My home health patient was over 90,  and had been in the hospital for months. He was home now  but quite debilitated.  You could tell by looking at his bone structure that he must have been an extremely handsome man in his younger day.  He and the woman had been married 60+years.  He had a pile of papers and bills on his kitchen table he was working through, none of which had been dealt with while he was gone.  His wife was not nice to him.  She constantly badgered him about something – “put your sweater on,” “why are you doing it that way,” “he doesn’t do his exercises,” “I don’t know why he won’t sit in that chair,” “he doesn’t walk enough.”   On and on and on.   The badgering grated on me.  I was always happy when the caregiver took her out on an errand when I was coming.  He seemed so long-suffering, just patiently taking her scathing comments, and always speaking kindly to her, at least in my presence.  He was tremendously sad, it seemed.
One Friday afternoon (these things always happen on Friday afternoon in home health – when the clinics are closing for the weekend) his heart rate fell below 45.  He ran very low most of the time, around 48-50, but this was getting into extremely dangerous territory.  I called his doctor, she told me he should go to urgent care clinic as they were closing.  I called the urgent care clinic, they said he should go to the emergency room.

We all know what a nightmare it is to go to an emergency room these days.  Someone like him, in no obvious distress and old as dirt would sit there for hours while other more urgent patients were attended to.  He began to cry at the prospect.  I knew that he was probably right, that it was just a temporary blip, but of course I could not take that chance; it was my responsibility to refer him for assessment. 

From out of nowhere came the woman.  Gone was the bitter tone in her voice.  Gone were the scathing words spewing out of her mouth.  She took his old, withered hand, held it in hers, and began to stroke it gently.  Then she began to kiss his hand and tell him it was all going to be okay.   She gently found his jacket and we readied him for what would undoubtedly be a long evening.  I was stunned by the change in her and realized that this, too, is what marriage is about.  We are no longer in love.  You drive me crazy.  60+ years is more than we bargained for, but… 

“I got your back.”