 who in this case will not survive their injury what does that do to you well it's like having your hand tied you know that you could help them i mean the skills are there that you know to do what we need to do what's missing is all the support around it i mean as a doctor when i go into a hospital it's just not me it's a whole team i have a whole system that works with me i have nurses i have staff i have equipment it's rare to to be in a situation where you have none of these