Karen Baker is 46 and comes in with a cough that has been remarkably worse over the last 3 months. She smokes a pack a day, and on exam has mild wheezing and a normal chest x-ray. You tell Karen that asthma is the most likely diagnosis and advise her to try an inhaler. She exclaims, "How could I have asthma at my age? I have never had it before!" Which is the recommended response to move toward agreement on the diagnosis and treatment?
