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Editorials |


Sigmund L. Wilens, MD
JAMA. 1964;187(13):1020-1021. doi:10.1001/jama.1964.03060260048013.
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For 30 years as a practicing pathologist, I have been trying to supply the answers to the perpetual question, "Why did he die?" It has become most fatiguing. The conscientious clinician very dutifully inquires after the autopsy findings. I may show him a Pandora's box full of pathology: ruptured viscera, infected and torn heart valves, thrombosed arteries, widespread cancer, or a peritoneum filled with exudate. "I know all that," says the earnest clinician with a tone registering anything from mild reproof to utter disdain, "but why did he die?" Eventually this proves very bad for my disposition.

In the good old days things were much more amiable. Oh, for the scientific subterfuges of yesteryear when the pathologist could say, "The patient died of 'fatty degeneration of the heart' or 'edema of the brain'." If he kept a dignified demeanor, his indifferently informed inquisitor might be satisfied. There was the big


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