Maybe one of the most complicated communication challenges is a situation where you never even have a chance to begin a relationship. It was more than skepticism on her part, more than a therapeutic relationship that required cultivating, we were the ones to tear off the band aid and expose her vulnerability. And it was too much for her. Our presence was too much. There was no miraculous turn around. No perfect words that changed the outcome. We were unable to reach her.

It happens sometimes. As clinicians with much to offer her, our interaction with Louisa felt like a failure. But was it our failure? Was it something we did? Or was it one more situation beyond her control. One too many. We can’t go back to find out because she doesn’t want us to.

I think she was overcome by the wash from the helicopter, by the thundering noise, the thump of the blades, the spinning and cutting movement of shadows. It was just too much. She had to look away.


Ann Brady is a symptom management care coordinator at a cancer center in Pasadena, California.