How do I keep going when I'm the only one holding a patient's care together?

You can navigate the entire system on your patient's behalf, and because you can, you have become the one who holds it all together. That is a heavy place to stand. When you are the person everything routes through, the weight is constant, and it wears you down in a way others rarely see. Being the one who holds it together is a gift to your patients and a slow tax on you. The system leans on people like you precisely because you will not let things drop. But no one can be the load-bearing wall forever. Your fatigue is not weakness. It is the honest cost of carrying what should be shared. So start handing pieces back to the system that should own them. For one patient, name one thing you are carrying that is truly someone else's job, and pass it there, even if it is imperfect. You do not serve your patients by burning out. You serve them longer by refusing to carry it all alone.