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Instinct and Action

Thayer A. Smith, MD
JAMA. 1985;253(1):25. doi:10.1001/jama.1985.03350250025005.
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It was a situation that neither medical school nor hospital training had prepared me for, although the current crop of medical students are probably better primed. I was only in my second year of private practice in a small group and seeing a new patient, a woman, who had brought in a 3-year-old foster child for some minor, long-forgotten illness.

It is understandable that many tots seeing a doctor in a white coat for the first time are somewhat fearful and inclined to tears, and she fulfilled my expectation. However, I quickly sensed the foster mother's cold air of hostility toward the child. To assert her authority, the mother picked up the child from the examining table several times and slammed her down vigorously, yelling at her to be quiet. The child responded heroically, stifling her sobs, apparently fearful of the consequences if she did not. I had no trouble


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