COLUMBIA — Twice around, over, under and through: the instructions for a perfect schoolboy knot.
But for those who lack dexterity, no amount of recitation will put the finishing touch on a necktie to go with a summer suit. That's where Joel Ewbank comes in.
As housemate to three clients with profound medical and developmental issues, each wholly dependent on a ventilator, Ewbank is more than a fashion stylist.
"These patients are my family members," Ewbank said.
Video by Megan May
A complicated lifestyle
A typical work day is not just a test of his technical training. Ewbank runs errands and completes household chores such as vacuuming and cooking. He recently found himself on the roof, cleaning gutters.
And heading home at the end of the day is not a respite. From his two-bedroom living space, Ewbank can hear the beeps and whirs he's learned to associate with work. Such close proximity can make a normal lifestyle complicated.
For example, Ewbank laughs when asked about his love life. He has no children from his first marriage but said his situation is similar to that of a single parent.
"I've got three very fragile individuals that I live with, and it's a package deal," Ewbank said. "It's been a deal breaker."
Luckily, Ewbank has found an understanding companion in one of his co-workers, a woman he first met in nursing school.
Apart from romance, years of experience have helped Ewbank remain positive in a blended home and work environment.
He served five years as a hospital foreman in the U.S. Navy, three of which he spent aboard an aircraft carrier as it traveled from port to port.
It was during that time that Ewbank learned his primary coping mechanism: time away. When his ship made landfall after a month on the Persian Gulf, Ewbank said most of his company would head straight for food not from a galley.
"I would find a hotel that had a swimming pool and a nice tub," Ewbank said. There, he could find some much needed solitude.
Finding a new perspective
After returning to Missouri, his home state, in 1999, he "zipped through paramedic school." Ewbank said the strenuous schedule — 24 hours on, 24 hours off — put another thought into his head:
"I want to do something fun."
So Ewbank became a mortician.
The fundamentals of directing funerals and providing total care are largely the same. Both involve working with families to make the best decisions. But Ewbank said the jobs also come with different perspectives.
"As an undertaker, I became kind of cynical about life," Ewbank said. "You work all you can, then get to retirement and get hit by a drunk driver. "
Now, Ewbank acknowledges that his clients will not heal physically. His job — and the optimism it offers — is less tangible than that.
Ewbank pointed to one of his clients as a prime example. For 30 years, he lived at the state hospital in Marshall. After a fraction of the time in a home facility, "he has his own room, his own flat-screen TV ... and the best wheelchair he's ever had.
"Fifty-eight years old on a ventilator, and he's still living life," Ewbank said.
At 37, Ewbank can say the same.
He's set foot on five continents, with plans to conquer the remaining two — South America and Antarctica — soon.
He took his "favorite staff member" to Paris, Rome, Athens and Cairo for the holidays in 2012. The pair will travel to London, Edinburg and Dublin this December.
"For a guy who's confined to his house, I get to go to a lot of cool places," Ewbank said.
In the meantime, Ewbank does more than live at work — he lives his work. He invites nursing students to intern in his home. He takes his clients on short jaunts to the grocery store or around the block.
"I just need to get them out so the rest of my community is aware that these people are here living in their neighborhoods," Ewbank said.
But for Ewbank, advocate does not always equal activist. It's sliced strawberries and birthday candles. It's a neat necktie for a sister's wedding.
"I don't know how much he can appreciate," Ewbank said, referencing the impromptu party he had thrown for one of his clients. "I don't know what he comprehends, but I think it's my obligation to provide as much as I can for him."