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A Piece of My Mind
October 11, 2016

Cough It UpA Health Care Paradox

Author Affiliations
  • 1Division of Infectious Diseases, Massachusetts General Hospital, Boston; and Massachusetts General Hospital Center for Global Health, Boston

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

JAMA. 2016;316(14):1449-1450. doi:10.1001/jama.2016.8186

Mr Childs kept losing weight. Every time he came to my office, he would greet me with a hug, and I would count more ribs through his piled-on shirts and sweaters. He was always cold. And his pulse was racing, trying to outpace the disease slowly consuming him. Aside from the wasting disease, coughing was his only sign of illness, and fatigue dominated his days. After a year spent scouring Mr Childs’ body for clues, we still didn’t know what that disease was. Being the subject of so many tests prompted Mr Childs’ joking that he would start charging me a “pincushion rate.” Though wasting away from visit to visit, he was invariably in good spirits, and his faith in my powers of diagnosis and healing never faltered. “You’re the best doc I’ve ever had, Dr Bebell,” Mr Childs would say. “I want everything to go through you, because I want everyone on the same page. You’re the only one who can make that happen.”