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October 13, 1989

Inferring Cortical Function From the Patient's Job: He Made Grass Trimmer, But Could He Have Made Vice President?

Author Affiliations

San Diego, Calif

San Diego, Calif

JAMA. 1989;262(14):1951. doi:10.1001/jama.1989.03430140065022

To the Editor.—  May I express my appreciation to you and to Dr Murphy1 for a fine review of blastomycosis in the June 2 issue of The Journal? May I also, however, express concern regarding one of the author's statements? The author states that "[the patient's] job suggested that his level of cortical function had never been high." The patient's job was that of a highway grass trimmer and tidier, a job he had apparently held for two decades. There is no suggestion that he did not trim in a straight line or that he was untidy. I respectfully submit that his job suggests nothing regarding his cortical function. Perhaps the patient would even be saddened by such a thought. I understand the author's meaning, or intent. However, we who are in medicine must take care not to infer patients' mental status from the nature of their work, lest