When your best is not enough...

I am currently training at a university hospital which not only has a busy Neurology service but happens to a big referral center for complicated cases. I am seeing patients with some of the most bizarre presentations which are defying known diagnoses. It's great to be doing all the things by the book, then thinking outside the box and knowing that you gave it your all. But what if that didn't work? What happens when your best is just not enough? You fight back anger and all emotion and let your patients know you tried. What makes it worse is that they know it too. They know it all too well, that you fought till the end for them. What makes it worse is when they console you; when they say, "I know doc, you tried your best but what's got to be will be." And I can't help but think that it doesn't have to be this way! It's just not fair. Some of the worst diseases strike some of the best people; people who have been living by the book of good health and should have been promised longevity because they were so honest and unwavering in their approach. It just makes you realize that we still don't have the answers to the question; "When I did everything right, why did this happen to me?" A lump arises in my throat every time a patient asks me this question and all the marvels of modern medicine just fade away and all humour fails to dissolve the pain. Why is my best not enough to let someone dream on; to let someone live on and not die an untimely death?