Monday, April 26, 2010

Till Death do us Part........

How do you keep the music playing
How do you make it last
How do you keep the song from fading too fast
How do you lose yourself to someone
And never lose your way
How do you not run out of new things to say
And since we're always changing
How can it be the same
And tell me how year after year
You're sure your heart will fall apart
Each time you hear his name.......

I meet elderly couples all of the time in my job. Most have been married for decades, although some are "newlyweds" who have been married after reconnecting after a divorce or the early death of a spouse.

I learn a lot about love and marriage, sacrifice, strength of character and stubbornness from these awesome, wise people. That is not to say I don't meet my fair share of younger and middle aged couples. I do. And they are lovely. But their lives are so complex and seemingly complicated with so many things going on such as raising young kids, having a career, and trying to deal with a life-ending illness.

The elderly are past all of that craziness and have survived somehow. They have been cruising along after managing to keep it together during all of the rough patches. I admire them and never tire of their stories.

They have so much wisdom to impart.

I thought I would share some of their stories with you.

(Names have been changed, but the details are real.)

Bob and Betty:

Bob and Betty have been married for 61 years. He is 81, she is 80. They were high school sweethearts, have never been more than a few blocks away from one another their whole lives.

Betty has ovarian cancer. Stage 4. She is quite frail and can no longer eat. Bob still makes her a meal three times a day. He places it on a silver tray with carved handles that they have had since their wedding day. He places a rose from their garden in a small juice glass on the tray. He brings it up to her room.

When she could walk and get out of bed, she used to flush it down the toilet so that he thought she was eating. But now she can no longer ambulate. So it sits there, uneaten.

"Betty doesn't seem to want to eat anymore. I am worried." He says to me on my visit.

Betty looks over at me with that knowing look.

"Leave the tray here, Bob. I will eat it later. I promise. I want to talk to the nurse for a little while now. It looks lovely, Bob. Thank you, dear. Now please go down and read your paper for a while. Ok?"

Bob looks at me. I tell him it is fine. He goes downstairs, all the while shaking his head and looking down.

After we hear him on the last step, Betty says to me, "He is driving me crazy."

She goes on to tell me how he tries to get her to eat all of the time. How he wakes her when she is sleeping to see if she is okay. How he just paces in the room while she pretends to sleep so that he won't keep asking her how she feels.

"Bob and I met when I was 12. He was 13. I liked him right away. So tall and blonde. He played stickball back then in the neighborhood with my brother. We lived just blocks from one another, but went to different schools. He asked me to his school dance when we were older. We married right out of high school."

"Marriage was hard. I cannot tell you how many times I wanted to leave him. But we have never really been apart all of these years. We stuck by each other. We watched as our parents died, all of our siblings died, and many of our friends. When the friends go, you know your time is near. It is just us now. Soon, it will just be Bob. I am so worried about him being alone."

I knew that they had 3 adult children nearby and many grandchildren. It was one of those close knit families that you envy at times.

"Well, your kids will be here to make sure Bob is okay", I added.

"No. They have their own lives. Bob and I always leaned on one another."

After we talked some more, I went down to see Bob.

"How is she doing? Is she getting better?" Bob asked me.

"No, Bob. She is not better. She is stable today and she is well cared for. You are doing a terrific job."

Bob breaks down and starts to cry. He tells me that he always thought he would be the first to go. That he was not prepared to lose her. That she was his "compass, his guide through life". That he will be "quite lost" without her.

"I was not a great husband. And she was not always a great wife. But we had each other. I could always depend on that. We built a life on that. Now that is over. My life is over. I just want her to get better. I don't know what to do."


Alice and Henry

Henry is a 95 year old gentleman. When I say gentleman, I mean it.

His wife, Alice, is years younger. They got married after Henry's first wife died at age 40. They have been married about 55 years.

Henry is dying from a chronic lung disease. He was always the outgoing one, always in charge. Alice has always just "followed along". They have several adult children but mostly like to keep to themselves.

Alice talked to me about their marriage.

"Don't think I am being mean, but I am finally going to have the apartment re-decorated after Henry dies. I love Henry and he provided me with a great life. We traveled all over the world. Went to the Opera, the Symphony and the theater each and every season. We attended countless galas and had a house here in Boston, one on Martha's Vineyard and one in Vermont, for skiing. We were always entertaining, always busy. I was a simple gal and he really showed me the best life. He really did. But now I want to live a little of my own life, while I still have the time and the energy."

Alice is 80.

Alice married Henry when she was 25 and he was 40. He was a widower with 2 kids in their teens. She had a toddler and was divorced. They raised all the kids well and are still very close. But you can see when they are all together that even though they are accomplished adults in their own right, Henry is still in charge.

"I will miss Henry. He was a good provider. God, we had some fun. He loved my daughter as his own. For that I will be ever so grateful. But I have never had a moment when I was just in charge of me. I am looking forward to that freedom. I will be sad and miss him. He was truly my rock. He saved me. But I know that I will be joining him soon and want a few stories of my own to tell when I see him again. All of our stories so far begin and end with Henry. I want a few Alice stories."

Raymond and Eileen

Raymond and Eileen live in a house in a nice suburb of Boston. He is quite ill with pancreatic cancer. He used to be an Air Force pilot.

Their home has not been updated since about 1970. There are pictures of Raymond near his planes, in his planes and flying his planes. He liked to dabble in art, and there are many oil paintings with his signature lining the living room and the family room.

Eileen is a nervous wreak. They are in their late 70's. Raymond was always healthy and worked out everyday. One day they noticed that his eyes were jaundice. Then 4 months ago, they received the bad news that he had pancreatic cancer. They are still in shock.

"Raymond just retired a few years ago. We had planned some trips and were going to see about selling the house. Now, I am just numb. I can barely breath."

She looked around and then said, "I am really pissed. He worked hard all of his life. It was his turn to have some fun, to let go of all the responsibility. I feel he got cheated."

Eileen went on to tell me about their marriage. How Raymond always encouraged her to have a life of her own beyond being a mother and wife.

"I took classes, I traveled with friends, I wrote a book once. But Raymond was my anchor. I couldn't have been so free to enjoy myself without him being there for me. He was a strong man, and tough. You always knew where you stood with him. And life almost stopped for us in the late 70's. Almost stopped. But his strength kept us going"

I asked her what she meant. In their tidy living room was a picture of a very handsome young man. Next to it, a diploma from a prestigious Medical School.

"This was our son, Ray, Jr. He was a wonderful man. He was a doctor and went overseas to help people in need. He loved to travel. He loved medicine. One day, they couldn't wake him. He had died. They said he had a brain bleed.

He was 34.

"Our world ended. Raymond was devastated. His only son. Gone. Gone! But he kept me going, kept our daughter Susan going. The funny thing about losing Raymond now is that I need him to help me get through losing Raymond. Isn't that crazy? But he is my strength, my anchor. He has been a difficult man at times to live with. I will feel adrift without him. What am I going to do now?"


I, like many of my colleagues, hear wonderful and sad stories like these all of the time. The one plus of hospice nursing is that we are invited into the homes and lives of our patients. And, as much as we help them, believe me when I tell you that we receive so much more in return.

I have learned many lessons about being married from my patients. They have taught me that marriage is indeed hard. That love comes and goes at times. That marriage has different stages just like life has. They have shown me what great devotion means, that is okay to have differences as long as you can still pull together during the hard times.

I hear these key words time and time again; anchor, strength, rock, compass and best friend.

So, I think that is the secret to long marriages. Being there for one another. Hanging in there throughout all of the changes in life. Being true to the marriage, not just to each other, because the marriage is bigger than two individuals.

Realizing that in the end, after you raise the kids, it really is just the two of you.

All of the stories end well. We follow our families for a year after the death of the patient. We stay in touch.

Bob could not care for his wife alone once she became much more ill. She died at our hospice house, a peaceful death surrounded by her family. Bob is now a fixture at the hospice house. He volunteers there several times a week. He places a small flower from his garden in a juice glass and places it on the patient's tray. He encourages everyone to eat. Even the nurses.

Alice not only redecorated, she moved to a retirement village and has a lovely home there and many new friends. Last I heard she was headed on an Alaskan cruise.

Eileen has reconnected with her daughter, Susan. The two have been estranged, but Raymond brought them together again towards the end of his life.

The anchor until the end.


  1. Nice post. I really liked it.

  2. This made me smile and cry all at the same time.