in sickness and in health

One of the first people I worked with during my training was a man who had had a stroke --rather a big one. It left him with difficulty speaking, difficulty understanding, difficulty walking and writing. For a man who had been a truck driver professionally, it left him unable to work. He was generally a positive person, but he had a hard time.

He was married to a lovely supportive woman who had her hands full with him. He was generally a positive person, but he had an independent streak, and the dependence that the aftermath of stroke requires left him frustrated at times. Every week, she brought him to our sessions. It was clear they loved each other very much.

Imagine my confusion when she told me they were getting divorced. They got along, even with the challenges of surviving a stroke. They enjoyed each other's company very much. The reason for the divorce? Not irreconcilable differences, not infidelity, not incompatibility.

Medical care.

What most people don't know, and what I didn't know until then, is that his access to care (and her access to respite) was compromised because they were married. Simply put, they couldn't afford to stay married because it meant he couldn't get the services he needed while she continued to have a job that could support their ability to have a place to live, utilities, etc. They weren't extravagant people, by any means, but even the least extravagant among us need a place to live and food to eat. In the U.S., your ability to work is strongly tied to your ability to access appropriate care (and your ability to access appropriate care is strongly tied to your ability to work, and 'round and 'round we go).

So they divorced. She continued to bring him to our sessions. They continued to live together when they could, but now, they could access more services and respite care.

I don't know what happened to them. That was a long time ago --the very beginning of the 21st Century.

You'd think further along in the 21st Century, we would have gotten our act together and an individual's ability to get or remain married wouldn't be tied so strongly to their health status. "In sickness and in health", right? Except here in the United States, it doesn't always work so cleanly. Still. (And it's not as easy as "pay for it" because what you are talking about can bankrupt a family very, very quickly. It's a matter of helping resources last longer, not getting someone else to pick up the tab.)

Thank you, in a way, to Dominick Evans for reminding me about this today. Dominick's example was about people who would like to get married but who can't because they would lose access to care. In the example I thought of immediately on reading what Dominick had to say, they were married but couldn't stay married. 

We have a ways to go and things to think long and hard about if we want to be a country where "family values" aren't just words on a bumper sticker. 

you can't see what they see

I had a new experience on Wednesday: taking my son for his very first eye exam. He had failed his school vision screening, and then failed his rescreen. 'Fail' is such a laden term, but that's what they call it when someone doesn't or can't pass.

So the exam began with the reading of the letters --pretty standard stuff. The instruction was, "Read the smallest line you can". He had never failed his screening before. He is doing fine in school. I wasn't worried.

He couldn't read any of the lines. At the ends of the lines, I could see a 20, a 30, and a 40. Huh. Not even the 40?

Next screen. Same instruction.

Nothing. And this time at the ends of the lines there were larger numbers to go along with the larger font sizes.

And so on.

Around the mid-100s, he attempted lines and missed some of the letters. He could read them all in a line that had a 200 at the end of it. 20/200. For both eyes.

He had been functioning with eyesight like mine without glasses.

Needless to say, I felt like a horrible parent. How could I not have known? There were indications, but they were really subtle and I didn't realize what they were until now. Because hindsight is 20/20. Get it? Moving on ...

I think people have areas where they function but they seem like they have no difficulties to the outside world. The term 'high functioning' is used a lot. We only see the outside presentation. We guess that everything is okay because we don't know. We only know there's an issue going on inside if 1) the person tells us or 2) it becomes such an obstacle that they can't cover anymore.

You can't feel guilty about not seeing signs in the past, because that was the past and you can't change that. But if someone tells you they are having a hard time with something, you might want to listen. And if there are signs of struggle, like my son and his vision test, you should definitely intervene --in this case, by asking for help from a trained professional.

My son doesn't want glasses, but he did pick them out and I hope he likes his choice. Sometimes, what's needed is not what's wanted, but in the long run, it works out better. If you need rest, medicine, glasses, hearing aids, help, ...there is nothing wrong with that. May you get what you need, and have a great day.