She came in with their teenage son to see him. She was about forty-five or fifty, with makeup and earrings and a nice blouse. I didn't recognize her at first -- she wasn't what I expected.

When my patient told me his ex-wife would be coming to visit, I simply imagined someone like him. I tried to picture his home; the squalor and decay that I associated with a pathology like his.

I overheard her at the front desk, asking, "Why can't anyone tell me where he is?"

I looked up from my charting and saw her. "I'm sorry," I answered. "I'm taking care of him. I spoke with your son on the phone. We just moved him to isolation -- it's right this way."

I led them to him and opened the door. Her face contorted and her posture stiffened, then she went inside. Their son followed.

I stayed outside, by the desk, writing my chart. I had a lot of questions I wanted to ask her, about his medical history, his alcoholism -- but it could wait until they were outside again.

I didn't want to go back in there.

She emerged a few minutes later, and took a moment to adjust her outfit and take a few deep breaths. She briskly walked toward me.

"When is he going to surgery?" she asked.

"Hopefully within the hour."

She thought carefully for a moment about her next question, and asked slowly, "What is that godawful smell in there?"

In a moment, I tried to imagine their divorce, maybe a few years ago, as his drinking got worse. Was there an ultimatum? A custody battle? In the end, maybe she felt she there was nothing more she could do -- so she took their son, and hoped that somehow her husband would turn it around, by himself.

He didn't, and now it had come to this: asking the emergency department intern about the smell.

I pursed my lips and looked into her eyes. "It's the foot," I said. "His right foot is just dead tissue."