WHEN DOCTOR’S ORDERS
ARE TOUGH TO OBEY

Journal of Healing – Dec. 14, 2005

By Mary Koch

  It has taken some time to sort through my emotions before I could write about Jimmy Chastain, who died Nov. 12. I’m experiencing the usual components of grief – sorrow, frustration, anger and a large dose of survival guilt – all for a young man I never met.

            I’d looked forward to meeting Jimmy someday. He sounded like a Georgia good ‘ol boy, and I mean that as a compliment. A Gulf War veteran, former iron worker, solid Republican, Jimmy owned an excavating and grading business. He loved to hunt and was a familiar sight driving around Blue Ridge, Ga.,  with his dog Buddy at his side.

            I met Jimmy’s wife Stacey more than three years ago through the Internet. Even though she’s 30-or-so years younger than I, we had a lot in common. She was a small-town, weekly newspaper editor, as I had been. We were both married to men who were diagnosed with locked-in-syndrome following brain-stem strokes. Their active minds were locked inside bodies that could not speak or move.

            Over the years, Stacey and I poured our hearts out to each other via e-mail, but we never talked on the phone. So when the phone rang that Saturday evening and I heard in a soft Georgia accent, “This is Stacey Chastain,” I knew immediately that Jimmy was dead. He was 37.

*     *     *

            IT’S DIFFICULT for me to reconcile the differences between Jimmy’s treatment following his stroke four years ago and that of my own husband. John has thrived, living at home these 12 years since his stroke.

            Stacey would have loved to care for Jimmy at home and would have done beautifully. But it requires a lot of support and money. The holes in the Georgia safety net were too large. Jimmy and Stacey sold his business and their home. They gave up their beloved dogs and eventually Stacey was forced to quit the demanding job she’d loved.

            Jimmy lived in a succession of nursing homes and hospitals, sometimes hundreds of miles away from Stacey, while Stacey advocated – no, battled – on his behalf. A paralyzed patient is at high risk in an institutional setting because of exposure to all the bugs that inevitably circulate. Each infection further compromises an already weakened system.

Jimmy was in a V.A. facility when Stacey first wrote to me. She had documented his inadequate care, and the facility administrators insisted that she take him elsewhere. Ironically, Jimmy was proud that the last project he’d worked on was a veterans’ memorial park.

*     *     *

            LAST YEAR Stacey finally found a nursing home that would accept Jimmy just a few miles from Blue Ridge. She praised the staff’s care and concern and rejoiced when Jimmy was moved into a private room, reducing his exposure to germs. But the constant pneumonia, urinary tract infections and intestinal blockages continued to take their toll.

            Stacey was especially proud that Jimmy stayed involved in directing his own care, which earned him the nickname “Dr. Jimmy.” On Nov. 7, Dr. Jimmy gave his final orders: no more tube feedings, no more interventions.

            “He said he was tired of hurting,” Stacey e-mailed. “It was a difficult decision to support, but we all did.”

            I asked Stacey for permission to write about Jimmy and his decision.

            “I think Jimmy is smiling that you would like to share his story,” she answered.

            I’m glad to make Jimmy smile, and I’m glad to share his story. Jimmy’s story will stay with me the rest of my life, as I struggle to understand.

  © Mary Koch, Omak, Washington 2005