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November 14, 1977

On Encountering Hopelessness

JAMA. 1977;238(20):2149-2150. doi:10.1001/jama.1977.03280210041017

SOMETIMES we encounter a situation for which we have not been prepared, which confounds us and calls our assumptions into question. Certain patients force such a crisis on us, allowing us in our resolution of it to again come to terms with our commitment. Paradoxically, the situation is not always generated by the seriousness or arcane nature of the patient's disease. Sometimes, in fact, the diseases are much like many others we have seen, unique in their particulars, but so familiar in their clinical presentation that we type them, treat them, and look for no more in them than an expected sequence of laboratory values and clinical findings, unless something stirs us to look deeper, and learn.

Report of a Case  A 78-year-old former baseball player and insurance salesman was brought to the emergency room by his wife, disoriented and unmanageable. His history showed that he had been forgetful and