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Soon after I finished my surgical training, I worked with a young doctor who was impressive not only for his clinical skills but also for his devotion to patients. He was large and powerfully built but never seemed to loom over his patients, miraculously shrinking down to their eye level whenever he spoke with them. He listened intently to every detail of their travails and always ended the visits by asking if they still had any unanswered questions.

One afternoon I was surprised to see him at a nursing station, his massive arms gesticulating as he complained to a nurse about one patient’s family. The patient was dying, and the young doctor had organized a meeting with the family to talk about withdrawing life-support machines and medications and starting comfort measures. The family had spent the entire meeting asking questions but then refused to make any decisions or withdraw any treatments.

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