Joan O'Gorman's weakened frame lay outstretched on a gurney as a nurse wheeled her down the sterile halls of St. Michael's Hospital in Toronto.
She was about to have surgery on a ruptured disc along her spine.
Her husband had been out of town on a business trip, so she was surprised when he showed up at her side en route to the operating room.
She recalls his first question to her: "Have you contacted a lawyer?"
Since she had been diagnosed with multiple sclerosis in 1986 - five years earlier - Ms. O'Gorman's marriage had been eroding. Before she went into surgery, her husband told her their house was up for sale and that he wanted a separation. He divorced her a year later.
Ms. O'Gorman, 51, is now part of a Multiple Sclerosis Society of Canada support group in which she says 75 per cent of the women have also dealt with failed marriages following diagnosis. But she notes that most of the men with MS are still married.
It's a trend researchers at the University of Washington have also noticed. In a study published this week in the medical journal Cancer, they looked at a sample of 515 people who had MS, a brain tumour or cancer and found that in 88 per cent of cases in which marriages ended, the patient was female. (Sixty couples divorced or separated or 11.6 per cent.)
While women readily take on the role of caregiver to their ailing husbands, men struggle with new domestic responsibilities and the greater dependence their wives place on them, the study's authors suggest.
So-called "partner abandonment" can take a major toll on the health of the patient, says Marc Chamberlain, a neurologist at the University of Washington's Fred Hutchinson Cancer Research Center and the lead investigator of the study.
Patients who were separated or divorced were far more likely to use antidepressants and be hospitalized than those who remained married. They were far less likely to participate in clinical trials, treatment regimens and complete radiotherapy.
Dr. Chamberlain's team also found that the longer a couple had been married before diagnosis, the more likely they were to stay together.
Ms. O'Gorman had only been married two years when she was diagnosed. She said her husband's initial support was swiftly replaced by resentment.
"He said I had lost my value as a human being," she says.
Three and a half years ago, the MS Society of Canada launched a teleconference-style support group for caregivers, who often quietly deal with the enormous stress of caring for their spouse until their frustrations reach boiling point.
"It's the validation of saying, 'I'm feeling so guilty about this' and someone saying, 'That's okay, so do I,' " says Nicole Mellin, assistant vice-president of client services at the MS Society.
The organization offers an information and referral telephone support service that, among other things, refers patients and caregivers to counselling services.
The Pencer Brain Trust, a Toronto-based non-profit that supports Canadians with brain tumours, offers monthly support group meetings for caregivers, which are well-attended, says Cheryl Kanter, a social worker at the trust's treatment and support centre.
"[Caregivers are] called upon to do things they wouldn't normally be asked to do," she says.
She encourages them to seek assistance from hospices and volunteers when they need a break.
"We're helping them avoid caregiver burnout," she says.
Yvonne Brenden, a 51-year-old who lives in Flagstaff, Ariz., says her husband, who took fantastic care of her for two decades after she was diagnosed with MS, had a burnout a year and a half ago.
"He told the kids he left me because he couldn't stand to see me get worse and see me die," she says. "I don't want to bash my husband. I know that it must've been hard to see me struggle."
Before he left, he drove her to medical appointments and support group meetings. He even attended some with her. But now he lives almost 100 kilometres away. Ms. Brenden, who lives alone and is wheelchair-bound, has to pay caregivers to perform the same tasks her husband once did.
Ms. O'Gorman, who also lives on her own, can function pretty well independently but needs to use a catheter for bladder control.
In her recent ventures in dating, she's been pretty upfront about her illness with men. But it took six years after her divorce to get past the thought that her illness made her an undesirable burden.
"At the time you felt like this was just your lot in life and you needed to figure out what you could turn it into," she says. "I wish I hadn't been so quiet and accepting of the isolation."
