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In a quiet voice and in her native Spanish, the woman explained to Dr. Shantanu Nundy that she had been feeling dizzy whenever she stood up.

She cleaned houses and worked in a store. There was a lot going on at home—and now this. She choked up describing it all.

Nundy’s clinic, called Mary’s Center, is a primary-care practice, and hers was a classic primary-care problem: common, yet strange; vague, yet worrisome—troubling enough to send the woman to the emergency room the day before, sticking her with a $200 bill. Still, the dizzy spells were not definitive enough for the ER to do anything about.

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The Atlantic

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