This question was originally posted on Quora.com and was answered by Amy Chai, MD, Internal Medicine, MS Epidemiology Internists never give up on their patients. Like, never. The derogatory nickname given to internal medicine doctors is, “fleas.” The stethoscope around the neck is called a, “flea collar.” The reason for this is that the “flea is the last to jump off a dying dog.” So instead of being insulted, we refer to ourselves as fleas. Many of my patients are extremely difficult with problems that will not be solved. The specialists have “washed their hands” of their problems. This is when you need someone who is there and will do what they can do. This does not mean that we do not recognize when nothing more can be done. Yes, we do know when that is the case. Sometimes that is true for patients who are NOT terminally ill, but simply have an unsolveable condition. You just keep taking care of them. Sometimes it is a person who is terminal. You just do what you can do, especially when the person has been discharged from the cancer service, but does not want to go to hospice. It is a hard position to be in. Sometimes it is far harder to “not be able to do anything” than it is to be the expert at “doing something.” Source
