I was clipping a ruptured aneurysm in the angry brain of a 35-year-old girl at 9 pm on a Thursday evening, when a nurse walked into the operating theatre with a message from the ER that she’d been asked to deliver: “There is a 95-year-old man with a large hematoma [blood clot] in the brain. He’s drowsy and paralysed in the right arm and leg.” Without seeing the scan or asking for any more details, deeply engrossed in the critical part of my ongoing surgery as I peered through the microscope, I responded crassly, “He’s 95; let him go in peace.” I could see the nurse nod her head through the corner of my eye, saying, “Okay, sir” as she exited. I dissected around the aneurysm and placed a clip perfectly on its neck, securing it from further rupture. I was ready to call it a day.

The nurse returned a few minutes later. “The family too doesn’t want surgery or any form of aggressive treatment, but wants to admit him under you for comfort care till he passes,” she ended. “Sure,” I replied briefly, while inspecting the precision of my clip placement and ensuring that no arteries were incorrectly stuck within. I sprinkled the now soft and peaceful-looking brain with saline, sutured the dura, and put back the bone. While we closed the head, I asked my colleague, the surgeon assisting me, “If that was your grandfather, would you operate on him?” “I wouldn’t do anything even if he was 75,” he replied, confident in his knowledge and experience that the elderly don’t recover well after surgery for a massive blood clot. “You finish closing, and I’ll go see the old man in the ICU and talk to the family,” I told him, removing my gloves, feeling the exhaustion of two four-hour operations in the day.