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A Piece of My Mind
December 23/30, 1998

Four-Wheel-Drive Medicine

JAMA. 1998;280(24):2070. doi:10.1001/jama.280.24.2070

Late Friday afternoon. The Northeast. It's been a week of two-hour committee meetings, a statistically significant number of walk-ins, and a pair of anniversary dinner candles burned down to stubs by the time I got home. So why should I expect that the last patient of the day (and of the week, for mercifully, the weekend is all mine) will be routine? Mrs Vest. Chief complaint: chronic back pain. She has earned a record two inches thick and diagnoses that reek of frustration: failed back syndrome, facet syndrome, rule out fibromyalgia.

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