Perhaps 15 years into our 42 year marriage, it became pretty clear that Nancy would outlive me. Women generally outlive men. She has always taken better care of herself than I have–better diet, more exercise, meditation, yoga, Sudoku. For me, this natural state of things was always premised on the virtual guarantee that I would, by predeceasing her, leave her to deal with the messy emotional and social fallout. Similar, in many respects, to my point of view concerning the weddings of our daughters–they just seemed to happen on their own, and all I had to do was show up properly dressed with as few prepared remarks as possible.
Along with the diagnosis of late stage pancreatic cancer came this ridiculous possibility that I would outlive her. A scenario I had literally never considered. I recall having laughed out loud at my father, 14 years older than my mother and with his own cardiologist, who would occasionally wring his hands about what he was going to do when Mom was gone. His worries were, as expected, unfounded. Mine, perhaps not.
[In fact, my concerns may be misplaced, just like my father’s were. Nancy is doing remarkably well with chemo, her blood chemistry is all in the green, her weight has stayed up and she shows very little in the way of slowing down. She doesn’t complain about her neuropathy the way she used to, especially during infusion week. My own health is “OK,” which is to say not perfect but not imminently dangerous.]
As an economist, I’m comfortable around statistics. As a reformed gambler, I still figure the odds and go with what seems most likely. As (determined by StrengthFinders) someone who practices intellection, these statistics and odds and percentages bounce around in my brain. I talk to Jesus about them in the Chapel. He reminds me we know not when nor where. I remind him of five year survival rates and the physical effects of long term exposure to chemotherapy.
Since Day One, Nancy has not wanted a prognosis attached to her condition, and has been more or less actively disinterested in her disease other than routine conversations with her oncologist. In this, her approach differs from mine, as I’ve always been more comfortable with a devil I know than one I don’t. But, as a spouse, I have recognized, out loud, that this is her journey, that I am beside her for care and support, that she will make these types of decisions–what and whether to talk about–and I will respect her choices.
And so here is the point. The spouse with the serious illness gets to make these calls, all of them. How much to know and how much to leave unsaid. What to discuss and what not to discuss. The caregiver must willingly include these in the inventory of things about which you will want to talk less. If, as in my case, you find a need to discuss concerns you cannot comfortably share with your spouse, do what I do and talk to a counselor every now and again.
In the most recent ten years of our marriage, when we both worked, we had maybe 30 minutes in the evening to sit together and discuss the day’s events. Now, we no longer have work, we have a few subjects that are off limits, and instead of 30 minutes we have more like 10 hours. Nancy has been more comfortable with these periods of sustained silence than have I, but I’m getting better. Spouses may want to prepare for these in advance, as they should not be misinterpreted as character flaws or a lack of bonhomie, as it were.
It has taken me awhile to understand God’s will in this radically-altered future of ours. This, what we are living, is God’s will. It is God’s will that Nancy carry on her lifelong interest in learning and teaching, and that she be allotted time to do so. It is God’s will that she can suffer in private and go out socially looking healthy and vibrant. It is God’s will that she have someone like me to hang around and take care of her. And it is God’s will that I have finally found a vocation, after decades of searching, that gives me a feeling of purpose and allows me to express my love language–acts of service–every day.
Life is not a bed of roses, and Christian marriage comes not without costs. But being married, at this stage in our lives, is a blessing beyond measure. If you are struggling in your marriage, it may help you appreciate each other by fast-forwarding the film 25 or 30 years, to an empty nest and a dread disease. For the sick spouse, you are unlikely to be able to purchase such loving care on the open market. For the caregiver, being in a position to uphold the marriage vows you made 40 years earlier is a great honor, likely held in high esteem by God. And no couples get there without weathering some serious storms along the way.
of something suitable for this site now that my regular second job is on hiatus, leaving some time to work on marriage issues. 
Which, in my opinion, would be a mistake. The first two items on the list deserve their place of prominence not just because they apply to young brides and grooms, but moreover because they enable couples to navigate the waters from “newlywed” to “golden anniversary.” Being fun, or funny, is one of the failsafe techniques for keeping relationships blooming. I like to think that my wife of 40 years has laugh lines around her eyes partially due to me; lacking any number of social graces, I’ve always tried to at least keep her smiling, if not laughing out loud.
As we age, our sexual abilities, wants and desires change. However, these changes do nothing to our ability to be interesting, perhaps playful, to show interest, to initiate intimacy, to be clean, shaved and fresh, to put clean sheets on the bed, light a few candles, put on some music, etc. Sexual encounters, once a couple is empty nesters, are fairly simple to arrange, but sometimes difficult to execute in the conventional way, or ways. With young kids in the house, it takes real commitment to intimacy to find time—or even a place—to enjoy each other’s presence. There’s some frustration built into each scenario—having the ability and not the time, or having the time with diminished skills—but it remains important to keep fun and physical intimacy in your relationship, else couples risk ending up living together as brother and sister, polite and considerate with nothing resembling passion ar mutual engagement. This is NOT how to keep a marriage strong and healthy.
As we have remarked often in this space, couples have a much better chance to make it to their golden anniversary—roughly 2-3% of married couples accomplish this—if they are friends as well as lovers. Friends don’t cash in their relationship because of a fight or disagreement. Friends tend to usually fight fairly with their friends; spouses perhaps not so much. John Gottman, in his book we have virtually worn the cover off of in this blog, 
Love's Sacred Embrace 