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July 8, 1983

Harold and Boots

Author Affiliations

Luttrell, Tenn

JAMA. 1983;250(2):188. doi:10.1001/jama.1983.03340020026027

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It was never entirely clear what Harold's chief complaint was. He fit fairly well in the disabled—from-his-nerves-and-back category, but when he came for a visit, I wasn't sure exactly why he was there, or what he wanted. His chief complaint seemed to be to complain. He would sit with his hands on his knees, head downcast, and speak slowly of his pain and his temper. There would be a pause, and I would make a suggestion or concluding remark, but Harold was never quite finished. He seemed to not want to be there, yet was never quite ready to leave. Earlier I shared with him the wisdom of the paindepression-pain cycle. He obliged me by attending a few counseling sessions and taking some antidepressants, neither of which affected him. He similarly eluded my attempts to nail down the exact organic nature of his problem: he either didn't go for referral