Kathy Wales will perform the same tasks as her fellow nurses when she starts work, but she took a different path to wearing scrubs.

The 15-year Air Force veteran stopped working in 2009 when her two young sons were diagnosed with a rare disease. She lost both in the years that followed — one to the illness, the other to suicide.

Their deaths inspired her to build a new career that begins next month at a Virginia hospital, a path that involves working through grief, helping patients with their mental health and honoring the lives of her children.

“The biggest thing I’ve learned is that you have no idea what someone’s going through when you see them walking down the street. You just have no idea,” she said. “And I really would like to try to be able to make a difference for people like us.”

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Kathy, 46, met her husband, Mike, in 1995 while they were stationed at Ramstein Air Base in Germany. They married the next year and bounced around the country, working as intelligence analysts before landing in Bristow, Va., about 40 miles outside Washington.

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One night in 2009, her youngest son, 9-year-old Alex, woke up disoriented, tripping over a metal toy truck and cutting his chin. A few stitches, Kathy thought, and that would be the end of it.

Alex started behaving strangely at the hospital. He wouldn’t sit in a wheelchair or allow anyone to touch him. When given a drug to reduce anxiety, he only became more agitated, trying to pull out his IV and pick nonexistent ants off his body.

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An MRI showed Alex had lesions on his brain and a blood test confirmed a diagnosis of adrenoleukodystrophy (ALD). The degenerative disease, which often strikes boys between ages 4 and 10, causes the brain’s nerve cells to lose their myelin sheath, leading to an inability to speak, blindness and deafness. Death often follows within five years of a diagnosis.

“Your best hope is buy a video camera and enjoy your time,” Kathy said doctors told her. “You might have six months.”

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“No parent ever should sit still for that,” Mike said. “We started looking for second opinions.”

Seven-year journey

It was the start of a seven-year quest to forestall an inevitable outcome that would give Kathy a painful crash course in nursing.

The first stop was the University of Minnesota, where Kathy learned Alex could get a bone-marrow transplant that might halt the disease’s progress. One candidate for the donation was Zach Wales, Alex’s older brother — but testing showed Zach also had ALD.

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Kathy said the diagnosis came as a “complete shock.” Zach’s ALD could become active at any time.

“That’s exactly what the doctors said would happen,” Kathy said. “And there was no way to tell how or when.”

Kathy stayed by Alex's side as another donor was found and the bone marrow transplant was performed — “a horrible process,” Kathy said.

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Alex endured daily chemotherapy for three weeks. He was nauseated, unable to walk and stricken with hives.

The treatment did nothing to halt Alex’s slow decline. When overnight nurse Saffie Kamara started to work in the family’s home in 2011, he was nearly blind and had a feeding tube.

Alex could speak and attend church and school, but his speech was deteriorating.

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Still, he charmed Kamara, then a 19-year-old nursing school graduate who worked with the family for more than five years. She would field text messages from girls at Alex’s school and reply as he dictated.

“After a while, I kind of tossed my nurse hat out of the window,” Kamara said. “I became a family member.”

Kamara found herself a vital part of the mini-hospital in the Wales home. It contained a pulse oximeter, an oxygen concentrator, a nebulizer, a ventilator and a host of other devices.

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The gear to keep Alex alive came with a cost. Kathy struggled for three years to secure Medicaid and battled insurers over payments. She searched for teenage-size diapers — Alex wouldn’t fit in children or adult diapers — and bought a custom wheelchair part-by-part, only to learn her insurance company wouldn’t reimburse her for the wheels.

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“You don’t get a case manager when you have a rare disease,” she said. “You have to learn everything yourself. There is no one to teach you.”

Not every family she worked for was as determined, Kamara said.

“I could pick up that it was different,” she said. “It was more than a mother’s love.”

Lt. Gen. VeraLinn “Dash” Jamieson, the Air Force’s deputy chief of staff for intelligence, who has known Kathy for more than 20 years, said the family’s home was a regular spot for parties and backyard barbecues. She said Alex was always included in activities despite his illness.

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“One of the most amazing things during Alex’s deterioration of health was Kathy’s ability to be the mom that created the house that every kid in the neighborhood — every kid in the school — wanted to be at,” Jamieson said. “It was a lighthouse.”

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Still, the end was approaching. Alex’s speech worsened to the point where his mother sometimes couldn’t understand him and, by summer 2016, he was “starting to give up,” Kamara said.

He died in September that year. He was 16 years old.

“We knew going in that there was no grand outcome at the end of this road,” Mike said. “We were fighting to keep him around — to let him have a quality of life that was as good as we could give him. It went from six months to him being here with us for seven more years.”

“Kathy was the rock,” he added.

‘Overwhelming loss’

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After Alex’s death, Kathy didn’t know what to do. Her son had been her full-time job.

Others around her had ideas.

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“You should be a nurse,” Kamara told Kathy. “You are a nurse. You care for your son … you are falling in love with it. I can see you have this passion.”

In February 2017, five months after Alex’s death, Kathy started an accelerated nursing program at the East Coast Polytechnic Institute University (ECPI) campus in Manassas. The program packed a lot into 18 months — anatomy, physiology, microbiology, pediatrics and nutrition. Kathy thought she could handle it. After all, she’d been through the Air Force.

Nursing school was harder, she said. And the medical know-how she picked up with Alex didn’t provide the advantage she expected.

Deep-suctioning — inserting a tube through the trachea to clear the lungs — was one example. She had done it for Alex many times. Doing it for a grade was different.

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“It’s obviously different in school with a plastic mannequin than with your child,” she said. “It’s hard when there’s a clinical instructor watching. When it’s your child sitting there looking at you, it’s a whole other story.”

About three months into the program, tragedy struck the family again. At age 20, Zach took his own life.

It happened on an otherwise “normal day,” Kathy said. Zach had come home from his apprenticeship as an electrician. He was going to go out with his girlfriend. He had ordered parts for his pride and joy — a big, black Dodge truck — and had made an appointment to have a tattoo filled in.

Kathy was studying for a test when she got the news.

“We were just starting to find our new normal,” she said. “It was the last thing I expected.”

The family searched for reasons. Zach’s brother had died months earlier of a disease that could affect Zach at any time. He had been in counseling, but stopped going when he turned 18, choosing consultations with the family’s pastor. Whether his final act was the result of a bad relationship, grief or guilt, the result was the same. Both boys were gone.

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“There are no words to describe what you feel and the just overwhelming loss and grief and hopelessness that you feel,” Mike said. “You have a future that you think is set. You look out in a year and you see your son’s career and family and kids and grandkids and things like that, and the natural progression of things is interrupted, erased completely.”

After a three-month break from school, Kathy did what she had always done: She came back. On June 3, she will begin as a nurse in the behavioral mental health program at the Novant Health UVA Prince William Medical Center in Manassas. At her pinning ceremony — an age-old tradition for new nurses at which they receive pins from veteran nurses — Kamara did the honors.

“Now that Kathy is doing this part of her life, going into her own field, it’s given her a sense of purpose,” she said “ I think that’s going to make her life happier.”

Jamieson said what her friend has gone through would leave her “rolled up in the fetal position.” Instead, Kathy is powering forward into another phase of life.

“You are never too old to learn, grow, have the career that you always wanted,” Jamieson said. “Kathy really is truly a role model and inspiration to all.”

Kathy’s mission is simpler. She is living for her sons.

“I don’t want anyone to ever forget them,” she said. “They were pretty unforgettable. We can help other people with what we learn. That’s the best way to remember them.”

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