May 7, 1997

A Crowded Room

Author Affiliations

Worcester, Mass

JAMA. 1997;277(17):1350. doi:10.1001/jama.1997.03540410028012

I entered the examination room to find one of my scheduled patients waiting. I am often amazed at what patients bring with them when they visit their doctor. Not just what, but who. And not just who, but why.

She had brought her large bag of medical problems. In the bag was the breast cancer of 11 years, seemingly an old problem, but always present and early to come out of the bag. There was the recurrent lymphedema of one arm with intermittent cellulitis. There were the chronic headaches. There were the perplexing hot flashes. Cervical spondylosis, hypercholesterolemia, the positive PPD, the stroke of several years back (no residual deficit, but that didn't allow it to be discarded), and her periodic depressive episodes were all there, waiting to be taken out as necessary. Somewhere in the depths of the bag were the lining of her maxillary sinus as well as