Lives in the Balance

Notre Dame Magazine, Summer 2009


FAMILY FRIEND GENE BOSCO AND BOB ROCHE (BACKGROUND).

 

Louise bends to stroke Bob Roche’s hair and murmur into his ear. “Robert,” she says softly, dropping the T in the French version of his name. “We have company.”

Their eyes meet for a moment. Louise smiles adoringly at her husband of 28 years. Roche swivels his head, his eyes fixed on a distant, unseen horizon. He sighs and moans. The low whir of medical equipment fills the sparsely furnished living room. Roche grimaces, smacking his lips. Gnarled by contractures, his hands slowly gesture without purpose.

“It’s so hard to see him like that,” Louise says, her dark fingers tenderly cradling his face. “He didn’t bring me here for this.”

The lives of the Roche family – and of countless others halfway around the world whose own lives had been ineffably touched by his years of service to the least among us – were indelibly altered on the night of December 4, 1997, when a rush-hour impact dispatched Bob to a place somewhere between life and death.

Friends and family say Roche is in a coma. Doctors call it a persistent vegetative state, the result of severe head injury. “He’s not in a coma,” explains his doctor, John Serlemitsos, MD. “He’s awake and has sleep cycles.”

Roche is fed by a tube through his abdominal wall directly into his stomach. He is unable to control his excretory functions or cough. Every few minutes Louise or one of the other family members in attendance 24 hours a day uses a slender plastic suction tip to clear his airway of saliva and mucus so he doesn’t choke to death. The daily routine is a constant struggle against pressure sores, pneumonia, and the ever-present infection risk to catheters and lines.

“Anything could become fatal,” Serlemitsos says. “Bob is somebody being kept alive by advanced life support. He would not survive without the support. For somebody to go 12 years like that is pretty remarkable.”

This isn’t the Bob Roche that friends remember. A native of Pittsburgh, Roche was the oldest of 6 siblings. An Eagle Scout and a seminary student, Roche grew up in a time when John K. Kennedy’s exhortation to ask what you can do for your country still resonated. It was an age of social consciousness. The civil rights movement, environmental movement and women’s liberation movement heralded an era of change.

A 1972 graduate of Notre Dame, Roche was a member of the last class before the university went co-ed. Denis Garvey a Charlotte, NC businessman, met Roche on his first day at the University. While waiting in line, he overheard a tall student with bushy hair mention that he was from Pittsburgh – his own hometown. “He was a big guy with a big laugh,” he recalls. “We became friends from that day.”

“He was always a big-hearted person with a social conscience,” says Bill Joyce, an elementary school teacher in Oakland, Calif., who like Roche received his degree from Notre Dame in sociology. “He was a good guy to be around. He had a very lively spirit to him.”


BOB AND LOUISE ROCHE IN MAY 1997, SEVEN MONTHS BEFORE THE ACCIDENT.

Roche attended graduate school in forestry at Oregon State University, but was disillusioned by the timber industry’s rapacious appetite for old-growth Pacific Northwest forest. “He was so terribly disenchanted with all those hills stripped of trees,” recalls his mother, Elizabeth, now retired in Ft. Myers, FL. “He was thoroughly beside himself.”

He quit graduate school and sought an opportunity to have a more direct and immediate impact on people’s lives. In 1974, Roche joined the Peace Corps, serving in some of the most impoverished regions of Africa. The places Roche went had no modern conveniences such as telephone or electricity, often lacking potable water and proper sanitation, where disease was endemic and scarce resources led to widespread starvation, strife and civil war.

Roche was assigned to the remote jungle village of Mwanda in the Democratic Republic of the Congo, a former Belgian colony once known as Zaire, where French is the national language but a half-dozen other tongues are spoken. He taught English, French, mathematics and agriculture.

“He loved the African people because they are very warm, family-oriented people,” says Elizabeth. “They are very friendly and hospitable. When you meet somebody, they’re likely to touch you and invite you into their home.”

He met Louise in 1979 in the capital city of Kinshasa. Roche was in the sprawling city to pick up boxes of vaccine to take back to his village. He and a handful of Peace Corps volunteers decided to eat lunch at a restaurant owned by members of Louise’s family. Louise had stopped in the restaurant while out on errands with her young niece. Unable to speak English, Louise’s sister-in-law was frustrated by the hungry Peace Corp volunteers and asked her to translate and take their order.

Roche was smitten. Louise was a petite beauty with lovely smooth chocolate skin. She was demure, and had a warm smile that melted his heart. Not quite 19 years old, she was also about ten years his junior. Undaunted by the gulfs of age and culture separating them, Roche knew immediately that he wanted to spend the rest of his life with her.

Roche returned to the restaurant for lunch the next day. Once again, Louise translated for him. This time, Roche asked if he could write to her. She said yes, and they exchanged addresses.

Roche courted her the traditional Congolese way, by establishing a rapport and negotiating with her family. As the only girl in her family, Louise’s father and brothers were fiercely protective of her. In time, Roche convinced them of his honorable intentions through his letters and by sending money for Louise to take English classes.

His tenure with the Peace Corps coming to an end, in 1980 Roche returned to the U.S. and sought a job that would take him back to Africa. By November, he had accepted a position with Catholic Relief Services (CRS), a Baltimore-based organization that serves the impoverished and disadvantaged in more than 100 countries. Roche was assigned as country representative for Mauritania, a desperately poor nation on Africa’s Atlantic coast.

As country representative, Roche coordinated the distribution of medicines, food, mosquito netting and other supplies. He was responsible for educational programs and helped support agricultural development, such as building roads so food crops can be brought to markets.

Providing relief services in Africa is a challenge but deeply rewarding, says Carl Foreman of CRS, a colleague who served as country representative in other nations on the continent. “It’s a sacrifice. You’re exposed to all of the local conditions; poor sanitation, cholera and malaria,” he says. “You tend to realize that there are a lot of things at your disposal [in the U.S.] that you really don’t need.”

In early 1981, Roche wrote Louise and told her he was returning to Congo to get married. Who is your fiancé, she asked. But he was evasive. In May, Roche visited Louise bearing clothing, jewelry and other gifts bought in Senegal for her and the family. He took the family out for dinner and popped the question. Sweeping her up in his arms, he asked in French, “Will you marry me?” Her family whooped in celebration.

“People were staring at us like we were crazy. I had to say yes so Bob would leave me alone,” Louise says, laughing at the memory. “He really touched me. I thought, he doesn’t know these people, and he’s bringing boxes of vaccine for the children in the village. That showed me he was a good person.”

Robert and Louise married on May 28, 1981 at Kinshasa’s city hall. For the traditional Congolese ceremony that followed, locals were hired as stand-ins to represent Roche’s family.

Over the next 14 years the couple traveled across Africa from one place of desperation to another – from Mauritania to Burundi, Djibouti, Ethiopia, Burkina Faso, Benin and Ghana. They visited Pittsburgh often on summer vacations and for routine medical and dental care. All of their children were born in U.S. hospitals – Robert in 1982, Melissa in 1984 and Annette in 1986.

In 1994, Roche was reassigned to the CRS headquarters and the family moved to the Baltimore suburb of Columbia, MD. Roche enrolled in the MBA program at Loyola College in Maryland. Louise took classes at the local community college, where friends admired her unique African hairstyles. She began doing hair informally at home, gaining a reputation for her artistic talents with cuts, braids and weaves. Their beautiful children were attending private school. Life was good.

Everything changed on that rainy December 4 evening.

Since Louise needed the car to pick up the kids at school, Bob took the commuter bus home. He stepped off the bus on Little Patuxent Parkway, the busy six-lane boulevard that runs through Columbia. His mind was likely occupied with the just-completed MBA final project report he was carrying in his briefcase, or perhaps he was just hurrying to get out of the cold drizzle. He may not have noticed that the light had changed. Roche stepped to cross the parkway and was struck by a car with such force that his body was found 90 feet away from the spot where his briefcase remained standing.

He was rushed to the R Adams Cowley Shock Trauma Center at University of Maryland, a legendary trauma center regarded as the last hope of dying motorists. Roche arrived in critical condition, with multiple fractures and internal injuries — the most serious of which was severe head trauma.

When her husband didn’t arrive home after work, Louise went out in the car to look for him. He had been expected to join the family in attending their youngest daughter’s school play that evening. Louise traced Roche’s route, detouring around the accident scene that still blocked the parkway, and returned home.

“There was no phone call from him. Nobody knew where he was. We didn’t know what to do,” Louise remembers. “Around 8:40 we heard a knock at the door. I opened and saw the police and just started crying.”

Amidst the flurry of phone calls to her mother-in-law, the neighbors and a friend to go along to the trauma center, Melissa, then 13 years old, asked her mother, “Does this mean our life is going to change?”

“I said, ‘I don’t know,’” Louise tearfully recalls.

She was unprepared for what awaited her at Shock Trauma. Roche was wrapped in bandages, his breathing supported by a mechanical ventilator. “They brought me into this room,” she says. “He was so swollen, with blood everywhere. His face didn’t look the same. I didn’t recognize him as my husband. That’s not Robert. And then I saw his hair and I knew.”

Roche lived through the first 24 hours. He survived the next seven days, and then the weeks stretched into months. After two months in Shock Trauma, he was transferred to a rehabilitation hospital and eventually into a long-term care facility.

He’s blind. He hasn’t spoken since the injury. He responds to painful stimuli, but there is no way to know whether he is aware of his surroundings. Serlemitsos says that Roche has likely plateaued in terms of recovery, improving as much as he ever will.

“Once in a while you hear about somebody who wakes up or speaks after being in a coma for a long time, but those are very unusual cases,” Serlemitsos explains. “Bob’s brain injury is much more global. The prognosis for any improvement at this point is very poor.”

Dissatisfied with the care provided by the nursing home, Louise became more involved in caring for her husband. The nursing home staff allowed him to remain in soiled bedding too long, which harms the skin and can lead to life-threatening pressure sores. Louise spent her days at the nursing home, drive home to pick up the kids at school and make them dinner, then return to the nursing home to spend the evening.

“I was spending more time with him than I was with the kids,” she says. “It was very stressful.”

Louise opened a hair salon in Fort Meade, MD, across the street from the vast National Security Agency campus, from which she draws a large portion of her clientele. The drive between home and the salon takes her through the intersection where her husband was struck.

Money remains an ever-present issue, even with occasional gifts of money from CRS. Roche receives medical assistance benefits, which doesn’t cover prescription drugs or a host of other expenses. Neither Louise nor the rest of the family are covered by health insurance.

One Christmas, Louise spent $1,000 to hire an ambulance and rent the medical equipment needed to transport Roche home. Spending the holiday together lifted the family’s spirits so much that in 2000 Louise decided to bring her husband home for good. “My husband did everything to take care of me and our children,” she says. “He did everything for us. We had to do this for him.”

Caring for her husband was too much for Louise to do by herself, so she asked her brother Batame Mupondo, who was trained as a nurse, to come to the U.S. and help. “He said, ‘Of course. I’ll do this for what Bob did for Africa,’” she recalls. Mupondo has cared for his brother-in-law for nine years.

The arrangement is better for Roche, giving him more attention than he could receive in any facility. “They have been pretty aggressive in keeping him alive,” Selemitsos says. “It’s remarkable that Bob has come along this far.”

“We’re happy that Bob can be with us,” Louise says. “His care is 24/7. Somebody is always with him in the house. We’re all committed to him.”

The family’s devotion to Bob is a fitting tribute to the African lives he enhanced in immeasurable ways, observes Garvey. “If there were ever a question of whether one person can make a difference, I think Bob is the answer,” he says.


ROBERT AND MELISSA ROCHE

Despite the family’s travails, the Roche children have thrived academically and as individuals. Annette, 22, is completing her undergraduate degree at the City College of New York. Melissa, 25, was awarded her degree from James Madison University in 2006 and works with her mother in the salon. Robert, 26, received a graduate degree in conflict resolution from Eastern Mennonite University.

Following his father’s footsteps, Robert is serving with Catalyst for Peace in war-torn Sierra Leone, helping people work through reconciliation and healing. The younger Robert has visited places throughout Africa where the name of Robert Roche is still remembered with affection.

The family’s loving care of Roche, however, couldn’t protect them from another disasterous event.

Mupondo was home alone with Roche on the evening of March 5, tube-feeding him in the bedroom, when fire broke out in the kitchen. As thick smoke billowed through the house, the slight 50-year-old Mupondo struggled to hoist the much larger and heavier Roche, but was unable to carry him out to safety. He called 911 and remained in the burning house by his brother-in-law’s side, waiting for the fire trucks to arrive. He was willing to risk his own life to save Roche.

“I would like to die rather than Robert,” Mupondo told a newspaper reporter covering the fire. “If [the fire department] hadn’t come, I would have liked to die with him.”

The home sustained $80,000 of damage and is inhabitable. Roche was temporarily hospitalized while the rest of the family sought housing elsewhere. Louise stayed briefly in a Red Cross emergency shelter. The family is together again in a nearby house made available by a friend. It will be months before their home is repaired. In the meantime, Roche is where his family wants him, back in the center of their lives.

“We’re so happy to be with him every day. He’s a joy,” Louise says, caressing her husband’s hair. “We just want him to wake up and come back to us. We weren’t prepared for this kind of life. We just want him to talk to us again.”


From Notre Dame Magazine, Summer 2009

 

2 Responses to “Lives in the Balance”

  1. kanuma papa nestor says:

    Bonjour,
    ma tante c’est moi nestor juste pour vous saluer de ma part
    bonne journée ok.

  2. kanuma papa nestor says:

    Bonjour, a ma grande famille aux etas=unis,papa bapteme ,vrement avec la sinceriter de mon coeur je vous remerci, par c’est que chaque fois si vous appelle d’avoir la volonter pour me conseiller, moi aussi je vous rassure que, je ferai de mon mieux pour étre le meiller dans ma vie,ma tante pour l’amour que vous avais en vers nous les enfants de ton frére vraiment je ne sais pas comment vous remercié alors j’implore au seigneur qu’il puisse vous accordé une longue, vie,ma grande salutation a ma soeur Melissa et Anette,Bay.

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