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A Piece of My Mind
January 19, 2016

A Final Course

Author Affiliations
  • 1Department of Psychiatry, New York Presbyterian-Columbia University; and New York State Psychiatric Institute, New York, New York

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;315(3):263-264. doi:10.1001/jama.2015.17057

I was a third-year medical student on a general medicine rotation, and my team had just been paged with our latest admission. Ms Nichols (not her real name) was a 35-year-old woman with metastatic breast cancer who had been declining despite intensive outpatient oncologic follow-up. She was brought in by her family with decreasing consciousness over several days. The emergency department physician thought that she was “actively dying,” meaning she was likely to die within the next few days.

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