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A Piece of My Mind
July 4, 2017

No Perfect Choice

Author Affiliations
  • 1Department of Psychiatry and Biobehavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles
  • 2Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles
  • 3Geffen School of Medicine, University of California-Los Angeles
JAMA. 2017;318(1):29-30. doi:10.1001/jama.2017.5523

On a recent Monday morning, as our clinical team gathered around the case conference table, we saw that Ms B was, once again, on our patient list. The obstetricians, psychiatrists, social workers, and case managers let out a collective sigh when her name came up for review, looking grimly down at their coffee cups. Ms B was, to put it mildly, a challenge for us all. Our integrated obstetrics and mental health program, working in the safety net hospital in a highly stressed, low-income neighborhood, sees tragedy every day. Ms B, however, stood out as even more troubled than the rest of our high-risk patients.

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