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- W2181802524 abstract "House staff dribble in, clack lunch trays down around center table, and stir up their collec tive energy before start of Noon Case Conference. 1 take a back seat and fix my gaze on blackboard. The particulars of today's case are condensed there in acronyms and mil ligrams per deciliter: they concern a 40-year-old Nicaraguan woman with a 7 -year history of mi graine headaches. A second-year resident now rises to begin, and 1 ease slowly back in my chair. His lulling remarks will soon drift into day dreams and afternoon agendas. But medical history unsettles me, batter ing poor patient like a stoning. Not only from migraine does her head ache: she is fully disabled from prior stroke, has cervical disc dis ease and osteoarthritis; she has glaucoma and a history of nasal fractures thrice repaired; more over, she is bothered by recurrent chest pain and admits to three psychiatric hospitalizations attempted suicide. My stomach tightens, and 1 shift uncomfortably in my seat in sympathy resident. WIll we accept his explanation headaches, even for purposes of discus sion? Can we ignore emotional havoc of civil war and cultural upheaval and part it plays in her pain? Does resident suspect my own reluctance to care these kinds of pa tients, whose problems are so insoluble? We quickly digress to usual debate: choice of this drug over that one, side-effect profiles versus the efficacy in my experience. Then a pause. The resident seems to capture," @default.
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- W2181802524 date "1991-01-01" @default.
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- W2181802524 title "Special Communication Being There: On The Place Of The Family Physician" @default.
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