Mary had a friend who died from AIDS when she was in college, and decided then that she wanted to work in that field when she graduated as a nurse. Her first position was on the HIV ward, an area that had a large turn over of staff. After several years, she decided to try a new position as a visiting nurse on the HIV team. She liked the flexibility of her position, but soon realized that seeing patients several times a week in their home was much different than caring for them in the hospital. She met spouses/partners and families. She thought nothing of stopping to pick up something she knew George, who was very wasted, would like at the grocery store, lending a new movie to John who had recently fallen and fractured his hip so wasn't able to get around, or making a copy of relaxing music for Fred, the perpetual insomniac. When possible, she would take a couple of extra minutes at the end of her day to read to Josh, a young man who lost his eyesight to CMV. Everything about the new position led to a sense of intimacy with her patients. When each died, she attended the funeral.

After several years in the field, Mary noticed that she often felt tired. She did not seem to see many of her old friends as often, and in the evening went straight home, had a late supper and spent an hour flicking through channels on the television without really watching anything special. She noticed that she started to dread going to the home of patients who were getting close to death. Co-workers noticed the change in her work habits and were concerned that she was burned out. Her supervisor suggested she attend a support group for HIV staff, and take some time off for a vacation. After several months in the group, she realized that she was suffering from "cumulative loss." She was eventually able to make changes in her practice that allowed her to still provide good care for her patients while keeping a safe space between her job and her personal life. She planned outings with old friends, and decided to take art classes at a local community college in the evening. By learning to take care of herself and set limits for her job, she was able to remain active in a field that she loved.