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A Piece of My Mind
August 11, 2015

A Story I Hope Ends Up Being True

Author Affiliations
  • 1Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
JAMA. 2015;314(6):563-564. doi:10.1001/jama.2015.5285

“Every person contributes,” he says. “You don’t have to join the Peace Corps to do something worthwhile. I don’t like it when her friends act like her job isn’t as important to the world as theirs.” He tells me about his 21-year-old daughter. She recently graduated from college and got her first job in communications, and he’s proud of her. “Do you have kids?” he asks.

He is 44 years old and battling anaplastic myeloma. I’m not sure of the precise ways in which it’s different from regular myeloma, but I know it’s bad. After two failed bone marrow transplants, he’s been admitted for salvage chemotherapy, but it has been complicated by respiratory syncytial virus and parainfluenza pneumonias and now increasing fevers with progressing pulmonary infiltrates for which his hematology team asked for infectious diseases consultation. That’s when I meet him. Our focus is to make sure there’s not a new infection here that we could treat to help him feel better; to give him some more time. My team and I interrogate him about symptoms. We ask about where he’s lived and traveled, what he’s done for work, what his hobbies are, his pets, his exposures. All the detailed minutiae of the infectious diseases social history—the careful, probing questions that sometimes hold the clues that no one else has yet uncovered. At the very least they give us a lens through which to see his life beyond all this. The one where he travels the world as an economist. The one he lives with his wife, his oldest daughter, his 4-year-old twins, and his toddler son.

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