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A Piece of My Mind
October 4, 2000

Dare We Go Gently

Author Affiliations

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

JAMA. 2000;284(13):1621-1622. doi:10.1001/jama.284.13.1621

Early this April morning, gray light seeps into my kitchen as I gaze out the window while sipping coffee, slowly awakening to melancholy, recalling how several years ago my sister died.


Beth was in her mid-20s when she fainted onto another kitchen floor, in the house of my mother and father, a continent away from me now; her profound anemia and petechiae suggested the acute myeloid leukemia that the bone marrow biopsy confirmed the next day. Not uncommon among persons with Down syndrome, Beth's leukemia responded to aggressive chemotherapy dosed over the ensuing four months with complete remission. Within the year, though, the disease relapsed, and ten months further on—an interval extended by still more chemotherapy—Beth died late on this day while I sat at her bedside, my one hand pushing the button that delivered small doses of morphine to her body, the other stroking her forehead in small circles.