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A Piece of My Mind
April 12, 2000

The Old Man's Friend

Author Affiliations

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

JAMA. 2000;283(14):1793-1794. doi:10.1001/jama.283.14.1793

Increasingly, my days are cluttered with busywork. It almost seems as if there is a great conspiracy to distract my fellow physicians and me from the important things we do. Not all doctors would agree on how to define the term important. I, for one, relish those rare moments when I can help a patient or family at a crossroad.

So it was for Agnes and Joe.

One of my partners had admitted Joe to the hospital the previous evening for yet another bout of bronchitis. Joe had severe, oxygen-requiring chronic obstructive pulmonary disease, cor pulmonale, and right-sided heart failure. The quip around my office was that Joe had only three alveoli left and two of them were infected. Joe had lived with COPD for nine years. Five years ago, he began to be increasingly forgetful. The passage of time made it clear that Joe also had Alzheimer-type dementia.

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