"why are we doing this?": Clinician helplessness in the face of suffering

Background: When the brutality of illness outstrips the powers of medical technology, part of the fallout lands squarely on front-line clinicians. In our experience, this kind of helplessness has cognitive, emotional, and somatic components. Objectives: Could we approach our own experiences of helplessness differently? Here we draw on social psychology and neuroscience to define a new approach. Methods: First, we show how clinicians can reframe helplessness as a self-barometer indicating their level of engagement with a patient. Second, we discuss how to shift deliberately from hyperor hypo-engagement toward a constructive zone of clinical work, using an approach summarized as ‘‘RENEW’’: recognizing, embracing, nourishing, embodying, and weaving—to enable clinicians from all professional disciplines to sustain their service to patients and families.