Coping with bad news

Nancy Hutton, an associate professor at the medical school of Johns Hopkins University, has one of the hardest jobs in medicine: She specializes in pediatric hospice and palliative care. She sees the sickest children—the ones with severe neurological problems that cause profound developmental delays, or with cancers slowly ravaging their bodies, or severe organ failures. The worst, though, is when she doesn't know exactly what's wrong with a child. "That's even harder," she said. "When you can't give something a name." Sometimes her job is to keep her patients comfortable: helping them keep food down without vomiting or easing their physical pain.