You know what makes this episode so gut wrenching to me. It reminds of the time time I got bad news about my dog's health.

What are the options?
Will she get better?
How long does she have?
Is she in pain?
Do we let nature take its course?
When do we say good bye?
How can we think about these things when she seems to be OK?
What's going on in her mind?
How can you say Good Bye when you might be the one sending them away?

You feel extremely protective, never want to leave their side, you want to squeeze as many life-times as possible into each minute, and you feel awkward at having control over how long they have before nature takes over.