My father died of COPD in 1998, a disease he had acquired not through smoking but as a result of the TB he’d contracted during World War II. Surgeons had permanently deflated his left lung in 1944, and it was rather a miracle that he thrived and lived to be 84. He had the privilege of dying at one of the teaching hospitals at the University of Pittsburgh. He’d been in the hospital for about 10 days, and had been resuscitated once. I’ll never forget the matter-of-fact, likeable young female resident, who came into his room on that tenth night and said, straightforwardly, “Mr. Anderson, it’s time for us to discuss how you want the next week to go.” She outlined his options, asked him several specific questions (Do you want CPR? Electric shock to the heart? Antibiotics? A feeding tube?), and simply took his answers. He had a few questions about the electric shock thing and decided against it. In fact, the only thing he said he’d want was antibiotics. The next morning, when I returned, he asked me to find the young doctor and tell her that he didn’t even want the antibiotics. “I’m going to go see Jack,” he told me, referring to his older brother who had died just 6 weeks earlier. He had previously made out an advance directive, but this conversation helped us come to terms with his impending death. He died peacefully two days later in the hospital, just before we were scheduled to move him to a hospice facility. We were very lucky – my dad still had “all his buttons” (his words!), and we knew we could rely on his judgment. What my brother, my husband, and I learned was how important it is, for the patient and the family alike, to have the comfort of a straight-forward, honest conversation. We’re grateful for him being at a great teaching hospital that supported this kind of discussion. And, my husband, my brother, and I, in addition to writing Living Wills, have all had the conversations with each other. Who knows if we would be as lucky as my Dad was, to be able to make things clear in those final days?