A “quest for answers” in the emerging field of postdeployment respiratory health

Abstract: "So, what's wrong with me?" asks James, as I finish reviewing his test results in our Veterans Affairs (VA) Post-Deployment Respiratory Health (PDRH) clinic. He is prepared to ask a series of follow-up questions: "What caused this? Do I need a lung biopsy? Will I get worse? Can I obtain VA benefits? Is there treatment? Will I need oxygen or a lung transplant?" And then there is the most pressing question: "Will I die from this?" As a VA physician-scientist in the emerging field of PDRH, I know well the tension that permeates the exam room in response to these questions. The pillars of our physician-patient relationship— confidence, trust, and hope-hang in the balance. Yet, at present, most of these questions lack satisfying answers. I often ask myself, "How do I answer these questions honestly without eroding my patients trust in me and the institution I represent?" In this Perspective, I will contextualize these questions as I have experienced them and describe the journey that ensues when answers prove elusive.

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