He cooked her meals and patiently fed her with a spoon

I hadn’t seen Lowell in almost six years. I bumped into him today in a lumberyard, we were both in a hurry. “I can’t believe it, Dr. Vainio, I found someone as nice as Joyce was and I married her. I never thought this could happen to me again.”

When I met Joyce, she was 67 and had Parkinson’s disease, which is a progressive neurological disorder with no cure. She already had the diagnosis when she first started seeing me. She was followed by a Neurologist three or four times a year and her Parkinson’s medicines were from the Neurologist.

But she saw me more frequently for her diabetes, blood pressure issues and increasing difficulty with eating. Her Parkinson’s disease was aggressive and she was deteriorating rapidly.

Joyce was enrolled and could come to the clinic, but had never used our services before. I could tell Lowell was skeptical at first, but quickly realized that our clinic had much to offer Joyce. He was a farmer; big, strong and independent and used to confronting problems head on. They had to travel for well over an hour to get to the clinic from their farm. He had cattle and had to put up hay, work his fields, fix fences and take care of his farm every day. This was severely complicated by Joyce’s illness. She had fallen several times and Lowell couldn’t leave her alone in the house for very long. She still wanted to be independent and would try to do things on her own so she wouldn’t be a burden to Lowell. Several times he came in and found her on the floor.

At first she mostly had a tremor at rest, but eventually she couldn’t drink from a cup or use a spoon. Her walking started to get worse and she couldn’t keep her balance. Parkinson’s disease causes muscles to become rigid and causes gait problems. This resulted in Joyce leaning forward when she walked, but she was unable to swing her arms for balance (we all do this, but don’t pay attention to it). She would be unable to stop and was unable to turn when she walked. She got stuck in corners.

Her blood sugars would get low because she wasn’t eating and I had to change her medicines frequently. Her blood pressure would go way up, then it would go very low and controlling it was increasingly difficult.

Her esophagus was not working right and she couldn’t swallow properly. Food got stuck and she had episodes of choking. She had to have several procedures to dilate her esophagus open again. Her smile became less frequent as her facial muscles wouldn’t work and her voice became softer and quieter over time. She was calm and gentle and trusted me completely. “I wouldn’t want to see anyone else.”

Also calm and gentle was Lowell. We had discussed nursing home care, but he wouldn’t think of it. “She took care of me all these years and I’m going to do the same for her.” They did have family that would help as much as they could and a visiting nurse allowed Lowell to get his farm work done several days a week. But mostly it was Lowell who took care of Joyce. He cooked her meals and patiently fed her with a spoon.

He helped her go to the bathroom and helped her in and out of bed. He gave her baths. Getting her out of the house and into the car to come to the clinic was an ordeal. But I never once heard him complain of his lot in life; he was always thankful that Joyce was still with him and took his increasing responsibilities in stride. He was in his early 70s and they had been married for many years.

In the course of our visits, Lowell learned that I had a backhoe and a bulldozer and our respect for each other grew. He would always give me advice on some welding technique or some way to work on a tractor that he had learned over the years. I think this was his way of repaying me for helping him with Joyce and I always looked forward to whatever he could teach me.

Joyce continued to get worse and nothing could stop her deterioration. She finally needed nursing home care and Lowell was with her as much as possible. They had a new doctor in the nursing home and I didn’t see her anymore. Lowell was with Joyce when she died. As they lived farther away, I didn’t hear about her death right away. I called Lowell as his link to the clinic was gone and he could no longer come here. “I meant to call you, Dr. Vainio, but I didn’t think I could make it through the phone call. I want to thank you and anyone at the clinic who was involved in Joyce’s care. She couldn’t have done any better anywhere else.”

Parkinson’s disease is a progressive neurological disease and most people get it after age 60, but it can happen as early as age 30. This is not a fatal illness and most people die with Parkinson’s disease and not because of the disease itself. Difficulty swallowing with resultant choking and pneumonia can happen and falls can lead to some deaths. The exact cause is not known, but it isn’t hereditary or contagious. Many people with Parkinson’s disease live active, productive lives. There are multiple foundations looking for treatments and cures, but so far no cure has been found. Diagnosing Parkinson’s disease can sometimes be difficult as it doesn’t always affect everyone the same way.

When I bumped into Lowell in the lumberyard, he told me his family had thrown an 80th birthday party for him this past summer. He was happily remarried and he introduced me to his wife. “Dr. Vainio, I don’t know how I got so lucky.”

I think I know. Lowell would never say this, but deep in his heart he kept a lesson we all learn in childhood, but most of us forget. In order to find true love, you have to be true love. He was all of that to Joyce and he’s ready to do it again.

This isn’t luck, Lowell.

You made this happen.     

Arne Vainio, M.D. is a Family Practice Physician at the Min-No-Aya-Win Human Services Clinic on the Fond du Lac Ojibwe Reservation in Northern Minnesota. He can be reached at a-vainio@hotmail.com.

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