Jim often says that Marilyn wasn’t just his second wife – she was the person who expanded his world. They met quietly and unexpectedly – in a bowling league. Jim, an accountant raised in a small town, had learned early that love is often expressed through action, watching his father care devotedly for his mother during her illness.
Marilyn Aiko Miyasato was his complement: worldly, vivacious, and shaped by a childhood spent moving across Europe, Asia and the Americas in a military family. Her father, whose family emigrated to Hawaii from Okinawa, grew up working on his family’s farm on Oahu, and later served more than 30 years in the U.S. Army. Her mother, a Japanese immigrant who spoke little English when they met, married Marilyn’s father in Japan in 1951. Deeply rooted in Japanese and Hawaiian values, Marilyn carried a respect for service and a stoic grace – emotions felt deeply but not visibly worn.
Jim hadn’t traveled much before Marilyn. He was captivated by her confidence, warmth and ease with people from every walk of life. Together, they balanced each other: Jim managed the practical matters – helping Marilyn catchup on some unfiled tax returns and keeping her old car running – while she found joy in every situation. They embraced each other’s children, and later, Marilyn formed a meaningful friendship with Jim’s first wife, Ellen, who would spend quality time with her during the final weeks of her life.
Marilyn was energized through helping others. After she retired from a 28-year career with the Army-Airforce Exchange Service, she began making jewelry for fundraisers and events such as the Wounded Warrior Project, Hawaiian cultural events, animal support groups and fundraisers for Jim’s church and Italian American heritage groups.
In January 2019, everything changed. After nearly having a car accident, Marilyn came home and told Jim, “Something’s not right. I need to see a doctor.” Though she rarely went to the doctor, an eye appointment led to a referral to primary care and several follow-ups, connecting Marilyn with several Inova doctors who would ultimately become her care team.
Marilyn was diagnosed with Type II diabetes and dangerously high blood pressure by her primary care doctor, Elizabeth Halabuk who referred Marilyn to Dr. Stuart Sheifer of Virginia Heart. But before Dr. Sheifer could see Marilyn, she suffered a stroke. At Inova Fairfax Hospital, the triage and emergency services team sprang into action to save her life while also supporting Jim. Jim, whose bedrock of support was Marilyn, suddenly became her caregiver and advocate. Marilyn would need many months to recover just to feel somewhat normal.
At Inova Mount Vernon Hospital, Marilyn began rehabilitation, paralyzed on her left side with partial vision loss. The team at Mount Vernon not only worked with Marilyn but worked with Jim to ensure he could care for her. Through determination, she relearned how to walk, first with a walker, then a cane. Though mobility at home grew more difficult, they lived fully – sharing “spa days,” attending cultural and family events, and staying connected to each other and the world.
But Marilyn’s health continued to deteriorate. Kidney disease required dialysis, and though she pursued transplant eligibility at Inova, she was ultimately unable to meet the physical requirements. Advanced coronary artery disease – later understood to be the cause of her stroke – led to further complications. Dr. Maseer Bade, head of vascular surgery, performed an eight-hour by-pass procedure to reconstruct veins in her leg so blood could flow freely. Cardiac rehab followed, but balancing recovery with dialysis proved overwhelming.
Still, Jim describes their Inova physicians as a “dream team.” “The staff of receptionists, nurses, technicians and doctors at Schar Heart and Vascular were always respectful, professional and vested in seeking the best health outcomes for both of us to ensure quality of life,” Jim says.
“Inova physicians as a “dream team.”
And Marilyn, even in illness, found a way to give. Inspired by a story she read online, where a man had placed a 10-foot inflatable duck in a dinghy with a sign that read “Joy” around its neck, Marilyn ordered rubber ducks – doctor-themed, nurse-themed, later police-themed, and handed them out during every visit to Inova. It wasn’t long before Inova and Virginia Heart staff members started to call her the “duck lady”.
“I’m giving out ducks,” she told Dr. Bade one day, “because you have a very stressful job, and I want to make you happy.” Marilyn’s care team began to look forward to visits from the “duck lady,” who added to their collections with holiday-themed and seasonal ducks.
In the final year of her life, Marilyn went into atrial fibrillation during dialysis and was rushed to the hospital and treated as if she were having a heart attack. Though stabilized, her heart disease continued to progress. After a stay in a care facility and a bout of pneumonia, she returned home, passing peacefully in October 2025.
Today, Jim remains active, particularly working with veterans and cultural groups. He has a bucket list – Japan calls to him, a way to honor Marilyn’s heritage. The couple has seven grandchildren located in Hawaii and distant parts of Virginia, and Jim treasures the opportunities to spend time with them. He has also made giving back to Inova a focal point of his life and has named Inova Schar Heart and Vascular as one of the beneficiaries of his estate.
“I am grateful,” Jim says simply, “for the fact that the doctors who came into our lives were not only great doctors, but of high character, and truly caring people.” Jim will tell you how much both he and Marilyn benefitted from the care provided by Inova. But his generosity is rooted in something deeper: gratitude, love and a belief – learned from Marilyn – that even in the hardest moments, you can find joy and you can bring joy to others.
Sometimes, joy looks like a small yellow duck. And sometimes, it becomes a legacy.