The decision was shared with Mr. Patel’s wife, who tearfully agreed to both – “Do everything.”

The clock started. Dr. James Cooper, the emergency medicine registrar, met the patient in Resus 4. Mr. Patel was awake but unable to raise his right arm or leg. His speech was dense, global aphasia – not just slurred, but absent. He followed left-sided commands with his eyes. The face showed a pronounced right lower facial droop.

Author: Dr. A. Rivers, Emergency Department, City General Hospital