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A Piece of My Mind
February 18, 1998

Perspective Shift

Author Affiliations

Edited by Roxanne K. Young, Associate Editor.

JAMA. 1998;279(7):500. doi:10.1001/jama.279.7.500

He looks so sad, so forlorn. He chews a lip as he studies his sneakers. His hands clasp together and then awkwardly separate like uncomfortable acquaintances. His foot drums to a beat internal and irregular. His forehead sweats. The pen in his hand has been chewed and gnawed. Little tooth rivulets carpet its plastic veneer.

I have seen this clinical presentation a thousand times.

The helplessness has surfaced. He can no longer suppress it. He is a steam whistle and the anxiety at facing cancer's horrible ambiguity has finally rumbled to the surface, erupting with volcanic emotional chaos. He expected better news.

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