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December 11, 1981


JAMA. 1981;246(23):2693. doi:10.1001/jama.1981.03320230019017

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I considered myself one of the best and brightest. Having just left a prestigious residency and fellowship program, I thought that I was honed to a fine medical edge. My first law of medical practice (more were certain to come) was soon declared: A wheelchair outside the treatment room door means trouble and should be avoided at all cost.

Nonetheless, I violated my own law one day, and after taking a deep breath, I stepped over a wheelchair, opened a door, and met John. He was a referral from a colleague, and I was silently furious because John, age 14 years, had cerebral palsy, was painfully deformed, and was extremely ill. He had been abandoned by his parents at an early age, knew few friends, and lived in a foster home. And there he was in my treatment room!

John had widespread cancer. During the next year, numerous and prolonged