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November 2018

Memorial Day Reflections—The Invisible Enemy

Author Affiliations
  • 1University of Colorado, Denver VA Medical Center, Denver
JAMA Intern Med. 2018;178(11):1444-1445. doi:10.1001/jamainternmed.2018.3109

It was a decade ago when I first met Dennis, an unassuming Vietnam veteran seeking treatment for gastroesophageal reflux disease, onychomycosis, and posttraumatic stress disorder (PTSD). It was not until the second visit, though, when I realized how profound his issues were. While reaching across the triangular-shaped room to get a blood pressure cuff, I accidently kicked a rolling stool. In a split second, Dennis, who had been resting easily in his chair, was sprawled on the floor on his hands and knees, tense and hyperalert. I apologized profusely for alarming him, and after a few deep breaths he responded, “It’s ok. I do this all the time. I can’t help it.”

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