Today was difficult, both physically tiring and emotionally challenging. My patient was very ill, and his illness can be directly attributed to alcoholism, and the organ damage and immune system suppression that it causes. He is almost certainly going to die during this hospitalization, and I know that and the Doctors know that. However, his family holds out hope, as most families do, and we will do all we can to save him, even though several of his organs and body systems are so damaged from the alcohol that we can't fix him, really.
Throughout my twelve hour day I worked very hard to coordinate all the tests, hang all the IV's , give all the medications required to correct all his specific problems, all the while watching him continue to worsen despite our efforts. Every call to a physician to report his condition resulted in a whole slew of new tests/IV's/Medications. During all this, his family is there talking about him, calling to him trying to wake him up, his little granddaughter is reading to him from her kindergarten readers, everyone is crying and praying and looking for some glimmer of hope that something is better. Nothing is better. They said thanks to me as they left for the evening and I felt like an imposter, because I'm not sure anything I did improved one single thing about his health, and I know that it didn't, but it's not fair to dash all of their hope, because it's all they have left. So I tell them we'll keep working as hard as we can to help him.
By the end of this weekend, (I am in the middle of a three-day stretch,) I will have spent more time with my patient and his family than I will have spent with my own. And all of this effort won't change anything, and I will be sad with them if (when) he dies. It feels terribly discouraging today, that all of our technology and medicines and advanced training can't win out over Alcohol!