‘Davey’ has been on the ward a month now and we are close to finding him a nursing home. It will be a relief to his family.

At age 87 he has successfully evaded major illness only to find himself struck by Alzheimer’s disease. He has faded quickly and now, after a bad fall, has landed under my care. My medical unit is full of such patients and I never fail to be struck by the diligence of their carers, in this case his wife.

He is so tall that the bed has been extended to accommodate his feet. Even in his decline his solid figure occupies the whole mattress.

“Who helped you care for him?” I ask Davey’s wife.

“Me.”

Small-boned and frail-faced at 77, she is diminutive. He would crush her with his weight.

“Yes, and who else?”

“Nobody.” He has been fully dependent on her for two years.

“You are a hero,” I marvel.

“My Davey means the world to me,” she says simply, wiping away a tear.

Over the month, we have all come to know her Davey. On the first day, he mumbled at us but then became mute, which she says is not unusual. Maybe it’s the monotony of the hospital. Or maybe he has sunk into the kind of comfort that comes from knowing that your wife no longer has to bear the heavy burden of your care.

“How are you today? Did you sleep okay? Is there anything we can do for you?” I can’t help wondering if these questions are patronising or essential but when he remains silent we must let our observations fill in the gaps. Looking after an uncommunicative patient is hard: it involves guesswork and conscience.

“Sometimes he will switch on and say, ‘Darling, make me a cup of tea’ and it’s like old times again.” It’s the only thing he can utter now and she spends the entire day at his bedside waiting to hear it, a paragon of patience.

As he waits for a nursing home, Davey has slipped to the bottom of our list. Our visits are shorter, we don’t prod him to talk and the tests have stopped. We think he is comfortable but when the patient can’t confirm it, who can really say?

A home is found and Davey is set to go tomorrow. Taking his hand, I search for the most appropriate thing to say in case he can understand me. “It’s been good to know you, and I think your wife is a hero.” He stares expressionlessly. My heart sinks.

Hours later, the code alarm goes off and instinctively, I hasten to the ward and find myself following the crowd into Davey’s room.

He is semi-conscious and his breathing is laboured. My intern is already there, struggling to examine him. The patient’s gown is pasted to his body in sweat. Finding evident signs of pneumonia, I make a split-second decision.

The crash cart is about to go into full action when I signal soundlessly to the nurse to stop. We all know a do not resuscitate order exists but a code team can offer other help.

“Do you want bloods, x-rays, antibiotics?”

“Nothing. Draw up some morphine though.”

“You want to call off the code?”

The intern looks conflicted but the student nurse mouths a thank you.

“Yes,” I say and watch the crash cart disappear and along with it, the crowd of helpers.

“He crashed just like that,” the intern whispers, a veiled plea for me to act.

“He is dying. Keeping him comfortable is the kindest thing to do,” I reply, charting more morphine.

“I think he will pick up,” the intern says glumly. His words sound like a rebuke but I don’t argue. I know that another young doctor is merely realising that we can’t steer the destiny of our patients, just be their partner for some time. As if to underscore the lesson, Davey dies later that evening.

In a society that is becoming increasingly concerned about the great cost and the heartache of futile medicine, Davey’s case might be viewed as an example of death with dignity. I felt that we had all acted responsibly and ethically, from stopping painful tests early in his admission to easing his inevitable death, which is why I could hardly believe it when I started experiencing flashbacks of turning back the crash cart that came to Davey’s aid.

What if we had nursed him back from his pneumonia? What if his wife didn’t mind him even through a tangle of oxygen tubes and intravenous lines? Studies show that young, healthy doctors can misjudge the quality of life the chronically ill find acceptable. What would Davey have wanted if he could talk?

Others may find these questions academic, even the reason behind why futile medicine abounds, but the hardest part of being a doctor is not just getting patient care right but in a way that you can live with the consequences of your decisions.

Too much medicine and you are left to rue the harm, too little and you can’t help wondering about compromised care. When making tough decisions, the courage of your conviction must be balanced with the humility that you might just be wrong and the knowledge that in the case of your greatest mistakes, patients pay with their lives. And yet, the challenge is to not be limited by this knowledge but instead use it to become an even better doctor.

So instead of brushing off Davey’s death I stay with the unease it triggers. And I eventually realise that it’s okay to feel pensive because every patient’s death should matter. Every near miss and every death, no matter how expected, is a chance to reflect on what role one played in the event. Death is normal, even welcome for some, but for a doctor it should never become routine. When death becomes routine it’s a short step away from complacency about a host of other things.

The best doctors I know say that getting the balance right in medicine is a lifelong test. The finest surgeons fret over deaths that their colleagues thought unpreventable. The wisest physicians lose sleep over dying patients even though they have left no stone unturned. I don’t think it’s through a misguided notion of rescuing every patient but because reflecting on the dying makes us better at caring for the living.

Davey’s wife sends me flowers. When I call her she says something remarkable. Ever since the day Davey came into hospital she has slept soundly, she says, “because I knew that you had taken over my worries.”

So now, when the crash cart intrudes into my thoughts, I imagine her sleeping restfully. And instead of brooding over too much or too little medicine, I am consoled by a definition doctors seldom consider – good medicine means taking over someone else’s worries.

Ranjana Srivastava appears on ABC’s Catalyst: Too Much Medicine at 8pm on Tuesday 27 October 2015.