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A Piece of My Mind
December 24 2008

Trying Not to Miss the Point

JAMA. 2008;300(24):2836. doi:10.1001/jama.2008.877

I worked at Sparrows Point for nearly 40 years.”It was the kind of social history I had encountered many times over the past nine months of my first year of residency. Mr M, a 76-year-old man, had presented to our hospital with complaints of indigestion, bone pain, and 30 pounds of unintentional weight loss. Computed tomography had revealed what was most likely metastatic lung cancer, and I was admitting him to the medicine service for further workup.

Like many physicians in training, as a first-year resident I was a new doctor in a community unfamiliar to me. I was raised in Louisville, Kentucky, attended college in Charlottesville, Virginia, and went to medical school in Ann Arbor, Michigan. Before starting my residency in general internal medicine at Johns Hopkins Bayview in East Baltimore, I knew very little about Baltimore and absolutely nothing about Dundalk, the community that my hospital serves.