Illustration: David KleinThe patient who came to me for a consultation was frightened. He was in his 60s and had gone to the emergency room a couple of weeks earlier because he was fatigued and had been losing weight. His blood counts there weren’t normal: He had profound anemia and a struggling immune system. This prompted a hospital admission for blood transfusions to correct the anemia and a bone-marrow biopsy to determine the cause of his deficiencies. The biopsy report indicated he had cancer, either myelodysplastic syndrome or acute leukemia, and the hospital physician told him he needed to see a specialist—me—and to get his affairs in order.

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Persons: David Klein