How do I handle patients who don't respond to treatment?

You can manage most treatment plans, which means the science and the routine are in your hands. What trips you now is the hard minority: the patient who does not respond as expected, the complication that does not follow the textbook. Those cases unsettle you precisely because you are good, because you can see clearly when things are not going as they should. The non-responders are where medicine stops being protocol and becomes judgment. There is often no clean answer, and the discomfort you feel is the honest discomfort of real uncertainty, not a gap in your competence. The best clinicians are not the ones who always know. They are the ones who stay careful and curious when they do not. When a case will not resolve, resist the urge to carry it alone. Bring it to a colleague, present it, ask what you might be missing. A second mind sees what a tired first one cannot, and the habit of consulting on the hard cases is itself a mark of good practice. You do not have to have every answer. You have to keep looking, together, until one appears.