Everyone Needs an Advocate

And there's nothing like an adult daughter...

My father-in-law, Len Mahon, contracted COVID several years ago. Already in his 80s, he had spent a career working in and around West Virginia coal mines. Like so many, he had ‘Coal Worker’s Pneumonconiosis,’ popularly known as ‘black lung.’

My wife and I found him one afternoon with cold symptoms and a fever, napping in the middle of the day…an unusual thing for a man who had always been a non-stop force of nature. (His wife Carma, my wife’s mother, had also been so afflicted but not to the same degree.)

The illness then made Len cough more forcefully and left him increasingly short of breath. We knew, before testing him, that he had COVID. It was in the time of the pandemic, and the infection was raging. It was also in the days when the vaccine was just being rolled out.

When we took him to the local emergency department we found that his oxygen levels were already dropping. He was admitted and was subsequently intubated (a tube placed into his trachea to support his airway) and placed on a ventilator.

It was a dicey affair for the next two weeks. He seemed to improve and was taken off of the ventilator but was unable to maintain his oxygenation. He was then put back on the ventilator once more.

The hospital staff, nurses, physicians and respiratory staff were magnificent. Many were former co-workers of mine at Oconee Memorial Hospital, Seneca, SC. They were ever kind to Len and the entire family as we waited, trusting God, professionals and science to do their best.

Two weeks into his illness he managed to come off of the ventilator. But weak didn’t fully describe his condition. He could barely speak, couldn’t swallow and couldn’t stand.

The assessment by physicians and therapists alike was not hopeful. My wife was told that her father would likely never walk again and might not ever be able to eat solid foods. Quite a kick in the gut for a long-time meat and potatoes guy.

A stubborn Irish-Appalachian, like her greater Mahon clan, Jan did not take this well. That would not do for her daddy.

A trip from the hospital to rehab, however, was not much more encouraging. The family was advised to expect very little and to get used to wheelchairs, ramps and boards to slide in and out of the car.

Finally Jan had had enough. She was his advocate from the beginning but she kicked it into overdrive.

She insisted on home speech therapy which worked wonders. He could speak, eat and drink. No more of the agony of ‘thickened coffee,’ a tool of torture to be sure.

And she began her own form therapy. Now, Jan is a counselor by training. This matters because she knows how to push back against despair; how to keep a person from spiraling into their own hopelessness.

But she is long-time believer in weight training who knows, personally, the value of fitness. About thirteen years ago she navigated a nasty cancer, followed by a life-threatening pulmonary embolism. Her underlying fitness helped carry her through that difficult time.

Jan began her own program of rehabilitation at home. Beginning with simple exercises, she moved her father steadily through resistance in the chair, brief standing exercises, even the seated use of dumbbells. She was not giving up. She took him and her mother back to the gym.

Eventually, Len was able to stand and transfer to chairs, even into the car, without use of any special devices.

About a year later, he was at the Kennedy Space Center, on a Florida vacation with the extended family. The wheelchair was still useful, but he wasn’t bound to it for all locomotion.

Jan continued to push her her father. In fact, in the years prior to his illness she had been taking both parents to the gym, twice a week, and encouraging them to walk the treadmill and lift weights. It was not uncomon for either of them to leg press about 270 lbs, not bad in your 70s and 80s! I suspect that this ‘pre-illness training,’ in no small part, set Len up for survival, just as it had his daughter.

In time he resumed walking, without cane or walker. He began to mow his lawn again, to drive and even golf. He has recently had some setbacks, but for an 86 year old man who survived COVID, he’s really doing remarkably well.

And I cannot help but attribute much of his success to the fact that he had, and has, a tireless, stubborn advocate in my wife, his daughter. She has never accepted less than the best for those she loves.

Why does this matter? Other than being a wonderful story of how to ‘honor your father and your mother?’ It matters because so few people have their own advocates. So few have anyone who will stand for them, fight for them, invest time, energy and money for them.

The world of the ER, which I inhabit, is full of those adrift. They are poor, or old, or sometimes even very young (children and adolescents need advocates, but we more readily realize that).

Those we see are homeless or alone. Their families are too often disasters. They are addicted. They are barely functional. The state does its best but we have far too few social workers and they are far too overwhelmed. Nursing homes are closing, and yet the need is exploding. Many people need them due to age, infirmity, mental illness, dementia, other disability or the ravages of substance abuse. Social workers are up to their tear-stained eyeballs.

But it isn’t just about nursing homes. I’m writing about those who simply aren’t fully capable of caring for themselves or of navigating even a minor illness or injury while facing life all alone. There’s a swelling tsunami of individuals who have no one to argue for the care they need when they are ill. They have no loved one to monitor their course when they are hospitalized. There isn’t anyone to ensure that they have home health when discharged. They have no champion to fight with insurance agencies, to get them to doctor’s appointments or pick up prescriptions. No one to ensure their home has water, food, power or basic hygiene.

The sad, hard fact of modern illness, injury and aging is this: without a passionate advocate, you’re in trouble. And it isn’t getting better anytime soon.

Further, our culture increasingly views child-bearing as problematic, as too expensive, or dangerous (as if it ever wan’t those things). Because of this, ever more persons in the west are embracing childlessness. Thus the future will be replete with those who have no intercessor with any connection more significant or passionate than the minimum required by their jobs and by state law.

My father-in-law was one of 17 children born in rural WV. Twelve lived to adulthood and have been fiercely devoted to one another as long as I have been part of this family. My wife is one of four children, all of whom love and care for their parents and one another. All are advocates.

As they grow older, as time passes, they can all view their father’s success, his added years, the holidays and birthdays and Sunday dinners and all the rest as the result of living life in the intricate web of family and with the gift of advocacy.

And it was never modeled better than by my wife, his daughter, Jan Mahon Leap.

Way to go baby. You nailed it.