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November 5, 1982


JAMA. 1982;248(17):2165. doi:10.1001/jama.1982.03330170069036

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She was an unmarried, 32-year-old woman who weighed more than 200 pounds.

"I'd like to have my feet fixed during my summer vacation. I have two weeks. Do you think that will be enough time?"

She worked in a bank and lived at home with her aging parents. She wanted her bunions corrected.

"I really can't afford to take off more time than that. I don't know how Mom and Dad will get along without me, even for that short period. I do all the cooking and house cleaning besides being the major breadwinner. They're really almost totally dependent on me."

He had been seeing her for years. Her parents were also his patients. It was true that they depended on her. They had complementary strokes, his on the right, hers on the left. However, what was equally true was her dependence on their dependency. Single and lonely, their need