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A Piece of My Mind
January 7, 1998

The Disability Blues

Author Affiliations
 

Edited by Roxanne K. Young, Associate Editor.

JAMA. 1998;279(1):15. doi:10.1001/jama.279.1.15

I glance at my nurse's annotation: "NEW PATIENT—H/O SUBSTANCE ABUSE. HERE FOR DISABILITY RE-EVAL."

Mr E, a 56-year-old man, enters my examination room. To describe him as disheveled is to oversimplify. He shuffles toward me in trash-picked sneakers whose tongues wag for want of laces. His pants bunch at his ankles like an accordion. Barely clinging to his hips, they drag down his whole being. Nose to the ground, he is forced to look straight up, past his brow and silver Afro, just to achieve eye contact. His posture suggests a question mark. He drools, unable to counter the gravitational pull on his lower lip. Gravity is the force that brings him to my doorstep. He is truly down and out.

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