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Arthur J. Barsky, MD

JAMA. 1997;278(8):673-679.

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

DrDelbanco:

Mr H is a 37-year-old man who has had multiple physical complaints for years without a clear medical diagnosis. An immigrant from Colombia to the United States, he is selfemployed, and works as an educator for the young in the inner city. He is covered by a commercial managed care insurance plan and is cared for by a medical resident in primary care practice at the Beth Israel Deaconess Medical Center.

His multiple physical complaints began during adolescence with nausea and vomiting without weight change In recent years, he has suffered from periodic pruritus ani, legs that become "weak" at times, and allergic symptoms including hay fever, allergy to cats, and recurrent itchiness around the eyes. He notes a frequent rectal discharge and had 1 episode of bleeding, evaluated by colonoscopy, which was normal. Liver function tests were mildly elevated in the past. He has experienced pain and numbness . . . [Full Text PDF of this Article]

Author Affiliations
Discussant

Dr Barsky is Director, Psychosomatic Research, Brigham & Women's Hospital, and Professor of Psychiatry, Harvard Medical School, Boston, Mass.

Footnotes
This conference took place at the Medicine Grand Rounds of the Beth Israel Deaconess Medical Center, West Campus, Boston, Mass, on March 18, 1997.

Reprints: Erin E. Hartman, MS, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, East Campus, 330 Brookline Ave, LY318, Boston, MA 02215.

Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Thomas L. Delbanco, MD, and Jennifer Daley, MD; Erin E. Hartman, MS, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.

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