Monday, January 16, 2012

A family learns the true meaning of the vow “in sickness and in health” - The Washington Post

The dark-oak farmhouse table where Page and Robert Melton spent many a dinner hour is now laden with vases and framed pictures, fragile pieces of their life together that have to be tucked into cardboard boxes. The movers are coming in the morning and, with much still to pack, Page thinks she could be looking at another all-nighter.

She picks up a sepia-toned drawing of blackbirds. They gave each other art in the early years of their marriage, and this was the first thing Page had given Robert. Next, a photo of Robert standing in front of the Virginia statehouse, looking every inch the formidable journalist he was, a guy who could intimidate colleagues with a dipped chin and glance over wire-rimmed glasses.

The next photo is one of her favorites: Robert with family members by the porch of their homey Dutch colonial in Richmond on the morning of their younger daughter's christening, in September 2002. A brilliant fall day, it was exactly one year before the heart attack and collapse that left the 46-year-old father of two with a brain injury so severe he would eventually live in an assisted living facility. How often Page had stared at that photo. Was he ill then? she'd wonder. Was there something she could have seen? Should have seen?

Page shakes off the thought and rolls bubble wrap around the photo, much as she has tried to cushion the hard edges of the part of their bifurcated life they refer to as "after the injury." Robert had come a long way since 2003, when he looked at his wife sitting by his side in the hospital and said, "You seem like a nice lady. How come you're not married?" She had gone home that day and put away the diamond and emerald ring he had given her when he proposed. Looking at it made her too sad.

Seven years later Robert was still mentally impaired and his personality far different than before the accident, but he knew his family, knew he had had a brain injury that upended their lives, and asked lots of questions. He carried with him at all times a reporter's notebook, in which he had written the information most important to him: his daughters' ages — 9 and 11 — and that he has "known my honey" 18 years.

He could remember snippets of his pre-injury life — the made-up song he and Page sang to their girls, his nicknames for colleagues, that he had been an Eagle Scout. And though he still broke Page's heart every day with a sweet and childlike simple-mindedness — repeating his plans to "take meds, wash hands and brush teeth" like a mantra, or excitedly announcing that he'd won a candy bar at a penny toss "and didn't cheat at all" — once in a while, he would say something insightful and completely on point.

Just days earlier, at the Sunrise assisted-living facility where he lived for several years, Robert had looked at Page with earnest eyes and the relaxed demeanor he used to have and asked if it was hard for her to pack up the house: "Does that cause you distress, darlin'? Make you sad?" Page took his hand, and her eyes filled with tears. "We had the best days of our lives and the worst days of our lives in that house," she said quietly. "So, it's very bittersweet to leave it."

"It is bittersweet," Robert echoed.

The girls were so young when Robert fell ill — Hope was 3 and Nell 18 months — that Page was the only one of the four who remembered those days. Page alone knew that Robert loved to work in the yard and tend the azaleas. Or that he liked to write his weekly Virginia politics column in the garage. Or that he held Hope on his lap as he read the New Yorker, letting the quiet daughter who was so much like him point to letters she recognized.

Page was the only one who remembered the day in September 2003 when, just home from the hospital after the heart attack, Robert hugged her in the kitchen and told her everything was going to be all right. Or the moment a day later when he collapsed and stopped breathing.

Wrapping up the contents of their home on the eve of moving day — and the beginning of a new chapter in their lives — Page couldn't help but reach back to those best and worst of times, and one other memorable day:

On a Saturday morning in the spring of 2010, Page had arranged for Robert to come home from Sunrise for breakfast. She had asked Robert's brother Will to drive down from Annandale to be with them and sent the girls out for the morning with Allan Ivie, a friend from childhood who had come back into her life. She had consulted with Robert's doctors and her minister. She cooked up some eggs. She was nervous as she sat down at the big oak table next to her husband of 16 years.

Then she had a conversation with Robert she had never imagined she could have.

* * *

During the eight weeks Robert Hamilton Melton spent at a rehabilitation hospital in Hanover, Va., after his brain injury, he would often pick up a notepad and pen, wander into another patient's room and start talking. Before he remembered anything about his personal life, he remembered he had been a reporter.

Writing under the byline R.H. Melton, Robert, 54, had built his career at The Washington Post, where he worked since 1982 as an editor and a reporter, primarily covering politics in Maryland, Virginia and the District. (He was a colleague of and became a close friend of my husband's.) He was considered the institutional memory, a thoughtful editor and an elegant writer who was often the go-to guy on breaking stories.

In Richmond, where he worked during the final years of his career, he broke stories that rattled the political landscape: One led to the resignation of the speaker of the House of Delegates in 2002, and another resulted in the federal conviction of a former executive director of the Virginia GOP. The Post nominated him for a Pulitzer Prize for beat reporting that year; in 2009, he was inducted into the Virginia Capitol Correspondents Association Hall of Fame.

At 6-foot-5, Robert was an imposing presence, both supremely self-contained and reserved. He listened more than he talked, and he didn't mind that he intimidated people.

"He could be very haughty and very snide," Bob Lewis, a reporter for the Associated Press in Richmond, says affectionately. "He did that to new people, just to see if they could roll with it. If you let it get under your skin, you failed the Robert test."

But beyond the tough exterior was a wickedly funny and loyal colleague and friend.

Growing up in Springfield, the second of five boys born to Mary Hope, a homemaker, and Eston Melton, a chemical engineer, Robert had a knack for language from an early age. At Annandale High, he worked on the school paper, as he did later at the University of Virginia, and, at 17, won a statewide oratorical contest with a defense of the First Amendment.

Page Boinest, a Richmond native and fellow graduate of U-Va., had met Robert in the mid-'80s when she was a junior reporter with UPI helping cover a special session of the Virginia legislature. Through the years, the two crossed paths, and friends even set them up on a date, but they didn't hit it off. Page found Robert private, hard to get to know.

In 1990, Page left UPI to join the staff of then-Maryland Gov. William Donald Schaefer, first as his speechwriter, later as his press secretary. At a business dinner in Annapolis with Robert in 1992, something changed. "I don't know how to describe it, but there was this chemistry between us — it had never been there before," says Page, now 51.

Married in 1995, their life together was a carefree mix of travel, work, politics. Their first daughter, Virginia Hope, was born in 2000, followed two years later by Nell Hamilton. On that day in April 2002, Robert handed their new baby girl to Page. "Now our family's complete," he told her.

It was the happiest day of Page's life.

* * *

On its destructive path up the East Coast in September 2003, Hurricane Isabel ripped through central Virginia, downing trees and leaving thousands, including the Meltons, without power for days.

From his office near the Capitol, Robert was writing story after story about the devastation. He had spent days clearing out his own back yard and was surprised at how tired the work made him.

He was working at his office on Saturday, Sept. 20, when his chest started to hurt. He thought perhaps he had eaten bad salami for lunch, but since he'd had a heart scare before — in 1997, he had been hospitalized with an irregular heartbeat — he walked across the street to the emergency room at the Medical College of Virginia, now Virginia Commonwealth University Medical Center. He was having a heart attack.

On Monday, doctors implanted a stent in one of his coronary arteries. Two days later, on his 46th birthday, he was allowed to go home.

A day later, the power finally came back on in their home. Robert and Page were in the kitchen when Robert pulled his wife into his arms and reassured her: "Everything's going to be okay now. We got the power back, and I'm home."

But the next day, Friday, Sept. 26, at about 4 p.m., the life they had known ended. Page was making dinner. Nell was in a high chair at the dining room table. Robert bent over the chair to scoot it in and suddenly dropped to the floor.

The children started screaming. Page called 911. Robert was barely breathing — then stopped. Page tried CPR. Neighbors came. Power crews in the area came in and tried to help. Page remembers a big burly man holding her 18-month-old. Still no ambulance. A sheriff's deputy came in and tried to revive Robert.

"He was gone," Page says.

Finally, after a half-hour, the volunteer rescue squad showed up. There had been so many cases of chest pains because people had been out clearing their yards that the emergency crew was stretched thin. Page jumped into the ambulance, and it headed to Henrico Doctors, the nearest hospital, about 20 minutes away. Henrico was overflowing and tried to divert the ambulance to MCV downtown. Page screamed at the driver: No, he'll never make it if you go downtown — just go to Henrico Doctors.

The driver did. But Robert had been down for about 45 minutes. When the cardiologist came to talk to Page, he told her, "I can revive him, but you're not going to want me to."

She had to decide on the spot. "Bring him back to me," she told the doctor. "Bring him back to us."

After about 20 minutes, the doctor came out. Robert was in a coma and on life support. The collapse was likely caused by a blood clot thrown off by the stent, doctors said, and Robert would either not make it, survive in a persistent vegetative state or, best-case scenario, come back but not resemble the man she knew.

After three days, Robert woke up. He was talking, mumbling, whispering, but none of it made sense. He didn't know who anyone was. Still, nurses told Page stories of miracles, people who came all the way back. She clung to those.

Doctors told Page that most of whatever progress Robert would make would be in the first year; the lack of oxygen to his brain had caused hypoxic-ischemic brain injury, moderately severe.

Robert spent several weeks at Henrico Doctors, where he had a defibrillator put in, then was transferred to a rehabilitation hospital. He'd had little physical impairment, but his cognitive loss was profound. He had severe language problems, couldn't sit still, was confused and frustrated to the point of violence. And he had no memory — short- or long-term.

The therapists tried all sorts of tools for dealing with the memory loss. They made him a "memory book." They made him lists. One gave him a PalmPilot. Nothing worked. Then one day, Page brought him stories he had written, newspapers, reporters' notebooks, his tape recorder.

He picked up one of the pads, started writing in it, and popped it into his back pocket. For the first time, he remembered something: "I was a reporter. I was a writer, wasn't I?"

After a month in rehab, Robert spent eight weeks at a residential facility for brain-injury patients in North Carolina. By January 2004, he had made enough progress to go home, but after about five months at home, the progress slowed.

He could speak and read and write, but he couldn't hold onto the meaning behind words. He had little judgment or control over his behavior and was increasingly frustrated. "He didn't remember his former life," says Page, "but he knew it was something more than he had at the time."

Doctors told Page that Robert would benefit from someplace with regular activities and a set schedule — a routine that was difficult at home with two small children — as well as caregivers to manage his medications and his own space to recover in. The only long-term choices were a nursing home or an assisted-living facility.

"At that point, it was like the dream died," Page recalls. "It was very hard, because when Robert came home, you have this not-even-rational thought that, 'If I just love him enough, he'll get better.' "

There are not many brain-injury patients at assisted-living facilities, not many healthy 46-year-olds bounding around with lots of energy. So the Meltons had to make it up as they went along when Robert entered Brighton Gardens in Richmond.

The first year was difficult. Robert's presence unsettled the older, feebler residents. He would complain to Page that bingo was boring or that there wasn't much to do. He struggled with his temper.

But, over time, the routine began to ease Robert's anxieties and help him function.

A checklist on his medicine cabinet, "Robert's Recipe for a Handsome Husband," reminded him to shower, shampoo and shave, and caregivers — as well as a companion Page hired to provide stimulation — helped him accomplish those tasks. He ate meals at the same table with the same group of men, all decades older than he.

Eventually, he started to embrace the activities — from beading to Bible studies, even bingo — and slowly his irritability evolved into a warm, jolly nature.

"At some point, he just gave himself up to it," Page says. "And that was huge to me, because I was beating myself up about the fact that he wasn't at home anymore."

Page visited Robert every day at first and eventually every other day, and the girls came for lunch every Saturday. When Brighton Gardens was sold to another company, Robert moved to Sunrise along with much of the staff, which had grown to love him and his family.

Today, he looks healthy and fit, and walks with confidence. Page makes sure he dresses well, and glasses at the end of his nose still give him a professorial look. But within seconds of meeting him, it's clear his mind is impaired. It's hard to know how much he comprehends, even when he answers a question. Conversations are limited and disjointed.

He sometimes latches onto the sounds of words rather than their meaning — saying, "Give my regards to Broadway," for instance, when he's told a friend "sends his regards." He often falls back on stock phrases or song lyrics.

The most striking thing about Robert is his personality. Once reserved and a bit aloof, Robert today is talkative and exuberant. He seems to spill over with wide-eyed joy and gratitude. He calls everyone "darlin' " or "babe" or "bro.'"

"Mabel, I cannot thank you enough for that toilet tissue," he'd say to the short Colombian woman who cleaned his room at Sunrise.

His outsize gregariousness — a reflection of an "organic personality disorder," says Nathan Zasler, his brain injury medicine specialist — enlivened the quiet halls full of wheelchairs and walkers there. As did his family.

Once, Page brought in leis and sunglasses, and grass skirts for the girls, so the four of them could lip-sync "Cheeseburger in Paradise" at the Sunrise talent show. "We brought the house down, didn't we?" she says to Robert on a later visit.

It sparks something else. "Do you know what I remember?" he asks Page. "I remember the Sailboat Song. Did you come up with that, darlin'?"

It was the made-up song they sang to their daughters at night.

Sitting together in the assisted-living home, Page starts to sing it softly, and Robert joins in, tapping time on the table and staring off into the distance:

All I want is a sailboat day. And we'll head toward the Chesapeake Bay. And we'll laugh all the way. Oh, won't it just be wonderful.

"After my injury, did the girls ever join in the chorus, hon?" Robert asks.

"I don't know," Page says. "But after you were in the hospital, I kept singing it, because it reminded them of you."

More …

http://www.washingtonpost.com/lifestyle/magazine/a-family-learns-the-true-meaning-of-the-vow-in-sickness-and-in-health/2011/11/04/gIQAahyAdP_print.html