His secretary had cancelled two appointments for the following week. When the geriatrician asked her why, she simply said, “They died.”

He frowned, though he wasn’t surprised. One patient was in his seventies and the other was in her eighties. People don’t live forever and the odds were simply greater that his patients would die sooner rather than later.

The male patient was a self-proclaimed curmudgeon. Though he often complained during his visits with the geriatrician (“Are you trying to kill me with all of these medications?!”), he was consistently punctual to his appointments and bought a box of chocolates for the office staff every Christmas.

The woman said little. She answered his questions, but balked when he asked anything she thought was intrusive. (“You don’t need to know anything about my memory. I’m fine, thank you.”) In her large purse was a small notebook. At the beginning of every appointment, she fished the notebook out and asked the questions she had written down before their meeting.

He felt sad. He missed them.

“When you do you want to see Ms. Smith again?” his secretary called out.

The geriatrician glanced at the calendar. There was a holiday the following month. More than five weeks would pass if he saw her after the holiday. Though she was close to 90 years old, Ms. Smith was generally healthy. Today, she showed him photographs of her new great-granddaughter. She laughed with energy and enthusiasm.

What if she dies in the interim?

“Before the holiday,” the geriatrician answered.