It was a gloomy day—dreary, sullen—in contrast to the previous night's Independence Day celebration. There was sadness in the department, too; everyone had seen the news splashed across the morning paper. Her body had been found. I doubt there was anyone who was not affected by this tragedy. When one of the nurses told me that her mother was here, I didn't have to ask whose mother it was.

I'd known before I saw the paper, anyway. Yet I'd been watching the news, as had so many others, hoping against hope that she would be found alive. She was only 10 years old, and she was a beautiful child—lustrous dark hair, twinkling mischievous eyes, and that captivating smile. I never knew her, but her picture was in the media. I can see it still. She had left a friend's house to go home for supper, riding her bicycle. It was a pink bicycle, like so many little girls have. Her friend even rode halfway home with her. She never made it the rest of the way. Her dad found her bicycle, an hour or so later, leaning on its kickstand a few blocks from home. She was found 2 days later, on the Fourth of July.

It wasn't simply that she was a pretty girl, or that it happened within a mile of our house, or even that it was any parent's worst nightmare. What really got to me, even before I met her mother, was the intensity of this family's turmoil played out so vividly in the media. All along I had been asking myself, how does one survive this kind of tragedy? Each minute must seem like an eternity of pain. How do they continue?

When the nurse informed me that the girl's mother had just been brought into the emergency department, I was both curious and terrified. I wanted to see her, to know how she was able to survive so horrible a thing as reassurance that if something as horrible ever happened to me, I might be able to survive it too. But I was afraid to see her pain. My anguished expression must have prompted the nurse to ask if she should find the other doctor on duty to see the patient instead. But I told her I could handle it. I picked up her chart, prayed that I wouldn't cry, and went into the room.

The chart listed the chief complaint as "unable to sleep". I don't know what I expected. Hysteria? Screaming? Pounding on the walls? Previously, I had given bad news to people who were not expecting it. But this lady was calm, and she looked me straight in the eye and said, "Doctor, I am not sick. You know that, don't you? I am not sick. My heart is broken". I stood in silence before her. I knew there was nothing in my black bag for this woman. All the sophisticated technology and state-of-the-art pharmacotherapeutics at my disposal were for nought in the face of this simple devastation. Totally unequipped by years of training and experience, I could only cry.

We get conditioned in this business to believe that we are not supposed to cry around patients. And, in general, I suppose this is a good rule of thumb. With all the tragedy, we would be crying all the time if we allowed our feelings to take hold. However, I would wager that in every clinician's career there has been a time or two when circumstances make it impossible to hold back emotion. I also now believe there are times when shared emotion between physician and patient is the best, if not the only effective treatment.

So I cried. We cried. We held each other and cried. She told me about her daughter's fine embroidery, and I told her about my little girl, too. We talked about her guilt, and her anger, and her despair. But mostly we cried. And then her husband came in and we all held each other and cried some more. And I knew then how this family would make it from minute to minute and from hour to hour. They would survive by spreading out their tremendous burden of grief to people who, like me, would be willing to share small parts of it, moments at a time, over weeks and months, maybe years, until the burden would become manageable. And I knew for that moment, I had given this patient the treatment that she needed.

It has been 4 years now. I have never seen this family again. They invited me to stop by their home as they left the emergency department that day, but I never could go—it was too painful. But I think of them often, and in some small way just writing this serves as catharsis.

Some have said that I should have avoided this encounter altogether or handled it some other way. In truth, I paid a price for treating this woman with my tears. In giving her the opportunity to grieve openly with me, I assumed a small portion of that grief myself. But I am not sorry. I am first a human being and only second a doctor, and the two are not mutually exclusive. And so, as I reflect on this experience I realize that I too am grieving—for a child I never knew, for a family that touched my heart. And as Independence Day rolls around again, I know that I will always remember.