Little Battles

Robert Malcolm, MD
JAMA. 1990;263(1):90. doi:10.1001/jama.1990.03440010088039.
Text Size: A A A
Published online

It's about 6 PM and I sit down for the first time in 3 hours. My time in combat is over for another day. Four admissions today: Two angry young men in their 30s who are addicted to cocaine and feel they use alcohol only to mellow out. A 15-year-old girl who smokes 10 to 15 joints a day and who—with the exception of cannabis—probably has not put a single new thing in her brain in more than 3 years. A 45-year-old physician's wife who has had five abdominal operations, massive addiction to prescription narcotics, and a profound depression. I have written orders for all four. The work earlier in the day was a sick call for those patients who were previous casualties of this war on drugs. Patients with psychotic depression, second-degree burns, "flu"like illness, and chronic pain syndrome were some of the convalescent wounded. The victims of this


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.