Everyone is tragic today. Real tragedy. A woman I have been treating for a panic disorder, who has been doing really well, came in looking utterly frazzled. It has been 2 months since I've seen her. She laughed in an almost demented sort of way and said she's only had one panic attack since I last saw her. It started three days ago when her son and brother (honest to god) were lost at sea. Then yesterday they were found. It was incredible, people lost at sea are rarely found at all, much less ALIVE. So she had a well-justified panic attack and is still getting over it. I think two months with only one panic attack is great. I think I, who have rarely in my life panicked, would have had a panic attack if my son and brother were lost at sea.

Then there was a woman who came in for a bus driver physical. She was muttering "I know I am going to fail, I know I am going to fail." I asked her what was going on, because I rarely fail anyone on a bus driver physical. (In fact, I have only failed ONE person -- she was blind! Her vision was 20/200 in both eyes -- and boy was she mad at me! "I've NEVER been in an accident!" she wailed. All I could think was that I wouldn't want her driving MY kids around, no WAY could I pass her! The acid test: would I let my kid ride with someone?) Anyway, this poor woman was a wreck because her son had just been diagnosed with bone cancer in his left leg. I think that entitles a person to be a nervous wreck. I did her physical, and she was ok, even had good vision. Then we talked a lot about her son. I hope he's going to be okay too.

My next patient was a wreck too. She had just buried her son two days previously. Her job wanted her back at work, but she just didn't feel ready. Besides, she was bitter because her job hadn't sent flowers, no card, nor had they attended the funeral. Her son had died in prison. She felt sure that they thought somehow that the fact he had been in prison for 15 years somehow negated the effect his death had on her. But of course it didn't.

Anyway, what can you do? I gave her a note for 2 weeks off work, and we talked a long time. My great grandmother once said that losing a child was the worst pain that you can suffer, and I believe her.

I am exhausted. My children love to come to work with me -- they think all we do is have fun. And we do have a lot of fun here. We like each other, we like our patients, and the atmosphere is generally friendly and easy-going. But some days are hard. I can't wait to go home and sleep.