Travels with Dr. Sam

Please save her, Doctor!

“Please save her, doctor, please,” the old man pleaded, tightly grasping my hand.

It had turned dark over an hour ago on a long Southern California summer day when I encountered him in the ICU. I guessed his age to be in his nineties. His small frame bent sharply forward from the waist. Deep wrinkles creased his tired face — one that had clearly seen more than its share of life’s miseries. His hands, coarse and calloused, held my outstretched hand firmly, his nails discolored and misshapen. A tuft of gray hair stuck out awkwardly from his large bald head. His body was falling apart, but his dark eyes were very much alive.

“I’ll do my best. But let me first see her,” I said, nodding sympathetically as I slowly extricated my hand and walked into the room. He shuffled in behind me, hands clasped behind his back for balance.

It was Friday evening, the end of a long work week. I had just finished rounds and was heading home when my pager went off.

I turned down the music in my car and called back, cradling my cellphone between my shoulder and left ear. This was back when cellphones were still a novelty and using one while driving wasn’t yet illegal.

“I’ve got a patient for you. And it’s a bad one,” boomed the voice of my friend Chris, the ER doctor, after a long wait while the nurses tracked him down.

“You better come in right away and see her. I don’t think she’ll make it through the night. She’s still a full code. You should talk to the husband about making her a DNR.”

I slammed my palm against the steering wheel, took the next exit, and turned back toward the hospital.

I had promised my wife a night out and made a reservation at a fancy restaurant. We were trying to rebuild our crumbling relationship. She had waited patiently through my years of school and residency, raising our kids mostly on her own, hoping that once I started working, life would normalize. But private practice turned out to be even harder than training. Long hours, sleepless nights, constant calls — I came home drained and irritable.

Despite years of trying, I was losing my grip on both family and career. A few weeks earlier, my wife and I had finally talked. We agreed to try again. I had promised her more time, more presence, more of me. I’d been looking forward to this evening, and so had she.

“I got a new dress and shoes,” she’d said when I called her earlier. “We’re finally going out. I want to look my best.”

How could I call and tell her I wouldn’t make it? Any explanation would feel hollow. But as a physician, I couldn’t go home without seeing the patient. I called her. She didn’t say a word. I heard her sobbing before she hung up.

In the ICU, I reviewed the chart. The old man hovered nearby, watching me closely. His wife was dying.

She was gaunt, all skin and bones except for a grotesquely distended abdomen. Her open eyes stared blankly at the ceiling, unresponsive to voice or touch. She was gasping for breath.

According to the ER note, she’d been diagnosed with Stage IV colon cancer only weeks earlier. Surgery wasn’t an option. She had failed her first round of chemotherapy. Hospice had been recommended, but her husband refused.

I held her cold hand and felt the unmistakable scent of death — something a professor once told me becomes instantly recognizable with enough experience. I knew in my heart she was dying.

But when I turned toward the old man, waiting for a word of hope, I couldn’t bring myself to deliver the blunt truth.

I placed a hand on his shoulder and guided him to a small waiting room. We sat on hard plastic chairs facing each other, a window behind him offering a view of her room. He kept glancing back at her.

“Mr. Rubin, your wife is very sick,” I began.

“I know,” he said calmly.

“She has an incurable disease.”

“I know, doctor.”

“Her chances of making it through the night are slim.”

He turned to face me fully, locking eyes.

“Don’t say that, doctor. You have to save her,” he said softly, his voice imploring.

“We’re doing everything we can. But her condition is terminal. I’d recommend making her a DNR. We’ll continue the care, but do you really want her intubated, her chest compressed, shocked, and put on life support?”

He lowered his head and began to cry. Quietly. Tears traced the creases of his weathered cheeks.

Then he looked up.

“Would you say the same if it were your mother? Or your wife?”

The question caught me off guard. This wasn’t supposed to be complicated. The ethics were clear. Her chances of survival were negligible.

But how would I feel if it were someone I loved?

“I would do just what I suggested,” I replied, projecting a confidence I didn’t fully feel. “I wouldn’t want them to suffer. I’d let them go peacefully.”

“Well, doctor, I disagree,” he said firmly. “Do everything. Just keep her alive.”

Later that evening, we intubated her and placed her on a ventilator.

That night, driving home through empty streets, I couldn’t shake the image of the old man. Normally, I could compartmentalize, leave my emotions at the hospital door. Not that night.

The house was dark when I arrived. I tiptoed in. The dog gave a soft bark from upstairs. I collapsed on the couch and fell into a shallow, uneasy sleep.

When I returned the next morning, the old man was still at her side, slumped in a chair, dozing off and waking in turns.

“He’s been here all night,” the nurse whispered.

“She’s better today, doctor,” he said, leaping to his feet when I entered. “She squeezed my hand. I know she’s going to make it.”

But she wasn’t. My examination confirmed she had deteriorated. I nodded and moved on, checking on her again that afternoon. He hadn’t left her side.

“Mr. Rubin, don’t you want to go home and rest?” I asked.

“How can I leave her, doctor? She’s all I have.”

My neck ached from the night on the couch. Tylenol hadn’t helped. I looked around her room — bare white walls, no windows, antiseptic air. Only the ventilator broke the silence with its steady whoosh.

The machines told a stark truth. She was barely hanging on. But he still clung to hope.

“I’ll be back later,” I muttered and walked out.

When I returned that evening, he was still there. Something about him broke through my usual detachment.

“You haven’t eaten, have you?” I asked.

“I’m not hungry.”

“You’ll end up as a patient too if you don’t eat.”

That startled him. He followed me hesitantly to the cafeteria. He insisted on paying and chose a bowl of soup and a slice of bread, slurping it with his toothless mouth.

“How long were you married?” I asked.

He looked up, puzzled. “Sixty… no, seventy years. A long time.”

Later that evening, I sat in my backyard with a stiff drink. The sun was setting. A few stars pierced the smoggy twilight. My wife joined me. We sat in silence. I wanted to tell her about the old man, but didn’t. That night, I fell asleep in her arms.

The next morning, she was worse. He followed me again to the cafeteria but allowed me to pay.

“Are you married, doc?” he asked suddenly.

“Yes,” I said.

“Take good care of her,” he said sincerely.

“I do,” I replied quickly, avoiding his eyes.

“I can’t let her go,” he whispered. “She’s everything.”

“If you love her so much,” I asked, “why not let her go?”

He looked at me, eyes moist.

“It’s a long story. After we got married, the war broke out — World War II. We were captured and separated. She was forced to work in a bomb factory. Her beautiful hands — she played the piano so well — used to make weapons. Can you imagine that, doc?”

He paused.

“When we reunited, four years had passed. Four awful years. I swore I’d never let go of her again. And now… I just can’t.”

She passed away that evening.

Her frail heart gave out. CPR was attempted. Drugs were administered. Her body arched under the shock paddles. But the monitor stayed flat.

The old man stood in the corner and watched. No emotion. No tears. Just silence.

When we stopped, he remained still. Eventually, he shuffled to her bedside, took her hand, and whispered to her, caressing her cold fingers.

That image haunted me as I drove home.

I said nothing to my wife. I just hugged her and cried. For the first time in years — maybe ever — I truly cried.

Weeks later, I passed by the ER at the end of a shift. Chris was working.

“Anything for me?” I asked.

“No, you’re good. Go home and rest.”

As I turned to leave, he called out.

“Hey — remember that old lady with colon cancer?”

“Yeah,” I said, a knot forming in my gut.

“Her husband showed up yesterday. The stubborn old guy who wouldn’t sign the DNR? Paramedics found him at home. Neighbors hadn’t seen him in days.”

My hands trembled.

“He died within minutes of arriving. Nothing I could do. Looked like he hadn’t eaten or drunk anything in days. Starved himself, I think.”

Chris turned back to his computer.

I staggered a few steps, braced myself against the wall, then drove home.

That night, I poured a drink, took a sleeping pill, and watched the sunset from my backyard.

But I didn’t sleep.