It was a bit unusual. I was taking a few hours of call on-site at the hospital. The scheduled person was sick, and a number of the senior staff physicians agreed to do the call to assure on-site medical coverage.

I was assigned three hours on a Saturday afternoon and evening. I hoped things would be quiet, as acute-care medicine was not part of my normal clinical activities.

Things progressed quietly when my pager went off. I identified myself on the phone, to which there was a momentary pause and then a request to attend to a patient on the unit for those suffering from dementia, with its associated behavioural challenges. The patient had fallen and had a few minor lacerations that I was being asked to examine.

When I entered the unit, the nurse who called me said, “I thought it was you by your voice and name, but I didn’t expect you to be doing in-house call. What happened to the young doctors that usually do this?” I explained the situation. She told one of the other nurses, who was clearly junior, that I had been the chief of medicine and recounted a number of our previous good-humoured interactions years before.

With this background of positive feeling, I asked to see the patient, who was approaching us. He was slightly stooped and walking slowly, indicative of medications often used in individuals with significant behavioural problems associated with dementia.

I shook his hand and introduced myself as a physician. He hesitantly gave me his name with an accent that I recognized as being British. As I checked the wound below the bandage, I engaged him in conversation about his place of birth, and he identified his birthplace as England, but when I asked about his name, he indicated that it was Scottish, to which I replied that I had studied medicine in Scotland. He smiled and looked at me with some apparent recognition as I named the university.

The examination concluded, and I wrote my computer note, much to the satisfaction of the nurse. I left the unit and later realized that I had left my stethoscope on the desk while typing my note. While returning on the elevator, the patient whom I had attended to was returning to the floor with his wife, who was affectionately holding his hand.

“You’re the doctor who visited my husband after his fall,” she said, smiling. “Thank you very much for seeing him on such short notice. I hope that when the dressing comes off he is as good- looking as he usually is.”

I replied, “I’m sure he’ll look wonderful. The nurses did a fine job in closing the small gap. The cut was not deep enough to need stitches. And I had a nice chat with him about his place of birth.”

As they walked away when the elevator opened, she said, “He lived in England during his youth, but was of good Scottish stock.” It was said with enormous warmth and affection.

As they walked away still holding hands, I could seethe vestiges of what must have been a long, caring and loving marriage, one that even the terrible effects of dementia could not dissolve.

I retrieved my stethoscope, thanked the nurses again and thought to myself that even a minor medical event can remind us what this enterprise of medical and nursing care is all about, and that the power of loving, longstanding relationships can be a bulwark against the ravages of illnesses that affect the mind.