This was the first exposure I had in which classical treatments were no longer an option and the patient was faced with a decision that had no desirable outcome. Although I cannot begin to imagine the decision that the patient faced, the experience continues to influence my interpretation of the practice of medicine. Through my observations of the patient, I have come to believe that as a physician there will be a time where I am faced with these challenges, and having the strength to help patients through these decisions will be the most challenging aspect of being a physician. I have learned that the best decision is not always going to provide patients with the most desirable outcome. Instead, it is the outcome that will provide patients with the greatest longevity and the best quality of healthcare. Through this understanding, I will be able to help support my patients through the challenging decisions they are faced