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Another Elephant

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      I did a virtual home visit this week to meet a new patient and her daughter. The patient was an elderly woman with very advanced cancer.  When the video opened, her daughter was front and center with a warm and welcoming smile.  I introduced myself as one of the doctors on the team with the goal to help make her Mom 'the best that she can be...given the circumstances'.  Her facial expression changed.   "Umm," she said.  "So, now what?  Do you need to speak with my Mom or just me?" she asked.   I gently suggested that this decision was up to her Mom.  The daughter squirmed.   "Well, my Mom is hard of hearing and speaks mostly Italian. How about you just speak with me?" she said.   I asked to introduce myself to the patient.  The daughter carried the phone over to her so that I could say 'hi'.  I asked the patient if it was okay for me to speak about her care with her daughter.  She obliged, and before I could say anything else...I was