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A Piece of My Mind
February 20, 2018

A Teaching Case

Author Affiliations
  • 1Division of Geriatrics and Palliative Care, Massachusetts General Hospital, Boston, Massachusetts
JAMA. 2018;319(7):657-658. doi:10.1001/jama.2018.0071

“I just want to go home,” he said to our team on morning rounds and little else.

The patient slumped limply against the side rail of his hospital bed, looking every bit the chief complaint of “failure to thrive” that kicked off the intern’s presentation on rounds. Struggling for years with multiple chronic illnesses, his cancer diagnosis one month ago had knocked him down even further. He had been discharged from a rehabilitation center only to present to our emergency department less than 24 hours later, when a visiting nurse found him lying on a tattered sofa not eating or taking medicines.