March 2024

Winter’s Solitude

Littleton, NH, lies on Route 302, near the Vermont State line. The blue-collar town is divided by the Ammonoosuc River, which flows from Mount Washington, some 20 miles away. In the spring, the river becomes a home to whitewater canoes and kayakers, as there are frequent rapids from Twin Mountain to Littleton. 

Seth Holcomb came to Littleton as a young physician fresh out of his Beth Israel Hospital residency in Boston, MA. He was a rising star with a bright future in research and academic medicine but chose another route. He was drawn to rural areas, which provided exciting recreation and a place to raise a family. His wife, Mary Ellen, shared his vision, and the two set off for Littleton, unsure what they would find.

For fifty years, Seth practiced medicine, and Mary Ellen worked alongside him as his office nurse. A talented man with a friendly demeanor, it was no surprise that Seth became a popular doctor in a town with few healthcare professionals. Did he make a fortune? No, he didn’t, but he loved his lifestyle. He enjoyed hiking, skiing in the White Mountains, and spending time with his children, Joshua and Kathy.

He remembered the day well. He had finished talking on the phone with his daughter, a chemistry graduate student at Duke. It was snowing lightly out, and the river had partially iced over. It was bitter cold outdoors, with the thermometer reading 8 degrees, when he walked to the kitchen to have coffee with his wife, Mary Ellen. 

Two things took him aback. First, she stared blankly at a wall, and then there was the memory problem. This had been going on for a while, but he could not kid himself that it had been getting worse. When Mary Ellen couldn’t remember the school that his daughter was attending, Seth became alarmed. He realized he’d been in denial and that something was very wrong. He would have to arrange an evaluation at Mary Hitchcock Hospital at Dartmouth College in Hanover as soon as possible.

The evaluation at Dartmouth confirmed what Seth had thought. His beloved wife was descending into darkness. At some point, Alzheimer’s would take over, and most likely, Seth would become like many of the strangers passing through their mountain town. Though an independent man, Seth didn’t look forward to being alone.

Over time, Mary Ellen Holcombe’s memory faded. She could remember where she went to High School but had trouble with friends’ names and last night’s dinner. Seth was healthy and fit and wanted to keep his wife at home as long as possible. He brought in high school students as companions some days to see patients, but he usually felt guilty doing so. 

Over time, he became depressed, a mood that he was not familiar with. He couldn’t see any meaningful future for Mary Ellen, and he could see nothing ahead for him. He dreaded the idea of moving to some facility with his wife, but on the other hand, he could never abandon her. A friend from medical school suggested that he talk to a therapist. There were few in Littleton, and he knew all of them through professional transactions. He decided to consult with a psychiatrist referred to him by a colleague. The man lived in Boston, and their sessions would be conducted over Zoom. However, Seth drove to Boston for an introductory meeting for the first session. He liked the man, and he felt he could be helpful.

After several sessions, Seth took a risk. He told the therapist that some days, he wanted to slap his wife, get in his car and drive West. Once, he even hoped that he would come home and find her dead. He was shocked at these thoughts, which were 100% in conflict with his nature and vocational oath: Do no harm. He was punishing himself all day for having the thoughts, but he couldn’t stop them from coming. He asked the therapist, Am I a terrible person?

The therapist smiled to himself. Now, they would get somewhere.

Therapist:  Tell me more about your thoughts.

Seth:  I never verbalize them, but inside, I am angry and hateful. I want my life back, and I want her to leave!  This isn’t fair. I have been taking care of people my whole life. When is it my turn?

Therapist:  If someone is robbed, how would they feel?

Seth:  But dead? Hate? Come on, Doc!

And so, it went on session after session until Seth Holcomb separated feelings from actions. Once, the therapist noted that he hadn’t seen anything about a murder in the Littleton Courier. The laughter that followed was a good sign.

Like the Ammonoosuc River that ran through town, life went on for Seth and his wife, Mary Ellen. Seth arranged for his wife to attend a senior center several days a week, and eventually, she lived in a memory unit in a nearby facility. He and his children visited her often, and Seth continued to hike and explore the White Mountains of Northern New Hampshire.