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A Piece of My Mind
November 18, 2009

Going Home

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Senior Editor.

JAMA. 2009;302(19):2071-2072. doi:10.1001/jama.2009.1559

Maria is going home today.

Her name was halfway down the daily patient schedule, and I met it with the usual mixed reaction of anticipation and dread. Over the ten years we had known one another as physician and patient, we both had changed in ways that allowed her appointment time to feel less like a wrestling match and more like a slow, mutual reality check. She was now nearing 70, her hypertension, diabetes, and cholesterol were probably as good as they were going to get, and her medications were finally set in a regimen that she understood and I was therefore reluctant to change. Treating her depression and anxiety, however, had been one of my greatest challenges as a young physician fresh out of residency. The limited medical and psychological resources for this uninsured, immigrant woman and the life story underlying her symptoms only magnified my baseline sense of inadequacy.