Thin and dark-eyed, the teenaged boy first entered my primary care clinic a few years earlier when I was beginning my pediatric residency and he was beginning adolescence. During the time I have known him, I have helped him and his family manage his attention disorder, acne, and appendicitis. I thought one of his follow-up appointments would be routine. As I entered his clinic room that day, I was smiling, looking forward to learning how he had been doing in school.
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