The medical record perplexed me. “Unfortunate 33-year-old-man with Down Syndrome here for routine visit for ear wax removal.” This gentleman had just moved to our area and needed a new doctor to take care of his ears. I was meeting him for the first time. He brought in an envelope full of records from his prior ear, nose, and throat doctor. Each visit was documented with an entry that began with, “Unfortunate 33-year-old man with Down Syndrome.” There were not only records printed from an electronic medical record (EMR), in which lines and even paragraphs can be copied and pasted, but also handwritten notes predating the EMR, in the typical doctor’s handwriting that I myself have taken to a new illegible level.