Wrinkles

Ben Ashby

For a bit over a year now, I’ve had the privilege of being in love. It’s ridiculous to say, but every moment of every day is made more colorful because she’s in my life, though we spend most of those moments apart. I can’t stop dreaming about the future, wondering what it might be like to spend bits of every day with her, full of long walks and babies falling out of clouds. In one of those moments, I wrote Timber a poem:

I think I’d like to see your wrinkles

To watch crinkles at the corner of your eye become folds in the sun

celebrating the giant forehead creases you’ll get from laughing too much.

To grow old and crooked together

pretending to be grumpy when our grandkids aren’t around

knowing you so closely that I discover your wrinkles before anyone else.

I think your wrinkles will be beautiful.

This was what I envisioned love to be like; two people becoming entirely familiar with each other, with beauty and quirks giving way to poor eyesight and early dinners over the course of decades. It’s a touching description of love, but through my time in the hospital, I’m realizing it may not paint the full picture. Here’s a bit of what I mean:

I met Adonis in the pediatric ICU. He was diagnosed with neuroblastoma at three months. His parents hadn’t finished decorating his room in their new rental home before he was whisked back to the hospital, maybe to never come home again. They prayed that his cancer, a type known for granting miracles, would wish itself away, but there was a fear that it would kill him.

I met Mary, a 40-year-old woman with metastatic cervical cancer. She’d gotten married the year before, two years after her diagnosis. She and her husband knew full well at the wedding that she was going to die. Their marriage revolved around her day-by-day decline in health. She’d been so sick for the last three months that they’d not even gotten to share a kiss.

I met Josh, a man who has had fifteen abdominal surgeries since 2000. He lived with a bladder bag and a bowel bag. He was morbidly obese, his hair was greasy and thin, and he was too tired to speak in full sentences. He fell in love in 1995: five good years, followed by nineteen where his wife drained his urine three times a day, paying fractions of their bills with his disability stipend. Her dancing partner is gone. She doesn’t travel anymore. They haven’t got any kids.

I met Alfonzo, a man who would lose his right arm. He was married in 1999. In 2002, his wife had a cerebral aneurysm rupture. She has no shortterm memory, so she asks him the same questions every day. She needs help using the restroom and dressing herself. He fell in love with her for her cooking. He had left his job to care for her and wondered what would happen now, without two good hands. Love can be a promise to celebrate each other, enjoying life in the company of someone you care about. Sometimes you do get to grow old with the people you love, but it is rarely like you imagined.

Love comes with a cost. The hospital is a place where many discover this cost for the first time. The introduction of unexpected suffering can be debilitating for the patient and their loved ones. As I watched dozens of families come to grips with new and disappointing realities, I felt some of this fear well up in myself. Love can be a commitment to suffer someone else’s death before your own. How could I keep a promise like that?

It was in my second interaction with Alfonzo that I found an answer. I visited him after his fasciotomy, before they were forced to amputate his hand. He was recovering well, anxious to return home to his wife. I reassured him that his wife was safe in the care of home health nurses. Tentatively, as if asking for a friend, I then mentioned the caregiver’s burden and asked where he found hope. Alfonzo pursed his lips, eyes following the lines in the ceiling tile, and said, “I can’t imagine doing anything else.”

It seemed I had been asking myself the wrong question. Caring for a loved one as they face unexpected, life-limiting illness may be a great burden, but it would be a much greater burden to leave them alone. Say I were to run from this second-hand suffering: Who would fill my place? Could I move on, knowing that the woman, or the parent, or the child I loved might be alone? This was a much easier question to answer.

When her wrinkles come early, I can’t imagine being anywhere but by her side.

-Ben Ashby is a fourth-year medical student at the UNC School of Medicine from Omaha, NE.-