You are eagerly awaiting the end of your shift, looking forward to when it will be slightly dark and less crowded, so you can use the swing in the middle of the local park. A moment on that swing brings back not only a sense of peace but also pleasant childhood memories.

For now, however, it is only your third hour seeing patients, and you are reviewing the intake notes for your next appointment: Margaret, a 58-year-old high school teacher. The triage nurse has noted “profound fatigue and a strange rash.” Shaking off your own exhaustion, you grab your stethoscope and walk into the examination room.