Dr. K sank into the chair in his office, enjoying two uninterrupted minutes before his next appointment. The month of February was always busy for the 62-year old family practitioner; inevitably his office would be filled with last minute “emergency” appointments from people suffering the usual winter maladies – cold, flu, sore throats.

He glanced at his computer to see which patient was his next appointment. It was Mrs. B, 58, a Jamaican-born woman who worked as a nurse’s aide. He hadn’t seen the patient in almost two years, and didn’t remember much about her. He stepped into the exam room and spoke to Mrs. B, who complained of stomach pain and constipation which had come and gone over the past several months.

After a brief physical exam which revealed nothing extraordinary, the physician diagnosed Mrs. B with irritable bowel syndrome and prescribed a laxative to help with the constipation. He also advised Mrs. B to limit her stress, which caused her to launch into a story about how she had five adult children and while most of them were self-sufficient, one was a “thalidomide baby” who had deformed hands and feet, and who relied of Mrs. B for care and assistance. Dr. K was sympathetic, but knew it was time to move on to the next waiting patient, and so he wished Mrs. B well, and advised her to contact the office if her symptoms didn’t improve.