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July 7, 2010, Vol 304, No. 1 >

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A Piece of My Mind | July 7, 2010

Old Men and the Sea

David A. Loxterkamp, MD, MA
JAMA. 2010;304(1):18-19. doi:10.1001/jama.2010.902.
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It was late on a Friday when I got the call: “New patient, trouble breathing. Too sick to see the doctor. Can you go to the home?” New in town, I was anxious to fill an empty afternoon.

His wife met me at the front door and led me to the living room where Mel was propped up in a portable bed. He had become stranded there three weeks before when his waterlogged legs would no longer allow him to take the stairs.

Before I could open my bag, Mel dictated the terms of our engagement: Hospitalization would be brief: he had no insurance and refused to let his illness exhaust his children's college fund. And whatever the cause, expensive tests and treatments must wait until he could purchase insurance through the window of open enrollment. It became clear that Mel had fixed ideas and that his decision to accept medical care involved a crisis of faith.

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Compression-Only CPR: Pushing the Science Forward
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AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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