Yesterday afternoon I was reminded of how the world keeps turning, and why it can be so easy to feel alone. We had a patient at the day hospital all day long. She has recently suffered very rapid, serious physical decline. Though she's had a diagnosis of myasthenia gravis for at least five years, nothing was ever done about it for her, no medication, no therapy, and the family had no information on the disease might progress, what to expect, what to do, etc. So all day long, the family met with various members of the team, the patient went through numerous tests--- but as there were no other patients, the staff spent a large part of the day setting up for the retirement party of one of our consultants. And at about 4pm, people started to arrive for the party, making a lot of noise as they did so. By this point, the patient's family was severely stressed out and emotional, and one of the daughters came over to yell at the head nurse about how inappropriate it was to have a party before the day hospital had even closed for the day, and with a patient still there with serious health issues. The doctor then took the entire family into a private room for awhile, and when they came out, everyone was crying, and I learned the patient was to be admitted to the hospital due to the serious nature of her condition. I spent the next hour while we waited for the patient to be transferred comforting the family and my heart just broke for them. While I knew there was no way the staff could have anticipated this situation when planning the party, I could feel very keenly how horrible it seemed to this particular family that everyone continued as if nothing were wrong, everyone around them was happy and having a party to celebrate someone else. I think the juxtaposition of celebrating life against having to face the fear of their mother's death was just too much. The hardest part of this job is the thin line between life and death, and how helpless you can sometimes be in making a difference.