It’s not easy to watch people suffer. The wonderful thing is that we can relieve suffering. The crappy thing is when it’s a person you love doing the suffering, and you can’t do a damn thing about it.

A few months ago, my (younger) brother Jay called me concerned about his increasing fatigue and shortness of breath. I suggested he go to the doctor.

A week later, he called again. “Hey, Lis. I’m in the ED at the University of Chicago. They called me from the doctor’s office to tell me my blood count was really low, and I might need blood.”

“Have you been having any bloody or black stools?” I asked. “Well, every once in a while. I’ll keep you posted,” he said.

That night while I was on shift, the night shift at the U of C was looking after my brother. He was admitted, had blood work done, and was given an iron infusion. He was discharged the next morning, with a colonoscopy scheduled.

I prayed for diverticulosis, a hemorrhoid, an AVM, anything but a mass. But that is what they found in Jay’s ascending colon, measuring about 8 cm.

Now I started to ask the question: Why him? He’s 34, he has no medical problems, he’s a good person, he does what he’s supposed to do. And it frustrates me when I think of all the people I see who seem to WANT something wrong with them.

His surgery went well, but that night his epidural pump broke. He went more than 2 hours without any pain medication. He called the nurse, who paged the resident. After 45 minutes and no relief, he called back, frustrated and in pain. Although I know the resident was very busy, why couldn’t they just keep him informed? Why did he not have orders for breakthrough pain medications? If I had been there, could I have done anything?

In our own EDs, we can control pain (or at least try to), diagnose, and fix the things that need fixing. As emergency physicians, we love the immediate gratification of opening an abscess, administering a dental block, reducing a dislocation, suturing a laceration. In my ED, I can do all of these to relieve the suffering of my patients.

What I can’t do is fix my own brother. But the more I thought about it, the more I thought of what I CAN do.