Dr. Richard Zalar was talking to his wife, Gertrude.
“Come on, darling, come on, baby,” he said as he walked her haltingly toward the bathroom. “Come on, sweetheart, sit down.”
Trude Zalar was not talking back. She was staring straight ahead, her face frozen. She looked stern; she looked absent.
She looked like what is left in the wake of the tornado of Alzheimer’s disease.
She has not spoken in three years. She shows no expression except an occasional grimace. She cannot dress or feed herself.
Her husband of 54 years does it for her. Every day, inside their Joliet home, Zalar, a retired physician, feeds her, washes her and dresses her. With the rarely accepted help of a housekeeper and a nurse’s aide, he does the endless, heartbreaking work of maintaining his wife’s health and humanity.
Zalar, 76, a tall, rangy man given to blunt talk and occasional swearing, knelt on the bathroom floor. He wrapped a length of dental floss between his fingers, reached into his wife’s mouth and began flossing her teeth.
Certified nurse assistant Roseanne DeLaFuente watched in frustration and awe.
“He brushes, flosses and somehow gets her to rinse,” she said. “Then he brings the little chair over, sits her in front of the sink and washes every part of her body.
“Even with me here — I could do that, but he wants to do it. Trude is his whole world. His whole life.”
Zalar finished brushing and attempted the rinse. “OK, open up, don’t swallow,” he tried, then sighed.
“Well, sweetheart, you swallowed the damn stuff,” he said. “What are you going to do.”
But the real question has been what Zalar is going to do.
– – –
The question began to form in 1993. One day, Zalar found his wife crying in bed.
“I said, `Why are you crying, baby?’ ” he said. “She said, `I can’t find my ring.’ “
It was her engagement ring. Zalar bought her a new one, then happened to open her jewelry box. There were two engagement rings inside.
He took her to the Mayo Clinic. They left with a diagnosis of Alzheimer’s, and a sense of foreboding.
She turned belligerant, once coming after Zalar with a kitchen knife. Then she grew quiet. She began to stare into the distance. She stopped saying anything but “Yes?” and “Really?” interjected randomly at the end of other people’s sentences.
Then one day in 1995, she said “Yes?” one last time.
“Then nothing,” Zalar said. “She hasn’t said a word to me since.”
– – –
Taking care of Trude, who turns 78 in three weeks, is an unceasing job.
Feeding her takes an hour and a half. Dressing her is complicated because she has a tube in her abdomen, draining a blocked kidney. The bandages around the wound must be changed regularly, and she must be watched carefully because she is unable to tell anyone if she is in pain.
Getting her out of bed is so difficult, said their son, Dr. Richard Zalar Jr., an obstetrician/gynecologist who lives near Los Angeles, that a nursing home probably would not even attempt it.
“The fact that she is eating and walks in the living room is just a result of his care at this point,” he said.
Zalar tried putting his wife into several nursing homes but took her back every time. At one, which specialized in Alzheimer’s patients, she fell and fractured her skull. At another, Zalar found her sitting in soiled undergarments.
He views most nursing homes with contempt and feels certain that he gives her far better care at home.
When she awoke one morning with a severely distended belly, for example, Zalar examined her and found a mass in her kidney that turned out to be evidence of the blockage that had to be drained.
“If she was in a nursing home, I don’t think she would be here today,” he said.
Zalar directs every conceivable aspect of her care. When the strap holding the urine bag she wears kept slipping down her thigh, Zalar invented a belt that anchored it to her waist. When her bra hooks dug into her fragile skin, Zalar bought her a hook-free sports bra, in the process developing a remarkable familiarity with modern female undergarments.
“Now I’m going to the tube bra,” he said breezily. “It slips over your head; there’s nothing to it.”
No decision is too small for Zalar to make, including the choice of his wife’s knee socks.
“Yellow, doctor?” Delafuenta asked, holding up a pair.
No, he ruled, green.
The burden is exhausting, but he insists on shouldering it personally. Delafuente and live-in housekeeper Bernadine Lewis urge him to let them watch Trude for a while, but Zalar usually refuses.
“I’m always afraid something will happen,” he said. “I don’t know what I would do if something happened to her and I was gone. I would go out of my mind.”
“You can’t persuade him,” his son said. “At this point, he doesn’t care about anything but her.
“He doesn’t want to take time to do anything else. He doesn’t even want to go get a new pair of shoes. He has become withdrawn from the other people he knows. Everyone is aware that it’s just him and her right now, and that’s it.”
– – –
To know what Zalar does begs the question of why he does it.
It is only partly because he feels that he can give her better care than anyone else. It is also that he can’t bear to be separated from her.
“We were just two peas in a pod,” he said. “I don’t know what I would do without her.”
She is an echo of the woman he married. But he vastly prefers the echo to silence.
“I suppose we’re as close as we could ever be,” he said. “I enjoy holding her, I enjoy touching her. I sit next to her and hold her hand. I kiss her on the cheek.”
The possibility that she might die fills him with terror.
“I just think really I’m too attached to her,” he said. “If she does die, I don’t know what to do. I want to die with her.
“It’s probably a fixation with me, that I can’t let go.”
Zalar Jr. thinks his father is driven by a mixture of love and gratitude, both for being his wife and for raising their son and daughter.
“Mothers have always been important to him,” he said. “His own mother died when he was 3. He was the youngest of six brothers and sisters. They put him in an orphanage for two years because there was no one to take care of him.
“Plus they were a good team; they had a good marriage.”
“They were very close,” said their daughter, Barbara Judy Wesoloski, who lives with her husband and two children in Wheeling. “They did everything together.”
They lived in a big house in River Forest and were a classic 1950s family. Zalar practiced general medicine in Chicago’s Austin neighborhood and then internal medicine in River Forest, Oak Park, Elmwood Park and at Loyola University Medical Center. Trude Zalar raised their son and daughter, volunteered at their schools and ran a meticulously organized house.
“Greenwich Mean Time set their clocks by when my mother had dinner on the table,” Zalar Jr. said.
She also turned out to be something of a financial whiz, to her husband’s good fortune.
“She basically built his retirement plan with their investments,” their son said. “He made the money, but she made more money.”
But to Zalar’s dismay, it was only when she entered a nursing home and he went through her belongings that he felt he really knew her.
There he found her documents from Joliet Township High School — a report card showing a 92 in the first semester of freshman high school English, a citation for exceptional honesty, a grade point average of 4.1.
He found poems she had written, notes from courses she had taken as an adult in etymology and French and paintings she had made while studying art. He also found all 347 love letters they had written to each other during the two years of their courtship.
“I found the registrar’s note from high school. She was ranked 38th out of 570 students. I was 92nd,” said Zalar, still awed. “I thought, here is a woman who is brilliant. What am I doing with her?
“I didn’t know she saved these things; I didn’t know she wrote so well. You live to this age, and you don’t know anything about your wife.”
Now that he does know, he is tireless in his determination that others know as well. He wrote a manuscript of a biography of Trude. He had a 90-minute videotape made about her life. He had one of her poems printed in a vanity book.
He had 500 postage-size stamps printed with her picture on it, sent 10 each to 50 friends and asked them to use them on their holiday mailings so that even more people would see how lovely she was.
“I guess its his way of honoring her, really,” said Wesoloski. “He loved my mother. He wanted to pay a tribute to her.”
Zalar’s late-in-life awakening, his son believes, helps fuel his determination to take care of Trude.
“I’m not sure how guilty he feels over not appreciating her at the time,” Zalar Jr. said.
– – –
If Trude has fallen silent, Zalar is anything but.
He is a tireless letter-writer to newspaper and public officials on a variety of public issues. His efforts have helped make his name known in the Joliet area, along with the fact that his father was a longtime member of the Will County Board.
Now he has applied his outspokenness to his wife’s cause. He has complained vociferously to nursing homes where he thinks she was neglected. He calls Alzheimer’s researchers in desperate search for treatment. He takes her to doctors, consults specialists and examines her frequently himself.
“If she just turns her head the wrong way, I’m going to the doctor with her,” he said.
“I’m a difficult guy to deal with,” he added, without apology. “I demand things for her.”
Furious at what he considers an absence of good nursing facilities for Alzheimer’s patients, he has proposed building one himself.
He wants to construct a 100-bed nursing home where residents would live in pods of 20, surrounded by trees, ponds, music and staffers specially trained to treat people with dementia. It would be built on 10 acreas of Joliet land that he said has been donated by a local real estate agent whose wife has Alzheimer’s. And it would be named for Gertrude P. Zalar.
For two years, Zalar has written flurries of letters to Alzheimer’s experts and public officials in support of the project.
“He’s contacted everybody, I think — anybody that would have any interest in this,” said Joliet Mayor Arthur Schultz. “He is very, very dedicated to his wife.”
But his efforts have come to naught. He would have to get a Certificate of Need from the state’s Health Facilities Planning Board to build a nursing home. But because the board has determined that there are already 192 empty nursing home beds in Will County, it has so far refused to grant the certificate.
Zalar has tried to get a waiver by countering that the empty beds are not in a facility specializing in Alzheimer’s. Besides, he said, the state should not be in the business of preventing private developers from starting businesses.
The state controls the building of new nursing or hospital facilities as a way of controlling health care costs, said Thomas Schafer, spokesman for the Illinois Department of Public Health.
– – –
To Zalar Jr., his father’s extraordinary efforts on his mother’s behalf pose a philosophical dilemma: His heroic efforts may help her avoid death now, only to bring her weakened body a harder death later.
“He can overdo it as well by keeping her going,” he said. “You have to die of something. But sometimes, the care can foreclose ways to die that might be better than others. It isn’t like there’s a none-of-the-above option. It’s going to be something.”
“I worry about that all the time,” Zalar said. “I’ve been told that all the time: Why are you doing this? I can’t say. Just because.”
Zalar’s children worry about him. “I know all this care is taking its toll on him as well as my mother,” Wesoloski said.
Zalar’s greatest frustration is that he has been helpless to slow the disease; the physician has failed to heal his wife.
“I do nothing for her,” he said fiercely. “If I could get her a pill, or something. . . . But I can’t do anything. Zip. Zip for her.”
Yet this is how he wrote about these hard days in his manuscript about his wife:
“How else would I be afforded an opportunity to support her in these trying days of her last illness if she was dependent on another source for that aid?
“How else would I be able to enrich our love affair, as has been my good fortune in these past four years?”
He found what some would find an odd way of describing himself under the circumstances: Lucky.
