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A Piece of My Mind
November 12, 2014

The Quality of MercyWill You Be My Doctor?

Author Affiliations
  • 1Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

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

JAMA. 2014;312(18):1863-1864. doi:10.1001/jama.2014.12933

I have noticed a troubling phenomenon in patients who are new to my practice and have multiple comorbidities. Joan (not her real name) first came to see me several months ago with a recent medical history that included an aggressive breast cancer, resulting in a double mastectomy, as well as a wide surgical resection of a melanoma that was discovered a short time after her first diagnosis. And if these misfortunes were not enough, just a few months out from her cancer operations, Joan was a passenger in a car that was struck by another vehicle, which eventually led to a rotator cuff repair of her right shoulder. Joan was still in a shoulder immobilizer when we first met, and she recounted each of these adversities in a measured, almost rehearsed way. Yet her emotion broke the cadence of our visit when she voiced one unaddressed concern at the end of the encounter:

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