How to approach the anxious patient, when the world is falling down inside you there is little left but to run and hide. 3 ER visits later and we are back at it again, questioning the mechanics of it all. Do we have the right diagnosis or are we missing something? Should I be searching for the zebra, will the insurance let me get the 24 hour catecholamine. I wonder sometimes if I am just spinning my wheels. And at the end of the day I pray that God is listening and that hopefully I am doing the right thing.