Susan Scott's family feared that the loss of her husband, followed by her 500-mile move from outside Boston, Mass., to Fredericksburg, Va., had clouded her judgment.
Scott had watched her spouse, Andy, die from amyotrophic lateral sclerosis, or ALS. He was a physical therapist, a big, energetic man with the heart of a teddy bear, and those who knew him said he devoted his life to others.
Of all the debilitating conditions he had treated, he often said he wouldn't wish ALS, or Lou Gehrig's disease, on his worst enemy.
"There's no reprieve with ALS," she said. "You don't get these peaks and valleys, it's just a steady decline everyday. That's hard to watch with someone you love."
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After his death, Scott decided she couldn't stay, alone, in the house where the couple had raised their four children. She left New England for a Southern locale and had no idea why she picked Fredericksburg. She didn't know a soul there.
She took a job with a health-care agency, where a supervisor noted her experience with ALS and asked if she would take on a patient with the same condition that had claimed her husband.
Scott agreed, and her friends and family were distraught.
They begged her sister, Linda Snider, to convince Scott that it would be too painful to watch someone else slip away before her eyes.
"Emotionally, I felt it was the worst thing in the world for her at the time," said Snider, who lived in Richmond but has since moved to Spotsylvania County. "It was as if she was backtracking rather than moving forward with her life, which is what we were trying to help her do."
Scott would not be deterred.
There were times she was overwhelmed by the extent of care required by her patient, Richard Cole, a former Navy corpsman living in Stafford County. But there also were moments when she realized Cole and his wife had been through similar experiences as she and her husband. The patient and nurse found themselves talking, not only about end-of-life decisions, but also happy memories.
Instead of being the worst possible situation for a grieving widow, it became the best way for the woman to find her place in a new world.
"It was all part of our universe's grand plan for me and him," she said about Cole in early December. "He tells me how much he appreciates my compassion, my empathy and my friendship. I tell him there's a reason he came into my life when he did.
"Rick saved me," she said.
Others recognized Scott's compassion, especially with a disease that hit so close to home. In December, Maxim Healthcare Services, the agency that Scott works for as a licensed practical nurse, named her "Caregiver of the Year" for the southern region of America. She was selected from caregivers in 18 states and a coverage area that extends from Virginia south to Florida, west to Nebraska and down to Texas.
The award honors those who help the most medically fragile patients and included a ceremony, with three other regional winners, in Orlando.
"It kind of took my breath away," Scott, 60, said about being honored.
There were plenty of times when ALS did the same to her and her husband, but in a different way.
Andy Scott knew all too well what he was in for when he was diagnosed with the disease. As a therapist, he had seen the way nerve cells in the brain and spine degenerate, causing muscles to wither and die. He knew his body would decline while his mind would know exactly what was happening.
He chose to emphasize quality of life, opting against machines and tubes that would extend his quantity of days. He died nine months after tests confirmed his muscle twitching was caused by ALS.
"It was just devastating for all of us," Snider said. "Andy was very popular, and people loved him."
His story had been chronicled in the Boston Globe and Patriot Ledger newspapers, and co-workers who were shocked by his sudden illness rallied to the family's aid.
"They sent in troops of people to take care of him and me, which was amazing," Susan Scott said. "It made everything better because with ALS, it can get pretty grim."
She stayed in her home in Norwell, a town in Plymouth County about 25 miles south of Boston, from her husband's death in June 2015 until she moved to a small house on Amelia Street in Fredericksburg in early 2016.
She took a few months to settle in, then started working with Maxim's office in Woodbridge. She was assigned to Cole in May 2016.
The first time she entered his home, Scott wondered what in the world she had gotten herself into. There were so many machines, pieces of equipment which her husband had never used.
Cole had been diagnosed in 2011, and he had a tracheostomy and ventilator to breathe, a feeding tube and a drain for his liver. She had to give him nebulizer treatments and insulin, change his dressings frequently and crush as many as 40 pills daily and feed them through his tube.
By 2016, Cole could no longer could speak. He communicated through an eye tracker, a device in which he'd gaze at the letters on a monitor, then his thoughts would be verbalized.
Previous nurses had gotten frustrated by how long it took Cole to communicate and were reluctant to enter his room, Scott said.
"It takes a tremendous amount of patience to wait for someone to type with his eyes," she added.
Scott had plenty of time to wait on Cole, as she checked tubes and monitored machines. She worked three 12-hour shifts and one four-hour shift each week and was at his side for 2 1/2 years.
In a press release from Maxim, Cole said, through his eye-tracking device, that Scott had become an important part of his team.
"I am lucky to have her as my nurse," he said. "I feel safe with her and trust her implicitly. She has made the quality of my life and my family's life much better, and for that I am truly grateful."
He died less than two weeks later. He'd been admitted to a hospital's intensive care unit, which Scott visited and sat with his wife, who didn't want to be included in the story.
"I told her this is the last gift you can give him, to tell him it's OK to go and die with grace," Scott said.
The nurse knew Cole's greatest worry was how his wife would fare, and Scott reassured him as well.
"Look at me," she said. "I sold my house and moved 500 miles away from everything I knew, and I'm doing fine."
'CARING AND HUMBLE'
Scott no longer is living alone in Fredericksburg. Two children are with her, temporarily, with their two giant dogs, another lives in Washington and the fourth is still in Boston. Her sister in Spotsylvania loves the Fredericksburg area, as do Scott's friends from Boston, who have visited.
Scott took a brief break after Cole's death, then was matched with a young student with developmental delays. Before her husband got sick, she worked 17 years as a nurse with medically fragile students, and she's glad to be back in school again.
Once more, her life is going full-circle.
She'll gladly take on other ALS patients, which is fine by Maxim. Scott has become adept at managing equipment, communicating with doctors and being compassionate, said Susan Gibala, a clinical manager.
"Throughout her work with Mr. Cole, Sue was — and is to this day — knowledgeable, kind, caring and humble," Gibala said.