I knocked on the door, wondering if he’d heard me over the noise of the tv. He opened up, and smiled.”Oh it’s you Doctor. Come in, come in. The clinic called and I got worried something bad was in the bloodwork.” I rushed to reassure him.

“Oh no, nothing like that.I just wanted to make sure you knew the results. Mostly everything is fine.” He looked at me seriously.

“Nothing about the cancer then?” I shook my head.

“No, nothing like that. Your blood is fine- no sign of anemia or elevated were count or low platelets. Your kidneys are good too. Completely normal.” He sat at the small table they shared meals at, and I could see his shoulders relax down, leaving his slightly stooped shoulders rounded softly.

I could see him look over at the couch, at her, while she starred at the tv oblivious to his regard. He looked back at me, and confirmed what I already knew.

” I need to live long enough to take care of her. That’s all. I’m ready to die anytime, but I can’t leave her alone. She’s not right anymore, you know that.” He called her name and she looked over at us, at my big smile and smiled back blankly.

“Oh, hello.” She said with glazed eyes before absently turning back to look at the tv.

“How are you guys doing? Is the home care enough still? Or do you think you need more help, in any way?”

 I always tried to make sure he had enough help looking after her, with his cancer and her memory gone at least 2 years ago. And I stopped by for visits to save him the drive to the clinic now, and the worry. He didn’t like leaving her alone, and it was getting difficult to take her places, too much work and stress for them both.

” No, no, we’re fine, just fine. I have my kids if I need help, although my son has his own medical problems, and home care helps with her baths now. I’ll ask for more help, I promise.” I looked at him consideringly for awhile, but he met my gaze with clear, strong eyes that never wavered. He may be old, but he had his convictions. 

“As long as you ask, then.” I trailed off, knowing that things would have to get bad before he asked, but he had his pride.

 She was his responsibility, and had been since the day they said for better or worse. He came from a time when that meant forever, not until things got tough.

 I had watched them for years now. She had been brighter when we’d first met, able to hold a conversation and ask her own questions. She’d nagged him like the old wife that she was, and they had bickered in the office the way only couples long married can.

 But she had slowly drifted away from him over the last few years, going on ahead. He anchored her down, refusing to let her float away completely before her body was ready. He knew it too, and we rarely spoke of it.

They say dementia is an end stage disease. It steals away the soul in bits, sometimes letting it visit before taking another chunk, taking them further away from you. It causes family to grieve loss after loss long before a body dies.

 You see, everyone knows. It’s too painful to speak of, the howling grief that leaves you with an imposter, only a shell remaining of the one you love.

“Thanks for coming Doctor. I’m sure glad to hear that.” We talked a bit longer, and his eyes got bright when we talked about planning for the worst. He walked me to the door, and we shook hands.

“We’re doing good here, don’t worry. We’ll be just fine” 

I smiled and left, walking down the hall of the complex they lived in and hearing my footsteps echo down the hall. For better or worse, in sickness and health. I wonder if we can ever understand those words until we live through them. 

I wondered if I would be able to do it as I walked away into the bright cold January day, going home to my partner.