A 46-year-old insured white man presented to the emergency department (ED) of his hometown community hospital with breathlessness. Physical examination in the ED indicated that he had a collapsed lung, and an x-ray film confirmed that there was an abnormality on his right lung and bronchus. He was admitted to the hospital with follow-up tests confirming non–small cell lung cancer that had spread to his brain. His 2 college-aged daughters were living at home with him while they were attending school, and his 14-year-old son was living with his mother in a distant town. He had a full-time job working as a computer technical support specialist, which required regular travel to various universities and conferences.
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