PT - JOURNAL ARTICLE AU - Denham, Amy C. TI - Learning From Ervin’s Care: Ethics, Health Care Finance, and Human Connection AID - 10.1370/afm.3182 DP - 2024 Nov 01 TA - The Annals of Family Medicine PG - 565--567 VI - 22 IP - 6 4099 - http://www.annfammed.org/content/22/6/565.short 4100 - http://www.annfammed.org/content/22/6/565.full SO - Ann Fam Med2024 Nov 01; 22 AB - A 70-year-old man with complex multimorbidity and intellectual disability was my patient for the last 5 years of his life. He taught me important lessons about the challenges of practicing medicine as a primary care physician. He embodied all the complexities of multimorbidity, the ways in which clinical decision making can be fraught with uncertainties and tradeoffs. He raised difficult ethical questions for his care team, questions about how to respect the dignity of patients who lack decisional capacity and who do not have surrogate decision makers. The gaps in his care revealed shortcomings of the US health care system, but his care in his final years also showed some of the bright spots in coordinated, team-based care. Most importantly, caring for this patient taught me about the rewards of the human connections that primary care physicians establish with their patients.