share news with patients about their diagnoses and results. When I have great news, when I poke my head into the exam room, I quickly say, “Everything's OK, don't worry, I’ll be in shortly.” The third time he comes in, he's flanked by two nurse practitioners. One of them we’ve known almost from the beginning. She's come to know our family well and has been a great source of support. The other one we’ve just met. She's already done the preliminary history and physical examination for my mother's neuro-oncologist. Turns out she grew up in Co-op City where my mother lives, and her husband went to the middle school where my mother taught art. We like her. Then there's another woman whom we have never met. She's wearing a short white coat, and she smiles shyly at us. Maybe she's a medical student or resident. My mother's physician greets us solemnly, shakes our hands, and sits down across the desk from my mother and me. He's dressed professionally for the occasion in a dark suit and tie, his hair neatly cut, and he's clean shaven. The rest of his colleagues remain standing on our right. He leans forward. The second warning shot: “I remember when you had that rough period with the radiation and chemotherapy. You weren't able to complete it, right?”

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