Saciid, a seventy-one-year-old Somali man, collapsed at home. His family began CPR, and he was admitted to our ICU where he was intubated and sedated. He underwent surgical embolization for a large liver hematoma. His GI bleeding continued; he had a large open wound and was septic. Intubated and extubated several times, his family was told there were no restorative options. However, he rallied such that he was extubated and discharged to a skilled nursing facility. A month later he was readmitted with pulmonary complications, sepsis, and a nonhealing wound. Family was told he would not survive, but they pressed for all possible medical treatments. Distrustful of our medical prognoses, they micromanaged his care, disregarding his grave condition. Systemic inconsistencies, including rotating doctors and nurses, terminology differences, and communication challenges between different services created confusion. Told more than once he would not survive the night, his family found him alive the next morning. As long as they could pray with him, it was worthwhile to do everything to prolong his life. Ethics was consulted for multiple issues including the family’s frustration with communication, their expectation of aggressive treatment, and Saciid’s caregivers’ distress with providing care they considered harmful and futile.