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June 15, 1984

'I Am Doing Pretty Well. Thank You for Asking.'

JAMA. 1984;251(23):3084. doi:10.1001/jama.1984.03340470020016

At the age of 32 years, she had borne five children and had undergone a hysterectomy. Two years later, because of nephrolithiasis and irreversible chronic inflammation, one kidney was removed. She felt chronically tired and had intermittent edema of her face and extremities of undetermined cause.

At the age of 37 years, she was referred for us to treat a cancer of the mouth with metastases to lymph nodes in the neck. The then-customary treatment was given, consisting of six weeks of radiation therapy to the mouth and neck, followed by a resection of the floor of the mouth, a radical neck dissection, and a temporary tracheostomy. During the next five years, she traveled the long distance to this hospital for five operations. On two occasions, portions of osteoradionecrotic mandible were removed, and three further ablations for recurrent cancer were undertaken. By this time she had lost all of her