Another day where I look through my inbox and discover bad news for someone. It happens almost every day, in one way or another.

Part of doing what I do is to listen, ask questions, and find clues. I think it’s fitting that Sherlock Holmes was created by a doctor, because I often feel like I’m putting together all the pieces, in order to find the answers in much the same way as that great detective.

If not nearly as impressively.

Sometimes, I wonder how much of what I do is based on the details and facts, like Sherlock, and how much is based on intuition.

Some things just don’t make sense. I shouldn’t come to the conclusion I do based on the facts that I have,

And yet.

Today was one of those. When I saw the results, my heart sank.

It had been a feeling, based on a hunch, that sadly seems correct now that the facts have come in.

This is part of the art of medicine. Knowing the “soft science” and moving forward based on imprecise details.

Knowing from the way a person looks and moves, realizing something is off, even when you can’t put the “what” into words.

But the other part of the art of medicine is the hardest.

Knowing how to break bad news, how to be present, how to help them decide what they want to do. How to relate.

Anyone can learn the technical parts of almost any job with enough applied effort.

But it’s the big picture that’s sometimes hard to see for the trees.

And sometimes, I’d like to sit and just hold their hand.