Deathbed

3

It seemed many hours since the coffee break. Actually, it was only a little more than four. But, by his lights, Father Koesler had spent a busy afternoon.

He had visited with nine newly admitted patients; heard three confessions; anointed five, three of whom would go to surgery tomorrow; and offered Mass at 5:30 p.m.

It was now 6:15 p.m. “Bay in hand, he was making his way through the cafeteria line. He was hungry, but too tired to eat much. From a fairly generous offering of ingredients, he put together a salad. That and coffee should do it.

The cafeteria was sparsely occupied. It was between visiting hours and much of the day staff had gone home.

Koesler took a seat at a long, empty table, said a silent grace, and started on the salad. He noticed Dr. Scott going through the food line. Scott appeared to be unaccompanied. As he settled with the cashier, he scanned the scattered diners, spotted Father Koesler, and headed in his direction.

That pleased the priest. He had liked Scott from the beginning and was sure he could learn much from him.

Scott sat down heavily, letting out his exhaustion. Koesler glanced at the doctor’s tray. Apparently, tiredness did not affect all men equally. In addition to a salad, there was an ample piece of pizza, sliced roast beef, potatoes and gravy, and a mixture of carrots and peas. No wonder the doctor’s frame, despite the stress and physical demands of his work, carried excess fat.

“I’m glad you happened on this time to eat,” Koesler opened. “Nice coincidence.”

“It was no coincidence,” Scott replied. “I figured you’d eat right after you said Mass, so I timed my break for now.”

“Oh?” There was something more. There had to be. Koesler waited.

“So, then, how did your first day go?”

“Busily. This is a very demanding place. I can see where you could burn out in a hurry here.”

Scott smiled and ran a hand through his beard. “Wait awhile. It gets easier. The newness does take its toll. But about the time you’re ready to leave us, you will have fallen into a routine. It’s the routine that insulates you. Just wait and see; I’ll bet in a very short time things will change for you.”

Koesler picked at his salad while Scott plowed into his meal. Several minutes passed. Still no hint as to why the doctor had selected a dining time that included Koesler’s company.

“Okay, Doctor,” the priest said at length, “I give up. Why did you decide to dine with me?”

“Scotty. Everybody calls me Scotty.”

Koesler would not return the dispensation. Only his relatives, fellow priests, and a few close friends used his given name with his implicit permission. Otherwise, he preferred his title. He was not discountenanced in any way by those who presumed to call him Bob. What others called him was their problem, not his. It was just that he felt he functioned on a professional level better if he was perceived by those he served as a priest rather than a buddy.

“Very well, then, Scotty, why did you schedule your dinner break to be with me?”

Scott was mixing a few vegetables with a small piece of the pizza and a forkful of potatoes and gravy. Evidently, he blended his food as he ate. Koesler did not want to look.

“I didn’t want you to eat alone.”

“Come on.” Koesler smiled.

“Okay.” Scott blended his food into an indescribable blob. “It’s this way: Even though your stay here will be brief, we’re going to be working together a lot, often quite closely. All the patients here are sick, almost by very definition. But you’ll find the sickest by far in the OR—operating room—and the ER—emergency. And those two are my bailiwick.

“Now, there are code blues all over this place. Shoot, people have been known to arrest out in the lobby while they’re waiting to register. But you’ll find you’re going to be summoned for codes down to the OR and ER more often than anywhere else. So I thought it would be good if we got to know each other better. And if you got to know this place and some of its personnel better.”

“But I’ve already had orientation—”

“To be a chaplain—a temporary one at that. There are things going on here besides the care of souls that are going to concern you—ready or not. Are you game to learn in the school of hard knocks?”

Koesler nodded. He felt the question was rhetorical.

“Right,” Scott affirmed. “First, how about some dessert?”

“No, thanks.” Koesler found it difficult to believe that Scott had finished all the food on his tray. But he had.

“Coffee?”

“Sure.”

When Scott returned, his tray contained two cups of coffee and one huge banana split. Koesler felt awe at Scott’s appetite.

“Okay,” Scott said, “let’s start with the boss lady.”

“Sister Eileen Monahan.”

“The same. She is unique—and I do not use the term lightly. She, and she alone, is the reason St. Vincent’s continues to sputter along. It long ago passed the point at which it should have been shut down. It is a financial disaster that is getting worse rather than better.

“Even in the brief time you’ve been here you must have noticed there are very few well-to-do, well-educated patients—white or black—occupying our beds. They’re mostly indigent blacks. And precious few Catholics.”

Koesler nodded. Making his rounds this day, he had not met a single patient, white or black, who would have fit socially or financially into Koesler’s Dearborn Heights parish.

Scott continued. “Lots of patients who come here not only can’t pay anything, they’re not covered by anyone—neither their own resources nor medical insurance. But by decree of Sister Eileen, not one of them is turned away. Somehow the hospital is expected to swallow their costs. As you can imagine, the hospital regularly gags on their expenses.

“Then, there are a goodly number who can’t pay their own costs—well, who can?—but, while they have no private insurance, they are covered by Medicare, Medicaid. Then things get complicated. What with DRGs—that’s diagnostically related groups—we can have the patient hospitalized for only a limited time and we can collect from the government only a set minimum fee. Not only is that extremely restrictive to the patient, the hospital is not going to get rich. Indeed, since the hospital cannot tuck administrative costs or any future planning in the bill, it begins a slow fiscal retreat.

“These are the kinds of odds facing Sister Eileen.”

“I see.” Koesler shook his head. “But then even more so now than when I asked Sister this afternoon, I find it difficult to understand why she bothers trying to keep St. Vincent’s afloat. Especially here in the core city.” Koesler’s hands were wrapped around the cup with its untasted coffee. He preferred warm hands to a warm stomach.

“She’s trying to bring the ideals of service of St. Vincent de Paul to Detroit’s inner city,” Scott explained. “And I’ll be damned if she doesn’t almost carry it off. And it’s all her, too. No doubt about it, St. Vincent’s Hospital and Sister Eileen Monahan are almost identical. They’ve been together so long they have become inseparable. She’s always here. She’s always available to everyone. She inspires a special spirit in everyone, from the orderlies to the volunteers to the head nurses.”

“Do I detect an omission of the doctors?”

“Oh, yes, you do. But as far as the doctors go, Sister Eileen has written the book on the care and feeding of doctors. It’s not that she can’t be firm with them when necessary. It’s more that she has a magical touch when it comes to the little things, the infinitesimal perks that are so dear to doctors. Things like—you know—‘Dr. So-and-So wants this special instrument in the OR’ or, ‘Dr. So-and-So wants the charts kept in this special way.’ Then, along comes Sister Eileen to say that Dr. So-and-So really ought to have that instrument. Or, without offending the nurse in charge, Eileen will see to it that an exception is made for Dr. So-and-So and that the floor nurses will keep his charts in his own peculiar way.

“But those doctors, generally, are the ones who have made a conscious and rather generous decision to stick with the core city. And in doing so they have made the not inconsiderable sacrifice of giving up great wealth and prestige patients. Outside of these, many of the other doctors on staff here simply could not ever be accredited to the swankier hospitals. But . . . they are all we’ve got. “

“I see.”

“Take for example Dr. Lee Kim.”

“The one who was working with you in the emergency unit.”

“Right.”

“He’s not a good doctor?”

“On the contrary, he’s quite good. He just can’t quite figure out what he’s doing here at St. Vincent’s. This is not in his timetable at all.”

“I don’t understand.” Koesler tasted the coffee. It was tepid. He shuddered and set it aside.

“He came here from Korea. Not unlike many other doctors. And, like many other foreign doctors, his progress has been arrested at an inner-city hospital. He makes no bones about it: He wants to be affiliated with the affluent suburbs.”

“And in this, I take it, he is not alone.”

“No, that’s true. But his ambition causes him to take a rather casual attitude toward some of his work here.”

“Casual?”

“Uh . . . for instance, suppose we have a terminal case. Somebody whose life system can be supported by mechanical means alone. Well, rather than waste half an hour of his valuable time, he will go to the family and say, ‘Do you want us to do everything?’”

“‘Everything’?”

“It becomes a rhetorical question. The point is, he could spend some time with the relatives, the next of kin, and talk about the quality of life this patient is not going to have in a coma and plugged into machines that will breathe for him, keep his heart going, filter his waste. Dr. Kim doesn’t want to spend a lot of time explaining the choices the family has. And the easiest way of getting out of that chore in a hurry is to ask the family simply, ‘Do you want us to do everything?’ Few families will have the gumption or the knowledge to ask about alternatives. They will say, ‘Of course, do everything.’ At that point, Dr. Kim will put in an order to plug in the life-support systems, and leave the patient to vegetate.”

“I see.” Koesler thought he did. “But what does conduct like that have to do with the hospital—or Sister Eileen?”

“For one thing, it drives costs up, most of the time needlessly. Instead of spending a lot of money on systems that keep essential body functions going, the patient should be allowed to die with some dignity. But doctors like Kim never quite give dignity a chance. So it’s that much more difficult to balance a budget.”

“I see.”

“Now, Dr. Kim is by no means alone in his approach to terminal patients. Where he could have a problem, that could cause the rest of us to have a concomitant problem, is in the clinic. Has anyone told you much about the clinic?”

“I know where it is. You treat outpatients there. You even have outpatient surgery.”

“Right. It’s also where we have some of our more pressing ethics problems.”

“Oh?”

“Normally, they’re not problems for most doctors. Certainly they’re not problems for other hospitals. But they’re very definitely problems for Catholic hospitals.”

“Let me guess: family planning.”

“Right.”

Koesler looked slightly puzzled. “Well, as far as the ‘official’ Catholic teaching goes, there are only two approved means of family planning. One is complete abstinence from sexual activity, and the other, under set circumstances, is the rhythm method.” Absolutely nothing had changed in the Church’s attitude toward family planning in the thirty-odd years Koesler had been a priest. Church approval of the rhythm system had occurred shortly before he had been ordained in 1954. “But very few pay much attention to that view any longer. Just the bishops, some priests, and a few very conservative lay Catholics.”

“But you see, Father, the bishops like to exercise a good measure of control over Catholic hospitals.”

“That makes sense. They’d exercise complete control across the board if they could. But family planning is a private matter between each couple. At most it might enter the confessional as a question or as a matter for some discussion. But I can see where in a hospital you’re in the external forum and the bishops might be able to control—or try to control—the hospital’s teaching and practices.”

“Exactly. And that’s where a place like St. Vincent’s is in a lot of trouble. If we don’t dispense information and devices for all medically approved methods of birth control, we lose government funding. That, in itself, I think, would not discourage Sister Eileen. But she knows our patients have a right to this information and service. And she is determined to make it available to them. The peculiar twist in all this is that most of our poor patients couldn’t care less about birth control. They figure the more babies the better.”

“So,” Koesler clarified for himself, “St. Vincent’s provides the information and means of artificial birth control under the threat of losing government financing—but against the bishops’ directives—and because the CEO believes it’s the medically and ethically correct thing to do, even though most patients don’t want the information in the first place.”

“That’s about it.”

“A dilemma. A real dilemma. But where does Dr. Kim fit into this?”

“As usual, Dr. Kim is involved in shortcuts. But, in this instance, they are rather significant shortcuts.”

“Oh?”

“I don’t have this firsthand, but from some of the clinic personnel I trust. Dr. Kim, when faced with any sort of problem pregnancy, will routinely perform a D & C—at least he will call it a D & C.”

“D&C?” Koesler asked.

“Dilatation and curettage. You dilate the cervix and scrape the womb’s lining. It’s standard treatment for any number of gynecological problems. But not for a problem pregnancy. Then it’s a euphemism for abortion. And that’s where St. Vincent’s draws the line. Our policy permits teaching methods of contraception, the implantation of IUDs, prescribing birth control pills, even sterilization . . . but not abortion. Not abortion.”

“I see.”

“It would be lots harder to prove, but according to some, Dr. Kim also schedules hysterectomies with some abandon.”

“He does?”

“Yes. Even when the woman’s condition does not warrant it, a hysterectomy is sometimes the easiest and at the same time the most lucrative therapy.”

“What a crime to perform such radical surgery if a woman doesn’t really need it!”

“Indeed. But it is convenient. However, if these charges can be proven, Dr. Kim will be out on his ear.”

“Oh, my. But”—Koesler’s brow furrowed—“there’s still a shortage of doctors. Wouldn’t he be able to tie in with another hospital?”

“Perhaps. But remember where St. Vincent’s is on the desirability list. It’s something like a baseball player being unconditionally released from a last-place team. And remember where Dr. Kim wants to go. Very definitely up from St. Vincent’s. Not down. Not even a lateral arabesque.”

“So,” Koesler concluded, “I would guess that would be motivation enough for Dr. Kim to clean up his act.”

“Maybe. Maybe. Unless he had an alternative.”

“An alternative?”

“He might try to hurry the closing of St. Vincent’s. If the hospital closed shop before he was dismissed . . .” Scott’s gesture signified a satisfactory conclusion, at least by Dr. Kim’s lights.

They picked up their trays and headed for the counter area. En route to the conveyor belt that would carry their trays to the dishwasher, they encountered a man who had just settled with the cashier and was scanning the cafeteria preliminary to selecting his dining place.

“Hello there, John,” Scott greeted him. “Have you met our substitute chaplain yet?”

“I haven’t had the pleasure.”

Scott introduced John Haroldson, chief operating officer of St. Vincent’s. Haroldson, of medium height, appeared to be in his mid-sixties. His heavily lined face was framed by wispy, wavy white hair. His eyes were a very light blue and when he smiled, as he was doing now, all the lines of his face moved in an upward direction. Koesler’s impression was of a rather nice-looking, friendly gentleman.

“So you’re going to be with us until Father Thompson returns, eh?” Haroldson observed.

“That’s right. This was my first day on the job and I must admit I’ve learned a lot, with a lot more to learn.”

“Don’t worry, Father, the hospital won’t jump up and bite you. You’ll get along fine. If there’s anything I can do to help, don’t hesitate to call on me.”

Haroldson headed for a table. Scott and Koesler deposited their dinner trays on the conveyor. They stopped together just outside the cafeteria. For the moment, they were alone in the corridor.

“That’s another one,” Scott said.

“Another one what?”

“Another problem area.”

“Oh?”

“Haroldson goes back in this hospital almost as long as Eileen.”

“That’s a problem?”

“Not in itself. It’s just that John has a bit of a persecution complex. He’s always moved up a notch behind Eileen, until, of course, her final appointment. When she became a supervisor, he was named assistant comptroller. She moved into a vice-presidency; he became a supervisor. Then he became COO with the likelihood of eventually becoming CEO. But Eileen leapfrogged him into the top job.

“It doesn’t show, but John Haroldson is a bitter man, and the principal target of his bitterness is Eileen. It’s really manifested when they’re together, especially in a meeting.”

“I’ve been here only a day, “ Koesler said, “and I’ve just met Sister Eileen this once, but it does seem to me she’d be able to handle someone’s bitterness. I mean, she’s already juggling any number of problems—most of them far more serious than envy.”

“It’s not that she can’t handle any sort of frontal attack that Haroldson might launch. It’s that the longer he stays here, the more he covets Eileen’s position. It’s a need, as he sees it, to balance the scales of justice. But he hasn’t long to go till mandatory retirement—a few months at most. And I get the feeling he wants to set matters straight before he has to leave here. “

“How could he do that?”

“I’m not sure. I just think that might be his aim.”

They began walking toward the elevators.

Almost facetiously, Koesler commented, “Well, there’s Dr. Kim and now Mr. Haroldson. Anyone else to be concerned about?”

“Sure. But once you know what’s at stake here and the lay of the land, you’ll be able to figure things out for yourself with no additional help from me.”

“I doubt that.”

“There is one more person you ought to be aware of who just might slip by.”

“Who’s that?”

“Sister Rosamunda.”

“Sister Rosamunda!” Koesler exclaimed. “Why, she’s the embodiment of the grandmother most people would want if they were able to invent their own!”

“No argument. It’s just that Rosey should have been retired years ago. But her ultimate fear is being put on the shelf. And Eileen is simply too kind to insist on her retirement. On the contrary, each year that it comes up—and it does come up each and every year—Eileen goes to bat with the corporation on behalf of Rosey. And in deference to Eileen, they allow Rosamunda to stay.”

“That sounds sort of nice. Very considerate of Sister Eileen.”

“Except that Rosey is left dependent on Eileen’s continued good will. As long as Eileen is in charge, the corporation will continue to defer to her on this. But eventually, inevitably, Eileen will be forced to pull the active plug on Rosey. And that will be the end of Rosey’s professional life.

“Add to which, Rosey—although officially she is listed as the sacristan and still has access to the patients—is getting senile. And on top of all that, she’s got a bit of a drinking problem. Not much, mind you, but enough to upset the applecart.”

“A drinking problem! You’ve got to be kidding!”

“I don’t kid. Not about that kind of thing. Now, Father, you know that’s not unheard-of. Although most Catholics—and I suppose that includes priests—like to think that someone like the aged and venerable Sister Rosamunda is above every human failing, above every human condition. But that’s just not realistic. With Rosey, it began years ago when arthritis joined her long list of medical problems. There was a lot of pain and a reluctance to depend on medication. Which, with an accumulation of ills like those that hit Rosey, wouldn’t have done all that much to relieve the suffering. Like many elderly people in pain, she turned to alcohol for some relief. She’s still on it.”

“Okay, suppose she is . . . what has that got to do with anything else?”

“Only this: that while there are some people—like the two I’ve mentioned—who might deliberately plan to undermine Eileen in running this hospital, somebody like Rosey could deep-six Eileen’s operation very effectively, if unintentionally. Or, she could even be used by someone who wanted to get at Eileen.”

A small bell sounded and the “up” button lit. Up was their only option. They were in the basement. They entered the elevator, silent during the one-story ride.

The lobby was vacant, with the exception of the receptionist, who was busy at her switchboard. The two men paused again.

“Let’s sit down for a moment,” Scott said.

Since no one else was in the lobby, the two men had a wide selection. They chose a two-person couch against the wall near the elevator.

“A group of us here at St. Vincent’s happen to appreciate what Eileen is trying to do,” Scott commenced. “We try as best we can to make it work—because of the way we feel about her. You’re going to be here only a few weeks. But in that time God knows what might happen.

“I used to read your stuff in the Detroit Catholic when you were editor. You struck me as the kind of person who would understand what Eileen is trying to do—that is, if you knew about it—as well as recognize some of the roadblocks along the way. So, for the duration of your stay in Father Thompson’s absence, and on behalf of those who are backing Sister Eileen—including Father Thompson—I guess I’m asking for your support.”

“Well, you have it. Very definitely. Just one question: How long do you think you all can hold things together?”

Scott ran a hand through his beard for a few moments. “Not long enough, I fear. Like all hospitals, the bottom line on St. Vincent’s is a deficit budget. The ledger for this hospital looks like a gigantic nosebleed. But for Eileen’s sake, we want it to last as long as it possibly can.

“Eileen is dedicated to serving the poor. And, inspired by her sacrifice, we join her. So we stay here as some sort of sign to whoever wants to recognize what we’re doing.

“Almost everyone else in the health care business is in it to make a living, if not a damn good profit, while we watch the money trickle away. It would be nice if someone bailed us out. But, then, there’s almost no way anyone could do that. Our deficit is a bottomless pit. So we say, ‘what the hell,’ and dive into the folly that is Christianity.” Scott paused and looked significantly at Koesler. “With all of that, are you still with us?”

“Gladly. But you have given me lots to think about.” He smiled. “I’ll see you tomorrow.”

They parted. After hanging his chaplain’s uniform in the closet of the pastoral care department, Koesler made his way to his car in the nearby parking lot. All the way back to his parish, St. Anselm’s in Dearborn Heights, he continued to ponder all that Dr. Scott had told him.

Without doubt, there was more to St. Vincent’s Hospital than met the casual eye. He would have to be alert to every nuance, especially those that affected Sister Eileen or her program.

At St. Anselm’s, he checked the desk in his office. There were only a few phone calls to be returned. He could do that in the morning.

* * *

I wonder what it will be like to kill a nun. Why should it be any different from killing anyone else? Is there some circle in hell reserved for murderers of nuns?

The whole business is ludicrous. I would laugh if I could. But I cannot. The pain—the pain in my head is killing me. It feels as if the top of my head is about to blow apart.

It is not as though death is foreign to this place. A hospital almost 150 years old! Thousands of people have died here. What is one more!

The good nun’s soul would be assumed into heaven. Why not? She probably is not aware that she is torturing me. That she is twisting a band of stress ever tighter until my head is ready to explode! The hounds of hell are screaming in my brain!

Will no one rid me of this troublesome nun? No one? No one! Then I must do it myself.

She must die. And I must do it. At the right moment. But soon—it must be soon!

* * *

The expression “As different as the night the day” could not find a truer embodiment than in a hospital. St. Vincent’s was no exception. Nor was there any doubt that schedules were established for the convenience of hospital personnel.

Day began when the day staff arrived at approximately 6:00 a.m. Day began slowly. Both staff and patients were trying to wake up. Patients’ conditions were checked. Cheery words spoken. Grunts returned. Sponge baths given. Medications administered. The action and commotion intensified as the day progressed.

Some patients did nothing; some were healing, some dying. Some were wheeled down to surgery. Some to therapy. Some to postoperative intensive care. Some returned to their rooms. Some received visitors. Some, if they could afford the rental, watched the mindless games and soaps of daytime commercial TV. Some who could not afford it watched one of the two “free” channels. One of these showed ancient slapstick movies. The other was the chapel channel, which, most of the time, showed a large, empty ornate chapel. Patients were fed three meals a day plus an evening snack, according to doctors’ orders.

A kind of climax was reached in late afternoon. After which came a gradual decrescendo.

Dinner was followed by prime-time TV and/or visitors. At 8:00 p.m., visiting hours ended and night prayers were broadcast.

Most employees had gone home, thus the hospital tempo slowed. There was a last-ditch effort to supply patient needs. After 10:00 p.m., in effect, the patients would not be needed until morning.

It was now just a few minutes after ten. All corridor overhead lights were off. Floor-level night-lights gave only scant illumination to hallways.

George Snell, a burly security guard, was on duty.

There was no reason anyone should have rested easily on that account. Though widely recognized for his prowess as a ladies’ man, George was by no means the most reliable member of a security force that was hardly topflight. It was, when all was said and done, the best security service St. Vincent’s could afford.

George, supported by both arms, was leaning against a wall on floor 3-D. Between him and the wall was a nurse’s aide, also theoretically, on duty, but who George knew could be talked into a short break.

“How about it, baby? How’s about a little?”

“I’ll say this for you, George,” replied the virtually imprisoned aide, “you sure have a way about you.”

“Yeah.”

“Why, you could charm a girl right out of her better judgment.”

“That’s the idea.”

“I know what the idea is, George. But we are on duty.”

“Duty, rootie. Everybody’s asleep.”

“No, they’re not, George. And if one of them rings that little bell at the nurses’ station, the charge nurse is gonna start wonderin’ where I am.”

“Don’t worry, baby, I’ll cover for you.” He winked elaborately.

“And you’re supposed to be on duty, too. What if something happens?”

“What’s gonna happen at old St. Vinnie’s? The hospital’s asleep and this end of downtown’s deserted. We’re the only ones awake.” He leaned closer.

“Well . . .” she vacillated, “where can we go?”

“I got that all figured out, baby. Room 3009 is a single and it’s vacant.”

“A single! For you? And me, too?”

“We will be as one.”

“A pretty big one.”

“Baby, we can stand here and talk about it all night. Or we can get it on.”

“Okay. But I got a hunch we’re gonna be sorry.”

“Baby, one thing I can promise you, you ain’t gonna be sorry.”

They made their way, she leading, down the hall to 3009. As she entered the room, she heard a dull plop behind her. She couldn’t believe her eyes. His clothing was in a heap on the floor. He must’ve been loosening everything on their way down the hall. If it were an Olympic event, George would win a gold medal for disrobing.

So there it was.

Two things seemed evident: He was ready and she was not likely to be sorry.

Lay on, George Snell.

* * *

Late evening—a quarter past ten—her time of day.

Sister Eileen had finished her paperwork. No one had disturbed her since night prayers at eight o’clock. Slowly, gradually, gratefully, her body chemistry was tapering off.

It’s funny, she thought, how, over the years, she had become so attuned to hospital routine that she and St. Vincent’s had become as one. Something like a couple who have been married a great number of years. The hospital’s ebb and flow was matched by her own emotional highs and lows.

As the patients and, in a sense, the hospital also, began to drift into quiescence, so did she.

As was her custom, Eileen would take one final tour of the various floors before bedtime. The pattern conformed to all the routines she had built up over the years. This was her time of silent prayer and reflection as she figuratively tucked the hospital in.

The night-lights gave an eerie glow to the otherwise darkened hallways. As she walked down the corridors she could hear the old building. Each evening it seemed that St. Vincent’s was settling further into the ground. It wasn’t true, of course; it simply was the sort of sound an old, well-constructed building makes.

The sound of deep, restful breathing emanated from most of the darkened rooms. Sleep, induced or natural, but a peaceful sound. A few patients still had their TV sets on. It was against the rules at this hour. But Sister would do nothing unless the noises were loud enough to disturb other patients.

There was something different about this evening. Eileen could not put her finger on it. But something was different. Was it a foreboding? She couldn’t tell. Just that tonight was different. Shivering, she pulled her shawl tighter around her shoulders.

From time to time, she passed by a window to the outside world. A solid coating of snow covered everything but the sidewalks around the hospital. The long-standing snow contributed its unreal glow to the dimly lit surroundings.

And the sirens. Always the sirens. Emergency vehicles delivering frightened, ill, or injured people to St. Vincent’s or one of the neighboring hospitals. Or a police car delivering someone in handcuffs to police headquarters.

“Hello, Sister.”

“Oh!” It was so unexpected. She had thought she was alone. But she’d been so deep in reverie, she had been unaware that the charge nurse had caught up and joined her.

“I’m sorry. I didn’t mean to frighten you.”

“You didn’t frighten me.” Eileen would not admit that anything in her hospital could frighten her. “I just didn’t hear you.”

“It’s these shoes. Plus I get in the habit of creeping around at night. How’s everything?”

Such a big question. “Okay, I guess. Just making some rounds before bedtime.”

The nurse was well acquainted with this routine, as was the rest of the staff. The joke had it that wristwatches could be confidently set depending on where Sister Eileen was in her nocturnal rounds.

“By the way, Sister, you haven’t seen Helen around, have you?”

“Helen?”

“Helen Brown, one of my aides. You know her.”

“Of course. No, I haven’t seen Helen. As a matter of fact, now that you mention it, I haven’t seen anyone but you so far. And I should have passed one of the guards by now.”

“The guards!” The nurse threw up her hands. “What next? I think the hospital should hire some agency to protect the guards.”

“Could Helen be in one of the patients’ rooms?”

“I suppose that’s where she must be. But she’s been gone longer than usual. I just wondered. I guess there’s nothing to worry about.”

“I don’t think so either. But I’ll keep an eye out.”

“Oops! There goes the phone.” The nurse hurried back toward her station where the phone was buzzing softly.

The guards! Eileen could make all the resolutions she wished and nothing would happen. This service, while it left very much to be desired, was the best St. Vincent’s could afford. Perhaps it was fortunate that police headquarters was on the next block.

Nevertheless, she would speak to John Haroldson, the COO, tomorrow. Perhaps he could get some favorable response from the service.

Dear God, how much longer could she keep this institution going? Sometimes she dreamed that she was literally Scotch-taping and tying string around St. Vincent’s to keep it together.

And always the nagging question, Is it worth it? Seemingly, it was the question on everyone else’s mind. She couldn’t afford to let her mind dwell on it. At least not overtly. Her attitude had to be steadfast, uncompromising. She was convinced that the moment she faltered, St. Vincent’s would come tumbling down. In this, she was not much mistaken.

“Oh!”

In her startled outcry, she scared both herself and the elderly gentleman who had just exited his room at her left.

She recovered quickly. “I’m sorry I startled you. Are you all right?”

“Whatinhell!” the old man muttered. “Goddam women! Gotta scream all the time! Scare a guy shitless, you let ’em. All the time gotta scream. Goddam women! “

“I said I was sorry. May I help you with something?”

“Goin’ to the bathroom. Can do that without you. Did it for years. Just don’t scream no more. Or I won’t have to go to the bathroom no more. Goddam women! Gotta scream all the time!” Muttering, he proceeded down the hall.

Eileen couldn’t suppress a smile. In the good old days, she would have been wearing a traditional religious habit. The old man had not recognized her as a nun. Undoubtedly, he would have been mortified if she had identified herself.

But it was odd. Twice tonight she had been frightened. That never happened.

She offered herself the simple excuse that both the nurse and the elderly patient had come out of nowhere suddenly, unexpectedly. It was the element of surprise that had frightened her. Nothing to worry about.

Though she was able to rationalize the episodes of fright, Eileen could not shake the feeling that something was different here tonight.

She shrugged the apprehension away. You could not function in a hospital in this part of town if you allowed yourself to be the victim of panic. It was either be brave and face this reality with confidence in God, or strike one’s tent and move on.

It was odd that she had encountered only the charge nurse and the bathroom-bound patient. True, she had not yet seen the missing aide, Helen Brown. That was not untoward; Helen might very well be occupied in another wing. But the absence of a security guard bothered her. She certainly should have passed one by now.

“Uh—!” Eileen had not screamed since she was a teenager. She tried to scream now. But no sound escaped through the large muscular hand that covered her mouth. His other arm slid under her chin, pressing hard into her neck.

She felt her body being lifted. She squirmed and struggled, but could not break free. Had she ever imagined such a thing might happen, she would have thought she’d be brave. But she was terrified.

It was ungainly, but she kicked and flailed. The more she struggled, the tighter grew the grip on her neck. An opaque pall dimmed her vision, intensifying her panic. Her heart pounded. A mounting sense of dizziness enveloped her.

Fearing she would never awake, she fought the lowering darkness. Yet she welcomed it as an escape from the pain and terror.

She gagged and lost consciousness as her assailant dragged her into room 3009.

* * *

Things have to be very serious before the sacred routine of a hospital is demolished. This, then, could be described as a very serious situation.

The CEO had been all but murdered. By a deranged, chemically dependent escapee from the detox unit. Sister Eileen had been saved, at the last moment, by George Snell, one of the hospital’s security officers.

The corridor lights had been turned up throughout 3-D. Many of the patients had awakened; several were wandering about the rooms and hallways. As many of the staff as could be assembled were present. Chief Martin, head of security, was presiding.

Once the resident on duty determined that Sister Eileen, beyond a few bruises and some diminishing fear, was all right, she had been placed in a bed and mildly sedated.

“Now, you wanna run that by me again? From the top?” Martin was pardonably skeptical at the tale of Snell’s singular skill, bravery, and efficiency.

“Well”—Snell basked in the figurative spotlight—“I turned the corner down there”—pointing toward the corridor’s dead end—“and Ī seen this guy grab Sister and start to drag her into this room.”

“Uh-huh. Then?”

“Then I got down here fast as I could. When I got in the room, he was chokin’ her. So I hit him. And he fell. And when he did, he let go of her. Then he hit his head on the bed and he was out cold. Then I called you. And you know what happened from then.”

“Uh-huh. Where did you hit the guy?”

“In the mouth . . . the face, I guess.”

Chief Martin studied the unconscious patient who was being attended by the resident. “Hey, doc, there any marks on that guy’s face? Like he’s been hit or somethin’?”

“No . . . no,” the resident said, “I don’t see any. Just this big bump on the back of his head where he hit the bed frame.”

“So,” Martin turned back to Snell, “if you hit him, how come he got no marks on his face?”

Pause. “Maybe I pushed him ... it all happened so fast.”

“Uh-huh.” Martin continued to ponder the scene. None of Snell’s story jibed with Snell’s previous proclivity to uninvolvement. But Martin was unable to come up with any alternative to Snell’s story.

There was one present who could come up with a different story. However, for many reasons, not the least of which was a personal interest in not having the facts revealed, Helen Brown wasn’t talking. But, barely able to stifle a smile, Ms. Brown recalled those events very clearly.

After his award-winning performance in disrobing both himself and her, Snell had propelled them onto the mattress with such enthusiasm that the bed slid several inches closer to the window.

Minutes passed as seconds. Snell seemed insatiable. No sooner was one episode concluded than another began. Ms. Brown had no way of telling how long that had gone on when she heard an unexpected and inexplicable sound in the corridor.

“George,” she stage-whispered, “somebody’s out there!”

“Shh! This is no time for small talk. “

“Come on, George!” Struggling to get out from under. “George! Somebody’s out there!”

Snicker.

“George, somebody’s fighting out in the hall!”

“And I’m fightin’ in here. I’m fightin’ to keep goin’ for you, baby.”

“George, don’t you think you ought to investigate?”

“I am, baby. And I like what I find!”

“George! George! They’re coming in here! George, they’re fighting! George, it’s a man, and he’s choking somebody! George!”

“Now, baby, get ready: Here comes the Snell Maneuver!”

Snell appeared to be going through a procedure not unlike a cowboy mounting a horse. Halfway through that maneuver, Helen Brown pushed him. She shoved with all her strength. It was enough.

Caught unaware, he toppled out of bed and, with momentum building, rolled across the floor. In rolling, he made contact. In effect, Snell took the man’s legs right out from under him, much the same as a roll block in football.

The man dropped Sister Eileen’s body and, tumbling over Snell, fell, hitting his head against the metal bed frame.

George Snell got to his feet and surveyed the scene. A detox patient, in pajamas and robe, unconscious. The CEO, unconscious. A nurse’s aide, conscious and naked, in bed.

This was the part from which Helen Brown never completely recovered. Snell wanted to get back in bed and continue with what he promised was the storied Snell Maneuver.

It was all Ms. Brown could do to dissuade him from his maneuver and persuade him to: get dressed and allow her to do the same, fabricate a believable explanation for what had happened—without ever coming close to the truth—and, finally, call his superior.

Sister Eileen would regain consciousness and apparently be none the worse for her ordeal. She would have a new, if guarded, regard for the hospital’s security.

And George Snell would become almost a folk hero to St. Vincent’s staff.

For another reason entirely, he would be enshrined in Helen Brown’s memory and imagination.

* * *

Father Koesler’s dreams were busy. In several of them, Sister Eileen was under attack, sometimes by the Nestorians of unhappy memory, sometimes by the modernists, sometimes by the Holy Inquisition. Koesler had a difficult night defending her.

It was one of those times when he was glad to see the dawn. Even if it was one of those dark, frigid, snow-caked mornings typical of a Michigan January.