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Thomas L. Delbanco, MD; Jennifer Daley, MD; Erin E. Hartman, MS

JAMA. 1998;279:621.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

In February 1997, at Neurology Grand Rounds, Dr Michael Alexander discussed rehabilitation for a young woman with left-sided neglect, slow mentation, and a dense left hemiparesis following an embolic stroke involving the right middle cerebral artery.¹ She was found to have mitral stenosis, although there was no previous history of rheumatic heart disease. Dr Alexander discussed her prognosis and stressed the importance of aggressive physical and occupational therapy and varied psychosocial and functional approaches to rehabilitation.

MRS X, THE PATIENT

I'm doing all right, but not great. I expected to see more improvement. I'm still not using my left arm or hand, but they're improving minutely. Before, when I'd go to bed, I couldn't move my arm from under me, but now I can. I'm walking with a cane. My heel chord is shortened. My insurance benefits are exhausted, so I'm not going . . . [Full Text of this Article]

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

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