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A Piece of My Mind
June 25, 2014

The Case for Social Medicine

Author Affiliations
  • 1Harvard Medical School, Boston, Massachusetts
JAMA. 2014;311(24):2483-2484. doi:10.1001/jama.2014.5240

The first patient I ever interviewed as a medical student was a middle-aged woman named Barbara. Wearing my crisp new white coat, the pockets yet unburdened with a physician’s paraphernalia, I walked in with only the intention of having a conversation. I discovered that Barbara had kidney failure and needed dialysis three times a week, which restricted her to working part-time. Barbara now had a systemic infection, for the third time in the past few months, which required an emergency department visit and a week-long hospitalization. She would be following up with her primary care physician and nephrologist, who are in different locations from the dialysis center she attends. A few weeks later, I met Lisa in the emergency department. She suffered from an acute exacerbation of chronic pancreatitis and was in excruciating pain. After gathering her medical history, I asked Lisa where she lived. Holding back tears, she said that she had been a nurse, but now lived in a homeless shelter with her 8-year old daughter.

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