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May 9, 1986

How a Farmhand Paid for His Cabbage: The Peter/Paul Principle

JAMA. 1986;255(18):2446. doi:10.1001/jama.1986.03370180072024

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To the Editor.—  A 53-year-old man underwent coronary artery bypass graft surgery after his second myocardial infarction. The surgery was elective, recommended because of high-risk lesions on cardiac catherization, and was funded by the state vocational rehabilitation program. His subsequent course was uneventful.Two months after surgery he returned to his primary physicians, reported no cardiac symptoms, and asked if he could return to work. For the previous two years he had done farm work, and it was assumed that his intention was to return to this, so he was advised that he could return to work with the usual precautions. Exuberant, he left the office volunteering, "Don't worry, doc! Now you will get your money." Two days later we noted on the front page of the local newspaper that our patient had indeed resumed an earlier occupation—bank robbery.Critics of coronary artery bypass graft surgery or vocational rehabilitation programs