I wrote this today after I saw 25 patients, answered six crisis calls, and worked with the police to identify whether or not a dead man was my patient (Thank Heaven he wasn’t).

There are a lot of hardships to being a physician. One of the greatest is the expectations to do everything. This is to be done in chunks of short time and with few resources.

Other specialties may disagree, but I think psychiatry has some of the hardest challenges in Medicine. We are dealing with people’s life-sorrows. What can I really ‘do’ for someone who is devastated by loss, pain, injustice, and deprivation? I see veterans haunted by war; men who have lost job/house/status; women beaten and raped; minorities harassed; gay people demonized etc.

I try to do what I can – my words and medicines are simple tools that don’t do much – certainly not as much as I want them to do.

Shakespeare’s “King Lear” is consider by some his most ‘tragic’ tragedy. One reason is a parent sees his children die before him – what greater sorrow is that? Just as we think things can be well, Lear brings in his daughter, Cordelia – dead. The broader reason is there is no sense of justice or meaning to the death and suffering. Yet, throughout the play little bits of comfort are given by people to each other. An arm is offered; company is given. These little bits may seem of little use but they keep the play from being utterly hopeless.

One of my teacher told me to remember always I may not be able to do much, but my influence is vast. Being with a person in their sorrow or going with them on their “Dark Night of the Soul” is “something”.

I try to take comfort in this. Even on days when I feel powerless I hold onto faith my presence and attempts do “something”.

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