Introduction

Rachel likes to think of herself as a nice Jewish girl, dedicated to doing what’s honorable, just as her parents raised her to do. But when her husband, David, survives a plane crash and is left with severe brain damage, she faces a choice: will she dedicate her life to caring for a man she no longer loves, or walk away?

Their marriage had been rocky at the time of the accident, and though she wants to do the right thing, Rachel doesn’t know how she is supposed to care for two kids in addition to a now irrational, incontinent, and seizure-prone grown man. But then again, what kind of selfish monster would refuse to care for her disabled husband, no matter how unhappy her marriage had been? Rachel wants to believe that she can dedicate her life to David’s needs, but knows in her heart it is impossible.

Crash tackles a pervasive dilemma in our culture: the moral conflicts individuals face when caregiving for a disabled or cognitively impaired family member.

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Excerpt

The next day, Lois saves my life.

It could be argued that I save my own life. I make the decision. But Lois opens the door, and I go through it. Her permission is my get-out-of-jail-free card.

I turn down Lois’s offer of a soda from the vending machine. We’re having a where-are-we-now-and-what’s-next meeting on an outdoor terrace at Valley Med. The fog’s lifted— it’s a lovely California early summer morning.

She pulls two metal chairs under the shade of an umbrella, leans back to study me, shakes her head, and sighs. “My God, Rachel, you’ve had a rough time. How are you feeling now?”

Her genuine concern for me is surprising. Disconcerting. Until now we’d only discussed David’s condition, David’s needs. I don’t answer right away, shifting uncomfortably as the bones of my ass dig into the unforgiving metal chair. Lois’s eyes reflect the gaunt, skeletal creature in front of her. “Still pretty weak,” I admit.

“The doctors say that for every day you spend in the hospital, it takes about ten days to fully recover.” Where she is going with this? “You were there for nine days? Figure two to three months to get back to normal.” I see her steal a glance at my bony arms, IV bruises, dull hair. “You need to take care of yourself.”

I look at my left arm, clutch it protectively. Take care of myself ? How exactly? With my copious free time and excess millions of dollars? How the hell am I supposed to do that while caring for two kids and an impulsive, incontinent, seizure-prone grown man? “Yeah.” That is so not going to happen. My sad little life is over. I’ll even have to sneak drinks.

Lois’s focus is laser, blatant.

I shift again. Damn, this chair is hard. Can she hear me whining about the lack of chardonnay in my future? Does she have any idea how selfish I really am? How cowardly? Can she guess that afternoons without my lover are more terrifying than my children losing a father or me a husband?

“There is another option.”

“I have options?” My creative imagination was stolen from the bag I put my clothes in at the ER.

“David doesn’t have to come home.”

I almost laugh out loud. Seriously? No fucking way. I couldn’t do that. What kind of a monster would refuse to care for her disabled husband? Not me, not a nice Jewish girl like me. I do the right thing. I fill the postman’s bag with groceries. Buy unneeded gift-wrap from the neighbor’s kid. Recycle. I will take care of my brain-injured husband, no matter how unhappy I’ve been in our marriage.

“There’s a facility in Gilroy called Learning Services. It’s out in the country, kind of like a ranch. It’s run by a lovely person— Dr. Jill Winegardner. She’s Jewish, I think.” Lois studies me. “She looks like you. I think you’d really like her.”

It shouldn’t have been reassuring that the director is Jewish. But it is. Lois is throwing me a lifeline—but all I can think about is Dr. Winegardner and I comparing matzah ball soup recipes.

Lois opens a folder, a brochure slides across the table.

She’s been preparing for this conversation. She’s been tracking my reality. I haven’t been alone!

“They have a day program as well as live-in, but I’d recommend that David start with few months in residence.” So gentle. But so firm.

“But . . . ”

She holds up her hand. “Just so you can regain your strength.” I allow myself to glance at the brochure, but quickly avert my eyes from that gateway to moral depravity. Yet, something shifts. In an instant I know I’m dangerously capable of considering her suggestion. Barely suspecting that my role as the heroine, the inge?nue, the victim, is about to be usurped—just like Bette Davis in All About Eve.

This can work. No it can’t. David can’t go into an institution. Crazy people go into institutions, put there by selfish relatives who can’t handle a little extra work. I can see the evil twin peeking from behind the curtain, stage left. The twin who would protest, “What about me? What about my life? My needs, my happiness? Don’t I matter?”

Lois watches me wavering. She seizes her chance. “Your kids are so young. They are traumatized, too. They need a lot of support. The demands on you are going to be enormous. It would be insanely difficult in the best of circumstances—but you’re weak, you’re drained. You have no idea how often I’ve seen perfectly healthy caretakers implode from the stress.” She moves in for the kill. “If you can’t do it for yourself or David, do it for Hannah and Joshie.”

My sore ass is forgotten. I lean forward. “Tell me more about Learning Services.” view abbreviated excerpt only...

Discussion Questions

1. Rachel Michelberg’s life was irrevocably changed by her husband’s plane crash and subsequent injuries. Has a dramatic, unexpected event ever affected you?
2. Have you been a caregiver? What were the challenges? What were the rewards?
3. At the time of the crash, Michelberg’s marriage was not going well, but she put the past aside to care for David. She decided not to be David's caregiver long-term, though. Her decision was brave, painful, honest, and difficult. Do you think modern American society expects caregivers to sacrifice their lives to provide care to ill family members? Do you think American society expects this of all caregivers, like mothers?
4. Michelberg faced multiple challenges in addition to caring for David—a terminally ill mother, traumatized kids, financial worries, and more. What do you think made her resilient? What makes anyone resilient?

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