Decisions with Love: Because Every Choice Extends Beyond Ourselves

By: Jan Ruiz-Nunez

The first time I faced a real medical emergency as a medical student, I was reminded of a decision I had made long before in a hospital. It was not about which treatment to choose or which test to order, it was about love and knowing that our choices are never truly our own.

When my mother was dying, I had to make the hardest decision of my life. The doctors told me there was nothing more to do and that her condition was irreversible. My brother and the rest of my family were three hours away by plane, desperately trying to get to her side. I sat by her bed, my fingers rubbing over a tiny mole on her right big toe, something I had seen my whole life but never thought would matter so much at this moment.

She had told me, months before, “My love, when the time comes, let me go. Don’t hold on to me. Promise me.” I nodded, fighting back tears, whispering a promise I had never imagined I’d have to keep so soon at only 21.

But I wasn’t the only one saying goodbye. My brother was not there yet. My mother’s sisters, my “abuelos”, her boyfriend, and my cousins, were all still on their way. And so, I made a choice: I asked for her to be intubated, not because I believed she would survive, but because our choices extend beyond ourselves. I knew that if I did not, my brother would live with regret, and my family would carry the pain of not being there. And so, I gave them time. Time to hold her hand. Time to say “Te amo.” Time to whisper “Gracias.”

When they arrived, we surrounded her. We honored her. And when the machines were turned off, we let her go… together.

Our Choices Extend Beyond Ourselves

This was something I had already learned long before, through my mother. Even as cancer took hold of her body, she fought with everything she had, not just for herself, but for us, her children. She endured pain with a strength that defied her illness, staying strong for the people she loved. She showed me that choices, even the hardest ones, are never just about the individual; they ripple outward, touching the lives of those who remain.

That moment shaped me, not just as a person but as a future doctor. Medicine teaches us how to treat diseases and how to save lives, but it does not always teach us how to make decisions that extend beyond the patient. A good doctor doesn’t just treat a person; they treat a life. And no life exists in isolation.

Every time we make a medical decision, whether it is continuing treatment, stopping resuscitation, or simply choosing words in a difficult conversation, we affect more than just one person. We affect their families, their friends, their children, and the people who love them.

As doctors, we will have moments where we must ask ourselves:

Is this the right decision for the patient?
Is this decision also compassionate for their loved ones?
How do we balance the science of medicine with the reality of human emotions?

Because medicine is not just about saving lives. It is about honoring them. Sometimes, that means fighting for a patient’s survival. Other times, it means helping a family find peace in letting go.

Every time you have to make a decision as a doctor, think first and foremost of the patient’s autonomy, their right to decide what happens to their own body. Their wishes must always come first. However, also take into consideration the people around them, the ones who will carry their absence, who will remember how their final moments were handled, and who will live with the weight of the choices made in that room.

At the end of the day, the greatest doctors are not just those who cure, but those who walk alongside patients and families in their most vulnerable moments, with compassion, with clarity, and with the unwavering commitment to honor both life and choice. And remember, “Every choice extends beyond ourselves”.