The Question of Being Alone by Amelia Zahm

*Some names and identifying details have been changed to protect patient confidentiality. 

“I’m glad you’re busy. I think it would be hard being alone if you weren’t busy.” I’m leaning over the corner of my deck, trying to catch her words in the cell phone signal that only reaches the northeast corner of my house.

“Yes,” I say. “It would.” I smile at the irony. I called my cousin Carolyn to check in, knowing that she’d recently had heart surgery. I called because when I am in a fit of loneliness and feel myself starting to isolate, I reach out to someone, hoping a thread of human connection will pull me back to the world.  She reminds me, in her passive-aggressive tone, that I am alone at ‘my age,’ and that this is not normal. She is twenty-five years older than me and much wiser. I roll my eyes, just like my mother used to do.

I recall my mother’s worry about me, that I would end up alone, her fears that I would never find a partner, never settle down, never have a structured, ‘normal’ life. I wonder about the experience of that kind of life, if anyone ever really feels settled or safe or complete. I wonder about normal. I sigh. Just like my mother used to do.


Skip and Anne sit across from me holding hands. He’s wearing clean, stiff wrangler jeans, dusty, square-toed cowboy boots, a pressed western shirt with pearl snaps, and a cowboy hat. She wears soft, elastic-wasted blue jeans, Keds, and a pale blue cardigan. She tells me about his back pain, how it’s worse after a day in the saddle, how he hobbles home at the end of the day, how it’s interfering with his job as a ranch manager. He used to spend sixteen hours a day in the saddle. Now it’s all he can do to ride for twelve.

He nods as she speaks, offering an occasional “Yep. That’s right.” She tells me how they met sixty years ago and married shortly after. She was sixteen. She tells me about their life working on ranches in Montana, Idaho, Oregon. He built fences and worked stock. She managed camp. She misses cooking on a wood-fired stove. With electricity, she just can’t get the heat right. Her bread never turns out the way it should. He never lets go of her hand.


Dad’s resting on the couch with a damp, cool washcloth over his eyes. I place my hand gently on his chest to make sure he’s still breathing. He slides a hand, smooth, cool, callous-free, over mine and squeezes.

“It’s fine, Mouse. I’m all done, and it’s fine.”

“What do you mean, Dad?”

“I’ve had a good, long life. Your Mom’s gone. And I have nothing left to do.”

“Ok, Dad. Whatever you say.” I squeeze his hand a little more tightly. It’s three days after Mom’s funeral. On that day, he held my hand so tightly that my fingers ached. In the months before, we held a fragile hope between us, as if not speaking directly of her pain or her decline would somehow save us from our fear.

“I’ll be leaving soon.”

I can think of nothing to say, no words to place in the space between our hands, in the space between our breaths, in the ever-expanding space of our grief. So we sit together in the silence, breathing in. Breathing out.


Lela comes to see me for back pain. She is eighty years old, and I stare in wonder the first time she comes to my office, her black, floral muumuu swirling around her round frame. A mass of black and gray hair winds and piles on her head, held tentatively with combs and pins. She lives at the end of a single-track dirt road on the edge of the timber up on the slope. She lived there with her husband for fifty-some years, until he died. She lives alone now, driving her kids mad with worry, but she won’t leave.

I quickly learn to schedule extra time for Lela’s appointments. She likes the acupuncture, but she comes to visit. She tells me about her children and her grandchildren, about her teenage years as a young bride and mother, when she lived 30 miles from town without a car. She tells me about the deer who visit her yard and the family of foxes that live along her road. She brings me garbage bags full of iris and daffodil bulbs. She brings me fresh baked bread. She brings me cookies. She hugs me at the end of every visit. She calls me honey.


I smile when I greet Lily in the waiting room. I haven’t seen her for three years, since she came to see me for fibromyalgia pain. She’s in her eighties now and still living alone. Her son and daughter-in-law help her out. She gets outside to water her flowers and walk her little dog, just like she used to, but the change in her mobility is noticeable. She tries twice before she stands up. She walks slowly, her joints clearly inhibited by new stiffness. Her smile is the same, and I laugh when she tells me her body is ‘going to hell, god damnit.’ She holds my hand as we walk down the hall, but not for support. She can walk on her own. “I’ll follow you,” she says. I squeeze her hand and show her the way.


Susan cancelled her last two appointments, so I’m happy to see her name on my schedule. In the waiting room, dark circles under her eyes, a wan complexion and slumped shoulders tell me she’s drained. As we enter the treatment room, she immediately asks me to dim the lights.

“Can I lie down?”

“Of course.” I set her chart aside to adjust her pillow.

“How are you?” She closes her eyes and clasps my hand.

“My Mom just died.” Tears push between her lashes.

“Do you want to talk about it?”

“No. Is that ok?”

“Yeah. Of course.” I pick up her hand to feel her pulse. My fingers rest on the soft skin of her wrist, feeling for the radial artery. I close my eyes and listen to the mysterious rhythm of blood. With each beat, I feel her grief. It travels through the pads of my fingers, into my veins. It bounces off the chambers of my heart. I feel her loss like an echo. It reverberates, and there beside it, I find my own pain, hollow, dark, empty. I exhale and open a space for the two of us to rest together. Unique, but not. Lost, but not. Alone, but not.


The first time Trevor walked into my clinic I almost dialed 911. He’s five foot two and weighs less than 115 pounds, but as I started to question him he withdrew so deeply into himself that I couldn’t find him. He stared at the floor, hands clasped in his lap. His medical history told me about his mental health, but he told me nothing. I talked and his hands clenched more tightly. His jaw hardened. I thought of guns and knives. I thought of school shootings. I felt my heart racing. I wished I’d never watched the news. For the first time in twelve years of practice, I was afraid of my patient. I was afraid for my patient. I took a risk.

As my fingers came to rest on his wrist, he looked up. He didn’t look at me, but when I asked if he wanted my help, he nodded his head. I exhaled and began. He comes back every week. Sometimes he smiles. Sometimes he doesn’t. Sometimes he talks and tells me how he’s feeling. Sometimes he doesn’t say a word. Every week I make sure I feel his pulses, rest my hand on his arm or leg as I talk to him, use touch to close the vast expanse between us and let him know that I’m here, waiting on the other side.


Evelyn has chronic neck and shoulder pain. It makes her head hurt and her right arm burn. I suspect Evelyn exaggerates her pain, because she exaggerates everything. She sighs and can’t get comfortable on my treatment table. She needs a different pillow and a bigger bolster and everything to be just right.  She tells me stories about her son and daughter and the dog they share, and she never says it, but I hear how much she misses them in the tone of her voice. And when she talks to me about her pain she puts one hand on my arm and the other on my neck and she touches every place on me that hurts on her, and between her palm and my skin something tingles, and I want to ask her not to stop, because the tenderness in her touch reminds me of my own mother, now long gone, and sometimes it makes me want to weep.


“I take it you’re no longer married,” he says, pointing to the silver band on the middle finger of my left hand. He’s lying on my table, making conversation as I place needles to address the arthritis pain in his hips.

“Actually, I’ve never been married,” I say, trying to deflect his inquiry.

“How is it someone as pretty as you has never been married?” I shake my head, thinking of ways to shift the subject away from my personal life. I ask about his daughter. That does the trick.

I don’t listen as he talks, the all-to-familiar question bouncing around in my head. I hear it in my office. I hear it at parties. I hear it from friends and from strangers. “You’ve never been married? You don’t have children? Why? Why, why, why?” After all these years, I still have no answer. I wonder why it matters.


“But I don’t want to go out with Marty, Mom. I don’t like him like that,” I whine, kicking my cousin Leslie under the table and glaring at her for bringing him up while we are having lunch with our mothers.

“Well, Leslie says he’s nice.” I kick Leslie again, hard this time. She jumps and scoots her chair back from the table a little. Linda, her mother, is biting her lower lip, eyes fixed on her plate, trying not to laugh.

“But Mom,” I plead.

“I raised you to be independent, but sometimes I think I did that job too well.” She’s shaking her head.

“But Mom,”

“Oh, Amy. I just wish you’d date someone.” She looks up at the ceiling.


“I just don’t want you to be alone when we die!” She slams her silverware on the table, giving up. We all dissolve into laughter. I’m only twenty-five, after all. I have lots of time.

In seven years she will be gone. Dad will have dementia. He will die more slowly. And she’s right. I’ll be alone. But in the thick of it, I’m not sure how Marty or anyone else could ease the pain of their leaving.


“I’m so lonely I can’t stand it,” her text says. “I hate living alone.” My friend Barb is learning to live alone after her husband dropped dead of a heart attack in front of her. After her own diagnosis of Hodgkin’s lymphoma nine months later. After an intense battle through chemo. In the face of her own returning health and a new diagnosis of ‘cancer free.’

I tell her I understand. I tell her I wish I lived closer. I tell her to go to acupuncture, to find a yoga class, to spend some time outside. I tell her that connecting with her body and herself will help. I tell her all the things I tell myself when the anvil of loneliness crushes my back.

I don’t tell her that I spent the weekend hiding in my house. I don’t tell her that I can stand in a room full of people and make myself invisible. I don’t tell her that I know if I fell down my stairs and broke my neck that no one would find me for days because I am that solitary. I don’t tell her that I believe living is the most terrifying risk we take.


Bud complains of…well, Bud complains. At his first visit, he tells me how being drafted and sent to Vietnam de-railed his plans to enter medical school. “When I came home, it was too late,” he says. “You know how it is. You get married, you have kids, you work, and then before you know it, your life is over.”

Over the course of several treatments, he talks about his career in business and marketing, his artistic pursuits, his daughter’s successes, but each revelation emerges tinged with the bitterness of regret. Regret for what could have been, what might have been, the happiness that must have been waiting at the end of a different road. Today he said, “I have all these dreams, but I can’t do anything about them. It’s too late. I guess that’s all I have, is my dreams.”

This evening I took a pad, a pen and a beer out onto my deck. With my feet propped up on my dog’s sun-warmed back, I take a drink and begin a list of my regrets. I write one and then another, but each time I go back to scribble it out. The pen digs deep into the paper. My hand follows a line as it swirls and winds around the page. I take another sip of beer. The doodle grows, looking a little like a circle, a leaf, a flower, a dinosaur. I set the paper aside and take another swig of beer. My head drops back, and I close my eyes, listening, wondering.

Photo used under CC.