Bob and Marie: A Love Story

Bob and Marie is a tale of disease, determination, and devotion. It is also a chronicle of one couple’s end-of-life struggles, a story of hope, help, humanity, and healing. Most of all, it is a love story.

Some mornings start so good…

Awakening at 5am that Tuesday morning, his stomach growling, Bob left Marie, his wife of over thirty eight years, snoozing peacefully in the bed next to him and made his way quietly to the kitchen. Finding a skillet and some bacon grease, he flipped the range on.

The bacon grease will add a rich meaty flavor to the eggs I really like, he thought, so a large scoop was added to the skillet from the larger metal grease container on the counter next to the range. Padding in his slippers to the refrigerator to fetch the eggs while the bacon grease melted, a familiar face appeared in the hallway.

Wagging his tail, the family dog, Brutus, had come to investigate the early morning light and noise in the kitchen, and was watching the kitchen fuss. Bob was distracted, as there had always been a warm spot in his heart for dogs in general, and this dog specifically, as the family pet. Silently ambling the twenty feet across the kitchen, Bob leaned down to pet him and scratch his ears affectionately.

The eggs and the range were forgotten.

Flames were licking the ceiling from the two highly flammable lard sources and the smoke alarms were blasting nonstop by the time Bob noticed, ten or so minutes later, as the burners had been left on HIGH.

What is that noise? And that smell? he wondered.

Waking in her bed approximately ten minutes later to the smell of burning paint and smoldering plastic, along with and the insistent clanging of fire alarms, Marie hysterically called 911 for the fire department.

Six minutes later the firemen from the next block over arrived, and had the fire completely out in thirty more minutes. The fire marshal commented to Marie while filling out his report that, if another ten minutes had passed without attention, and the flames had reached the attic, the entire house would probably have burned down.

The grease fire was of sufficient heat, smoke, and intensity the insurance claim was almost sixty thousand dollars.

How could this have happened? Bob asked himself silently. I’m hungry!

Marie got a serious scare, and a new kitchen, out of that experience.

Robert Sean Hanlon was a 6’4”, 260-lb, retired, ex-New York cop of Irish descent, sixty seven years old, who could remember all the details of arrests made thirty years ago but couldn’t remember what he had for lunch. In good physical health, his brain had stopped making new memories, making him forgetful.

Very forgetful.

Older memories were also gradually fading into a dense fog.

Diagnosed with Alzheimer’s disease over six years ago, Marie had been Bob’s nonstop caretaker since then. During that time, as his cognitive abilities and memory steadily deteriorated on almost a daily basis, she would care for him, night and day, 24/7, 365, looking out for his safety and welfare, just as she had done for her children many years ago. The weight of the constant vigilance consumed her.

“I don’t know what I am going to do with him! He gets a little worse every day.” she complained, the hopelessness, despair, and resignation easy to pick up in her voice.

Physically well-rested, Bob was mentally oblivious.

Intellectually intact, on the other hand, yet physically and emotionally exhausted, Marie was drained, mainly from high stress, little sleep, and less help.

After over seventy two months of her solo constant care, and a fire, I began making a series of three projected one-hour psychiatric home visits as a Registered Nurse to make a comprehensive evaluation of Bob’s mental and physical status, and suggest a treatment plan, with a desire and an intention to maintain him in the home, if possible.

Costing a fraction of the charges for hospital inpatient care or a nursing home, home visits for patients are very cost-effective. The patients and their families usually prefer the affected individual to remain in their home as long as possible, so it is convenient, cost effective, and stabilizes them in a comfortable and patient-friendly environment.

Bob was living at home because Marie wanted him there. Period.

Approaching him on my first visit, right after lunch, Bob was sitting at the dinner table with Marie, sandwich crumbs on a plate in front of him.

His appetite is good, was my first impression.

“Hello, Bob. Let me introduce myself. My name is Gene and I am here to help, if I can. How are you doing today?” extending my hand to shake his.

A grunt was his only response. His eyes glassy, Bob’s vacant stare was aimed at a point somewhere on the ceiling above my head. Blinking several times, he struggled to focus. At no time were there an awareness and/or acknowledgement of my presence, much less a response to my introduction, my handshake offer, or my stated purpose for being there. My words had been scrambled in his head and came across to him as nonsensical gibberish.

The receptive part of his brain that took in information from his environment, organized, and interpreted it so it made sense, wasn’t working. Neither was the expressive portion of his brain, which would normally formulate a rational reply from the previously received information. The connection between the receptive and expressive parts of his brain had been broken, leaving him incapable of rational thought.

Sitting right next to him, Marie prompted him, “This is the Registered Nurse I told you about, Bob. Tell him how you slept.”

Closing his eyes, another couple grunts were heard along with a low groan before he leaned back in his chair and dozed off to sleep.

Being mute is not unusual in the seventh year of Alzheimer’s disease and Bob was pretty much unresponsive by the time I began visiting. Amazingly, Marie was able to interpret his grunts and body language very accurately; much like a mother interprets her baby’s nonverbal gurgling and cooing, regarding what they want or need at any time.

In the late 1980’s Marie was sixty six. “I am twenty years older than the average American caregiver, Gene.” she knew from her online research. “Believe me; twenty years ago this process would have been much easier.”

In addition to being older than other caregivers and not as energetic as them, there had been no breaks, time-outs, or vacations while taking care of him all those hundreds of long days and nights.

None.

As a result, Marie was weary and worn out. Exhausted. Shot.

Dipping into her well of physical and psychological reserves during all those weeks, months, and years had drained her, and now her reservoir of energy, patience, and understanding was running critically low.

Taking his blood pressure, pulse, and temperature when I arrived after lunch was a matter of course and standard operating procedure.

Asking about any pain he might have or his sleep patterns was a waste of time and effort. Bob could not make enough sense of my questions to formulate a logical or rational reply, just a grunt or two.

After a few minutes and a couple groans he would usually drift off to sleep in his chair for his afternoon nap, as a toddler might.

Helping Bob to his favorite comfortable lounge chair on the Florida room, ten feet away, for his snooze, afterward Marie would talk to me for the rest of the visit. Frequently our conversations would last two or three hours, as she needed a friendly and willing ear that would allow her to just talk, ventilate, and get the frustration, helplessness, and sadness off her chest.

The American Association for Retired People (AARP) in 2009 estimated there are 65 million American family caregivers, providing care for chronically ill, aged, or disabled family members at least twenty hours per week. Two thirds are women. The numbers steadily increase every year.

Of those sixty five million total caregivers in 2009, over ten million of those were caring for more than four million Alzheimer’s patients because it is the most common form of dementia for people over 65, and more than 70 %, of those with Alzheimer’s disease are cared for at home. Thirteen percent of the home caregivers provide support forty hours a week or more.

(In 2016 eleven percent, 5.4 million, of US citizens 65 and older are estimated to have Alzheimer’s Disease and 15 million unpaid Americans are providing care.)

Cold statistics, however, were not very comforting or helpful to Marie because Bob was not a number to her. He was very personal and special, with a face, a heart, and close to four decades of shared experiences, children, love and affection.

“It breaks my heart to see him this way, after all those years when he has been the incredibly dependable and strong one!” Marie sadly sighed.

Unable to find anything helpful to say or do, I just listened.

At the same time, there wasn’t anything to be gained in both of us wallowing in the despair and anguish, so I changed the focus of our conversation a little, from Bob to her.

“It’s amazing to me you have been taking care of him twenty-four hours a day, for all those years! It’s incredible, Marie! You have had no help?” In order to gain a fuller understanding of the entire situation I needed to grasp the background and whatever events had led up to this point.

“Well, Gene, you might say I am very protective of him and only want the best of care for Bob. Nobody else can, or will, provide the care for him I am!” Marie stated proudly. “I love him dearly, and when we married in the church over thirty eight years ago it was my vow to take care of him in sickness and in health, and I have every intention of honoring that promise!” she stated emphatically, looking me directly, and a little defiantly, in the eye.

Initially concerned I might conclude Bob required a nursing home, which was simply not an acceptable option to her, her initial worries passed quickly, however, as the discussions progressed.

“I‘m not here to add more stress to your life, Marie. My goal is to reduce your stressors and help in any way possible, if you let me.”

“Hmph!! Well, that’s good to know, Gene, because I just need some help in how to keep him safe and sound, here at home!”

“Understood. Let’s discuss in detail what needs to be done, okay?”

It was clear Marie was fiercely proud, loyal, and protective of her family. A lioness, albeit exhausted, discouraged, isolated, lonely, and sad, yet she was a determined and somewhat defiant lioness shielding her diseased mate as much as possible against the ravages of time and illness.

“How did this happen?” I asked. “Did he suffer a head injury or something? Being a cop is rough work sometimes.”

“No.” she explained patiently, “It has happened a little at a time over the past six years. In the beginning he was just forgetful and needed a little help remembering things that needed to be done on time. Gradually, over time, however, the things he forgot became more and more basic. Our home address, where we had lived for over twenty years, our home phone number, the names of our neighbors, and the name of our dog, Brutus, with whom he used to play with every day after work, all of those memories are gone!”

“What did the doctors say? Anything they can do, Marie?”

“Well, he takes other medications for his blood pressure and cholesterol, and they seem to work, but the doctors have no medicine for him which can slow down or stop the Alzheimer’s disease. They are helpless to make him better and I feel the same way! So I just do the best I can to make his life safe, and comfortable.” Marie murmured, resignedly accepting his fate, and hers.

I knew hopelessness and helplessness about the future were two important signs of depression, for both of them, but that information was kept to myself because bringing it up wouldn’t be particularly helpful.

“Do you think Bob is depressed, Marie?” probing a little further in order to fill in the psychiatric gaps in his clinical picture.

“When he first became forgetful Bob was aware enough to know he was losing it, and it was getting worse. It was depressing to both of us. After a while, however, he stopped getting more depressed and leveled out. The doctors told me it was because Bob couldn’t remember the things he had forgotten anymore, so it didn’t bother him.”

Although he would be oblivious to his own daily deterioration, Marie would have to watch it happen, day by saddening day.

“Witnessing him decline on a daily basis is depressing to me!”

“I can see how it could be discouraging.” I lamely offered. This very gloomy, disheartening, and disillusioning situation had no easy answers.

Pressing on to gather further information for my assessment, I asked another exploratory question to fill in the gaps about the family structure, relationships, and history.

“Who helps you with him? Do you have family, or friends? Neighbors?” I asked her on the second afternoon visit, after Bob was put into his easy chair for his nap.

“There’s nobody to help! Bob retired ten years ago from the police department and we moved to Florida for our ‘Golden Years!’ I have since come to hate that term! I don’t know any of the neighbors well enough to trust them with Bob.”, sounding a little exasperated and frustrated with me for continuing to ask about possible sources of support.

Moving on after a pause, realizing that an extended series of questions were a necessity in the evaluation process, Marie explained more, “Our daughter, Penny, has three kids in New York and is married to a workaholic lawyer who makes very good money, but spends long hours at work, building his practice. She is busy raising her children.”

Nodding, I made mental notes for later.

“Donald, our son, is a successful architect in Philadelphia and in the process of building his business, which also involves long hours at work and big sacrifices. Like with Penny’s husband, one of the sacrifices made was time spent with their loved ones! I don’t blame them. They have their own families and lives to live! Penelope calls me two or three times a year to fill me in on what is going on in their household, as does Donald’s wife, Cherie, but we are slowly growing apart, and it saddens me.”

“So there really aren’t any other relatives, friends, or neighbors around to help, right?” I inquired.

It’s hard to believe. Nobody? I wondered.

“No.” she slowly and sadly admitted, a hint of resignation in her voice. “There isn’t.”

“I can’t really fault the kids though,” Marie continued, “When I put him on the phone to talk to them, he frequently can’t remember their names or how they fit into his life anymore. The sound of their voices is sometimes familiar but Bob just can’t place them or remember why they are important! He just can’t make the connection. Most of our family history we all made and shared together has been erased!” she sadly admitted.

“All those times together… vacation weeks at the lake, swimming, fishing, water skiing …football, baseball, and basketball games… holidays spent as a large group of close relatives, milestones for the kids… first step, bike ride, first dance, first date, first kiss… the fun… laughter…. smiles… tears…fears …cheers…. wins… losses ….. have all faded into a fog… lost.” she murmured wistfully, looking away, as her brave smile dissolved into a stream of tears.

“Heartbreaking.” was all I could think of to say, handing her a Kleenex.

Marie was grieving for those precious and priceless lost family treasures, and those to come.

Wiping away the streaks from her cheeks a few minutes later, she went on. “A couple months ago on the phone, Donald’s wife, Cherie, told me her husband didn’t like seeing his Dad like that – a frail, weak, and vulnerable soul. He wants to keep his memory of his Father intact, the strong, capable, decisive, and respected guy he has always been. Now Bob is broken, lost, and childlike, and well, if it could happen to him it could happen to anybody! Nobody is safe, and the thought scares Donald. It scares me too, as I can also see in Bob my own human frailty and mortality staring me in the face!”

An impossibly difficult situation, I was feeling as helpless and useless as Marie.

“I know exactly how Donald feels because I hate seeing him this way too, and it is scary, but I wont abandon him now, when he needs me, just because the going has gotten tough!”

I couldn’t help but admire her loyalty, dedication, and determination.

As the visits continued it became increasingly obvious Bob presented multiple, and nonstop, trials and tribulations to Marie.

Medications were a whole new and different challenge for her. Marie knew from the monthly AARP bulletins four in ten seniors did not take their medications as ordered because they were either too costly, didn’t help, or weren’t necessary.

Knowing his police pension was generous and completely covered the costs of the medications, we knew it wasn’t the price that was the problem.

His pills weren’t taken as ordered because Bob had forgotten what to take, in what dosages, and when. Or double and triple doses would be taken because the memory of those previous doses taken earlier in the day had already been erased from his memory banks. This erratic all-or-none compliance and non-compliance led to confusion and agitation, or sleepiness, and hopelessly confused the clinical picture for the prescribing physician, further increasing the difficulty of ordering appropriate medications in adequate dosages.

“I had to take over his blood pressure, cholesterol, sleeping, heartburn, and anxiety medications too, because Bob just couldn’t do it! It’s just one more responsibility on top of all the others I have, Gene.” The stress and strain in her voice was substantial and obvious.

“Administering his medications, making sure he takes the right doses on time, looking out for any possible side effects, and reporting to the doctor how he is doing on his meds is somehow now my job too, Gene!! The only problem there is I have no medical background or training! None!”

That would be my role. “I can, and will, help you with your medication concerns, Marie. My written field reports will keep the doctor up to date on a weekly basis, and I will notify him directly by phone whenever it might become necessary.” assuring her as gently as possible.

“Thanks.” she murmured gratefully. “It’s one less thing for me to handle!”

Finally she was getting a little help.

Asking about his sleep patterns, she just shrugged her shoulders, looked down at the floor, and in a slow, tired voice replied, “He gets more and better sleep than me!”

“What do you mean, Marie?”

“I get an average of three to four hours of sleep a night, and have since he has been sick! The little sleep I do get is very light because I have to get up when he does, or bad things can happen!”

“What kind of bad things are you talking about?”

“You heard about the fire, right, Gene?”

I had heard there had been a fire in the past but none of the details. The fire had been the incident which eventually led to my home visits.

“One morning Bob tried to make himself some eggs at 5am, forgot he left the skillet on high, and caused a large kitchen grease fire that required the fire department to put out! He almost burned the house down! Poor baby! I worry about him, so the knobs to the range are now kept in my purse!”

I was beginning to grasp and understand what she faced.

“Another half dozen times or more Bob has let himself out of the house at three or four in the morning and wandered the street, lost, until a neighbor or the police found him and politely escorted him back home!”

It was becoming very clear to me why she didn’t get much quality sleep. Bob could easily and quickly become a danger to himself and others.

“Now I lock all the doors from the inside with a key before we go to bed and put it in my purse. I had to lock up his guns and sharp knives too! I’m afraid he will get hurt, unintentionally or otherwise.” The stress and pressures of keeping up with a large, curious, oblivious, and demanding toddler-in-essence, nonstop, for many months and years  seriously strained her abilities to cope.

The more I heard about Bob the worse the situation sounded.

“I am a realist and live from day to day, Gene. I don’t kid myself because the eventual outcome is painfully clear. It hurts my heart to even think about losing him! At the same time, we have been married a very long time and Bob has been my rock! It’s hard to even think about my life without him! Who can I depend on? What is there to look forward to without him?  My life will be empty and sad once he’s gone!”

Eventually all of his memories would be lost, I knew, including the names of loved ones and family. Marie knew it was coming too and dreaded that final insult. It would be the unkindest cut of all, and the one that would hurt the most. Bob, her partner, protector, and provider, not to mention her mate and the love of her life for almost four decades, would forget her name, who she was, what her relationship to him was, and why he should care about her.

“The only saving grace then will be that Bob will be pleasantly oblivious to the whole process!” the pain, sadness, and cynicism of the despairing situation starting to drift into her consciousness and conversation. She bitterly resented being in this position.

” It isn’t fair. We did everything the right way and don’t deserve this, neither of us.”

Even the simplest tasks, like putting on socks and shoes and getting dressed, would become impossible at some point in the future. Marie helped him get dressed and undressed at the time, even though Bob protested loudly occasionally. “More and more frequently he simply forgets in the morning what needs to be done after pulling his pants on, leaving his belt unbuckled and fly unzipped.”

Marie shared a story about Bob that was a bittersweet testimony to their relationship, his character, and their marriage. It had touched her deeply.

At the end of the day Bob would get tired, in a process called Sundowners Syndrome, and would have trouble remembering what to do next in the normal course of preparing for bed, so she would help him.

One night at ten PM, which was his bedtime for years, she sat on the bed next to him and started to unbuckle his pants. Marie had just got his belt unfastened and started to pull his pants down when he firmly pushed her away with his forearm, stating loudly, in no uncertain terms, “Get away from me! I’ll tell my wife!”

It was sweet because, even in his diminished state, at some bedrock station in his soul, he was faithful to her.

Bitter because Bob didn’t realize she WAS his wife.

My listening and reflecting the futility and sadness of the predicament on every visit would not be particularly helpful, however, so I decided to explore other possible avenues of assistance or support.

“Are there any neighbors you know well who could help, Marie? Friends from church?”

“No, none I know well enough to ask.” she replied, “There’s a church around the corner. I used to go there when we first moved here ten years ago because Church has always been a significant part of my life. I enjoy going because it renews my spirit and faith, but it has been impossible to attend for the past six years, since he was diagnosed! Bob requires every ounce of my time, energy, and focus to keep him safe.”

Finally, there is an opening to present a possible solution!

“It’s clear you are doing a terrific job taking care of Bob, but six years is a long time without a break, Marie. Everybody needs and deserves a little pause or vacation from time to time to recharge their batteries. Have you looked into the respite care facility around the corner? The one associated with the church you were talking about earlier?” I gently asked.

Acknowledging her massive dedication and devotion to Bob so far, and giving her permission to take a little break, for herself, as well as Bob, is necessary. Her well of patience and humanity is next to dry.

“I don’t know much about that particular facility, Marie, but most of them are regulated by the state, adequately staffed, and qualified to take care of him for short periods, while you could run your errands and shop. Everybody needs a break from time to time, and you are long overdue.”

“Hmm, I hadn’t really given that much thought, Gene. He’s like a toddler now, and tends to wander off and get lost or in some sort of mischief whenever I go shopping for food, to the bank, or out paying bills. Bob needs constant supervision. Maybe the respite care would work, for short periods of time, but I don’t want to leave him for long periods with just anybody! He’s my baby!”

Literally, Bob was her baby.

“There is also no doubt you could use some help, or a break. It can’t hurt to check it out, maybe for just an hour or two.” I again suggested.

“Well, maybe…” Marie replied, reluctantly, as I left, agreeing to think about it.

When I returned a couple days later she reported calling the respite care center and dropping by briefly to check it out, leaving somewhat soothed but still hesitant to take that step.

Upon my next arrival she quickly volunteered, before I had a chance to say anything, “I took your suggestion and left Bob at the respite center for an hour yesterday. Telling the staff and Bob I was going shopping, I left thru the front door. Quietly returning thru the back door twenty minutes later, and again 45 minutes later, I was determined to see if they were taking good care of him!”

“So, how did it go, Marie? Were they taking good care of him?”

“He never saw me return as I silently spied on him from behind. It was good to see Bob amusing himself at a card table with some colored building blocks, red and green colored salt and pepper shakers, and spoons, under the staff’s watchful eyes, both times, completely oblivious to his environment, and my absence!” a shred of optimistic excitement creeping into her voice.

“So far, so good.” she said quietly, and hopefully, to herself, crossing her fingers.

Cautiously leaving him the next Monday for two hours, Marie completed all of her grocery shopping, and made a bank deposit, which made the brief test run an unequivocal success! Soon she began leaving him there for up to four hours with a clear conscience, and became more industrious and productive than any of the previous six years!

“Sometimes I even call my sister, Frances, and we have lunch together, something we both enjoy, but haven’t been able to do for years!” she exclaimed with an broad smile!

It’s good to see her animated about something again.

After a month of almost daily successful visits to the respite center Marie decided both she and Bob were ready for the acid test. “On Monday morning I dropped him off for four hours and ran all my errands. On Thursday afternoon I met Frances for lunch for two hours and spent the last two hours painting at the beach!”

I smiled.

“It was wonderful, Gene! The ocean waves, sun, and the salt air are just so relaxing and invigorating at the same time! I love being in Nature!”

She has a modest life of her own, and is enjoying it again.

Marie’s mood and energy levels improved and the bags under her eyes began to fade.

“There are even times when I use the entire four hours for sleep! Can you believe it? Deep, peaceful, guilt-free, wonderful, calm, uninterrupted, and regenerative sleep! In fact, I may very well do it every week!” she chuckled, with a little grin.

A new woman, Marie was even caught smiling and laughing on occasion.

“After I drop him off at the respite center I have begun stopping by the church for fifteen or twenty minutes to rejuvenate my soul, too!” she confided one morning.

Meanwhile, my supervisor was very unhappy with my documented performance and took me to task because my field reports indicated I was doing little for Bob, who was technically the “Identified Patient”.

Explaining to the supervisor Bob was mute, disoriented, and unresponsive didn’t help. The rules were the rules and must be adhered to, no matter the situation.

Medicare would not pay for her treatment, so there was a serious dilemma.

Pretending my conversations with Bob were yielding responses that made some kind of sense would allow the visits to continue, even though my reports would be a total fabrication.

Or the truth would be told and let the beauracracy intervene.

Explaining the situation to Marie, her response was, ”Oh, dear.”

A week later I made my difficult decision. “I have decided to just tell the truth and let the chips fall where they may. I’m sorry.”

Patting my hand reassuringly, she supported my choice, “Telling the truth is always the best choice, dear.”

It was clear she wanted me to know their situation was manageable now, and reasonably doable, which I appreciated because part of me was feeling like I was abandoning her.

Bob wasn’t being abandoned as much because he was never really there, through no fault of his own, of course.

After visiting most weekday afternoons for three months I reluctantly and sadly bid them farewell.

Saying goodbye is always difficult for me, but Marie made it much easier.

“Don’t worry about us, Gene. Bob and I will both be okay, to the end. Thank you for all your help.” as she hugged me goodbye.

I was glad to hear it.

Both Marie and I knew something positive had happened, whether or not any governmental administrator was aware, or not.

The beauracracy would continue bumbling, stumbling, and fumbling its way along without a lot of concern about the people involved or the results produced as long as there was blind adherence to the strict, unwavering, and largely irrational and unproductive protocols. The regulations and the bureaucratic BS would live forever, whether they were helpful or not, unlike the patients.

Progress in this case was made in spite of the regulations, not because of them. The relatively successful resolution of a very difficult situation was a triumph of a little common sense and Marie’s indomitable will, overwhelming resilience, and human spirit.

Continuing to be a truly a lost and helpless victim of time and disease, Bob would become a little less capable and aware each day.

Marie would remain her loyal and loving self, only a little more each day as Bob became increasingly lost and needed her, continuing to love him and care for him to the end.

In addition, there was a rebirth for her to attend to.

For Bob, my hope was his days would pass as peacefully and safely as possible, for his sake, and hers.

For Marie, it was good to know her reawakening would continue, while honoring him into the grave, as she promised. It had become pretty clear both could be done, and done well.

I had mixed feelings. There was a little sadness because the opportunity would be lost for me to watch Marie reclaim the enjoyment, pleasure, and vitality in her life, and blossom, while respectfully helping him to the end.

At the same time, her renaissance was a joy for me to watch.

There are valuable life lessons to be learned from both Bob and Marie.

From Bob the takeaway might be humility, because even the most physically powerful, incredibly competent, and dynamic forces of nature can be brought to their knees over the years with the passage of time and disease. Be not too proud of one’s physical or intellectual powers because they can be fleeting, and lost.

The lessons to be learned from Marie are about loyalty, dignity, devotion, family, and the sanctity of marriage vows. She was a terrific woman, the kind you don’t run into every day, and I wished her all the best for the rest of her years, with and without Bob.

Overall, priceless examples of the core values involved in two lives honorably-lived were indelibly demonstrated by Bob and Marie, regarding life, love, and marriage – people struggling, yet decently and respectfully living their lives together through the ups and downs of their marital existence with dedication and determination, loyalty, and love.

Patients and people like Bob and Marie make healthcare so rewarding because it’s a chance to make a small contribution to somebody’s life and receive a priceless lesson in living one’s life in return.

Sometimes, as one life comes to an end, another life is born, or reborn. In the end all but love is dead, just as the poet said.

On my last visit  after the goodbye hugs, Marie pulled me aside as she walked me to the front door and thanked me for my help . “As you know this was a very sad situation before, and I will dearly miss him when he is gone, but now things are better, Gene, and my church visits have convinced me that I’ll see him again one day and from that point on we’ll be together forever!”