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Not knowing why takes away our power to prevent

Abigail Schildcrout, MD
Physician
January 13, 2014
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I recently went to a visitation at a funeral home for my friend’s daughter. She was 24.

She had had developmental delays and multiple medical issues, but this was not expected and the cause is not known.

My friend is a doctor. A really good one. One with fiercely loyal patients because she is a fierce advocate for them. She is one of those doctors with phenomenal interpersonal insight on top of top-notch clinical skills. Her bedside manner is impeccable.

And now she has to answer the same question from scores of visitors — why? — without an answer. The same way she has to answer her patients’ questions of “why me?” or “why my mother?” or “why my husband?” without an answer.

Sometimes we just don’t have answers. Sometimes we just don’t know why. And not knowing why takes away our power to prevent. That’s why we do research. That’s why we have scientists. Because finding the answers to the “whys” is what gives us the power to figure out the “hows.” How to fix. How to prevent.

Always searching for answers so that we can have some semblance of control. Always looking for reasons so that our world can make sense.

So many doctors get angry when their patients don’t do well. When they can’t find a cause for something. When their treatments don’t work. They can’t tolerate the powerlessness.

Most doctors that I know keep thinking about their patients (or even other people’s patients they hear about) who don’t do well – and keep coming back to “why is this happening?” “what can I do?” and “what should I have done differently?”

These are also questions that parents ask when something is wrong with their children. They reflect a sense of responsibility coupled with a feeling of impotence.

For my friend, herself a beautiful healer, there is a loss and a wound that will never heal. May she someday find peace, even if not answers.

Abigail Schildcrout is founder, Practical Medical Insights, and blogs at DocThoughts.

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