Quality of Life can also go through change in the mind of a person. I once cared for a young Canadian woman who had attempted suicide after her fiance’ cheated on her. She had come to the United States because of a law. Once upon a time (I think around the 1970’s) if someone found a person who had attempted suicide in Canada and they took them to a hospital, they would then become financially responsible. This young woman sadly said, “If I didn’t die and someone found me, I didn’t want them to be responsible. So, I came here.” Unfortunately ( or rather fortunately) she landed at UCLA in a newly-formed Respiratory Care Unit with me taking care of her. She was near death and yet survived. She finally went back to Canada. A lovely Thank You letter was sent to me much later about her new marriage, family, and teaching career. Fate? Karma ? who knows…