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Article |

Little Battles

Robert Malcolm, MD
JAMA. 1990;263(1):90. doi:10.1001/jama.1990.03440010088039.
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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


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