"Whether it's substance abuse or smoking, sexual promiscuity, dietary choices worsening a metabolic syndrome, and other things, there are many reasons why people don't get better or experience the same damaging effects on their bodies. Depending on the cause, there is probably a support group or educational platform I would make a part of their therapy, along with the education I can give about how things end badly when prevention is not part of the picture. I also know that there are persons for whom none of these efforts will do any good. If that's because of mental illness, psychiatric referral is indicated; if not, then there just may be no helping them. As an ER doctor, I have to come to terms with the fact that there are some people who can't be helped."