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Clinical Trials

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A Different Vow
By Kate Arnold

(Page 1 of 3)

"Do you know where my husband is?  Because he's a good one and I'd hate to lose him." This is her third husband, so Holly, my 80-something-year-old patient, has room to judge. I tell her he's reading his book downstairs and she says, "He's such a patient husband." She asks this question every five minutes of her two-hour-long visit.  She doesn't know what city she's in, but she know she's in love with her husband.

A year and a half ago, I was finishing my post baccalaureate premedical program at Georgetown. I was twenty-four, taking physics with 19-year-olds, and trying to find a job for the year I would spend applying to medical school. In an effort to convince myself that the work was worth it, I read Final Exam by Pauline Chen, MD. Dr. Chen says that good doctors recognize when death is inevitable and then strive to make the transition to death more comfortable and peaceful.  Believing her, I decided to spend my year learning how to be with patients with hard diagnoses. I got a job as a research coordinator for clinical trials for Alzheimer's disease, which is how I met Holly.

It struck me that Holly was so in love with her husband when she had lost touch with every other part of her life.  In marriage vows, you promise to love each other forever.  In over 50 percent of marriages, people are unable to keep this promise, and that’s both frightening and depressing to people in their twenties considering marriage—myself included.  And yet, as I watch, my patients and their spouses face the hardest thing I can imagine together, in the process, they restore my faith in marriage as a sacred commitment. To love another in sickness and in health is a profound promise; and yet, it’s the tip of the iceberg when Alzheimer’s is involved.  On your wedding day, you didn’t promise not to get mad when your spouse forgets a dentist appointment, forgets your wedding anniversary, forgets how to converse, forgets your name. And if you're the one with Alzheimer's you didn't promise to never give up and to do your best to fight the disease you’ll eventually lose your life to.  With a diagnosis of Alzheimer's, these are the vows some choose to make, spoken or unspoken. And patients who can do that save their marriages.

Interspersed throughout the struggle are funny moments, and the only way to keep your sanity is to laugh. The patients tend to be disinhibited and, given that most of them were somewhat proper 80-year-olds, the things they say can be unexpected.  When I asked Mr. O’Farrell, my Irish patient, if he helps out with chores, he said, "Well, sometimes I'm an ass." Later in the visit, I asked him to address an envelope to himself and he wrote, "Mr. Wonderful.” I made a copy of the envelope and taped it above my desk to keep me smiling. One caregiver, who’s usually heartbroken at visits, laughed while telling me that on Valentine’s Day, two beautiful bouquets arrived because her husband accidentally ordered flowers twice.


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