The Smiths were here again, dressed so nicely and polite as always– Tom’s hat and Maggie’s dress just so. Tom helped her with her walker, and yet obviously his walker was present as well. Maggie didn’t remember my name—she always knew me before—her dementia, just worse. Tom’s PSA had doubled since his last visit. He looked so gaunt; his weight dropped another ten pounds. He wouldn’t take the pain medicine—could not help Maggie if he did. We talked as usual; they as always asked about my family, about my problems. Leaving with an appointment in a month, his disease was unremitting. I knew that he wouldn’t be back again.