"It's just one of those things that happens".

I thought this prenatal visit would be like any other. But then I read the patient's name-Rosa. Six months earlier, Rosa had left Minnesota with her husband and kids to visit their home and family in Mexico. Their 18-month-old, Manuelo, had been dying. He was diagnosed with the neurodegenerative condition Tay-Sachs disease. She had a second pregnancy that developed normally and I worried. Two days later, her baby, Luz was in my clinic and a blood test showed she had Tay-Sachs disease. Luz died on the way home after two days after Rosa' delivered her next baby. Rosa believed U.S. doctors were wrong. Manuelo didn't have Tay-Sachs. Manuelo's difficulties were from mal de ojo-the evil eye. Rosa told me that they had stopped Manuelo's antiseizure medications a month before his death, and he had seemed better, almost rolling over again. This improvement was strong evidence that mal de ojo had caused his problems. But it had been discovered too late, so Manuelo had died. Caught between wanting to respect their beliefs and worrying about the baby, I probed for any doubt in Rosa's thinking. During their last clinic visit, I asked Rosa how she understood what had happened to Manuelo and Luz. She still believed mal de ojo was responsible. It has been 9 years since that farewell. Recently, I heard from Rosa's extended family in Minnesota that Rosa, Pedro, and their kids are well and plan to return to Minnesota this year. I am looking forward to seeing them. My existence as a physician is dependent on and continually shaped by the patients and families that come to me for care. There is a lot in that process that is not in my control. For me, caring for Rosa and her family was "one of those things that happens," and something that has sculpted me into the physician that I am. (PsycINFO Database Record