Dear Nikola,

Reflecting on what you have reported to me about your care of David, the following considerations occur to me:
a) my admiration of your devotion to and care for David has no boundaries. I would like to think that when I was younger and less disabled, I would have acted similarly, but I am probably deceiving myself to assuage my feelings of guilt.
b) If my understanding that David is at present hospitalized at Newton Wellesley is correct, then he will be discharged soon, because Medicare pays only for a limited number of days of hospitalization and the hospital will be forced and by financial considerations to discharge David as soon a possible and consistent with the administrative rules. 
c) The hospital is not permitted to discharge David to the street. It must make arrangements to have David cared for, if necessafry at public expense, in a manner that is acceptable to David, but, since you have made an appearance, if not as a family member then as "best friend", the arrangements that the hospital makes must also be acceptable to you.
d) If you absent yourself from the discharge negotiations, it seems likely to me that David will assure the hospital employees who arrange the discharge that YOU, that YOU, will take care of him, without inquiring of you whether YOU are willing and able to discharge that function.
e) It's not for me to presume to define your future relationship with and obligations to David. As a physician, and from what you have told me, I infer i) David will NEVER recover his health to be able to lead an independent existence, ii) David's health will continue to deteriorate until he dies: A) in whatever home he has, B) in a nursing home, C) in a hospital, D) in your apartment or in lodgings with which you have provided him, or E) on the street. iii) The remaining days, weeks, months or years of David's life will continue to be punctuated with medical crises and emergencies.
f) Nursing home admission from a hospital is a routine procedure managed and manipulated by professionals.
g) Nursing home admission from a hotel, boarding house, private home or from the street is NOT a routine procedure and 
requires guarantee of payment of very high fees, not less than $350.00 PER DAY and perhaps as much as $450.00 per day.
Medicare DOES NOT PAY for nursing home care except for a limited period but ONLY subsequent to discharge from a hospital.
h) If you consider yourself unwilling and/or unable to care for David subsequent to hospital discharge, you must make this fact unmistakably clear, before or at the time of discharge.
i) My urgent advice to you is that unless you wish to adopt David and care for him as a family member, you decline to
participate in or accept resonsibility of any kind for David's discharge from the hospital.
j) I consider the above VERY IMPORTANT, and should be pleased to discuss it with you over the phone or face to face.

EJM