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June 17, 1983


Author Affiliations

The University of Texas Medical Branch Galveston

JAMA. 1983;249(23):3233. doi:10.1001/jama.1983.03330470065036

I think that putting the latest Agenda Book on the top of the pile triggered it. I swung around in my chair, and scores of books and journals started slipping over the telephone and down the side of the desk, submerging me on the floor, pinned between the wastebasket and the wall. The avalanche had struck.

Visitors often peered past me and quietly pondered the piles stacked on the table at my elbow. Some even murmured admiration at the accumulation of materia medica. Yet, no one had forewarned me of the price of prolonged procrastination. Oh, retrospectively, there had been minor slips and tremors as the drifts accumulated deeper and deeper. But I had always been able to steady them with a reassuring reshuffle and the resolution that I would get back to them soon. Now it was too late.

Gingerly, I extricated my head and shoulders out from under