Her brother’s keeper – the story of a caregiver

My friend Pam was a tough girl, growing up as the youngest of 6 children in a strict, devoutly Catholic family. She was athletic, scrappy and loud – always laughing and finding humor in life. She was intense and focused in everything she did to the point of almost being intimidating. We grew up together in our tiny town of 500 people and were in the same class from kindergarten through twelfth grade; two of the 17 students in our class.


Pam’s closest in age sibling was Alan, who was some five or so years older than her. He was a tall, thin boy with dark, perfectly kept hair and thick glasses. Both he and Pam had inherited the family trait of very poor eye sight. Alan was a nice, somewhat shy boy who had an accident when he was very young that affected his speech and cognitive skills requiring assistance with both while growing up. As kids, none of us thought much about Alan being any different than the rest of us, he was just Pam’s big brother. What we did know was not to poke fun at Alan or say anything disparaging as Pam’s love and protection for him was fierce, and her wrath was not one any of us wanted.


Alan would graduate a few years ahead of Pam and move out of his parents’ house and in with one of his older brothers. After high school, Pam would attend university, get married and have three sons. I would see her occasionally, both of us coming home to see our families for the holidays or a rare class reunion. Mostly I would keep track of her as I did my other classmates, through the grapevine, which generally consisted of what my parents heard from her parents when they would run into each other at the local diner or grocery store. I knew from that grapevine that Alan had somewhere along the line moved in with Pam and her family.


Pam’s boys are raised now and have all moved on with their lives and Pam and her husband are close enough to retirement to see the light at the end of the tunnel. And while the boys moved out, Alan remained with Pam and her husband.


I learned a couple years ago that Alan had been diagnosed with cancer and while no such diagnosis is fair, Alan’s diagnosis seemed especially cruel in light of his lifelong challenges.


But Alan was a trooper through his treatment thanks in large part to the support of his family. In their true family spirit all five of his siblings and his dad supported Alan through his treatment. Pam would post a barrage of pictures and videos on social media and keep everyone up to date with the minutest of details about Alan’s health – and it was all done with humor and lots of laughs. Alan’s siblings were merciless when it came to humor – nothing was off limits.


Alan fought hard through every relapse, posing for pictures with a smile or a silly thumbs up gesture. He never complained Pam told me as Alan would battle for a couple years. He would be diagnosed with this type of cancer and that type, with one spreading here and another being “caught in time.” He was a warrior, but so was his sister as a caregiver.


During this intense time for Pam, I too was diagnosed with my own cancer and was fighting for my life. I was commuting some 3,600 miles round trip to a clinic that specialized in treating my type of cancer. I was overwhelmed, exhausted and scared to death. But every three or so weeks, without fail, I would get a smile in the mail; Pam would send me a card.


Nothing fancy or over the top and generally quite simple with artwork of a sun or a beach on the outside and blank on the inside except for Pam’s sweet words. She would write kind thoughts of me, about how she was thinking of me, how the weather was where she lived and always how she prayed for me. She, like Alan, never complained. She never told me in any detail of her woes of caring for Alan, of how much she had on her plate or how worried she was for her brother. Pam focused on me in her cards. She made me feel during those moments of reading her words, that there was nothing else of concern in her world except me.


I did my best to return Pam’s kindness and generosity but I fell miserably short, only sending her a few cards, asking about Alan occasionally in a text, or posting a sad face emoji or “Praying for you” statement on her timeline following an update she would post about Alan’s health. I was not near the friend to Pam during her difficult times with Alan’s cancer that she was to me during mine.


I would learn yesterday that Alan had suddenly succumbed to his cancer. I was stunned. How had I not known that he had gotten that sick? How had I not paid enough attention to know his time was now? Pam was always there for me when I needed someone, never failing me with her recognition through her cards. I on the other hand, had again come to realize I was not the kind of friend I wanted to be.


I would speak with Pam shortly after Alan passed away and she would tell me she felt as if she had failed Alan, “I was supposed to be his protector” she said, “But when he said to me, ‘Pam, I can’t do this anymore,’ I knew I had to let him go.”


I was shocked that this woman whom I had known all my life, who was tougher than most, confident and fierce, been her brother’s keeper and his caregiver through his cancer journey felt that somehow, she had fallen short. Yet what I saw was a hero.


For years she had put the needs of others before her own, caring for those around her, never stopping even when her kind gestures were not reciprocated. Pam shed light again for me on how special caregivers are with their selfless and kind acts when we patients are frustrated, overwhelmed and worn out with our fight. I believe there is a special place in heaven for our caregivers.


Rest in peace, Big Al.