To all those who supported me at the Durham Veterans Affairs Medical Center and Duke University, and to the many learners, trainees, and colleagues around the world who have encouraged this work and contributed to it, I give my thanks. Jack Feussner and Drummond Rennie have been my most important career mentors by allowing me to dabble in this seldom funded, but purely pleasurable, line of investigative work on the clinical examination.
Sheri Keitz and her mentorship of the Duke University Medical house staff in preparing the Education Guides that accompany the book have kept the writing very honest, elevating everything to a higher standard than I could have accomplished alone. Barry Bowlus, Annette Flanagin, and Cathy DeAngelis took charge of all the arrangements with our publisher, freeing me to concentrate on content because there are no shortcuts when the imprimatur of JAMA is attached to The Rational Clinical Examination. Cara Wallace and Angela Grayson helped with the editing, and Cassio Lynm, Alison Burke, and Ronna Siegel have provided us with illustrations that convey more information than words sometimes allow. Pete Compitello from NewGen, Helen Parr, Jim Shanahan, Robert Pancotti, and others from McGraw-Hill Education and Holly Auten and her colleagues at Silverchair have taken what we put on paper and transformed the information to print and online formats in a way that met and then surpassed our vision.
Kenneth Goldberg and Rob Minton covered all my clinical and hospital tasks when I took time off, and David Matchar and Eugene Oddone made possible a 6-month escape from work. I especially thank Joanne, Lauren, Michael, and Brian for their love and for their continued forgiveness for the many times I am physically present while working on The Rational Clinical Examination though my mind is elsewhere. I owe Joanne a lot of Sunday morning bike rides.
Having never worked on a book before, I had no way of knowing how it would affect my life or the lives of those around me. I was deeply embedded in editing for The Rational Clinical Examination when my 11-year-old son entered our study at home and said, “Mom, I think you need to take a break. Look,” he declared, pointing to my hands; I was shaking out the cramps after hours at the keyboard. “Isn't that flick sign?” My poor children had spent so much time during the past year watching me display signs as I worked on each chapter that one of them could correctly identify flick sign. I responded, “See! Everyone flicks their wrists, whether or not they have carpal tunnel syndrome!”
I am particularly indebted to my family, who supported my work on many nights, weekends, and holidays in order to complete my portions of the book. I am also thankful for the great number of people who have been critical to the success of the project at the Durham Veterans Affairs Medical Center and Duke University. Beth Weast, Sarah Williams, and Phillis Scott were a tremendous help in holding things together at work and helping me find time to move the book forward. My personal and professional mentors, Gene Oddone and Dave Simel, helped me develop my passion for including best evidence in my clinical practice and teaching. I want to give special thanks to Dave. As he has done for so many, he created this opportunity for me and provided steady support, guidance, and tolerance as I made my way through each chapter. Finally, this work was only possible through collaboration with many Duke house staff and faculty members whose constant drive for understanding improved the quality of our work and elevated our standards to the highest level.