Heroic is the only way to describe Ann, an Irish woman who lives in the US. Not everyone at home in the Republic knows the family's story, so she doesn't want to be identified. But she has been through hell for her husband, and the miracle is that they have come out the other side.
Eight years ago, John had a brain haemorrhage on his way to a job in Texas. The family was living more than 300 miles away, in Oklahoma, where it had recently moved, from Massachusetts. John had just set up his own company. He was self-employed, so there was no sick pay when he fell ill. There was no social welfare, and the family had no health insurance.
Ann and John have four daughters. The eldest was in her early 20s at the time, but the youngest was only six. Ann was faced with colossal hospital bills, overdue rent, mounting household bills, a family to feed and a 700-mile round trip to visit her husband in hospital, where he remained for four months.
The effect on the family was devastating. "The two older ones were pretty good, but the third one was just about to go to college. It was very hard on her. She was all packed for college and we had to call it off."
They all had to pitch in to keep the family afloat. Ann hadn't worked outside the home since her first child was born. She got a job as a receptionist, but the pay was not nearly enough to make ends meet. Then John came home from hospital.
"He was like a nutcase, there's no other way to put it," she says. "He went off one person and came back somebody else. This . . . irritating . . . person came back. His short-term memory was shot to bits. He would try to get out of the car when we stopped at traffic lights. You couldn't ask him to do anything. He had to be watched all the time in the beginning."
Most irritating of all, he couldn't understand that there was anything wrong with him. He tried and failed to go back to his business. "When he was in hospital, he used to say he was in a hotel. We all knew he wasn't the man he was, but he wasn't aware of it. To look at him, you would never know there was anything wrong. But he would be inappropriate. You never knew what he was going to say. It could be very embarrassing."
Even though they were new to the area, the neighbours rallied round. "People were so kind. It was unbelievable. People my husband knew at work would call and just talk to me, talk and talk and talk for hours - people I'd never even met. I was dumbfounded.
"People would knock on the door and hand me an envelope with, maybe, $25 in it. This charity organisation - I don't know how they found out about us - knocked on the door one day and asked how were we fixed, let's see the bills. They paid our bills for a few months."
After three years of struggling to make ends meet, and struggling to cope with a husband who had lost his social skills, Ann had had enough and came home to Ireland. "He wouldn't come with me. He moved in with one of my daughters, who was just married a few months. Imagine, her father landing in on top of her. But he soon realised the error of his ways."
Back in the Republic, Ann and John were eventually referred to Dr Deirdre McMackin (pictured below), senior clinical neuropsychologist at Beaumont Hospital in Dublin. John's principal problem was that he lacked insight and could not see anything wrong with him or his behaviour. McMackin was piloting a technique to bring out insight in patients, using as a model the treatment used to counter schizophrenic delusions. Patients are confronted with their belief that there is nothing wrong with them, and asked to consider it a delusion.
The treatment lasted a year and was a turning point for the couple. "It was getting him to accept that he wasn't the same as before. He just wouldn't admit that there was anything wrong. It's very hard to help someone when they don't see that they need help," says Ann. "Now that he knows, he's actually much better. I knew he needed to see a psychologist. I felt he should have had that immediately. But we couldn't have afforded it in America."
Their relationship has improved immensely since the treatment, and such is the difference in John that he has gone into computers and is taking a new job, with much more responsibility. "He is 95 per cent better than when he came home first," says Ann.