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Cancer Care Chronicles
January 9, 2020

First Rites—A Spiritual History Case Study

Author Affiliations
  • 1Indiana University School of Medicine, Bloomington
  • 2Riley Hospital for Children at Indiana University Health, Indianapolis
JAMA Oncol. Published online January 9, 2020. doi:10.1001/jamaoncol.2019.5980

My patient was playing high school tennis when she noticed a painful bump on her right hand. She had heard about some players getting bone spurs, but the bump became bigger and more painful over the next few weeks. Soon it was marching band season, and she had trouble playing her trumpet. Her parents brought her to a pediatrician, who noted her symptoms of back pain, trouble breathing, and the hand mass. A chest radiographic image was taken, and she was found to have pleural effusions, fluid accumulating between the lungs and a saran wrap–like covering for the lungs (the pleura). A chest computed tomography scan was done, and the pediatrician then sent the patient to my pediatric oncology clinic.

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