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Mark J. Pellegrino, MD
JAMA. 1986;256(13):1793. doi:10.1001/jama.1986.03380130121041.
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The morning was not going well. In the first two hours at the freestanding ambulatory clinic where I worked, 13 patients had already come in. Their ailments ranged from anterior talofibular ligament sprains to viral upper respiratory tract infections. Only a fraction of the charts had been written by the time I entered the room where the next patient awaited.

Sitting on the examination table was a young girl of about 5. She was wearing a ruffled pink dress with a large white bow tied in the front. Her hair was light brown, the color of sweet honey, with gentle curls that barely reached her shoulders. But her right hand was immersed in a bowl of Betadine, and her large brown eyes gleamed behind a thin haze of tears. When I came in, she looked a little frightened.

Standing closely beside her was a tall woman in her early 30s,


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