Sable Monroe

Who Gets to Decide If You Live?

When my younger brother was fighting for his life in the ICU with COVID-19, a family conflict over medical power of attorney exposed just how dysfunctional our relationships had become.

You’d think that when someone’s organs are failing, the family’s primary concern would be whether that person survives.

You’d think.

But in my family, even a medical emergency can turn into a contest over who gets to be in charge.

My brother’s heart was in serious trouble. His organs were failing, and machines were helping keep him alive.

Meanwhile, his personal life was complicated enough to require a flowchart.

He had a wife.

He also had a woman who was the mother of his oldest child.

And although he and his wife were estranged, they were not divorced.

If this sounds like the opening of a daytime soap opera, stay with me. We’re just getting started.

When Medical Power of Attorney Becomes a Family Conflict

My brother had designated the mother of his oldest child as his medical power of attorney.

From what I understood, anger toward his wife had played a role in that decision.

Now, choosing someone to make medical decisions for you is serious business. It’s not the same as deciding who gets your favorite jacket if you die.

You’re placing enormous responsibility in another person’s hands.

A medical power of attorney can authorize someone to make healthcare decisions when you’re unable to make them yourself, depending on the document and applicable law.

And when you’re lying in the ICU, that legal designation matters a great deal more than who is currently speaking to whom.

My brother’s wife was still legally married to him, but that didn’t automatically mean she was the person he had authorized to make medical decisions.

That responsibility had been given to someone else.

And as you might imagine, that complicated matters considerably.

I contacted his wife by email because I believed she needed to know how seriously ill he was.

Eventually, my mother learned what was happening.

And then the telephone calls began.

My Mother Wanted Me to Fix the Medical Power of Attorney Situation

My mother contacted his wife, and I listened to one of those conversations while remaining on mute.

There I was, a grown woman listening to another grown woman attempt to take control of a situation neither of us had the legal authority to control.

It was an impressive display of confidence, considering the circumstances.

My mother wanted me to intervene.

Intervene how?

My brother had designated someone else to make medical decisions.

I wasn’t his healthcare agent.

I wasn’t his physician.

I wasn’t a judge.

I didn’t have some magical document tucked away that allowed me to override his wishes because my mother was unhappy.

What exactly was I supposed to do? March into the hospital and announce that my mother had requested a management change?

The ICU is not a corporate department.

But my mother has always had a particular talent for deciding that a problem belongs to somebody else, preferably me.

Growing up, I learned that responsibility in our household was not necessarily distributed according to age, authority, or ability.

Sometimes it was distributed according to who could be pressured into doing the work.

And I was frequently that person.

My brother occupied a different position in our dysfunctional family.

He was the favored child.

That didn’t mean his life was easy or that our mother never mistreated him. It meant that when it came to whose needs took precedence, I understood the pecking order very well.

His crisis was everyone’s crisis.

My role was to help fix it.

My own feelings about the situation were apparently a minor administrative detail.

At one point, I remember thinking that if my mother could have traded my place for his in that ICU, she probably would have.

That’s how starkly I experienced the difference in how she valued us.

And yet, despite all of that, I wanted my brother to live.

I wasn’t sitting there hoping the medical power of attorney arrangement would create a catastrophe. I wasn’t interested in punishing him for his relationship choices while he was fighting for his life.

I wanted the medical professionals to do their jobs and the person he had designated to understand the gravity of the responsibility.

What I didn’t want was to become the family fixer yet again.

Because here’s something I learned long before COVID: being related to someone doesn’t automatically give you authority over their life.

And being the loudest person on the telephone doesn’t change that.

My mother could be furious.

His wife could be upset.

The woman holding medical power of attorney could have her own feelings.

But none of those emotions magically rewrote the paperwork.

Meanwhile, the person at the center of all this was lying in a hospital bed, gravely ill.

The situation should have inspired some humility.

Instead, it exposed the same family dynamics I’d been watching since childhood.

My mother wanted control.

I was expected to help deliver it.

And my brother’s personal decisions had placed several women in positions where their interests, emotions, and responsibilities collided.

How a COVID-19 Hospitalization Exposed Our Family Dysfunction

You would think a life-threatening illness might bring clarity to a complicated family.

In our case, it mostly brought additional complications.

My brother’s COVID hospitalization didn’t create our family dysfunction. It simply made the existing problems impossible to ignore.

The favoritism.

The expectation that I would fix things.

The competing relationships.

The assumption that whoever made the most noise should somehow get the final say.

And through it all, my younger brother was fighting for his life.

I wanted him to survive, but I was beginning to understand that his recovery wouldn’t necessarily resolve anything happening outside the hospital.

If anything, the situation was becoming more complicated.

Because while my brother was in intensive care, there were still dogs to look after, women with grievances, and a landlord who was about to hear considerably more family business than anyone had planned.

Yes, dogs.

Plural.

And one of them was about to become a major character in this already overcrowded production.

Apparently, my family had decided that a medical emergency wasn’t dramatic enough on its own.

We needed a supporting cast.

And possibly animal control.

This is Part Two of Family Secrets, COVID Exposed, a four-part personal memoir series by Sable Monroe.

Next: The Dog, the Women, and the Circus, publishing October 18, 2026. A dog attack, feuding mothers, a hospital departure against medical advice, and romantic musical chairs. Because apparently, surviving COVID was only half the battle.

Previously: The Soup Outside the Door, published October 14, 2026.