Most of my patients I can help.  I can fix cuts, scrapes, babies with fevers, cases of influenza and manage diabetes and hypertension.  In those patients that are beyond medical help I can usually justify my inability to fix- they have drank themselves or eaten themselves into this condition.  Or, maybe they are just old.  They have lived a long, satisfying and complete life.  But on occasion I am struck with sorrow and a feeling of helplessness.  I don’t know how to react when something is beyond medicine, beyond my ability to fix. 

The other night I treated a young girl for a common illness.  She was sick but I could sense there was something else causing her depressed state.  At the end of her visit her father told me her mother had passed away that week.  He may not be able to afford her medications because he had taken some time off work for his wife’s death and funeral.  I wanted to hold that little girl and cry with her.  I cannot imagine losing my mother early in my adolescence when I needed her the most.  I touched her arm and told her I was so sorry.  I felt helpless.  What do you say or do in a situation like this?

Another time a man in his early 30’s came in as he had been feeling ‘off-balance’ lately.  A CT scan of his head revealed a large brain mass.  The neurosurgeon informed me he would die within six months.  A picture of health with a beautiful wife and two young children, they were all about to endure a horrible tragedy in the death of their husband and father.  What can you possibly say to someone in this situation?

I am not good with emotions.  I am a doer and a fixer.  For some of the things we see as nurse practitioners there is not easy answer, no quick fix.  We can’t provide adequate comfort or understanding.  For me, these are the most difficult situations I encounter.  The ones I take home with me and still bring tears to my eyes months later.  Some things I am not able to fix.  The most I can offer if a sympathetic word and a silent prayer but that never seems like enough.


**Like all other cases and patient stories on my blog, details of these stories have been changed significantly to protect patient privacy


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