The little old Chinese man, looked so pale, he didn’t know what to do with himself. His short-term memory had been impaired for some years but had worsened in recent months as he deteriorated.

We both used our second language to communicate with each other, Mandarin. Both speaking with thick accents, but able to understand each other. His supportive daughter had come over from China to look after her parents. They had lived in New Zealand for over twenty years.

He had always been terrible at reporting his discomfort. His daughter talked about when he had appendicitis and had not told anyone until he almost died of an intra-abdominal infection after his appendix had burst. His stock answer would be to say, “I am fine,” but his body language was a give away for his wife and daughter. He didn’t let anyone know that he had painful shingles until he was found writhing in bed, crying because of pain, telling his family that the pain was so bad that he wanted to die.

Too tough for his own good, he never complained of being tired, even when his family noticed him falling asleep at the dinner table. On questioning he said that he had black bowel motions and had occasionally vomited up blood. In recent weeks this had been worsening. Initially his bleeding was only sporadic, and a transfusion every three months was enough to keep him going with decent quality of life. Over the course of the past year, the time interval between transfusions had been decreasing. From quarterly to two monthly to every month. And then fortnightly followed by weekly. His last Hb (Haemoglobin) had been measured at 41. Normal Hb being ~130. 41 is usually not compatible with life, and his skin looked pale and translucent.

The hospital doctors had told our patient and his daughter that there would be no further transfusions and to plan for his death. The old man did not want to talk about any of this, and had forgotten what the doctor had said by the time he arrived in hospice. We didn’t bring it up with our patient again. Being told again would provide no benefit at all and would only cause him unnecessary distress.

His son was reported to look just like our patient, and they had not physically seen each other for six years. Modern life was busy and the COVID Pandemic had really worsened the ability to meet face to face. Virtual contact is better than nothing but in no way is it a replacement. A letter was urgently written to support the son’s application to return to New Zealand. Writing it I was worried that he would not be able to make it back, as the government’s Managed Isolation Quarantine is difficult to find a place in and it is usually inflexible when it comes to life and death situations.

Will the reunion of the two look-alikes take place?