'Mary must have pulled her IV out. There was saline and blood spilled on the floor.' Charlotte opened the door to the patient's room, and they both entered.
By the light of a bedside lamp, Mary Allen lay in a serene pose of sleep, her arms at her sides, the bedsheets neatly folded back across her chest. But she was not sleeping, and that was readily apparent. Her eyelids hung partially open. A washcloth had been rolled up and placed under her chin to prop up the sagging jaw. Relatives paying their last respects did not want to stare into a loved one's gaping mouth.
Abby's task took only moments. She placed her fingers on the carotid artery. No pulse. She lifted the gown and lay her stethoscope on the chest. She listened for ten seconds. No respirations, no heartbeat. She shone a penlight into the eyes. Pupils midposition and fixed. A pronouncement of death was merely a matter of paperwork. The nurses had already recognized the obvious; Abby's role was simply to confirm the nurses' findings and record the event in the chart. It was one of those responsibilities they never explained to you in medical school. Newly minted interns, asked to pronounce their first dead patient, often had no idea what they were supposed to do. Some made impromptu speeches. Or called for a Bible, thus earning an exalted place in the nurses' annals of Stupid Doctor stories.
A death in a hospital is not an occasion for a speech, but for signatures and paperwork. Abby picked up Mary Allen's chart and completed the task. She wrote: 'No spontaneous respirations or pulse. Auscultation reveals no heart sounds. Pupils fixed and midposition. Patient pronounced expired at 0305.' She closed the chart and turned to leave.
Brenda Hainey was standing in the doorway.
'I'm sorry, Miss Hainey,' said Abby. 'Your aunt passed away in her sleep.'
'When did it happen?'
'Sometime after midnight. I'm sure she was comfortable.'
'Was anyone with her when it happened?'
'There were nurses on duty in the ward.'
'But no one was here. In the room?'
Abby hesitated. Decided that the truth was always the best answer. 'No, she was alone. I'm sure it happened in her sleep. It was a peaceful way to go.' She stepped away from the bed. 'You can stay with her for a while, if you want. I'll ask the nurses to give you some privacy.' She started past Brenda, towards the door. 'Why was nothing done to save her?'
Abby turned back to look at her. 'Nothing could be done.'
'You can shock a heart, can't you? Start it up again?'
'Under certain circumstances.'
'Did you do that?'
'No.'
'why not? Because she was too old to save?'
'Age had nothing to do with it. She had terminal cancer.'
'She came into the hospital only two weeks ago. That's what she told me.'
'She was already very sick.'
'I think you people made her sicker.'
By now Abby's stomach was churning. She was tired, she wanted to go back to bed, and this woman wouldn't let her. Abuse heaped on abuse. But she had to take it. She had to stay calm. 'There was nothing we could do,' Abby repeated. 'Why wasn't her heart shocked, at least?'
'She was a no-code. That means we don't shock her. And we don't put her on a breathing machine. It was your aunt's request, and we honoured it. So should you, Miss Hainey.' She left before Brenda could say anything else. Before she could say anything she regretted.
She found Mark still asleep in the on-call room. She crawled in bed, turned on her side with her back to his chest, and pulled his arm over her waist. She tried to burrow back into that safe, warm haven of unconsciousness, but she kept seeing Mary Allen, the washcloth stuffed under her sagging chin, the eyelids drooping over glassy corneas. A body in its first stages of decay. She realized she knew almost nothing at all about Mary Allen's life, what she had thought, whom she had loved. Abby was her doctor, and all she knew about Mary Allen was the way she had died. Asleep, in her bed.
No, not quite. Sometime before her death, Mary had pulled out her IV. The nurses had found blood and saline on the floor. Had Mary been agitated? Confused? What had induced her to tug the line out of her vein?
It was one more detail about Mary Allen that she would never know.
Mark sighed and nestled closer to her. She took his hand and clasped it to her chest. To her heart. I do. She smiled, in spite of the sadness. It was the beginning of a new life, hers and Mark's. Mary Allen's was over, and theirs was about to start. The death of an elderly patient was a sad thing, but here, in the hospital, was where lives passed on.
And where new lives began.
It was 10 a.m. when the taxi dropped Brenda Hainey off at her house in Chelsea. She had not eaten breakfast, had not slept since that call from the hospital, but she felt neither tired nor hungry. If anything, she felt immensely serene.
She had prayed at her aunt's bedside until 5 a.m., when the nurses had come to take the body to the morgue. She had left the hospital intending to come straight home, but during the taxi ride, she had been troubled by a sense of unfinished business. It had to do with Aunt Mary's soul, and where it might be at this moment in its cosmic journey. If, indeed, it was in transit at all. It could be stuck somewhere, like an elevator between floors. Whether it was headed upward or downward, Brenda could not be certain, and that was what troubled her.
Aunt Mary had not made things easy for herself. She had not joined in prayer, had not asked Him for forgiveness, had not even glanced at the Bible Brenda had left at her bedside. Aunt Mary had been entirely too indifferent, Brenda thought. One could not be indifferent in such a situation.
Brenda had seen it before, in other dying friends and relatives, that mindless serenity as the end approached. She was the only one who dared address the salvation of their souls, the only one who seemed at all concerned about which way their elevator might be heading. And a good thing she was concerned. So concerned, in fact, she had made it her business to know who in the family might be seriously ailing. Wherever they were in the country, she would go to them, stay with them until the end. It had become her calling, and there were those who considered her the family saint because of it. She was too modest to accept such a title. No, she was simply doing His bidding, as any good servant would do.
In Aunt Mary's case, though, she had failed. Death had come too soon, before her aunt had accepted Him into her heart. That was why, as the taxi pulled away from Bayside Hospital at 5:45 a.m., Brenda had felt such a sense of failure. Her aunt was dead, her soul beyond salvation. She, Brenda, had not been persuasive enough. If Aunt Mary had lived only another day, perhaps there would have been time.
The taxi passed a church. It was an Episcopal church, not Brenda's denomination, but it was a church all the same.
'Stop,' she'd ordered the driver. 'I want to get off here.'
And so, at 6 a.m., Brenda had found herself sitting in a pew at St Andrew's. She sat there for two and a half hours, her head bent, her lips moving silently. Praying for Aunt Mary, praying that the woman's sins, whatever they might be, would be forgiven. That her aunt's soul would no longer be stuck between floors and that the elevator she was riding would be heading not down, but up. When at last Brenda raised her head, it was eight-thirty. The church was still empty. Morning light was cascading down in a mosaic of blues and golds through the stained glass windows. As she focused on the altar, she saw the shape of Christ's head emblazoned there. It was just the projected figure from the window, she knew that, but it seemed at that moment to be a sign. A sign that her prayers had been answered.
Aunt Mary was saved.
Brenda had risen from the bench feeling lightheaded with hunger, but joyous. Another soul turned to the light, and all because of her efforts. How fortunate that He had listened!
She'd left St Andrew's feeling wondrously buoyant, as though there were little cloud slippers on her feet. Outside, she found a taxi that just happened to be idling at the curb, waiting for her. Another sign.
She rode home in a trance of contentment.
Climbing the steps to her front porch, she looked forward to a quiet breakfast and then a long and deserved
