It has been long since but the memories are still vivid. It was during my internship when two patients showed me their capability to predict time of death without any knowledge of complicated scoring systems or many years of clinical experience.

Being on call during my first internship I was asked to the emergency room where a patient in respiratory distress had just arrived. On my way to the emergency department my heart rate increased twofold and my hands became sweaty, pale and cold as I felt my inexperience leaning heavily upon me. Before opening the door I gathered all my courage and walked in calmly trying to look as "cool" as possible. The little old lady in her 70s with average respiratory distress looked up towards me and followed me with her eyes when I approached her bed. At her bedside, just before I was about to introduce myself, she said with a clear voice: “Don’t be afraid doctor, I won’t die”. I was startled, could not get a word out of my mouth when she went on “I won’t die now, I’ll die next Friday”. As it was only Monday, I was baffled. When I asked her how she knew she only said, “I just know”. She did not refuse to be treated and improved on diuretics and oxygen. Over the next few days she remained stable and we talked about her life and how she had enjoyed it even though she had no children. As I was convinced she would not die I did not bring up the subject anymore. However, from the way she expressed herself talking about her life in the past sense, it was clear she was closing her book of life. On Friday morning she was found in cardiac arrest from which we could not resuscitate her.

The second patient was a man in his 60s admitted for the evaluation of what seemed to be colon cancer with metastasis in the liver. Considerable weight loss and his worsened nutritional state with anemia made him frail. His wife spent as much time as possible at his bedside as she wanted to be there in case his condition would worsen. Several days following his admission, I was making rounds when she was about to leave for home. At the bedside she asked me if it was “safe” to go home as she always did. I told her that her husband’s condition was stable and that she could safely go home. Her husband looked up at me and smiled. He then turned to his wife and asked her to be back before 11:30. When she asked him why, he said “Because I’ll be dead by 11:30, and I would like to have you here when I die”. I felt very uneasy with this situation as his wife looked at me in disbelief asking me with her eyes to disprove his statement. I asked him how he knew, as he had already been stable for quite some time. He said, “I just know”. She told her husband she would try to be back before 11:00. I walked his wife to the hall when she asked me if she really had to be back before 11:30. I told her I had no reason to believe he was going to die but told her the story of the lady that died on Friday. She made up her mind and assured me that she would be back at 11:00, as she was. When she arrived he said he was glad she had come and closed his eyes. We were both at his bedside when he died at 11:15.

In my current profession as an intensivist I’m sometimes assured I have postponed death using sophisticated technology and treatment schedules. Remembering these two patients always makes me wonder what my contribution really is.