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Invited Commentary
November 2018

Posttraumatic Stress Disorder in Primary Care Practice

Author Affiliations
  • 1National Center for PTSD, VA Medical Center, White River Junction, Vermont
  • 2Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
JAMA Intern Med. 2018;178(11):1445-1446. doi:10.1001/jamainternmed.2018.3108

Imagine this. You are watching a movie. It is a grainy black-and-white film, clearly not a Hollywood production. The first thing you see in the center of the screen is a raised desk supporting an old-fashioned Underwood typewriter. Behind the typewriter sits a woman intermittently pecking at the keys. Each time she taps a key, there is a distinct sharp click—it is not too loud, but it is a sudden brief, crisp interruption of the silence.

Below, and directly in front of the desk, is a long bench occupied by 8 middle-aged men seated with their backs to the typewriter. Each time a key strikes the paper, they all jerk upward in their seats, blinking and grimacing, almost in unison, settle back quickly to their previous sitting positions, and then jerk up again, repeatedly, each time the typewriter key strikes the paper.

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