As Charlie’s heart failure worsened, his twig-like fingers searched over his chest and he asked, “Doc, can you show me where my heart is?” Confused, I pointed just left of his sternum and inquired, “Why do you ask?” He explained he feels like he is drowning and uttered “I grew up on a farm Doc and if things get worse a shotgun to the heart is quick, but can be messy!”

Charlie appeared younger than a man in his late 80s, white trimmed beard, crystal blue eyes and a baseball cap. A...