“Dear doctor, I have still pending a final voyage along the coast of my beloved Chile.” Architect by vocation, avid reader, Don Dago intensively enjoyed designing open spaces as a way of expressing himself. As a survivor of cataclysmic earthquakes, he told me that afternoon that before dying he intended to travel again along the southern coastal path of Chile. He knew the route like the back of his hand, and described it as the most beautiful he had ever seen. But this time it would be different. He was going to travel with his son and grandson, a sacred fraternity, that made this challenge more attractive, something for which he was willing to overcome the natural fear of what he faced. The recurrent chest pain had restricted him to an ICU room, reminding him after each movement that his youthful spirit was confined to a nonagenarian and sick body. His preserved cognitive functions allowed him to recognize the real fear: dependency.

From humble origins, Don Dago forged the history of his people according to his precepts with passionate dedication. As he was an excellent conversationalist, not surprisingly, my medical visits evolved into real gatherings, but ultimately I managed to obtain his consent to perform an endovascular coronary procedure, which was successful.

A couple of years later, the man and his body lay again on an ICU bed, but this time as a terminally ill patient with severe heart failure. However, our interaction remained intact. He accepted the inexorable destiny with a never fading smile. He asked for a sketchbook where he drew some landscapes of his last voyage, the rocky cliffs and the profound crevices along the rocky wild coast of Chile. Talking despite his shortness of breath and dyspnea, he enlightened the room with the epiphany of endless sunsets over the deep blue of the Pacific Ocean, the cry of the seagulls, the fog surrounding distant lighthouses. But more touching were his memories about three generations just sitting at a campfire on lonely beaches under the light of Orion, Betelgeuse, or Aldebaran, deep down in the southern hemisphere. One poet wrote, “Only taking risks we can find what will save us,” and Don Dago provided a crude example that this sometimes can be true.

Now at the twilight of his life, it was time to be consistent with our previous decisions. He completely agreed, again smiling despite the facial mask. “This was our trade-off. I accepted the coronary procedure just with my final voyage on the horizon. However, no more invasive technologies are acceptable. Dignity is my only goal now.” After that, I witnessed the last visit of his wife, a life partner who did no more than confirm that it had been the right thing to do. There were tears but no despair.

He has been gone now for a couple of years. Sometimes I remember him, especially on misty autumn days. I do not know why but his name evokes a specific landscape far away from Santiago where ancient forests fall to the edge of the sea. I can imagine him just walking around there in a sensitive mood, and just thinking that the adventure of life is one deserved to be explored until the last minute. I have been an intensivist for so many years now but never stop thinking that in the window of every patient’s experience you can find the signals that can lead you to become a better human being but also an intensivist who cares, who looks, and acts differently. It is crucial to find the balance between compulsive technological care or just listening to the patient’s dreams. Every patient should be given the opportunity for a last voyage when this is possible even if it means avoiding additional intensive treatment. This was Don Dago for me, a man who lived and died like he wanted to.