‘Guardian angel’

It’s often the little things that make the biggest boosts in quality of life; that was one of the first surprises. A change in fluid medication allows a woman to sit at the dinner table again with her family. An electric scooter enables a man to get around more easily.

“When you walk into a person’s house, you see their life spread out before you — maybe they’re smoking, or they’re having two or three cups of coffee, and that’s why their stomach’s upset,” Inouye said. “You see the interactions between family members.

“You’re on their turf and their time. And you quickly realize: No longer are you in control of the conversation.”

At the beginning and end of each visit, Inouye asks patients if they can pray together. Although a few people have been turned off by her zealousness — “I’ve been fired a few times,” she conceded — an overwhelming majority of her patients embrace the spiritual guidance.

Diane Richardson watches as Inouye performs a checkup on Richardson’s mother, Harriet Small.

“Elderly people, especially of African-American descent, that’s instant recognition that ground has just been leveled and we’re sitting on the same ground together,” she said.

Doris Banks was a full-time caregiver for her 101-year-old mother when their family doctor referred them to Inouye in 2006. Banks herself had just had knee-replacement surgery and could no longer take her mother to doctor appointments.

Inouye’s home care and nurse visits helped her mother remain at home until her death in December 2006. “Sometimes I would be at my wits’ end when she would come, and she would pray with me,” Banks recalled. “Then we’d go back to mother’s bedside and join hands with her and the nurses, and we’d all pray.” Inouye even led a prayer at her mother’s funeral.

Home-care aide Cheryl Jones has known Inouye to buy medications for patients who can’t afford them and to tend sick patients at night and on weekends. “One of our patients kept saying, ‘I want to die’ because her children weren’t coming to see her,” Jones recalled.

“Dr. Inouye called her daughter and they reunited, and she had a much better death than she would have.”

During a recent visit to see 93-year-old Harriet Small in Roanoke’s West End, Inouye checked Small’s tube-feeding incision, examining it for infection and discussing her progress with her caregiver daughter, Diane Richardson.

It was May, and Small had already been through five home-care aides since the start of the year. (“They’re paid so little, they quit for something better-paying as soon as you get them trained,” Richardson said.)

Small, who has dementia, told Inouye about the people she observes from her bedroom windows, repeatedly saying, “Look, there’s somebody coming, and there’s somebody going.”

“I’m so glad to see you talkative,” Inouye said cheerfully. “When you stop yelling, that’s when I get worried.”

Inouye pronounced Small’s incision healthy; the swelling of her legs had cleared some, too. She praised her daughter and the latest home-care aide for their fine work, and marveled that, just last fall, “we thought we were going to lose her.”

Then she prayed: “Lord, it’s a great blessing that Miss Harriet is doing so well. ... and is able to find joy in tough circumstances.

“We pray especially that you will strengthen Diane and give her courage to keep loving her mom and honoring you.”

“That’s my guardian angel right there,” Richardson said as Inouye left the house, wheeling her doctor’s bag behind her.