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A Piece of My Mind
December 20, 2000

Lost by Degrees

Author Affiliations

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

JAMA. 2000;284(23):2974-2975. doi:10.1001/jama.284.23.2974

“Bachelor's, master's, PhD, damn bachelor's, master's, PhD," my patient muttered as he paced the hall of the locked hospital ward. He said little else, ever, other than to echo the words of others. Invariably he would conclude his utterances with a sometimes hushed, sometimes hollered "Damn bachelor's, master's, PhD." Occasionally he called out "John Hill!" his name, as though it was a distant beacon for his evanescing self.

John was tall and almost bald. As he paced, his searching gaze wandered from the doors of the ward to the carpet in front of his feet. Whenever I crossed his well-worn path, he looked up and smiled lightly. His smile was also only an echo of my own. John's vacuous blue eyes never changed; they never expressed even a glimmer of recognition.