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June 1, 1984

The Power of Words

Author Affiliations

Shedd, Ore

JAMA. 1984;251(21):2805. doi:10.1001/jama.1984.03340450025019

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The patient who had undergone pneumonectomy for lung cancer had been passed along from the previous house staff team. This unfortunate, middle-aged man had received the best of what modern medicine had to offer: months of intubation, antibiotics for aspiration, pulmonary toilet, and ventilatory support, all in the intensive care unit. He was psychotic, we were told, as a result of his long stay in unreal surroundings. His therapeutic goals seemed to have been reduced to a bare minimum: "get him off the ventilator" and "get him to the floor."

He was not my patient, but I talked to him on several occasions and offered him a tablet to write on. Coherent words were never forthcoming, but his eyes seemed to express appreciation for the effort.

Finally, the patient was sent to the floor, and when we arrived at his bedside during rounds, I was appalled to hear the intern