Try as he might, the Jobbing Doctor finds himself unable to make any significant impact on some of his epileptic patients.
It's impossible. I've spent years trying to get it sorted out, and now I think I'll have to admit defeat.
In the same way that I spend a lot of time and effort helping those with addictions, I also like to strain every sinew to help those with epilepsy.
I find it really hard to get epilepsy right, and as a result I keep going at trying to help people become seizure-free. I change doses and medications, I adjust combinations, and yet I have a hard core of five or six patients who I cannot make any significant impact on.
This is so frustrating, as I know, from family experience, what a difference good control will make. I have this overwhelming sense of failure in that I cannot improve their illness.
In other areas referral might be an option, but in my patch none of the neurologists seem to be interested in epilepsy, and my last patient who was seen by them had such a bad experience of lack of support, interest and empathy that I'm not inclined to refer again.
So when it comes down to it, the buck stops with meJobbing Doctor