“There’s an old Mexican adage,” the doctor said. “The appearance of the bull changes when you enter the arena.” He admitted he could find no confirmation of this saying or its lineage, but it’s something he thinks about when he talks to patients and families. “It’s something I try to keep in mind,” he said.

What he meant was that it’s easy to say you want no extreme measures taken at the end of life when you’re not at the end of life. But when death is pawing the ground in front of you, when it’s charging right at you, when it’s close enough that you can spy its wild-looking eyes, its flared nostrils — well, that’s another matter.

“Yes,” he said. “I try to keep that in mind.”

And now I’m keeping it in mind, too.