The Gospel According to Mary Mason

A FOOT OF SNOW BLANKETS THE GROUND. Standing outside the hospital entrance, a robotic Santa twists and turns as it greets passersby. The radio’s blaring Christmas carols, and by the time Clare finds a parking space in the staff lot a chorus of pa rum pum pum pum’s loops in her ears. Her boots march in lockstep, the ground beneath her feet crunching to the music as she makes her way to the sixth floor. Pa rum pum pum pum. Rum pum pum pum. Rum pum pum pum.

Inside the building, the holiday theme continues. Silver tinsel streams from the heating ducts. A plastic tree sits on top of a filing cabinet, bobbing with ornaments, its white tablecloth base littered with glitter. Clare is twenty-five years old and tackling her first real job. She’s a do-gooder.  An optimist. And when she looks at the feeble attempts to bring Yuletide cheer to a cancer ward, her first response is I can do better. And when the first bed she checks is empty, she naively thinks people get better, too.

She digs into her pocket for her cellphone and calls her supervisor. The man’s gone from Room 304, she says.  Mr. Kowalski. They think he was transferred to the ICU but the ICU has no record.

The woman on the other end of the line is a former nun. Whiskers on her chin and a polyester pantsuit.  Mary Mason nimbly skirts the question, knowing the answer, knowing that Clare knows the answer as well. Her voice is thick with an Irish brogue.

Keep your nose to the grindstone, she says.

After a lifetime of service, Mary Mason considers social work a trade, not a profession. Once she saved souls. Now she prefers getting things done.  There’s always a list, a list a mile long. Make sure the home health aide shows up.  Guide them through the insurance maze.  Plan the funeral arrangements when the poor family’s paralyzed with pain. That’s the bricks and mortar of it. The Savior himself was a carpenter. Bricks and mortar. Nuts and bolts. Get things done.

They both stare at the lit screens of their phones.

Time’s not standing still, says Mary Mason. You’ve got what? Five ten people on the queue?

Clare makes her way to the second name on her list.  The walls of the pediatric ward pop with freshly painted murals.  Reindeer frolic over marshmallow clouds.  Six foot candy canes wield arms and legs and toothy grins. Instead of lifting her spirits, Clare retreats further.

Most jarring of all are the voices wafting from the ceiling. Someone has piped in department store Musak. The usual cacophony of noise–machines beeping, a voice droning over an intercom, nurses gossiping around a desk–all compete for her attention. Like an orchestra conductor waving his baton, Clare wills the sounds to weave together. An elevator pings.  A woman cries. Bing Crosby croons. And pulsing like a heartbeat is that Christmas carol. Pa rum pum pum pum. Rum pum pum pum. Rum pum pum pum.

She finds her second client lying on the bed, his arm tethered to tubes, his eyes closed. Though the graphs are undulating and the lines zigging and zagging, the boy hasn’t spoken in days.  Clare glances again at the clipboard. In two weeks’ time, Patrick will be sixteen.

If life were fair, his skin would be tanned from the sun, a spray of freckles flitting across his cheeks. Instead his lips are cracked and cold, his bare arms gray atop the sheets.

If life were fair, he and his mother would be arguing about his haircut. His mother would be saying Mohawks may have looked good on certain indigenous tribes but you’re a white kid from the suburbs, Kemosabe.  Instead his scalp is bald, his eyebrows thin pale ridges.

If life were fair, his mother would be standing in the bleachers, shouting at the umpire, saying can’t you see that pitch was a ball and not a strike!Instead his mother sits by his side thinking God give us one more week. Maybe in a week’s time I’ll be ready. Maybe in a week’s time I’ll be able to walk down the corridor without collapsing, be able to get in my car and start the ignition without wanting to drive into the nearest concrete wall.

The woman has kept a nonstop vigil by her son’s bedside. Clare shuffles the papers in her clipboard. Would you like a glass of water? she asks. I could fetch you a donut, a cup of coffee, anything. Is there a clergyman I can call?  Perhaps a neighbor?

In lieu of responding, the woman ignores her. She runs her fingers up and down a rosary while her mouth contorts in prayer. So many walls, thinks the woman. So many hard concrete walls.

Clare waits. She pretends to read the papers in her hands. But staying focused is difficult. Machines pummel her ears.  The girl next door is moaning. A few doors down the hallway someone’s thwacking the floor with a mop.

Then all of a sudden Clare hears a voice. The boy’s eyes are closed. His lips sealed tight. Clare looks at the machines. The lines on the graph are still rising and falling. The neon numbers are oscillating on the screen. She’s not sure where the voice is coming from but it’s loud and clear. An adolescent voice. The voice of a boy who’s confident but shy, tentative but brazen, willful yet scared. The voice of a boy who’s fifteen.

You know, it’s funny, he says. There’s nothing I wanted more than my driver’s license. Freedom! You know what I mean?  So I marked each day on the calendar.  I’m thinking four more months til I’m sixteen. Three more months til I’m sixteen. One more month til I’m sixteen.

Now each day passes like time lapse photography. The sun goes up and comes down in a blink.  If only I could stretch each hour. Each minute. Each second. If only I could make the Earth stop spinning. You know what I mean?

Clare glances at the mother. She’s fumbling at the beads and mumbling her prayers, bunching her skirt in her lap. Concrete walls, she’s thinking. Concrete walls.

You know what I mean? says the boy. You know what I mean?

But once again Mary Mason whispers in her ear.  Put one foot ahead of the other, she whispers. Other souls need tending. You offered food, drink, and compassion. What else would the Good Lord expect?

Before entering the NICU, Clare washes her hands and puts on scrubs.  Of all the rounds she makes each day, this is her least favorite. Life in this ward can turn on and off like a switch. It’s as if months of prenatal love and nurturing didn’t count and with the push of a button thought and breath are permanently deleted.

Poof! Gone.

The couple is hovering near the incubator, its blue lights casting a ghastly shadow over their child. Clare checks her clipboard. The baby doesn’t have a name yet. At twenty-nine weeks, he’s splayed on his back, naked except for a diaper and a knit cap. There are sensors on his chest, a port in his belly button, and an IV in his foot. A tube feeds oxygen through his nose.

Cold, he stutters. The boy tries to bring his knees up, tries to turn over on his side and do that somersault thing but somehow he’s stuck. Cold, he says again.

Clare turns to the parents. Each day she introduces herself and each day they act like she’s brand new. Since it’s only their second week in the ward, the parents wear their work clothes under their scrubs. A suit and tie for the father. Heels and a pencil skirt for the mother.

Other parents know the routine. They wear sweatpants and sneakers. Lug tote bags filled with snacks and sweaters for the long siege. But Baby X’s parents are still working under the illusion that everything’s fine, that their schedules will just need to be tweaked and adjusted, that every problem has a solution and every solution lies at the tip of their fingers waiting to be grasped.

The mother grabs Clare’s wrists. They want to ventilate him, she says.

Ventilate him? says Clare.

Why aren’t they using the CPAP? says Mary Mason. They should try the CPAP first.

The father has been walking through the room, inspecting the other babies, taking notes on his phone. He joins them mid-conversation.

Those face masks? Can’t he get one of those face masks?

They’re called CPAPs, says Clare. There’s medication, too. They are several things they can try before they put him on the ventilator.

He needs another echocardiogram, says the mother. To check the heart valve. His heart valve doesn’t seem to be doing its job.

PDA, too?  Mary Mason clucks her tongue. The child, bless his soul, has scored a trifecta.

Those lights, the baby stutters. Can’t you do something about those lights?

Clare wonders how much the parents know and don’t know. About the eye damage, about the brain bleeds, about the learning problems down the road. It amazes her time and time again how courageous her clients are. Even the babies. Especially the babies.

Years ago, says Mary Mason, doctors believed that newborns felt no pain. That their nervous systems were too immature to process discomfort. So operations were performed without anesthesia, and procedures were performed without drugs. Christ Almighty, says Mary Mason.  Can you imagine how much those children suffered?

Meanwhile the mother pushes up her green sleeve and glances at her watch.  Good lord, she thinks. How am I ever going to make that 3 o’clock appointment?

Tears stream down the father’s cheeks. My life for his, he thinks. My life for his.

I’m so cold, the baby stutters.  I’m so very, very cold.

All around Clare, alarms are sounding and nurses are scurrying.  The mother glances at her watch. The father weeps. The baby opens his mouth and tries once more to speak. Clare has no idea if the voices are inside or outside her head.  All she knows is that everything is reaching a crescendo. Footsteps are pounding, sirens are shrieking, shoebox-sized infants are bleating like lambs. Pa rum pum pum pum. Rum pum pum pum. Rum pum pum pum.

Her last patient for the day was moved to the hospice wing five days earlier. Clare checks her clipboard.  Ralph Schwartzbaum is eighty-three years old and barely conscious.  A steady dribble of relatives visits him. Sometimes he opens his eyes and responds. Sometimes he lapses into a deep sleep. The family has retained an aide 24/7, a luxury few of Clare’s clients can afford.  His wife keeps the aide company, a shopping bag filled with knitting supplies by her side.

This room is thankfully free of machines. A TV hangs from a wall, the volume turned low. On the screen, a gaggle of women are sitting around a fake living room, observing a food demonstration.  While the aide watches intently, the wife focuses on her husband. It’s close to five o’clock. Clare peaks through the louvers of the window and realizes that the sun is setting. A blue gray flatness lays like a hand as far as she can see.

My Goodness! says the aide.  A small explosion emanates from the TV as oil splatters on a hot stove. They didn’t see that coming, did they?

Clare turns. Did you say something?  Excuse me. Did I miss something that you said?

The aide has menus and grocery shopping on her mind. Should I throw together a meat loaf tonight? Or maybe a nice beef stew. On TV it looks so easy, don’t it?  The mess practically cleans itself up.

The wife dips into her shopping bag and pulls out her supplies. Within seconds, her hands are webbed with yarn. Her fingers are dipping and weaving, counting the stitches under her breath.  And while she’s counting, she’s thinking. Visions of bonds, coins, and gold pieces dance in her head.

Though she loves her husband dearly, she has no illusions. Ralph was a man of secrets. Somewhere there’s a lifetime’s worth of savings sheltered from pesky lawyers and the IRS. He must have kept a safety deposit box. Where the hell’s the safety deposit box?

Pork chops! says the aide. That’s the ticket!

Clare asks to see the aide’s notes.  From what she can gather, the end is near. The man’s heart rate has been irregular. He hasn’t spoken in hours. His body is immobile except for an index finger that relentlessly taps his thigh. Buried in Clare’s clipboard is a checklist of referrals. She flips through the pages searching for the right names and the right numbers. It’s important is to be ready when the time comes.

All three of them are taken aback when the man suddenly sits forward. The wife drops the knitting needles while the aide turns from the TV. Time seems suspended as they all stare. Slowly the man grabs the bedrails like he’s ready to bolt. Opening his mouth, he gasps for air.

Instead of stepping forward, Clare instinctively steps back. She knows there is a protocol. There are rules that lay out her actions and behavior in times just like these. Instead she’s numb. Her thoughts are whirling like a tornado and inside the storm only a small hollow tunnel looms.

I’m right here Ralph, blurts the wife.

The aide has seen Death’s face in all its permutations. She knows the movements for what they are. Jesus, she says. The man’s a goner now.

He’s stopping by the wayside, says Mary Mason.  Let the angels take him home.

But Ralph’s mind is elsewhere. His thoughts are swimming with pristine beaches and blue skies. Is this Acapulco?  he wonders?  Oh to be in Acapulco with a pina colada and a blonde!

In one tremendous effort he reaches for that cold glass with the tiny umbrella perched on the rim. He’s almost got it. He can taste the sweetness of the pineapple and the salt of the seawater on his tongue. In the distance, he sees a woman striding toward him, her breasts bounding over her bikini, her hips swaying in the sand.

The next moment he’s dead.

The following hour passes in a blur. Clare calls family members on the phone, speaks to the funeral home, has a doctor prescribe a sedative for the wife. She has no remembrance of whatever words were spoken. It’s like an out of body experience. Only instead of lying on a gurney she’s walking and talking and watching other people watch her.

When it’s finally time to drive home, she’s terrified.  The distance between her and her car seems endless. Arrows are painted on the floors. Signs are posted on every wall. Helpful attendants sit at every desk. Though it’s impossible to get lost, she’s sure she’ll never reach her destination.

The din is even louder now. Her heart thumps. Machines beep. Elevators ping.  Babies are stuttering and teenagers are pleading and old men are sharing their dreams.

Go to the chapel, says Mary Mason. You’ll find what you need in the chapel.

Covering her ears, she inches her way down the corridors.  She passes the cafeteria and hears the clattering of trays, the shouting of children, the scraping of chairs against the linoleum floor. She passes the gift shop and listens to the drawers of the cash register open and close, to change jangle on the counter, to the crush of a receipt thrown into a paper bag. Wherever she goes, the piped-in music follows–tormenting her, mocking her, shadowing her footsteps.

You’re almost there, says Mary Mason. A few more paces and you’re there.

Finally, she locates the door that marks the chapel. Slowly she opens it and proceeds down the rows of pews. In front of her is a large stained glass window. She glances to her left and right, realizes she’s alone, and for the first time that day sits down.  Even though an assortment of prayer books is piled on the wooden seat, her hands stay limp by her side.

The relief, when it comes, is overwhelming. The air is light and unencumbered, the pews more comfortable than they look. She hears nothing and sees nothing. At last, her head is cleared of sound and her mind at peace.  Closing her eyes, Clare lets the silence swallow her. The room is blessedly quiet, her thoughts urgently at rest. Only her lips move as her mouth forms the most gentle of creases, listening for that still small voice within.