Bob had not heeded our advice to remove the gold band from the left third finger. For him, it was a symbol so strong and powerful that the thought of taking that away from Jackie was just unbearable. She had already lost too much to dementia: her affable personality, her independence, her memories, and her language. Still, we were pragmatists, it would be lost. We had been through this before. Surely such an important valuable should be kept at home for safe keeping and not remain with Jackie on the dementia unit. Bob smiled at us, his blue eyes twinkling, stating: “It has been on her finger since she was 19. It needs to stay with her so that she will know I carry her in my heart forever. She will know if I take it off.” Jackie adjusted poorly. First, leaving the unit unaccompanied, setting off a massive search. Then came the refusal of care, the hitting and slapping when frightened, the pacing and looking for her beloved husband. Arms flew in protest to the most seemingly benign requests, like changing soiled clothes. Soon the fragile skin on the arm was open from these protests and the break in its integrity led to an infection. The swelling of her hand would commence in the next 48 hours, making the ring little more than a tourniquet. We had indeed been right. Trying to mitigate our indignity, we called Bob to tell him it would now have to come off. He relented, knowing that it might be causing her physical pain at this juncture. Ring removal is not something that they teach in all internal medicine residencies, and it was certainly not something I learned in medical school. Yet, as a geriatrician, I had performed this task many times. Ironically, the rings that proved to be the most stubborn and hard to remove were not those that had more sentimental value or those that depicted a stronger bond with a life partner, but those that had been less expensive. The cheaper versions held steel shanks in the core, making extraction much more difficult than those made of pure gold. The ring snapped with two revolutions of the cutter, a sure sign that the ring had been as pure in gold as Bob's heart had been all 50 years of marriage. We removed it rather unceremoniously, not fathoming the full meaning of the act and the impact on Bob or our resident. Bob held it for a moment and turned it over in his hand, caressing the band that still bore the date and his initial message to his bride. Tears spilling over in his eyes, he choked “I love you.” As a clinician, I have witnessed patients with advanced dementia having moments of intense clarity before, but I was not prepared for Jackie to stop resisting the attempt to bandage her arm, look at Bob, and return the “I love you” back. We all desperately needed that. For the nurse and me, that moment was a stark reminder of why Bob had struggled so much to allow us to take off the ring. At some point during the endless set of tasks that needed to be done to care for a person with advanced dementia, we had shifted to a point of pragmatism that partially belied our ability to be compassionate and understanding. Her words helped us remember to nurture that again. For Bob, he left knowing that his beloved returned his feelings through the maelstrom of her disease. For Jackie, it provided seconds of respite from what must be a frightening world with complex, inconstruable signals through which the only thing that can permeate is love.