ABSTRACT
Mary had done a field placement in a hospital neonatal intensive care unit; she then came to AIDS work wanting to expand her skills and intensify her work with terminally i l l patients. Within the first months, she experienced several patient deaths and felt sadness for only one, whom she had been able to reach as had no other professional provider. Mary not only felt quite confident about her skills in case managing but also in her ability to go through the losses of cognition and physical deterioration experienced by her patients, which she viewed as "part of the package" of working with AIDS patients. This homeostasis was soon interrupted when her father became il l and was admitted to an ICU and intubated. Mary continued to work, informing her supervisor of her personal crisis. Not unexpectedly, Mary defended against the emotionality of her AIDS work to remain connected to the myriad feelings of her father's crisis and subsequent death. During that time, her excellence at case management reflected the displacement of her need to remain effective.
