A Second Chance: Dole VA Team and Veteran Find Hope in the ‘Spoon Theory’
By Dole VA Office of Communication Services
At first, it seemed like just another appointment at the Robert J. Dole VA Medical Center. But this visit in August would become a turning point for Vietnam-era Veteran Gary Smith, his wife, and the team of caregivers who treat him.
Like many Veterans, Smith managed his health as best he could while only visiting his doctor once a year. In August 2025, though, his wife told his provider, Physician Assistant Laura Black, that something had changed: Gary had been quicker to anger, and his mood had grown darker over the summer.
“I just didn’t feel like myself,” Smith recalled. “After the car accident, everything felt harder, and I was upset more often, sometimes over nothing.”
Driving near a railroad crossing in June, a sudden train horn startled a deer. The animal leapt in front of Smith’s car, totaling the vehicle and rattling the Veteran, who still deals with post-traumatic stress disorder from his time in the military. Since then, he had been living with more pain and sadness.
Black sensed there was more going on than just physical pain.
“When I see someone struggling, I try to look at the whole picture, not just the injury or illness,” Black said. “We sat and talked longer than usual that day, because I wanted to help both him and his wife understand what was happening.”
Black introduced the couple to the “spoon theory,” a way to explain the daily reality for people with chronic pain or illness. According to this metaphor, spoons represent units of energy. Healthy people start their days with what feels like an unlimited supply, but for those with chronic conditions or PTSD, every task—whether it’s getting dressed or handling stress—uses up a spoon. With a finite number of spoons each day, when they’re gone, so is their ability to cope.
“I could see a lightbulb go on for both of them,” Black said. “It helped them understand each other better. I also suggested they use a ‘safe word’—a way for his wife to gently tell him when he was becoming overwhelmed. It’s not about blame. It’s about support.”
For Smith’s wife, this made all the difference. “Before, I just thought he was angry at me,” she explained. “Now I understand he’s struggling sometimes, and the safe word gives us a break—a chance to reset before things get worse.”
Supported by the team, Smith also decided to quit drinking—a change that made a real difference in his health and their marriage.
When he went for a follow up with Dr. Alyssa Schartz, a clinical pharmacy practitioner, he brought a battered, old spoon he had found stuck in the asphalt. He cleaned it up and carried it with him, saying it reminded him of his own journey.
“He came in with tears in his eyes, and I shed some happy tears, too,” Schartz shared. “He told me, ‘This spoon was beaten up and tossed away, but I wanted to give it another chance—like you gave me.’ On the back, it said ‘USS Mexico,’ so it had a story of its own. He felt like it symbolized what Veterans go through.”
Schartz reminded him that, thanks to the changes he had made in his life, “he’s literally starting each day with more ‘spoons’ than before.” The results showed: he needed fewer medications, felt less pain, and his relationship at home was stronger.
Reflecting on the past few months, Smith is grateful for the team’s support. “Sometimes, just a few minutes of someone listening can change your whole life,” he said.
At Dole VA, simple acts of listening, caring, and creative problem-solving are helping Veterans and their families find hope, strength, and new beginnings—one spoon at a time.