His wife sits barefoot on a wooden chair in the second-floor bathroom, her blond hair slightly tousled, her hands, gnarled from the illness, gathered in her lap.
He has already gotten her up, bathed her, brushed her teeth and dressed her in a blue skirt and paisley blouse.
Now it is time for her makeup. He gently brushes powder over the unhealed bruises from her fall last winter. "That all right?" he asks her. "Okay," he answers himself. Rouge comes next. He joshes: "When I'm mad, I put some on her nose."
Wilson is 60. His wife, Betty Ann, the veteran Republican member of the Montgomery County Council, is 57. They have been married for 35 years. But the 16 months since she received a diagnosis of Lou Gehrig's disease have been like no others in their lives.
This morning, he will finish her makeup, put her jewelry, perfume, stockings and shoes (the black ones with the gold buckles) on her. He will hoist her out of her chair, help her to the elevator in their home, get her into her wheelchair, tie a red-and-white checkered napkin around her neck and feed her a fruit bar and coffee for breakfast.
Just to begin the day.
It is a day that begins like those of many of the nation's estimated 25 million caregivers--friends or relatives who perform a wide variety of tasks for those who are unable to care for themselves. Theirs is a broad fraternity of people who may be ministering to a terminally ill relative, or simply grocery shopping for a shut-in.
It is a group, experts say, that is largely untrained and often beleaguered; that delivers the equivalent of $196 billion a year in health care services; and whose members often suffer an anguish all their own.
"We're not the professionals," says Suzanne Geffen Mintz, president of the National Family Caregivers Association in Kensington. "We don't go home at 5 or 6 o'clock and shut that down. This is somebody we care about. It makes the task of giving care that much harder. More meaningful, maybe, but harder."
In July 1998, doctors told Betty Ann Krahnke that she had amyotrophic lateral sclerosis, a fatal and incurable neurological illness that is also called Lou Gehrig's disease, for the baseball great who died of it.
She and her husband cried at the news.
ALS lays its victims low, as it has Betty Ann, by slowly but inexorably paralyzing physical functions. Speaking, moving, eating, swallowing and breathing can be shut down in various sequences. Only the senses and the intellect are unaffected.
The disease, whose cause in most cases is unknown, usually runs its course in three to five years.
Betty Ann now cannot walk or stand on her own. Her speech, which was the first to be affected, has deteriorated so that only her husband and close aides can understand her. And even then not all the time.
She has lost the muscular ability to keep her head raised--though her husband will forgetfully scold, "Hold your chin up"--and must wear a neck brace. She has to be fed and must chew carefully to keep from choking. And she wears special reinforced mittens at night to keep her hands from balling into painful fists while she sleeps.
But she has continued to work, helped daily by a special nurse's aide her husband calls "a living saint," a computerized voice synthesizer that speaks for her, and the devotion of her staff and colleagues on the council.
As she has failed, though, slipping down the classic steps of the disease, her husband, who cares for her nights and weekends, has had to witness each deterioration and to try, as best he can, to make good each loss.
It is an impossible task.
He had a home elevator installed in April and a wheelchair ramp in May. He got an electric wheelchair in June, and a wheelchair van--from the family of a deceased ALS patient--in July.
Although the couple have had help from their three daughters and many, many friends, he has had to learn how to cook--chili, fish, casseroles and crab imperial--to shop and to apply makeup.
At night, he will often doze with the paper in the sitting room of their Chevy Chase home, near a black-and-white photo of their 1964 wedding, waiting for her call from the kitchen to turn the page of a book.
He is an amiable man, a successful accountant by profession who retired last spring and who happily remained in the shadows during his wife's political career. He had hoped this might be a joyous time. "We've raised our family," he says. "This was the time that we had intended to enjoy the fruits of our efforts."
But now he has placed himself in the spotlight. And the growing weight of illness and responsibility has sparked--along with compassion--feelings of grief, frustration, anger and guilt.
"I can't understand you when you fuss!" he will say when the day has become long and he is tired and his wife's speech becomes excited and unintelligible. "I can't understand, and I'm not listening."
Or he will fume, "Damn," upon realizing he has forgotten to charge the wheelchair's battery overnight.
And the routine can be numbing.
"There's very little change in your day-to-day activity," he says. "You know next morning you've got to get up. You've got to go through the same routine. You've got to get her bath, get her dressed. There isn't any variety.
"There's a lot of selfishness in the thing," he says. "When she's sitting there taking a lot of time eating, I say, 'My food's getting cold! Why do I have to do this and let my food get cold!' You feel put upon."
He has also tried to prepare himself for after she is gone. He makes time to lunch with friends or play tennis or sail, though he said he never completely forgets the disease. He has saved the flooring that was removed for the elevator and has contracted to have the device itself taken away when it no longer is needed.
"I've seen too many people . . . who basically spend full time and attention to caregiving," he says. "When ultimately she dies, then what do you have left?"
These are common emotions for one in his position, experts say.
"He's hard on himself," says Joan Deye, a nurse volunteer with the National Capital area chapter of the ALS Association and the coordinator of the Krahnkes' Rockville-based support group. "I don't think its a realistic thing to watch the person you love die and not have very strong emotions."
Mintz, of the caregivers association, says: "The anger really isn't at her. It's at the disease and what's happening to them. One of the issues in caregiving is recognizing that it's okay to be angry. Look what's happened to your life.
"It's a very hard job," she says. "And they're doing the best they can."
A day spent with the Krahnkes this month proved that to be true.
Once downstairs in her wheelchair, Betty Ann waited quietly in front of the fireplace in their living room, as the grandfather clock chimed 8 a.m. and morning sun streamed in the windows.
"Now, you want a drink?" Wilson asked her. "A breakfast bar?" He tied the napkin around her neck. He fetched the bar, tore open the wrapper, and put it in her hands. "Can you do it?"
But she was trying to tell him something.
"Purple ring?" he asked her, trying to understand her extremely halting speech, his lips moving with hers. "Where is that? In the what? I don't understand where it is. In the which?"
Suddenly understanding, he said: "In the ring thing. Purple ring in ring thing." And he hurried upstairs to look.
A few minutes later, they were ready. He had found the ring, wiped her mouth after breakfast and gotten them on their way in their green van to a reception in North Bethesda for juvenile justice advocates, where Betty Ann would play a short speech on her voice synthesizer.
Most of their day, though, was to be spent at the outpatient clinic of Johns Hopkins Hospital in Baltimore, where Betty Ann would undergo a series of exhausting and painful tests to monitor her respiration.
They arrived about 11. Wilson took her to the bathroom and then began shepherding her among the pulmonary technicians for the tests.
At each station, her case was called up on a blue computer screen and the grim details unfurled: Krahnke, the screens all said. Betty Ann. Height: 63 inches. Weight: 143 pounds. Diagnosis: ALS.
In the first tests, she had to blow into a tube multiple times so her lung power could be measured. But she had trouble closing her lips around the tube, and her husband tried to help. It was tiring and unpleasant, and she seemed upset.
For the next test, she had to do the same thing lying down. He gave her a "power hug" as he got her out of the wheelchair and onto a gurney. This effort was even harder, and she groaned with exhaustion after each round.
"Three down, five to go," he said. "Are you all right? There is no alternative to saying all right."
Finally, she underwent a procedure in which a thin rubber tube was inserted through her left nostril and into her left lung to measure the strength of her diaphragm. This was the worst. It was painful, and it made her cry, cough and gag.
He stood behind her. "Let's do it," he coached during the worst of it, "and be on our way." When it was finished, he said "good show," but she looked drained and moaned that it had been "awful."
Later, he would drop her off to play bridge with old friends in Bethesda--someone now must hold her cards for her--then go back and bring her home for the night.
"This stuff is all-consuming," he said wearily between trips. "There isn't any slack." Then he chuckled. "But that's what we agreed to 35 years ago. When you say in sickness and in health . . . "
And he still feels fortunate.
At the end the day, when Betty Ann was back home, they sat at their dining table, held hands and prayed. They prayed for a miracle, and for guidance, and they gave thanks.
"I'm lucky," he had said of his wife earlier. "I've lived with her for 35 years. Nobody else can say that."
CAPTION: Wilson Krahnke applies wife Betty Ann's makeup before a public appearance.
CAPTION: Wilson Krahnke applies lipstick to Betty Ann, a Montgomery County Council member who has Lou Gehrig's disease.