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Volume 359:2409-2412 December 4, 2008 Number 23 Next

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Nurse practitioner Gail Metcalf toted her medical bag up the steep stairway of a triple-decker house in Dorchester, a low-income neighborhood of Boston, and greeted her patient, Mrs. E, a Jamaican woman in her mid-80s. Mrs. E, who is legally blind and has chronic obstructive pulmonary disease, hypertension, neuropathy, a thoracic aneurysm, and other medical problems, sank into a lift chair and began describing her symptoms as Metcalf examined her. Her back ached and her arms burned, she said, especially at night: "That's the time when it really comes on. Sometimes, I feel life is leaving me."

Mrs. E's agitation . . . [Full Text of this Article]

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Dr. Okie is a national correspondent for the Journal.

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