Mrs. B came into the emergency room one night, years ago, with some stress related issue. After taking her history, I began to suspect there was something else bothering her. As I was beginning her physical exam she blurted out, “I know there is a breast mass but you’re not going to send me to any breast cancer doctor!” She had already decided to avoid standard treatment and her next comment explained why, “My aunt suffered because of awful unnecessary surgery and chemotherapy,” she said. I sensed there was no changing her mind and that meant trouble for my patient.
The story evolved as my pat...
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