I’m so sorry, but the pain was too much, and I couldn’t continue. I have witnessed patients crying themselves to sleep while nurses held their hands, praying for their treatments to be approved, giving them one more chance at life. Nurses try to juggle 8, 9, 10, or more patients during their shifts, holding onto their compassion with the last thread of hope that things will improve. Yet, they’ve also seen many colleagues leave inpatient care due to the greater stress, longer hours, and lower pay compared to clinics nearby.

Pharmacists struggle to find cheaper options that provide the care their patients need without burdening an already struggling system. Technicians work tirelessly to ensure all the X-rays, MRIs, ultrasounds, echocardiograms, and other studies are completed to find out what the patients need to recover. EVS teams, often understaffed as they can earn more elsewhere, rush from floor to floor to keep beds clean and hallways free of trash, while ensuring towels and linens are stocked. Food and nutrition workers work furiously, with little time to prepare their own meals, to serve hundreds of patients.

Security guards do their best to keep the staff safe, especially in an era where people bring guns into places meant for healing. Physicians and advanced practice providers are doing all they can to follow the Hippocratic oath and not lose their empathy or altruistic idealism. They are caring for increasing numbers of patients with decreasing resources.

Everyone in the hospital trenches fights hard to care for patients, but they have forgotten that they don’t have to fight this battle alone. We are all in this struggle together. The clock is ticking on length of stay, observation hours, door-to-doc time in the ED, on-time starts in the OR, and the pressure to do things faster and “more efficiently.” Financial pressures loom, bringing sweat to my brow and blurring my vision. I can’t see a way to move on.

I can’t continue living in a world where caring for others has become a battle for survival of the fittest, favoring those who know more about running a business than holding a hand. I see no way forward and no way out. I apologize, but you will have to go on without me. In my final moments, I ask two questions: How did we get here, and what will you do when I’m gone?

The author is an anonymous physician.