From me there would be one: "yes" or "no."

"No" meant watching Charlie suffocate to death. How could I choose that? What fate had delivered that sentence to me? "Yes," however, must mean an ominous procedure. What kind of machine? Why had I not been prepared for this? Wasn't there some other medical option to relieve his agony and terror?

I'd been given a Sophie's Choice. For an instant I saw the scene as a still shot from a film -- the doctor and his emergency team, the nurse and the patient in the unforgiving hospital light. They all looked at me silently. I needed time. Give me a minute. Just a second.

Charlie and I had promised each other never to allow extraordinary medical procedures. No life support. We'd been married more than 40 years. I would never let anyone hurt him. I heard the click of the minute hand from the wall clock. In 15 minutes, unless I said "yes," Charlie would be dead.

This long day's odyssey had begun when I called the cardiologist to tell him Charlie had awakened somewhat disoriented and with signs of a cold. The cardiologist was a member of Charlie's medical team, formed three years earlier, when his previously diagnosed emphysema went from mild to severe, affecting his already damaged heart. The team also included a pulmonologist and a senior internist (our primary doctor). Along with the hospital we chose, they represented the best medical care available. Despite living with the cruel realities of irreversible and progressive illness, we felt fortunate to have these doctors, who stood between us and the horrors of dehumanizing, high-tech medicine.

Our cardiologist told me to bring Charlie to the hospital's emergency room. Trusting his judgment, I followed directions. Yet on this day, no member of the team was in the emergency room, where Charlie was kept for 10 hours. It was an ordeal that clearly led to his breathing attack.

Charlie is gasping. Do I say "yes" or "no"?

I said "yes," and never heard Charlie's voice again.

Intensive care , Day 1: Early the next morning, I entered the intensive care unit and saw Charlie "on machine." It was a respirator; attached to it was a long tube inserted into the mouth and down the throat to the lungs. The tube was kept in place by tape stretched across his face like a gag.

Charlie was awake and in obvious anguish. When he saw me, he lunged in a futile attempt to rid himself of the tube and other lines. His hands were tied to the bed. A doctor stood nearby. I told him that in the last year, Charlie, with his increased breathing problems, had developed acute claustrophobia. Any restraint sent him into a panic. Could he be given more sedation?

The doctor said no, that it would relax the lungs, decreasing his breathing capacity. I turned to Charlie, who was looking at me desperately. "Please don't panic," I begged. "I'm going to call the internist -- his office is just across the street. He'll be right over." I was confident that once our primary doctor, our friend and the leader of his medical team, was here, he would relieve Charlie's suffering.

At 7 p.m. -- 11 hours after my call -- the internist arrived. I described the lunging periods. The sedation seemed to last about 45 minutes, followed by 15 minutes of Charlie's struggle. Despite his hands' being strapped down and my gentle restraint, he had managed to dislodge the tube and pop some of the other lines. I said emphatically, "I don't want him to suffer."

The internist, who was with us all of five minutes, explained that his visit was strictly a courtesy: "When a patient is in intensive care, only the attending doctors are in charge." Intensive care, he added, does not mean one-on-one nursing care. The nurses are often dealing with two or three critically ill patients at a time. He suggested that if I were strong enough, I should stay around the clock, because Charlie needed constant attention.

He left. I stayed.

Never before had I experienced such a feeling of abandonment. I felt weak and helpless, like a child who has lost her parents. The medical support I had built and nurtured for three years had vanished. Despite his generous insurance coverage, Charlie had become just another numbered patient, institutionalized in a huge teaching hospital. Not a word of comfort or compassion had come from our doctor.

As the night wore on, the lunging periods seemed longer and more unbearable. I had to look into Charlie's pleading eyes. I asked the nurse to call the doctor on duty so he could possibly increase sedation. When he arrived and saw me in a corner of the room, he asked the nurse who I was. The nurse answered, and he said loudly, "Get her out."

Days 2 to 14: The intensive-care nurses are on 12-hour shifts. Most are not permanent staff, so there is little continuity. Rarely did Charlie have the same nurse twice. I was there 15 to 16 hours a day and tried to blend into that strange, artificial world without natural light or color except for the "scrub" outfits worn by the nurses.

Day 15: The respirator was removed. Charlie couldn't talk or swallow.

Day 16: One doctor discussed the merits of doing an angiogram. Later, another doctor told me Charlie was dying. Still later, a third doctor told me Charlie would have to be moved to a rehabilitation facility.

Days 17 and 18: All agreed that Charlie would die soon. I was reluctant to leave at night, though he was sleeping most of the time. The nurse encouraged me to go home for a few hours and promised to call if I were needed.

Day 19: I returned to the hospital at 7 a.m. Seeing Charlie sleeping, I mentioned to the nurse that he must have had a peaceful night. "Actually," she said, "Charlie had a bad time around 4 a.m., and I asked him if he wanted me to call you. He shook his head no."

I wanted to scream at her betrayal. What heavy and painful knowledge she gave me. That last, lost moment of being with Charlie in his suffering is a burden of sorrow I shall carry always.

Day 20: At 6 a.m. I called the night nurse from home to see if there was any change. She said cheerfully, "He looks like a million dollars. I shaved him and gave him a bath."

Charlie died at 7:45 that night. It had taken him three weeks.

Two weeks later, the internist, our former primary doctor, called to ask how Charlie was doing. I told him Charlie had been dead two weeks. "Oh," he replied, "the hospital listed him as discharged, so I had no way of knowing."

Maureen Malloy D'Honau w'49 lives in San Francisco. A longer version of this article appeared in the San Francisco Examiner.