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A Piece of My Mind
August 9, 2016

It’s Rough Out There for Us

Author Affiliations
  • 1Department of Internal Medicine, University of Washington School of Medicine, Seattle
  • 2Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;316(6):585-586. doi:10.1001/jama.2016.4460

Debi was a fastidious woman in her mid-60s. Prompt, precise, and well turned-out, she had earnest eyes, an incisive wit, and a roomy intellect. Debi always carried an electronic tablet with her, and her swiping and tapping lent a syncopated beat to our examination room exchanges. She was simply a treat.

Because Debi had a high-level spinal cord injury (SCI) and multiple chronic medical concerns, she preferred to see us both quarterly and paid to be driven the two hours to our Louisville offices to do so. One of these appointments each year would be reserved for an old-style “annual physical,” during which we’d help Debi change into a gown, transfer her to our adjustable-height table, and perform a head-to-toe assessment. During our other visits, however, examinations were quick, as Debi would invariably arrive wielding lists of carefully researched and prepared questions that would often take a full 30 minutes to answer.

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