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Less Is More
June 2016

To Cure Sometimes, to Relieve Often, to Comfort Always

Author Affiliations
  • 1Department of Medicine, Stanford University School of Medicine, Stanford, California
  • 2Department of Medicine, Palo Alto Veterans Affairs Healthcare System, Palo Alto, California
JAMA Intern Med. 2016;176(6):731-732. doi:10.1001/jamainternmed.2016.1220

“New admission for NSTEMI. Please call the ER.” My eyebrows furrowed as I looked at my pager. It was shaping up to be a busy call day. I glanced through my new patient’s medical record and called the emergency department physician. It seemed straightforward: a 77-year-old man with a history of coronary artery disease was presenting with nausea, chest discomfort, and a new troponin elevation of 12.0 ng/mL. A familiar protocol of serial laboratory tests, ECGs, and medications—drilled in to me by my years of training—was the next step in his care. I still remember how I framed this gentleman as a “bread and butter ACS case” (acute coronary syndrome) to my intern as we went to evaluate him.