Learning you can't help someone who doesn't want help

My first week of inpatient medicine was exciting and amazing. Patients came in very sick and one to two days later they were able to come home again. From my eyes, it looked as though patients were on the verge of death and were given another chance at life everyday in inpatient medicine. I found it so exciting that we were able to diagnosis a problem and fix it- what could be more gratifying than that?!

Unfortunately, at a metropolitan hospital, not every patient wants to get helped. In fact, we had several patients who left "AMA" against medical advice for one reason or another. One patient in particular really disturbed me when he left AMA. A patient came in for a life-threatening condition where his airways were closing up and he was unable to breath. Since he was so sick, he had to get a tube placed into his throat to breath for him. For several days, he was kept alive through the help of machines. On the 4th day, he woke up and extubated himself (a crazy painful ridiculous thing to do) and demanded to be discharged. He was brought to our floor to stabilize his other medical problems, try and figure out what caused his airways to close up in the first place, and to make sure that he was stable enough to go home. Within 5 minutes of arriving, he demanded to leave. I spoke with him to try and find out why he wanted to leave. I thought that if I tried hard enough, I could convince him to stay, I could be his advocate. Instead, after everyone on our team tried to reason with him he walked out. I felt really uncomfortable watching a man who I knew would not live much longer without medical help walk out, convinced he was doing the right thing for himself. He was so proud that he showed the doctors who was "boss." He loved making a scene. It was really painful for me to see that his need for another drink was leading him to a very soon early grave. He could not be reasoned with and everyone on the team shrugged him off. In the end, we cannot make a patient do anything. A patient has the right to make their own decisions, even if they are the wrong decision. Even so, it was really discomforting to know that the next time I saw this patient medicine would not be able to do much to help him. To me, it was my first experience watching a patient die.