Within a few days of moving into our home 27 years ago we met Ron. He ambled over from his home across the street and a few doors down, his bearded face erupting into what would soon become a familiar smile. A construction worker by trade, he had done several projects for the previous owners and he regaled us with detailed stories of the before and after.
He was hard not to like. He was a fixture in the neighborhood. It seemed he was always puttering around in his garage on some thing or another, door open for all to see, all the while keeping an eye on the homes and lives of those around him.
He watched with a purpose it seemed, for whenever we needed help, Ron would appear. If we brought home furniture, it seemed Ron would be there, ready to carry it into our home before we were. If we were having work done on the home, Ron would stroll over to see what was going on, engage the workers with a smile, and offer suggestions on how it could be done easier or better. Many times, he was right.
When our garage spring broke, he was there to prop up the door until we could get a new spring. Each 4th of July, he seemed to purposely be outside waiting to see when I would start to pump bike tires for our family’s annual ride to the parade. When I would start to struggle with the small pump that plugged into my car’s lighter socket, Ron would be there with his air compressor, calling me over so he could help.
We were not close friends, we did not have deep conversations on the meaning of life and the universe, or anything intensely personal, but that does not mean that I did not love the man. He was a rock, someone I knew would always be there to help when called upon, who would do so expecting nothing in return. I am anything but handy, but the rare occasions I was tempted to start a project I did so with the knowledge that Ron would be there if I found myself in trouble.
That began to change a few years ago. A fall at home resulted in a broken neck, and the subsequent surgery left him with a metal halo around his head. It was hard to watch him moving slowly down the street with a walker, so thin and frail. It seemed the Ron we knew was fading away. Before long he had even faded from sight. Months went by without us seeing him at all. His lowered garage door symbolized his withdrawal from the neighborhood.
A few weeks ago, we learned just how much he had lost. One Friday his wife Jeanne reached out to Lisa asking if I would be willing to stop by their house. She had been trying to check his blood pressure and could not get a reading. As I left the office I grabbed a blood pressure cuff and an extra stethoscope, stopping by to see Ron before home.
Jeanne welcomed me with a smile, but I soon saw there was not much for her to smile about. As I entered the bedroom where he lay, I was taken aback at what I saw. Big, strong, gregarious Ron had metamorphosized into a gaunt, frail, old man. To my eyes it seemed he had lost over 50 pounds since last I had seen him. His skin was pale, his cheeks were sunken and there was no spark in his eyes. I wrapped the blood pressure cuff around his arms and inflated it and anxiously watched as the numerical reading dropped lower and lower before I could hear his pulse. I checked twice to make sure I was not mistaken. The top number was 74, the lower number undetectable. His pulse was weak, irregular and over 140. He was seriously ill, perhaps dying.
Given his appearance the thought occurred to me, “Does he even want to live like this?”
I began asking questions about his quality of life, and with each response I was more convinced that the answer to my unspoken question was most likely, “No.”
His responses revealed that his mind had also deteriorated, perhaps even more than his body. Although we had been neighbors for 27 years, recalling my name was a struggle for him. I quickly went through a standardized memory questionnaire and sadly discovered that he had advanced dementia. Feeling myself emotionally shaken, I shifted my brain into “doctor mode”, did my best to suppress my feelings of sadness and loss, and began the difficult conversation about whether it was time for hospice care.
As I discussed the seriousness of his current state, the likely progression of dementia, and what that future would look like, Jeanne quickly realized that it was time. As mentally clouded as he was, Ron seemed to grasp it as well.
The next decision was mine. As I sat at the bedside looking at the man who had been so kind to my family so many times over the years, I was saddened by the feeling that I had not thanked him enough for his help, hadn’t gotten to know him better, and hadn’t been enough of a neighbor to him. I realized that now, in what were going to be Ron’s final days, I had a chance to give something back. He had been there for me; I could now be there for him. I offered to be his hospice doctor, to guide his care in his last days, to make sure that he did not suffer and that he passed with as much dignity as possible. His wife gratefully accepted my offer, and I made the call to the hospice agency.
He died 11 days later.
Although the time was short, it was long enough for Lisa and I to give back some love to Ron and Jeanne. Dementia can take a heavy toll on caregivers, and Lisa learned just how hard it had been for her. Lisa listened Jeanne’s stories of falls, messes, and unkind words, of how Jeanne had endured the types of wounds so often inflicted by those who minds are betraying them.
Lisa gave support and encouragement as Jeanne dealt with the emotions of trying to love someone who had become unlikeable at times, as Jeanne lived out the word of the vows, “for better or for worse, in sickness and in health, til death do we part.”
I stopped by frequently to see Ron, monitoring his status and encouraging Jeanne that she had made the right decision and was doing a great job caring for her husband. It was emotional for me, but I saved my tears for when I was home. I did not want to add to Jeanne’s pain. he passed away barely an hour after my last visit.
Those 11 days have had a profound impact on me and have led to countless moments of reflection. In addition to the expected feelings of wishing I had said or done more sooner, I have found myself pondering other things as well.
Perhaps the most lasting impact is my understanding of what it means to love someone. There was nothing wrong about my desire to give back to Ron because of all he had given me, but that is not what defines true love. True love is not transactional.
I am reminded of the words of Jesus, “If you love those who love you, what reward do you have?” Jesus made it clear that even bad people do that. True love is more like what Jeanne did for these last few years. Alone in her home with a man who had in many ways become unloveable, she loved him anyway. Sometimes in anger, sometimes through tears, often in frustration, she took care of him, cleaned up after him, and fed him. Love is defined by deeds, not words, and her deeds speak loudly to me.
Bart
