Couple's wedding vows put to immediate test

Every photograph tells a story. Some, like these, tell two.

They are pictures of Jim and Trisha Duguay’s wedding day. A day 18 months in the planning, every detail seems perfect: Orange Gerber daisies float in glass bowls, a three-tiered cupcake wedding cake waits in a reception hall, bright pink rose petals dot the Dahlonega winery grounds. A ray of sunshine bursts through threatening mid-May skies just as the early evening ceremony begins.

Trisha, 27, a blond and vivacious administrative assistant, beams in her lace wedding dress with a fuchsia sash, her toenails painted to match. Jim, 38, a soft-spoken engineer, cradles her face as he kisses her.

But look closer, and you’ll see another story unfolding.

Trisha leans heavily on her father’s arm as she walks slowly down the aisle. She and Jim have to sit during the marriage ceremony, which has been shortened to just a few minutes.

Behind her smile, Trisha’s pale blue eyes droop. Jim’s betray a look of fright. As they stand to kiss each other, Trisha holds tight to the leg of Jim’s pants, as if she’d fall if he weren’t there.

This was not the joyous moment the Norcross couple had imagined. Trisha wanted nothing more than to marry Jim. She’d known it since she first spotted him across their office parking lot more than five years before. Jim had dated seriously, but waited his whole life to find “the one” — Trisha.

Now, that day was here. More than a hundred guests were gathered. Their favorite restaurant was catering. Their favorite band was booked to play.

But that morning, Trisha had awakened in her sister’s house in Dawsonville feeling sick and dizzy, her head pounding, her ears ringing and echoing. She’d had migraines on and off for years, but nothing like this. This pain was far more intense, and with it came nausea and difficulty balancing.

She closed the blinds and hid beneath the covers, hoping it was just stress getting the better of her. She slipped on one of Jim’s shirts, seeking comfort in the scent of his cologne. Why didn’t we just elope? she thought.

Late in the afternoon, after a reassuring call from Jim and with help from her father and her bridesmaids, Trisha managed to get out of bed and into her wedding gown.

Now she and Jim were before the minister, finally taking the vows they’d long hoped to: I will trust you and respect you, laugh with you and cry with you, loving you faithfully through good times and bad, regardless of the obstacles we may face together.

Almost immediately, that commitment would be put to the test.

An unlikely, perfect match

They were supposed to be on their way to their honeymoon, a seven-day Caribbean cruise. Instead, just as their reception got under way, Jim and Trisha were rushing to the hospital.

Jim was frightened. Something was terribly wrong with his new bride. He’d known it as soon as she walked down the aisle. Trisha, still in her wedding gown, was lifted into a family member’s car, and they set out for Northeast Georgia Medical Center in Gainesville, 30 minutes away.

As they left the winery, the brief break in the weather ended; the lovely setting was engulfed by dark clouds. An ominous sky thundered. Rain gushed.

“It was like the Titanic,” Jim remembers thinking. “You are on this ship. Everyone is dressed up and everything turns into this nightmare.”

When they reached the emergency room, Trisha vomited. She began coughing and gurgling. She underwent a CAT scan; doctors quickly diagnosed swelling on her brain and planned emergency surgery. But suddenly, her oxygen level plummeted and she struggled to catch her breath. Doctors and nurses hustled to stabilize her.

Jim looked on helpless, in disbelief. How had it come to this? Until now, everything in their life together had been so perfect. Jim and Trisha: a silly, happy, passionate love story.

They were an unlikely but somehow perfect match. They’d attended the same high school, Lassiter in Cobb County, but 10 years apart. Trisha Rushing was a child of divorced parents who’d moved back and forth from Pennsylvania to Georgia over the years. Jim Duguay was the only child of parents married for 40 years. She was loud, outgoing, full of fun and spontaneity. He was quiet, earnest, straight-laced.

In 2005, both ended up working at the LPA Group in Norcross. Jim, a civil engineer, designed airport expansions. Trisha was a dynamo of an administrative assistant. She told friends about the cute guy she’d spied from afar. Then Jim’s assistant went on leave, and Trisha got moved to his side of the office.

They began going out in groups with other co-workers. One night, Jim was the designated driver, and he dropped off Trisha last. She’d gone inside when he told himself it was now or never. He was crazy about her. She made him feel good. She made him laugh.

He called her and she came back out, already in her pajamas. He kissed her. After that, it was as if they’d always been together.

They both loved dogs and the Georgia mountains and Willie Nelson and football: Auburn (his alma mater) on Saturdays; her beloved Pittsburgh Steelers on Sundays. They played board games, Uno and Scrabble and Trouble, and she always won. Trisha, known to everyone as “The Planner,” orchestrated endless getaways — camping, hiking, the beach.

Jim began each weekend by buying her flowers every Friday. She showed him how serious she was about making a life with him, paying off $16,000 in credit card debt to start their marriage with a clean financial slate.

Once, on a business trip, Jim asked Trisha what he could bring her. The cheesiest thing he could find, she told him. He delivered: A hot pink T-shirt emblazoned with the airbrushed message: “Jim and Trisha Forever. ’Nuff said.” Despite Jim’s pleadings, Trisha wore it constantly, to the store, hanging out with friends, as pajamas. “It’s me,” she’d say. “I love it.”

So when he decided to propose in late 2008, Jim decided traditional was not the way to go. They flew to Las Vegas. Once on the ground, he draped her in a pink boa and donned sunglasses with sideburns a la Elvis. A limo took them to the “Welcome to Las Vegas” sign. With an Elvis impersonator crooning nearby, Jim and Trisha got engaged.

A frightening diagnosis

Trisha had been in a regular room at Northeast Georgia Medical for about six hours when, early on Monday morning after the wedding, the medical team declared a code blue. Trisha had stopped breathing.

Jim was whisked away to another room, where he dissolved into sobs. He was certain his bride was dying. He bent over, his arms wrapped around his stomach, and cried uncontrollably. A chaplain arrived. The two of them prayed together.

Two hours passed. Doctors operated successfully to insert a shunt in Trisha’s brain to drain excess fluid and reduce the pressure on her brain. But there was a dire diagnosis. Trisha’s father, Jim Rushing, gave Jim the news: Trisha had a brain tumor.

An MRI image showed the tumor visible in Trisha’s fourth ventricle, near the base of her skull, as well as inside fluid spaces of her brain. Unclear was whether the tumor stretched further, into her brain stem, which controls bodily functions including heartbeat and blood pressure. If the tumor had taken root there, it would be catastrophic.

As she rested in intensive care, Jim got the OK to see her. Her head was bandaged, and staples closed an incision along the part in her hair. But Trisha smiled a big smile. Her blue eyes lit up.

Jim felt a rush of relief. He started chatting. How are you feeling, he asked. How are you doing?

“You know I have a brain tumor?” she said.

Yes, he told her.

“You’re not going to try to hide things from me, are you?” she said.

No, he said. “I just didn’t know how to tell you.”

Trisha could feel his distress. She knew the effect she had on him. She didn’t want to cry in front of him. He was the more sensitive one, and she couldn’t bear to see him hurting.

“I am going to beat this,” she told him, then joked: “You are not going to get rid of me this easy.”

Jim had been grappling with the unthinkable, not sure how he would go on if he lost her. But as he watched Trisha smile and laugh, he felt a surge of hope.

A hospital honeymoon

Ten days. Trisha’s doctors, concerned about her overall health, determined they needed to wait that long before operating on her brain. Those 10 days, Jim decided, would be the best honeymoon he and his new wife could manage. Room 4712 became their honeymoon suite.

Though she had some pain, Trisha was alert and upbeat. Her sense of taste was dulled, but Jim went on missions for her favorite foods — macaroni and cheese, grilled cheese sandwiches, hazelnut cappuccinos. He rented romantic comedies. He slept by her side in the narrow hospital bed, holding her hand through the night.

The whole time, Trisha wore her “Jim and Trisha Forever” T-shirt. She went on her Facebook page to update her status to married and thank friends for their thoughts and prayers. She would have the surgery, she wrote, and probably be out of work for six more weeks.

Jim, too, was feeling more confident that he and Trisha would be home soon, settling into married life. He knew there would be challenges ahead, but told himself that once the operation was done, they could both get back to the life they’d had. They would tackle any health problems together.

For now, though, he had a simpler goal: a special dinner for the one-week anniversary of their wedding. He asked family and friends for privacy. “This is our day,” he told them.

He picked up steaks from a nearby restaurant. Nurses folded towels into the shapes of swans and hearts. They sipped ginger ale and had raspberry sherbet for dessert. And they spent a lot of time talking.

Am I going to die? Trisha asked.

There’s a chance, Jim told her, but there’s always a chance when someone has surgery.

What if we can’t have children?

We’ve done great so far, Jim said. We can travel the world, and we can look into adoption. Either way, we’ll be happy, he assured her.

What if she was disabled? I’ll take care of you, he promised. I will always be by your side.

“When we became married, we became one person,” he said. “It’s just like the wedding vows: No matter what happens, I will be here for you.”

As they talked, Trisha made one thing clear. She had told her parents, too: She didn’t want to languish in a vegetative state.

“If there’s a chance, don’t give up on me, but if I am going to be in a nursing home the rest of my life, let me go,” she said.

Jim promised, but he couldn’t dwell on that possibility. He had to believe things would be all right. He prayed for a positive outcome.

Early on the morning of May 25, Trisha was taken into surgery. The operation lasted six hours. The tumor, as doctors had feared, was deeply seated in her brain stem. Not all of it could be removed.

This time, Trisha wouldn’t wake up.

Tears, prayers, letting go

Slightly inclined in her hospital bed, her blond hair swept back in a ponytail, Trisha looks like she’s sleeping.

A vibrant woman who woke up ready to go every morning at 5:45, she now occasionally yawns and squints her eyes, but never opens them.

A prayer quilt and a pink stuffed pig rest at the foot of her bed. Her toes, peeking from under the blankets, are still manicured in fuchsia pink. Her mother, Kristen Livengood, reapplies the polish she wore on her wedding day. Sometimes she sings to Trisha, a Carpenters’ song she sang to her as a child: On the day that you were born the angels got together and decided to create a dream come true ...

Since June 22, Trisha has been at Emory University’s Wesley Woods Center, a long-term hospital and rehabilitation center. Her room is quiet, often the only sounds are the soft hum of machines helping her stay alive.

In the first few days after her surgery, Trisha showed some signs of recovery, but never regained consciousness. Immediately after the operation, she suffered a series of strokes. Sometimes her fists are clenched, her legs extended and rotated inward in what is known as “posturing,” a sign of brain damage. Other times, she looks calm, stable. Either way, she never shows eye movement and can’t breathe without assistance.

Over the past two months, doctors say, she has been in a severe vegetative state. It means there’s virtually no chance the functioning she has lost will return.

Jim sits in an armchair by her bed. He has been by her side every day since they raced to the emergency room in mid-May. He uses a laptop computer to keep up with work assignments.

Mostly, Jim attends to Trisha. He frets over her when she runs a fever, placing cool washcloths on her forehead. He strokes her cheeks and leans over to talk to her and kiss her. He sprays his cologne on a tissue and tucks it into the pocket of her nursing gown.

He tries to be strong, but on many days, he’s clearly shaken, fragile. His hands sometimes tremble, his eyes are red and swollen from crying. He looks like a man returning from battle.

He’s grown close with Trisha’s father, Jim Rushing, who’s also kept vigil here. One afternoon, as they keep watch, Trisha’s dad hugs Jim and says, “Jim, we will always be family.” He tells him: “If there’s anything she wanted, it was you.”

Jim can’t help but think that Trisha’s years of once- or twice-a-month migraines were a sign of her brain tumor. But her doctors say those headaches were likely unrelated. Far fewer than 1 percent of women with migraines have brain tumors. Unless other symptoms — such as vomiting, seeing double and buzzing in the ears — were also present, migraines alone wouldn’t be a red flag for more.

Still, they say, it’s likely her tumor, because of its size and location, had been growing for at least 10 years. Such tumors can take root in childhood and grow very slowly.

Dr. Patricia Haibach, a Wesley Woods internist who has helped care for Trisha, knows better than anyone that her patient’s prognosis is dismal at best. Still, she says, she has often found herself hoping against hope that Trisha might emerge from her coma.

“I believe in God and there is a chance, but at what cost?” Dr. Haibach said. “We don’t know if Trisha is suffering. It could be 20 or 30 years in a nursing home, and what kind of quality of life would she have?”

For weeks, Jim held onto his hope, too, thinking that somehow Trisha would get better. But as the days went by, he grew wearier. As much as he prayed for a miracle, he also remembered his promise to her. He realized he needed to be clear about what lay ahead and make a decision.

He met with Emory doctors who had reviewed Trisha’s case. The tumor, they told him, was in a profoundly bad place. Because it couldn’t be completely removed, it would grow back. There was nothing more they could do to help her.

Jim met with Trisha’s parents and her sister. Trisha had told them what she wanted, they agreed. She wouldn’t want to continue living this way.

Ten weeks after her wedding day, Trisha was moved to hospice care. Soon after, Jim and her parents decided to remove her feeding tube. It was the most peaceful way to let Trisha go.

Jim didn’t want to do it. It was an agonizing decision. But he kept telling himself: This is what Trisha would want. He had given her his word.

“Trisha would want us, her family, to move on and live our lives,” he said. “How I am going to move on, I don’t know. I don’t have a road map for my future. I just knew I had to honor her wishes. I couldn’t be selfish.”

In late July, Jim and the family stood quietly by as the last fluids flowed into Trisha’s feeding tube. It would now be a matter of days, maybe weeks.

As the tube emptied out, Jim sobbed. He and family members held hands around Trisha’s bed. They cried. They prayed.

Jim, who is Catholic, prays every day, throughout the day. He asks God to talk to Trisha, then tells Trisha how much he loves her, that he is here to take care of her.

“I think the Lord put us together so she wouldn’t have to go through this alone,” Jim says.

As he talks, he looks around Trisha’s room. Almost everywhere, there are photographs, pictures of one beautiful, heartbreaking day in May. They tell the story of a couple on their wedding day, smiling, kissing, vowing to love each other faithfully, come what may.

How we got the story

Helena Oliviero first heard about Trisha and Jim Duguay after getting a tip about their wedding photographer’s blog. Oliviero contacted Jim Duguay, and he agreed to share the couple’s story. When Oliviero first started reporting the story in July, Trisha was at Emory University’s Wesley Woods Center. Over the next few weeks, Oliviero spent several hours with Jim, interviewing him several times. Helena also interviewed Trisha’s parents, her sister, some of her bridesmaids and other family members. Jim also signed a waiver to allow the AJC to interview Trisha’s doctors and nurses at Wesley Woods and Northeast Regional Medical Center. Some of the scenes and dialogue in this story were re-created based on those interviews.