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Clinical Crossroads Update
December 22/29, 1999

A 44-Year-Old Woman With Severe Pain at the End of Life, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 1999;282(24):2354. doi:10.1001/jama.282.24.2354

In September 1998, Kathleen Foley, MD, discussed the management of severe pain in a 44-year-old woman near the end of life.1 Mrs L was admitted to the hospital with a flaccid left arm, her first manifestation of metastatic lung cancer. Her hospital course was marked by severe back pain secondary to metastases and exacerbation of her usual severe headaches. Her physicians tried several regimens to control her pain, eventually consulting with the hospital pain service.

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