Working in hospitals can be isolating and frightening. How should doctors feel about their patients? Should we aim for dispassionate technical precision alone? Should we grieve when we practice in unforgiving environments? Or when things go wrong? Should we suffer? In this essay I return to The Gambia to revisit a harrowing experience as a medical volunteer. By reflecting on the despair I felt through much of that time, I seek to explore the distress of humanitarian workers and doctors everywhere.