The majority of us in medicine are in it because we care.  But sometimes caring means saying “no.” We say no to one more initiative when our team is already stretched. We say no to a patient’s request when it’s not in their best interest. We say no to ourselves when we know we can’t do it all. ...

We don’t always talk about guilt in medicine unless it’s framed as toxic or as a byproduct of impossible systems. But some guilt is earned. Some of it’s useful. The kind that nudges us when we’ve strayed from our values. And some is not. What follows is a story out of several that came to mine fr...