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A Piece of My Mind
September 11, 2002

Beyond Hope?

Author Affiliations

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

JAMA. 2002;288(10):1203-1204. doi:10.1001/jama.288.10.1203

The heavens conspired to make it a gloomy day. Outside, as black clouds rolled across angrily, the sky dumped rain on the earth with a vengeance. Beginning my first term as a medical registrar, I opened the envelope addressed to me, containing a letter equally bleak:

Dear Doctor:

Thank you for accepting this man into palliative care. His poor outlook has been communicated to his family.

Recently turned 25, Sam had celebrated the milestone by becoming engaged to his long-time partner. They expressed their commitment by forsaking heroin. Five months later, the urge to use heroin was overwhelming. One last time, he promised himself.

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