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A Piece of My Mind
March 5, 2014

What Would You Do, Doctor?

Author Affiliations
  • 1Division of Emergency Medicine, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2014;311(9):911-912. doi:10.1001/jama.2014.910

The first time I remember hearing, or perhaps really feeling, this question came when I was a junior resident in pediatrics. By then I had assembled a small cohort of primary care patients for whom I truly felt responsible. With the initial shock and blind ignorance of intern year behind me, I had begun to understand my role in guiding my patients through a healthy childhood, or at least navigating through a complex medical system. One patient, Alek, was a sweet 4-year-old boy, whose parents had emigrated from Albania in the hopes of improving his medical condition. Alek was missing a small part of chromosome 4, which resulted in a host of problems including development delays, seizure disorder, vision problems, and chronic aspiration. He couldn’t speak and barely walked. He was happy, bubbly, and beloved. His mother and father would bring him to his clinic appointments dressed in their Sunday finest—he in a navy blue sweater with a cartoon character emblazoned on the front, his mother in a long flowery dress with boots, and his father in a tie. They always brought me some sort of gift, a box of candy or Alek’s preschool picture in the same navy blue sweater he wore to his appointments. I still have that picture in my desk.

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