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A Piece of My Mind
February 7, 2007

The Importance of the Right Heart

Author Affiliations

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

JAMA. 2007;297(5):447-448. doi:10.1001/jama.297.5.447

The poet Wallace Stevens suggested that “Perhaps the truth depends upon a walk around the lake.” Beyond the intuitive sense his statement makes, that concept has veracity for me since it was on a similar excursion, a casual drive through the countryside, that I gained an insight so evocative it eventually led to a change in how I practice medicine.

A friend who is a classical musician was explaining to the rest of us in the car a direction Beethoven had given to the players of the second movement of one of his middle string quartets, Opus 59, No. 2—a movement Beethoven reportedly found so soulful that he was brought to tears as he composed it. “‘Si tratta questo pezzo con molto di sentimento,’ Beethoven told us,” our friend said. “Treat this piece with great feeling.” Applications of the direction beyond its relevance for musicians came immediately to mind, including many for those of us in medicine: “Treat this patient, or family member, or student, or colleague with great feeling.” What a lovely principle from which to function; but one that the difficulty of simply getting through our day may make hard to follow. Pondering Beethoven's statement further, I recalled an extraordinary clinical case about which “feeling” is one of my most vivid memories.