Deathbed

2

Either out of incipient friendship, compassion, pity, or some combination thereof, Dr. Scott seemed to have taken Father Koesler under his wing. Having completed what was expected of them in the emergency unit, Scott and Koesler were immersed in a coffee break in the hospital’s small, ancient cafeteria.

It likely was friendship, thought Koesler, since they were able to endure long stretches of silence without forcing meaningless conversation. That pleased Koesler, for he had had positive feelings toward Scott since their meeting just a few hours before, although, given the in-built stress and sudden demands of Scott’s work, Koesler thought it odd that the doctor appeared so lighthearted.

Scott’s receding hairline and clipped beard framed a rather cherubic face set off by a neatly trimmed mustache. The hair was a salt-and-pepper mix. Scott carried a bit of unwanted weight. He probably would have been considerably more overweight if his work did not demand so much time on his feet and so much physical activity.

“Remarkable looking woman, isn’t she?” Scott ran a hand through his beard.

Koesler started. He realized he had been idly regarding a woman who had been making her way slowly through the cafeteria, stopping to chat at almost every occupied table.

Though he had never met her, Koesler well knew who she was. During the years he had been editor of the archdiocesan newspaper, he had published her picture many times. She was the highly regarded Sister Eileen Monahan, OSVDP (Order of St. Vincent de Paul), chief executive officer of St. Vincent’s Hospital for as long as anyone could remember.

Yes, she was a remarkable looking woman. There was a saying as well as a general agreement that nuns were ageless. That had been more generally true in the recent past before most religious orders of women had changed their minds, their rules, and their habits. The traditional habits covered everything but a woman’s hands and face. Facial wrinkles often were pulled smooth by a tightly fitting coif. The casual onlooker could never tell whether a nun had any hair at all, let alone whether it was gray or white.

But now was the day of the modified habit. Usually consisting of an off-the-face veil and a modest dress or suit whose only relationship to the former habit was its color. It was, for religious women, a day of truth in advertising.

The truth was . . . Sister Eileen had kept her figure. Granted it was a mature figure—Koesler guessed she must be in her mid- to late-sixties—but she was a grand looking woman. A very attractive, interesting face, and eyes that had endured a lot of suffering, her own and others’.

Both Koesler and Scott detected a pattern to her tablehopping. She was working her way toward them.

Sister Eileen seated herself across from Koesler and smiled warmly, extending her hand across the table. “Well, if it isn’t Father Koesler. I haven’t had the opportunity to welcome you to St. Vincent’s.”

“Thank you. I guess now I’m official.” Koesler noted she had a very firm handshake. “Although I have been welcomed.”

“The pastoral care team?”

Koesler nodded.

“What did they tell you?”

“Well, Father Thompson bequeathed me his beeper. He said it was the kindest thing he could do for me. He said it would free me from being lashed to a telephone.”

“By and large, that’s correct,” Scott agreed.

“Sister Mary Kevin introduced me—or rather, reintroduced me—to the theories of Kübler-Ross on the process of dying. And she described the chaplain’s routine when there’s a death in the hospital. And Sister Rosamunda—well, briefly, she urged that I spend most of my time being quiet and listening. Come to think of it, that’s pretty much what all three of them advised.”

Eileen sipped her coffee. “Not bad advice, at least for a start. This may seem like a very strange enterprise at first. Most beginning chaplains, especially after undergoing the orientation you’ve just had, are apt to be a bit nervous about what to say to sick or, particularly, to dying people. The best advice anyone can give at this point is that which you received.

“But it would be a serious mistake to overlook all the experience you’ve had in the priesthood. How long have you been a priest, Father?”

He paused to figure. “It’ll be thirty-two years in June.”

“Yes, and you’ll always be drawing on those years. In no time, you will feel very much at ease. In the meantime, ‘shut up and listen’ is not bad advice.”

“Actually, it’s at least the second time I’ve gotten precisely that advice.”

“Oh?”

“Yes. The first time was just after Cardinal Boyle—he was a mere archbishop at the time—appointed me editor of the Detroit Catholic. My onetime pastor, Monsignor Stitt, was presiding over a formal dinner. I guess I was making too many comments to suit him. Anyway, he said, ‘Father Koesler, if you’re going to be an editor, you had better learn to shut up and listen. ‘ I’ve never been able to figure out what that had to do with being an editor. But I thought in general it was good advice. I’ve just never been able to follow it very well. I must confess I am not a very good listener.”

“Well,” she finished her coffee, “if you’re not, you’re not. We’re both kind of old dogs to learn new tricks. “

Her frankness in admitting the difficulty of change surprised Koesler. He did not want their discussion to end just yet. “May I get you another cup of coffee?”

“Why, yes. That would be nice.”

“How about you, Doctor?”

“No. I’ve got to get back.” Scott excused himself and left. He was odd-man-out in this conversation between two people who had dedicated their lives to religion. It had happened to him many times in this Catholic hospital. He knew the signs.

Koesler returned with two steaming cups.

“What have they had you do so far, Father?” Young nuns and priests would have begun on a first-name basis. These two were of an older school. They would use each other’s title.

“Earlier this morning, I took Communion calls to my floors. Later, I covered a death in the emergency unit.”

“What do you think so far?”

“I’m not sure. Maybe it’s too early to tell. I’ve certainly brought Communion to the sick often enough. But there was something different about this. In a parish situation the sick are in their own homes. The people here seemed a bit more . . .uh . . .vulnerable.”

“That’s very true, Father. At home most of the activity revolves around the sick member of the family, who remains in familiar surroundings. Here the sick person is part of a broader system. He wakes up, is fed, is medicated, and retires when the system tells him to. And often he is not even wearing his own bedclothes. “

“That’s going to take a little time to get used to. But the death scene will take even longer to get into.”

Sister Eileen smiled. “Problems?”

“Well, first I learned that in a code blue, everyone except the chaplain breaks his or her neck to get to the scene. “

“That’s right.” She grinned. “The chaplain’s just in the way until the patient either makes it or doesn’t.”

“Well, I waited for the family to arrive. When they did, Dr. Scott met them, explained what had happened to the deceased, answered their questions, then left them to me. And all hell broke loose.

“I took them to what you jokingly call a quiet room and I got a look at the abyss where there will be the weeping and gnashing of teeth.”

“So what did you do?”

“Remembered what I’d been told and shut up and listened.”

Eileen leaned forward and put her hand on his arm. “That’s all they wanted you to do. They wanted to vent their grief, and your silence as well as your presence allowed them to do that. I think as you follow up with this family, you’ll find them thanking you for being there and letting them express their emotions.”

“I hope you’re right. But then, you probably are; you’ve been at this so long—oh, pardon me; I didn’t mean to imply anything about your age.”

She laughed. “Don’t apologize. I have been at it a long time. Though not quite as long as this hospital’s been here.”

Koesler had been aware, vaguely, that St. Vincent’s was an antique. Everything testified to that: the worn hardwood floors, the high ceilings, the creaks and squeaks, the smell of the place—somewhere between mustiness and the odor of sanctity. But he was unaware of its exact age. “How old is it?”

“Almost 150 years.”

“Wow!”

Sister Eileen chuckled. “Sometime between then and now, I came upon the scene. Fresh out of the convent, I came here as a nurse, then moved up to supervisor, then briefly a vice-president, and finally, chief executive officer.”

“You’ve paid your dues. But this brings up another question . . . if you’ve got the time?”

“What could be more important than satisfying the curiosity of our temporary chaplain?”

“Well, I’ve asked this question of others, both before I came here and during my orientation. But I have yet to get an answer I can understand.”

“Yes?” She smiled.

“Why go on with it? Why perpetuate St. Vincent’s Hospital?”

Sister Eileen turned quite serious. She did not immediately reply.

“There are municipal hospitals here in downtown Detroit,” Koesler persisted. “And from all I know, they lose money regularly. It must be far worse for St. Vìncent’s. Yet there’s no reason you have to stay here. Almost all the other Catholic and private hospitals have either closed or moved out to the more financially secure suburbs. And no one counts them cowardly for doing so. It just makes good financial sense to get out to a place where you can survive.”

She chewed her lip. Koesler was mildly surprised at her hesitancy to answer. She must have faced this question, internally and externally, many times.

“The answer is not involved, Father. We are here because this is where the poor are. Of course we could move to another area in the core city. But why should we? We’d only be seeking another poor area. And the poor we have with us right here.

“Oh, yes, we could move out to the suburbs. Mind you, I am not in any way speaking pejoratively of the other Catholic hospitals that have done so. They use much of their profit for the benefit of the poor.” She fell silent.

“Then, why?” Koesler pressed. “Is it some sort of death wish?”

She searched the priest’s face, seeming to assess his ability to understand.

“We do it—no, I should accept the responsibility . . . this supremely impractical decision is almost totally mine—I do it because our founder told us to. If St. Vincent de Paul is identified with anyone, it is the poor. According to our orders constitution, we were founded to serve the poor. That is our primary purpose. Some may interpret that to mean that if they are going to serve the poor, they must first themselves survive. There certainly is something to be said for that. It is extremely practical. It’s just that I don’t see it quite that way. “

The little coffee left in Koesler’s cup was cold. He pushed the cup aside. “From your explanation, I must assume that you represent a minority viewpoint?”

“Decidedly.”

“One woman against the world.”

“Just about.”

“But how do you manage to keep the place open? I mean, even with the best of intentions, there’s all that red ink at the end of the fiscal year. That’s reality.”

“Indeed it is. I wouldn’t argue the point. Fortunately, a majority of the board of directors of the Vincent de Paul Health Corporation are members of my order, and dear friends. But even a couple of them are wavering. In fact, in four years we must begin to break even or there simply will no longer be enough support for us to stay open.”

“Any plans? On how to break even?”

“Some . . . oh, don’t worry; we won’t go down without a fight. But”— she checked her watch—“I’d better saddle up and make some rounds or we won’t last the day.”

They rose and took their cups toward the counter area.

“What have they got you doing this afternoon, Father?”

“I’m going to check the new patients on my floors. Then I’m supposed to see if the other chaplains come up with anyone who wants confession or needs the Sacrament of the Sick.”

“Sounds like a busy afternoon. And don’t forget—”

“I know: Shut up and listen.”

Sister Eileen pointed an index finger at him and used her thumb as a facsimile of a gun hammer.

Smiling, they parted.

* * *

They had told him that security was lax and that he probably could get around the hospital pretty much at will. He hadn’t believed them. But he had been willing to try it. And now he was simply amazed.

It hadn’t been difficult getting past the lady who screened prospective volunteers. As rehearsed, he claimed that he worked part-time as a janitor for a nearby community theater and that he wanted to spend as much time as he could spare helping those less fortunate than himself. Yes, he understood that his acceptance as a volunteer was no promise of regular employment; if it happened, that would be nice, but he was in no way counting on it.

A few more questions and a few simple forms to fill out and he was issued a long white hospital coat. His picture was taken and the print affixed to his identification badge: Bruce Whitaker, Volunteer.

On the face of it, the coat and ID were indistinguishable from those of most of the other hospital personnel. Nurses, aides, even many of the doctors, wore the same. Of course the identification differed. But few people did more than scan the ID tag. At most, some looked at it just long enough to get his name.

Things were going far better than he could have hoped.

Of course there had been that unfortunate collision in the corridor with the aide who was carrying a food tray. That had been a bit of a mess. But it had been her fault as much as his. She should have looked before she picked up a full tray from the cart. Anybody could have been coming down the hallway at that precise moment. The fact that he’d been studying room numbers as he walked quickly and distractedly down the corridor was his excuse. What was hers? Besides, he had stopped and helped clean up the mess.

And then there was the specimen bottle. He had been thrilled when the nurse asked him to take it down to the lab. They trusted him! It was a good feeling—a good feeling that lasted until he reached the basement corridor. That was when he had dropped the bottle. Damned terrazzo floor! The bottle had bounced, then hit and shattered. Oh, well; the nurse would never remember who she had entrusted the bottle to. As for the specimen, there was plenty more where that had come from. He smiled. How clever! He would have to tell the others about that.

For better than an hour, no one had bothered him. He tried to appear purposeful, as if on some mission, as he familiarized himself with the various departments of St. Vincent’s.

So far, he had been most impressed with the emergency unit. So much seemed to be going on there that his head had been figuratively spinning from watching all that activity. He must tell the others of the near catastrophe he had observed. The one where the unconscious man might have died if the one doctor’s orders had been followed. But the other doctor had ordered an additional test and, as a result, the patient’s life was saved. Whitaker had been even more impressed than the others present at how easily a fatality could be caused by a simple mistake. Yes, he must tell the others about that.

Hello! What’s this? A section of the hospital he had not been shown on his orientation tour. Or had he? He couldn’t quite recall. In any case, the sign identified it: Clinic.

He wandered in casually, cautiously. His first impression was that it was a combination of the emergency unit and a pharmacy. The facility contained a huge store of medical supplies as well as many separate cubicles where patients could be seen and treated. About all it lacked of the emergency unit were the trauma rooms and the exotic equipment they held.

He’d better investigate and see what went on here. There was some activity behind the curtain in cubicle two. As authoritatively as possible, he walked to a spot just opposite the cubicle. He pretended to study a chart lying on the long, curved counter. Though he didn’t know who was speaking, he could hear quite clearly.

“How many times has this been for you?” a male voice asked.

“I d’know,” an indifferent female voice replied. She sounded black.

“You don’t know how many times you’ve been pregnant?” An unmistakable tone of incredulity.

“I don’t rightly know that I’m pregnant now, y’see.” She sounded strangely disinterested.

“You said that you haven’t had a period for two months!”

“I said that because you axed me how long it’s been.”

“You said you’re suffering abdominal pain.”

“Stomach ache.”

“But your abdomen isn’t particularly tender.”

“It still hurts.”

There was a pause. “Okay,” the male voice continued, “you wait here for a few minutes. There’ll be a nurse in to see you in a little while.”

The curtain was whipped back, then closed behind the man as he left the cubicle. Whitaker was able to see inside for only a second. The patient was seated on a gurney. She wore a print hospital gown, much the same as those used in the emergency room. And she was, indeed, black.

The man’s garb was similar to Whitaker’s. White shirt and blue tie; dark trousers topped by a white frock coat. There was an identification badge, but Whitaker could not read it. Draped around the man’s neck was a stethoscope. Whitaker assumed, correctly, that he was a doctor.

The doctor glanced briefly and quizzically at Whitaker. But the white hospital coat and ID seemed to assuage his curiosity. Whitaker busied himself at the desk.

“Maggie,” the doctor addressed a nurse, “get a specimen from the gal in two. I want a urinalysis done.”

“Okay.”

The nurse squeezed by Whitaker on her way to and from getting a bottle. Yet she didn’t seem to notice him. He couldn’t get over it: it was almost as if he were invisible.

The nurse obtained the specimen from the patient in cubicle two and departed. Some twenty minutes passed before she returned. Meanwhile, Whitaker concentrated diligently on remaining as still and inconspicuous as possible. He didn’t notice that one edge of his sleeve had fallen into an open stock bottle cap containing a concentration of Gentian Violet. The dark blue-purple solution was slowly seeping up his sleeve.

The nurse handed the doctor the test results. With the chart under his arm, the doctor reentered the cubicle. Once again, Whitaker could see the patient only momentarily. She seemed quite young. Again he could hear their voices clearly. It helped a little now that he knew what they looked like.

The thought crossed his mind that it would be better for the patient if there were more privacy. But he dismissed that thought quickly in favor of the advantage it gave him to be able to overhear their conversation. It did not occur to him that few, if any, in the clinic would ever bother to eavesdrop.

“Well, Ms. Tyler, according to our records, you’ve been at St. Vincent’s quite a few times. Though usually in emergency or maternity.”

Whitaker assumed the doctor had referred to the chart. Ms. Tyler did not reply.

“You’ve been pregnant five times and you have four living children; is that correct?”

“Not ‘zactly. I been pregnant more like six, seven times.”

“The others were abortions?”

“I didn’t have nothin’ done.” Somewhat truculently.

“Spontaneous abortions, then. Well, you’re not pregnant this time.”

“Thank the Lord.”

“Thank the Lord, indeed. You’ve just got a stomach upset. And I’ll give you something for that. But you could have been pregnant, couldn’t you?”

“How’s that?”

“You’re sexually active now? You have a boyfriend?”

“Oh, yeah.”

“But, Ms. Tyler, you’re a diabetic. The last two times you were here for delivery of a child, you almost died. Didn’t the doctor or a counselor give you any information on family planning? On how not to get pregnant again?”

“Oh, yeah, they done that.”

“What did you decide on? What form of contraceptive did you agree on?”

“Oh, they fitted me with a wire.”

“An IUD? Then what happened? It’s certainly not in place now.”

“It come out.”

“And you didn’t come in to have it replaced? Don’t you know that without it you could get pregnant again?”

“I guess.”

“Look, Ms. Tyler”—his tone grew conciliatory—“this is very serious. Your diabetes—your illness—very much complicates matters when you become pregnant. You could die. As a matter of fact, if you get pregnant again, you probably will die. And you might have been pregnant this time. It’s just luck—and no more than luck—that you aren’t.

“Ms. Tyler, you’ve got four children. You don’t need any more, do you?”

“No, sir.”

“You don’t even want any more, do you?” He sounded hopeful.

There was a pause. “But I can’t lose my man. If I don’t give out, Tyrone be gone.” She sounded worried.

“There’s a way we can fix this all up.”

“There is?”

“Yes. It’s called a tubal ligation.”

“A what?” Nervous.

“We could tie your Fallopian tubes.”

“My what?”

“It’s a simple operation. We can do it right here in the clinic. We can even do it right now.”

“It’s an operation?” A touch of panic.

“Yes. But it’s such a simple operation, we can do it right here in the clinic.”

“What do it do?”

“It’ll make it impossible for you to get pregnant ever again.”

“And I don’t have to wear anything or do anything more?”

“No. The operation will take care of everything.”

“And I can give out to Tyrone?”

“Tyrone will never have been happier.”

“Then I guess it’s okay.”

Whitaker had been listening to their conversation so intently that he hadn’t noticed the nurse’s aide who had been standing next to him, studying him. “Bruce”—she’d read his ID—“if I were you, I’d take my sleeve out of that Gentian Violet.”

Startled, Whitaker glanced first at her, then at his sleeve. The solution had crept upwards until now it had darkened a significant portion of his cuff. And the aide—she was the same girl he had literally run into earlier when they had spilled the lunch tray.

“It’s all right . . . it’s all right,” he repeated inanely as he squeezed the cuff. He succeeded only in staining his fingers.

Bruce left the scene in rather total confusion. But he’d heard enough. He must get to the others as soon as possible and tell them what he’d learned. And he would have to do something about that nurse’s aide. She had noticed him. She had read his ID. She knew his name.

Whitaker had assailed his duties that day confident he was unnoticed. But someone else, due initially to nothing but a series of coincidences, had noted, then taken some interest in this ill-omened man. There had been the food tray collision; the dropped specimen tube; the patient bent almost into pretzel shape when Bruce had tried to adjust her electronically powered bed; the cracked stained-glass window in the chapel where he had tripped over a prie-dieu.

At that, the silent observer hadn’t noted the nurse who was still searching for the chart Bruce had accidentally set afire; the patient who would never find her dentures that Bruce had accidentally flushed down the toilet; or the medical library where books were now out of order because Bruce had tried to look up some information. Not to mention a variety of other mishaps.

But merely from what had been noted, the observer was impressed. Never had the observer seen such a star-crossed creature. However, on the one hand, volunteers were not in great supply, and, on the other, one never knew when information about such a person might come in handy.