This JAMA Clinical Guidelines Synopsis summarizes the American Gastroenterological Association Institute’s 2018 guideline on initial management of acute pancreatitis.

This Viewpoint attributes improved understanding of the role of autoantibodies and B-cell activity in MS pathogenesis and the development of effective therapies to the ability of physician-scientists to bring clinical insights to laboratory research and it emphasizes the importance of supporting and encouraging these investigators to reinvigorate science at the bedside.

This Viewpoint proposes a framework for international cooperation among governments and organizations to replace competition and hoarding with equitable global distribution of COVID-19 therapeutics and vaccines as they are developed.

This Viewpoint proposes that universal respiratory precautions in the operating room—use of respirators with face masks and eye protection—could protect staff from possible coronavirus disease 2019 (COVID-19) infection and facilitate resumption of elective surgeries canceled during the first wave of the pandemic.

This population epidemiology study characterizes trends in polymerase chain reaction (PCR) test positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Washington State and the Seattle area between March 1 and April 16, 2020, before and after statewide physical distancing guidelines and stay-at-home orders.

This Viewpoint discusses considerations that might lead physicians to change their practice based on RCTs reporting non–statistically significant differences in primary outcomes, including trial methodology, totality of evidence, cost, invasiveness, and labor-intensiveness of the interventions being compared.

My first glimpse into the craft of physician-writers did not come through Anton Chekhov, Walker Percy, or William Carlos Williams, whose works I only came to after medical school. As a schoolboy, I loved W. Somerset Maugham, although he never practiced medicine, and his craft had little to do with his medical degree. My introduction to physicians as writers came through my textbooks. Boyd’s Pathology made me aware of literary voice, the ability of authors to place themselves in the text, let their personality come through, and subtly become a character in the reading experience. On the topic of defining the moment of death, Boyd in his single-author text wrote, “It was the author of the book of Ecclesiastes who said, ‘There is a time to be born, and a time to die.’ Fortunately it is the clinician, not the pathologist, who has to make this difficult decision. Sometimes, however, the kindly doctor may find himself murmuring those moving lines from the last act of King Lear: O let him pass! He hates him/That would upon the rack of this tough world/Stretch him out longer.”

Forty years ago, in 1980, Jimmy Carter was president. Pac-Man debuted. In medicine, smallpox was declared to be eradicated. Additionally, on May 9, 1980, A Piece of My Mind was inaugurated in JAMA. The first essay, “Tuna on Rye, 1984,” was written by then–senior editor Samuel Vaisrub under the pen name Sam Vee. He introduced the column with an editorial entitled “For the Peace of Your Mind.”

Listen to the JAMA Editor’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA.

We hasten to assure our readers that a piece of my mind...is not intended as a sounding board for peevish gripes, nit-picking beefs, or sundry assortments of righteous indignation, which are usually prefaced by an angry “let me give you a piece of my mind.” Nor is this section of The Journal meant to be a podium for pompous preachments and ex cathedra pronouncements. Nor again is it designed to be a forum for half-baked speculations and warmed-over hypotheses. Least of all is a piece of my mind envisaged as a jamboree of jokes and a shivaree of limericks.

“Your medical clearance, sir?”

Meeting basic food and shelter needs of a growing population and catering to the insatiable consumer demands of people profoundly influences the quality of our environment. President Nixon observed that many of our present social problems may be related to the fact that we have had only 50 years in which to accommodate the second 100 million Americans. To provide for the increasing needs and demands of people, we are polluting our air, soil, and water. Unchecked population growth, people pollution, is not merely a problem, it is a paradox. It is an issue that is intimately private and yet inescapably public.

As my Italian father would say, since the house is burning      let us warm ourselves, and so

with a weak smile the rabbi

In this narrative medicine essay, a level-one trauma nurse compares Arizona’s 2 seasons with the waning and the waxing of patient admissions and with the cycle of grief for loss of her mother and son, realizing how much their deaths have affected her nursing.

In this narrative medicine essay, a primary care physician describes his patient’s struggle with obesity, sees himself in his patient, and wonders if his own struggles with weight loss impede his patient’s efforts to lose weight.

In this narrative medicine essay, a family physician shares the beginning and ending of a near 12-year journey with a patient, helping him reach sobriety that led to a full though short life and feeling humbled to have been so entrusted to travel with him.

In this narrative medicine essay, a psychologist peels back the layers of her reticence and comes to terms with working with transgender patients as a member of LGBT community.

In this narrative medicine essay, a primary care physician describes a drawing by a 7-year-old patient who is sitting on an examination table with her mother cradling her baby sister with the physician’s back to them entering data in the computer as an example of a system that is sacrificing human contact for electronics.

In this narrative medicine essay, Donald M. Berwick shares the story of his patient Isaiah with the 2012 Harvard Medical School graduating class as an example of a patient who deserved the treatment that cured him of leukemia but whose life was lost to poverty and exhorts them to regard health care as human right that must be preserved in the clinic and in public.

In this narrative medicine essay, a resident physician recalls the joy she felt while learning the formal language of medicine as a student and anticipates the lifelong joy of learning to interpret that language in ways most helpful for her patients.

In this narrative medicine essay, an attending physician shares his observations of how the changing nature of electronic medical record (EMR) hospital progress notes—often entered out of sequence and becoming ever longer and more unreadable—can hamper interacting with patients and providing patient care.

In this narrative medicine essay, a group of physicians from an academic program in bedside medicine offer their observations on deficiencies in the assessment of US medical residents’ clinical skills and suggest principles for enhancing the teaching and high-stakes assessment of these skills to improve diagnostic accuracy and achieve truly patient-centered care.

In this narrative medicine essay, a physician reflects on the rise of professional boundaries; on the ways in which such boundaries can in some instances foster uncaring patient-physician relationships; and on ways physicians might balance providing objective medical care and addressing social and economic injustices in the lives of their patients.

In this narrative medicine essay, a physician shares his thoughts about how the phrase “there is no evidence to suggest,” commonly used in the medical literature, can lead to false inferences and suppression of clinical intuition, and suggests four alternative phrases for clarifying inferences and improving shared decision-making.

In this narrative medicine essay, an emergency medicine physician recalls an encounter early in her career when she was asked by parents to make a recommendation regarding ending life support for a young child, reflects on the way practice has changed from physician-centric to patient-involved decision-making, and discusses how her husband’s pancreatic cancer diagnosis brought up a different perspective.

In this narrative medicine essay, a medical student reflects on individualized teaching practices in medicine, such as “the Socratic method,” in the context of her intervening course work related to a PhD in ancient history.

In this narrative medicine essay, a physician reflects on his father’s experience, at the age of 85 years, of getting a physical examination from a new primary care physician that ended up setting off a cascade of examinations and treatments.

In this narrative medicine essay, an African American physician reflects on her experience one day with a white member of her ward team made up of two interns, three medical students, and a senior resident that sparked cultural and racial discussions throughout their month together that usually do not occur in such a diverse group.

In this narrative medicine essay, a physician reflects on an experience during his medical residency involving the family dynamics of a couple in an effort to treat the pain of the husband.

In this narrative medicine essay, an attending physician reflects on the evolution of the role of the attending physician from a supervisor in the background to a micromanaging supervisor to ensure that the proper steps are followed to meet the quality metrics in place in the current health system.

In this narrative medicine essay, a medical student reflects on the ways in which she has seen racism and implicit bias affect clinical practice and emphasizes the importance of examining and challenging these biases to address health inequalities.

In this narrative medicine essay, a physician recounts an error in which his patient received double the dose of a medication he prescribed, and what he learned from asking the patient for forgiveness.

In this narrative medicine essay, a physician describes the power of anecdotes and stories as tools for public communication, education, and advocacy.

In this narrative medicine essay, the author discusses the inaccuracies of generational stereotypes and unfounded criticisms about trainees, and the problems that faculty members who voice these criticisms can cause among physicians.

In this narrative medicine essay, the author describes his experience with a patient referred to as “unreasonable,” and what the experience taught him about the need for physicians to perhaps improve their communication skills with patients rather than jump to labelling them.

In this essay, the author relays his personal experience with ethnicity-based discrimination and discusses the “microaggressions” that medical trainees from underrepresented groups based on race/ethnicity, gender, or sexual orientation experience.

In this narrative medicine essay, a teaching physician uses the fictitious characters Holmes and Watson to dispell the belief held by many physicians—that a thorough physical examination is an unnecessary art of the past. His emphasis: taking time to gather data and observe can avoid unneeded tests and guide accurate diagnosis.

This narrative medicine essay summarizes ways in which physicians can use polite and scripted interruption to help patients effectively communicate their medical concerns, encourage further details, improve accuracy of the diagnosis, and set the agenda for the medical visit.

In this narrative medicine essay, an anesthesia resident describes his feelings of loss and unease when a coresident is admitted as a patient and dies of an overdose of fentanyl; this article emphasizes the importance of prioritizing physician wellness programs to help avoid burnout and substance use disorder.