Despite twenty years of medical practice in Vallejo, California, I won’t tell you I have seen it all. But I can tell you I have met Mildred and Thomas. After you hear their story, you may want to meet them too.
Through thick and thin. In sickness and in health. These are the grand concepts. The notion that two people can be soulmates and destined to be together forever has immense appeal. But why is it such a rarity? Why does the myth so often fracture during the long years trying to sustain intimacy and friendship? Till death do us part, you say? One is more likely to encounter a fogless summer in San Francisco. It is that rare?
But it happens. I have seen it. Mildred and Thomas are an interesting case study. When I first met them, Thomas was 82 and he appeared to be suffering from moderately advanced dementia. Mildred w s 80, bright, alert as can be, and deeply, irrevocably in love with her husband.
At our first encounter, Mildred had brought Thomas for a checkup and accompanied him in to the exam room. Thomas beamed when I asked him how he was. “Just peaches,” he said, his smile betraying two missing teeth. I asked the usual array of questions, seeking to learn whether Thomas had experienced any chest pains, shortness of breath, trouble with his urine or bowels, or other untoward problems. To each question, Thomas smiled and replied, “Nope, none of that for me, thank you.”
Next I did a brief mental status exam. “What year is it, Thomas?”
“That would be 1888,” came his quick replay.
“Who is the president?” I asked.
“Kennedy,” said Thomas without hesitation. “A very good president he is.” Then he added, “Doc, you don’t need to worry about me. I’m just peaches.”
Knowing I would not get much further taking a history from Thomas, I turned to Mildred to ask about her husband’s health. Mildred smiled and said, “You’ll have to forgive my husband. He’s getting a might forgetful. That’s why I brought him to see you.” Mildred went on to describe how her husband’s memory had been getting worse over the past year. He otherwise was in remarkable health, with no physical complaints.
After talking with Mildred for a few minutes, it was pretty clear her husband had Alzheimer’s. For confirmation, I ordered the usual battery of tests to rule out other possibilities and scheduled a follow-up visit two weeks later.
As it turned out, Thomas’ tests were all negative, confirming the diagnosis of Alzheimer’s dementia. At his follow-up appointment, Thomas had no recall of meeting me previously. He assured me he was “just peaches.” My main goal for this visit was to educate and support Mildred. The spouse usually suffers more than the Alzheimer’s patient himself or herself. It is the spouse who carries the heavier burden, seeing their loved one retreat down that darkening tunnel.
I told Mildred about her husband’s test results and the implications. I offered her the services of a social worker and a dementia support group. “Not just now,” she said. “Thomas and I are doing fine. But I’ll let you know if we need anything.”
At that point Thomas moved to his wife, smiling broadly, and gave her a big kiss on the cheek. “You don’t need to worry about us, doc. We’re just peaches.”
Since my discussion with Mildred had only taken a few minutes and my next patient had not arrived, I decided to get better acquainted with her and her husband. Such knowledge could come in useful down the road.
“How long have you been married?” I asked.
“Twelve years,” responded Mildred.
That took me aback, since I had assumed they must be past their golden anniversary.
Seeing my surprise, Mildred said, “We’ve been close since we were teenagers, but we just got married 12 years ago.”
“How is that?” I asked.
“We were always meant to be together,” Mildred said. “Thomas and I fell in love when he was 15 and I was 13. Our parents didn’t approve, so we ran away together. I was 14 when we did that. We got as far as Stockton. Our parents found us, dragged us back to Vallejo, and wouldn’t let us see each other or even talk. It was terrible.”
I glanced at my watch, knowing my next patient was probably waiting, but I had to hear more.
“Thomas eventually moved away. I stayed in town. We both got married to other people. Those marriages were good. Nothing special, though. Neither of us had kids. Thomas’ wife died 15 years ago and my husband’s been gone 14. That’s when Thomas moved back to Vallejo. An old friend from high school gave Thomas my phone number. He called one day and was I ever surprised. We met for dinner at the old Hickory Pit and got married four months later. It was like a dream was come true. The last 12 years have the best years of my life.”
“It must be hard with Thomas’ memory going,” I said.
“His memory is good enough. He remembers everything about us as teenagers. He knows he loves me. And he still treats me like an angel. Now how many 80-year-old women have a marriage as beautiful as this?”
I acknowledged it was rare.
“We were meant for each other,” said Mildred. “We always were. Thomas is my life. I can’t say he’s my other half, because we’re so mixed together there are no halves. There is only a whole. Now, we’ve taken enough of your time, doctor, and we need to go. Thomas promised to rub my back this afternoon. The rheumatism’s setting in.”
As they walked down the hall, arm in arm, I marveled. For years in my my exam room, I have witnessed a diverse tapestry of long-term relationships. Some have been withered things, held together by masking tape and barbed wire. Some have been partnership bound mostly by the glue of financial need, perhaps, with a superficial glaze of affection. But some — a precious few — have thrived on the foundation of true love. They are beautiful to see, these small self-contained universes.
What distinguishes these latter marriages from the common long-term relationships based on convenience or tradition? Perhaps the soulmate concept is true. Maybe there really is one individual out there with whom each of us is meant to be. Mildred and Thomas spun into different orbits for more than fifty years before a special gravity pulled them together. What constituted this magical force stretching across miles and years?
Doctors are always on a quest to answer questions. These questions usually revolve around explaining symptoms, or preserving health, or treating illness. But when I am in the exam room, I often have other questions in the back of my mind which I selfishly hide from my patients. One of the many mysteries I hope my patients can help me understand is: Do soulmates exist? For me, I believe I have found mine.
But do we each have a Mildred or a Thomas somewhere out there, and how do we find our destined partner? Or, perhaps, If Mildred or Thomas is already at our side, do we recognize them for who they are?
Mildred and Thomas could not answer all my questions. But as the left the exam room arm in arm, I knew they had answered their own.
(July 2005)