Drs. Sklaver, MacDonald, Cassiere, and Matz raise several valid points pertaining to the piece by Ms. Bingham. First, to Dr. MacDonald's central question: Is the story true? To our satisfaction, the answer is "yes." In the patient's initial telephone encounter with her internist, she is told to call a neurologist. That could hardly have been fabricated. As a response from her physician, it is unacceptable, as Dr. Cassiere rightly points out.

Second, Dr. Sklaver asks whether any of Ms. Bingham's demands are unrealistic. Perhaps. She certainly has a right to a quick and accurate diagnosis when giving such a history. Beyond that, perhaps her expectations were too high. But she was seriously ill, desperate, and, thankfully, determined to get help. This was a patient who fell through the cracks. It happens to the best of us. We must never blame the victim.

Dr. MacDonald is concerned that the identity of the internist may be determined. It is certainly not immediately apparent. Yet with a fair amount of detective work, his identity could be known. But why would anyone bother when similar stories could be told of many of us?

Finally, Dr. Matz worries that the internist will not be informed, and Drs. Sklaver and MacDonald question our reasons for publishing Ms. Bingham's piece. If the story is essentially true, as we believe it is, then it is a poignant example of missed opportunity. We have all been there, more than any of us would want to admit. Rather than blaming one internist, we are attempting, through this and other "On Being A Patient" pieces, to inform us all. It's a reminder we all can use.