I saw Jim in the hospital the other day. An 82 year old man with follicular thyroid cancer, someone I had seen for years. At visits, his TSH levels seem to always fluctuate. And for a guy as lean as he was, he was taking 300 mcg of T4 just to suppress his TSH to where it ought to be for his stage of cancer. Which sometimes may be a hint that compliance or absorption is an issue. But at every visit, he would deny missing his doses. And his dear old wife of 60 years would always remind him: "Dear, remember you missed those few days?"

I remember her well. Short, in contrast to his 6-foot stature. Sweet smile, wrinkles but always blue eye-shadow. And whenever I called with results, she would be the one I'd talk to because his hearing aids made it difficult to understand an accented doctor on the phone.

And so, I was surprised when he was admitted for myxedema coma. My colleague who admitted him found his TSH to be over 100. When we did some investigating, it seems that he had not picked up any prescription refills since June, which explains a lot about his condition. But says nothing about why it happened.

And then the nurse tells me: His wife passed away this last May.

And perhaps out of devastation? Or simply because there was no one to remind him? Or maybe he just lost the will to live? I don't know.

He was still quite somnolent when I saw him in the ICU today. I held his hand, and spoke to him- I don't think he quite heard me.

But I hope he gets better. And wherever she is, I hope she helps him find the will to live on.