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​The text message read, check your email, sent a new referral – this is a tough one. I sighed. It seemed all I got these days were hard cases. Of course, that’s not true, but I found myself a bit fragile, worn out by the constant stream of families needing help, compassion fatigue you could call it. I cleaned up the last remnants of breakfast, dumped my toddler’s sippy cup in the kitchen sink, and then padded to my home office, coffee in hand. Opening the email, I scanned the details: Emily Donelson 87, husband Edward Donelson 85, stroke, wife unable to care for him at home because of her own cancer diagnosis. I inhaled sharply. This may be my toughest case yet.

​Putting my fingers up to my ear, I touched the headset to shift my mind into work mode, then hit the dial button. While the phone rang, I smiled at the framed picture of grandpa that sat nearby, a reminder of why I do this work every day. “Hello, is this Mrs. Emily Donelson?” 

​“Speaking”

​“This is Sarah, a case manager at Options Placement Agency. We received your information from the hospital, and I am reaching out to discuss your husband’s care. Do you have a few moments?”

​“Sure,” a timid voice came back through the line, a brief pause filling the space.  

​“I understand that you are having difficulty caring for him at home?” 

​“Yes.” She didn’t elaborate, forcing me to probe.

​“Can you tell me a little more about the situation?”   

​“He has always needed help, but now with the stroke I can’t lift him. I am too weak.” The voice fell to a whisper. “I have cancer. Stage four. Lung.” She said each word succinctly, like she was sucking poison through a straw and spitting it out.  

​“I’m so sorry you are going through this difficult time.” I felt remorse for this soul, but stopped from vesting all of my sympathy and emptying my emotional bucket so early in the day. There were sure to be a lot of other sad stories to listen to. “Do you have any family or friends that can help you with these decisions?”   

​“It’s only us. We have a nephew but we haven’t talked to him in years. What will happen to my husband after I’m gone?” She spoke with a controlled edge in her voice. “I need a plan. It shouldn’t have to be this way,” a hint of wistfulness etched her tone. “I always imagined us taking care of each other in our last days.” 

​My full understanding of the predicament suddenly dawned, and my thoughts grasped at comprehension, but it was as futile as trying to preserve a snowflake in the palm of my hand.  How unfair. 

​ I wanted her to cry, scream, express wild emotions at the injustice, but none of that transpired. Most of my clients would have, but not Mrs. Donelson. Her stoicism was unusual. While my thoughts processed, my lips replied, “Let’s see if we can come up with some options that may work for him. From what you have described, I think we need to look for assisted living that provides a high level of care.”

​“I don’t think assisted living will work. I need a place he can stay for the rest of his life. If he has to move to a nursing home later on no one will care where he ends up.” 

​ “Who will help make the arrangements if that were to happen?”

​“Our lawyer.” 

​I pictured a legal aide stamping invoice after invoice and the couple’s money siphoning out of their accounts into the fat pockets of the attorney that sat in his large leather office chair, a list of nursing homes spread out before him. “Norma, call Radiant Convalescent Center and see if they have a bed for Mr. Donelson,” he’d guffaw.  What a nightmare.

​“Do you have financial resources to cover the cost of care?” 

​“We planned for this years ago and purchased long-term care insurance.”  

​My head buzzed and ears perked up, finding some relief for her. At least the insurance will cover the majority of the cost 

​I picked out some places that would meet his needs and set up visits for her later in the week. “I’ll be reaching out in a few days to see how the tours went and help plan for next steps” 

​Click. The phone line went empty, and so did my mind. Processing this situation was useless when there so much work to be done, so I shoved my emotions aside like the pile of dirty laundry I hid under my bed. Eventually, I would get to it.  

​A week later, I sat at the same desk with thirty-eight new tasks to complete. I scrolled through the names, filtering out the important calls of the day. Emily Donelson, on behalf of Edward Donelson, sat at the top of the list. Reviewing my notes, I pushed the call button quickly. Trepidation and anticipation rolled around in my stomach like a washing machine on spin cycle. My emotions heightened, and the phone rang twice before she answered. 

​“It’s Sarah at Options Placement Agency on a recorded line.” 

​“Hi.” She panted out a weak greeting, and I heard heavy wheezing on the other end. 

​“Are you all right?”

​“I’m just having a bad day. Can’t. Catch. My breath.”

​“Are you sitting down? Maybe you should sit down.” The intensity of her breathing increased, and with it my worry.

​“Give me a minute.” I heard shuffling of papers in the background and the whine of a TV spinning the local weather. After a few minutes, she came back, fullness returning to her voice. “Turned up the oxygen, that’s better. What is it you need, dear?” 

​“Is there anyone I can call to come and help? I’m worried about you.” My finger poised over the 9 on the dial pad.  This would be a first. How would I tell them where to go?

​“I’m okay, just having a spell. The treatments aren’t working, and the doctor says I don’t have long. You were calling about my husband?” She deflected. 

​ Tears tugged at the corners of my eyes. Will the weatherman be the only one with her, when she takes her last breath? ​I refocused. “How is he doing? Were you able to visit the communities?”

​“They were nice, but that isn’t going to work for him. He needs a nursing home for rehab. The hospital helped find one that his insurance will cover, and he’s transferring there tomorrow.”

​We continued to talk about the specifics, and I promised to follow up with her in a few weeks to discuss the long-term options. I hope she will be here in a few weeks when I call, I thought as I spoke.

​She picked up on the first ring. My breath eased, and I felt my body relax a bit, grateful to hear her voice. She sounded brighter, billowing with hope. “Edward is graduating to the assisted living.” Her wings clipped as she fell back to earth. “I hope I made the right decision. There have been problems in the nursing home part.”

​“What problems?”

​“They can’t seem to keep any nurses, so they bring them in from an agency. It’s a new crew every day. I never know who to talk to. Last week, he ran out of his medicine. When I asked why, they said it was out of stock. Edward can’t function without his medication. I pleaded with them and even called the pharmacy myself, but there were no answers. Eventually I went to Walgreens and had it filled.” She stopped for a hacking cough that sounded like a train rattling through her chest. 

       I pictured Mrs. Donelson in the driver’s seat of an enormous Buick, head barely above the steering wheel, oxygen tank strapped in the passenger’s seat like a baby. I had to stifle a laugh. The sad truth was it probably took every drop of strength she had to get that medicine. My amusement quickly shifted to anger.  Couldn’t someone from the facility offer to go pick it up? “You have other choices for his care. There are lots of assisted living communities that have more stability.” I named a specific community that would be a good fit.  “Here’s another idea. You could bring him home and hire help?” I suggested.

​“I’ve thought of that and put some calls out, but my husband doesn’t want to change. This is one of the few options with a nursing home if he needs that in the future, and I don’t want to bring him home. He needs to get used to living without me.”

​ I can’t believe she is having to plan his life out like this.The incredulity of the situation hit me again like a splash of cold water to the face. “If you have these problems in the nursing home, I’m worried it will also happen in assisted living.”  

​“It’s just too tiring to continue the search. I want to stick with the plan and see how it turns out.” She wouldn’t budge, and I hung up, perplexed.

​ Why wouldn’t she want to consider other options? Perhaps their relationship was more complex than I believed. Regardless, she remained stuck, melting into a riptide of powerlessness, the very thing she feared.

​ Answer. Answer. Answer. Come on. I willed her to pick up the phone. 

​“Sarah, I’m so glad you called. It’s happened again. He is without his medication. He called me crying in pain ten times today. What should I do? Panic laced her voice as she spoke. Her composure thawing like an icy pond on a spring day. 

​I imagined her on the other end of the line, wringing her hands, brow creased, puffs of oxygen rushing into her nostrils. Maybe the lack of oxygen made her brain foggy and clouded her judgment. I wanted to shout, “Let’s look for a new place,” but was stuck in the same proverbial mud. Who was I to tell her what to do? I held the situation at a distance, avoiding any feelings that dared to override logic. Despite my own forbearance, I cared deeply about Mrs. Donelson.   

​This is not my problem. I can’t carry this burden. This is beyond my scope. My brain argued, trying to protect itself like a turtle retreating into its shell. “I suggest you call and ask to speak with the administrator. Surely they can sort this out.”

​“I called this morning, and no one has called me back.” She paused for a long time and I sat with her in the seat of helplessness. “Do you believe in God?” The distraught voice cracked on the other end of the line, and she began crying softly.  

​“Yes ma’am I do,” ashamed at the beat of hesitation in my voice. This is a recorded phone line. Be careful. You could get in trouble talking about God with clients. It crosses professional boundaries. 

​“Will you pray for me?”  

​I bit my lip, taken aback by the request, but I couldn’t stop the floodgate of emotions that erupted. My entire heart gushed out of my body and melted into a puddle at her feet to be lapped up like a thirsty dog. Pray for her now. The inner prompt tugged at me. Screw it. It doesn’t matter if this gets recorded.

​“Can I pray for you now?”   

​“Yes. Please.” She sobbed.

​I began praying in earnest. Words of petition, comfort, and hope ran out of me and through the line to her ears, where I wished them to settle into her spirit and replenish the empty cistern. “Father, we lift up Mrs. Donelson to you. You know the heartache she is experiencing. We know that you have the power to change this situation and to help Mr. Donelson get his medicine. I ask that you provide a way for that to happen. Please give Emily peace in her last days. Your word says that you give peace that surpasses all understanding. We don’t understand how you brought them to this point, but we trust that you are going to make a way and bring comfort in these times. In your name, we ask all these things. Amen.”

​Silence hummed as our tears and sniffles mingled together. I felt redness creep up my neck. Too much, Sarah. What were you thinking?  

​ “What a beautiful prayer. I feel so much better.”  

​Within minutes, we were off the phone and I started to reflect on what just occurred. Leaning back in my pink office chair, I closed my eyes, wiping away the tears with a wad of toilet paper that was a poor substitute for Kleenex. 

​My child. Today was a gift to remind you that it’s never wrong to share the love and compassion I’ve given you with others. The thought came to me clear and concise, as real as any conversation with a friend.  

​It feels good to be close to you, God, and obey your prompts. Please make a way for her.   

​ A few days later, I called to follow up.  

​ “I’ve worked it out. Walgreens has the medicine on automatic refill and is going to deliver it every month. I am so relieved that he can stay where he is.” 

​“How are you feeling?” 

​”Now that this is resolved, I am much better.”  My health has stabilized for the time being.”

​ We exchanged pleasantries, and I let her know she wouldn’t hear from me as often since he was settled. We didn’t breathe a word of our last encounter, a sacred moment only for that time and place. I marked the file closed, and with the click of a button, she was gone from my inbox, but I am forever changed.  

​Did God answer my prayer? Perhaps. I am not naïve enough to treat him like a vending machine. There are times my prayers aren’t answered as I have wished. The outcome of the Donelson’s trajectories won’t likely change, but my heart did. Maybe the point of prayer is to draw us closer to God, he is mysterious like that.  Through this divine appointment I learned to be a better vessel of compassion and tenderness, and I want to believe that Mrs. Donelson learned she is not alone in her sufferings.

​Many times over the past six months, I’ve wondered what became of the Donelson’s. Give her a call and see how they are doing. The thought of an automated voice on the other end of the line responding, “this number has been changed, disconnected, or is no longer in service,” leaves me sad. I can’t bear the knowledge, so I do nothing, content to place it in God’s hands, and grateful for the encounter that renewed my faith and compassion.