in sickness and in health

one of the unexpected consequences of working at an alzheimer’s disease clinic is the appreciation that it’s given me for marriage.

on one hand, it’s given me a much deeper appreciation for what exactly this lifelong commitment entails. we see couples in the most unpleasant of circumstances: the couple who came in a few weeks ago, for example, where the wife is in her fifties and suffering from early onset alzheimer’s. she forgets everything after a few minutes, can’t do anything on her own, becomes extremely anxious when her husband isn’t around — to the point where i imagine that he has to be with her all the time, answering the same questions over and over again, making sure she doesn’t wander off and get hurt. there’s no cure or treatment for alzheimer’s this severe, and unlike most cases, this woman’s body is still in good shape since she’s so young… so there’s a chance that their lives could be like this for a decade or more. or consider the couple who came in a few months ago, where the husband’s alzheimer’s has progressed to the point where he’s mute and incontinent and starting to become belligerent and aggressive. they’ve been married for 51 years, and she now has to take care of him in every sense imaginable. this is the stuff you don’t often see in your twenties, when all you see of marriage is the perfectly printed wedding invitation on your fridge and happy couples running through parks in commercials for david’s bridal. this is the real stuff that marriage is made of, the for-better-and-for-worse, the in-sickness-and-in-health. this is commitment — not just when you’re both young and attractive, not just when you still have your bodies and wits intact, but also when you’re old and your bodies are giving out and your frontal cortices are deteriorating to the point where you can’t put a coherent sentence together. for me, it has been a sobering picture of marriage, and it has impressed upon me a much deeper understanding of what commitment really is.

on the other hand, as natalie reminded me this morning, working here has also given me incredible faith in marriage. we see some beautiful stories, especially in the healthy research patients who serve as controls in our studies. natalie told me about the couple she interviewed last week, where the wife, beaming, declared that the man sitting next to her was her soul mate. to be able to say that after 50 years of marriage, after having children and mortgages and cross-country moves, after weathering the best and worst of life together — that’s mind-blowing! but even the clinical patients, the ones whose cognitive problems are glaringly obvious and stressful on their relationships — they give me hope for marriage too. on more than one occasion, i have interviewed a couple and listened to their heartbreaking story — progressive memory decline, loss of functioning, depression. but when i go through their history and ask how long they’ve been married, almost invariably, they turn to each other and share a little smile. sometimes it’s the only smile i see during the entire interview. even in the midst of bleakness and despair, the distant memory of their wedding still brings them happiness, and their marriage is what sustains them.

i was reminded of this again this morning, when joe brought a patient to the lab for testing — an adorable elderly gentleman with bushy eyebrows wearing a tan corduroy jacket with elbow patches. joe, making small talk, asked him if he lived on the beach, presumably based on the address he saw in the file. the man smiled and said, “i’ve done two things right in my life. fifty-four years ago, i married my wife. and forty years ago, i bought a house on the sand.”

i almost cried when i heard that. i’ve always been a big sap, and i am all the more so now that i’m with a man i adore; and to hear things like this, from people who are easily in their 70s and 80s… it melts my heart. it gives me hope and faith in this whole marriage thing, in the crazy idea of tying yourself to one person for the rest of your life.

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One thought on “in sickness and in health

  1. the notebook! have you seen it? 🙂 i’m a big sap like that too. i get all teary-eyed when i read stories about that. my grandmother is going through the same kind of stuff, only her husband is gone already, so my mom is taking care of her, and i can see how hard it is on the caretakers…

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