As a doctor at the end of a 24-hour shift in the intensive care unit, it's usually easy for me to fall asleep. Exhaustion hits me like a rock and it doesn't matter that the morning sun is pouring into my bedroom. After so many long hours of fighting for life and pushing back death, when I finally hit my bed and close my eyes, the next day arrives in an instant. Except for that one day when I couldn't sleep no matter what I tried. Saddened from seeing the familiar turmoil as my patients' families were caught unprepared, confused and distraught by an unexpected medical disaster, I tossed and turned in bed. In the ICU, every day is about people with devastating illness, the fragility of our bodies, and our mortality. There are lots of questions. Should we pursue aggressive, possibly painful interventions, or should we shift our focus and allow a natural and peaceful passing? In the end, it usually comes down one question: "What should we do?" It's an impossible question, for which there is only one, impossible answer. It's up to you. I decided to write Last Wish to help my patients and everyone who reads this book be better prepared to answer that question. My patients allowed me to share their stories as they struggled with life, death and somewhere in-between so that their victories and also their failures could help you think about your own wishes and those of your loved ones, and be better prepared if you're faced with an unexpected tragedy. In this book, just as with my patients, I'm not advocating any particular path, just showing you what the road might look like so you can consider the issues. I hope Last Wish will provide some insight for you and your family. At the very least, I hope it sparks discussion and helps you to consider planning for the inevitable mortality we all face. Lauren Van Scoy, M.D.