Ray was motivated; he asked to receive physical therapy daily to regain the strength that was necessary for him to maneuver in his home. While providing therapy daily, I strongly advocated for him to consider placement in short-term rehabilitation. After one week, Ray agreed to be transferred to a local short-term rehab facility only; it needed to be close enough that Cherie felt comfortable driving there.

One week later, I was helping Ray into the van that was to take him to rehab. As I helped push his wheelchair down the steps (one slow bump at a time) I advised, “Remember today, because when you are walking up the stairs back into your home in 2 weeks, it will be that much sweeter.”

He thanked me for my efforts when he got into the van and assured me that he would request my care when he was re-referred for home care therapy when he returned. As he was being driven away, I gave him a playful salute, which he returned in kind.

Within 3 days, Ray would be in the hospital. A few days later, he would take his last breath.

When I was in outpatient physical therapy, my recommendations and decisions seemed to carry far less weight. In the outpatient environment, the decisions appeared to impact only two people: (1) the patient, who may or may not get better in spite of me and (2) my boss, whose vacations depended on my collecting an extra unit whenever I could.

Home care is different. Every decision I make and every recommendation that I share has a visible impact not just on my patients, but their families as well.

.     .     .     .

Cherie used to wake up at 3 AM, unable to fall back to sleep. On those nights Ray (her partner for 45 years) would wake up and join her in conversation until she was ready to fall back asleep once again. They each shared with me how those 3 AM conversations were often the best part of their day.

I am not naïve enough to believe that Ray would not have died if I had not sent him to rehab. As a matter of fact, I am quite certain that he would have. What I do know, however, is that Cherie missed an opportunity to have at least 3 more conversations at 3 o’clock in the morning with the man that she had loved and spent her entire life with.

When I woke up this morning at 3 AM, I rolled over in bed and saw my own wife resting peacefully; I sadly wondered if Cherie was awake, and (if so) what she might give at that very moment not to be alone.


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