HOLD FAST | William Cass


That morning officially marked the start of Marsha’s third year after graduate school in her position as the social worker at the wing of the children’s hospital in San Diego for severely-handicapped/medically fragile patients. To celebrate the occasion after arriving, she’d treated herself to an outrageously expensive latte from the coffee cart that stood between the employee parking lot and her building. It was a little before 7 am, and she’d just settled into the chair in her tiny office when the phone rang on her desk.

She answered it and the charge nurse at the front desk said, “We need you up here. There’s a situation.”

Marsha closed her eyes and pinched the bridge of her nose. She said, “What’s going on?”

“Mrs. Flores is here. I told her she had to speak to you before going to see Pablo. She’s not happy.”

Marsha squeezed her nose harder. Pablo was Mrs. Flores’ grandson. He was about to turn two, and had been with them since shortly after birth. His complications included a trach, vent, g-tube, and seizure disorder; he was non-ambulatory and non-verbal, requiring adult assistance, like the vast majority of patients in that wing, for all his care needs. His parents had each barely turned twenty and weren’t married, so his mother had made the admission. But his father, Mrs. Flores’ son, came down when he could from Los Angeles, where he’d moved recently for a new construction job, to visit on weekends. Pablo’s mother worked long hours seven days a week cleaning hotel rooms and could only come occasionally, so it was Mrs. Flores who spent the most time with him. She came almost daily, accompanying him to his medical appointments on the acute side, attending interdisciplinary team meetings, and singing to him in Spanish while she rocked him at his bedside. No other grandparents or family members were identified on any of Pablo’s hospital records.

Marsha had spent an uncomfortable half hour with his mother before leaving the previous afternoon when she’d stormed into her office still in her maid’s uniform after finding out that his father had taken up with another woman in L.A. His mother had insisted on removing both his father and Mrs. Flores from the approved visitors’ list. So, it was left to Marsha to explain to Mrs. Flores that she could no longer come to see her grandson.

Marsha blew out a breath. She moved the hand from her nose to her paper cup, opened her eyes and said, “Can you send her back to my office?”

“I’ll see if I can,” the charge nurse told her. “Not sure she’ll come. She’s pretty angry.”

They each hung up, and Marsha took a long sip from her cup. It was just before shift change, and the hallway outside Marsha’s office was busy with incoming staff, so she didn’t notice Mrs. Flores standing in her open doorway until she cleared her throat loudly a few minutes later. The older woman glared at her through squinted eyes, her jaw set tight. She was short and round with brown hair beginning to go gray. Like always, she wore a dark dress with a thin belt and carried a big black purse. That morning, she held it in one hand and clutched a large grocery bag in the other; Marsha supposed it held clean clothes for Pablo because Mrs. Flores insisted on doing all of his laundry at home. She said, “I was told to see you.” It came out hard.

Marsha gestured to the little round table next to her desk and said, “Come in. Please.”

Mrs. Flores took the chair closest to the door, settling her girth on its edge and placing the things she carried at her feet. Marsha swiveled her own chair around so they were facing one another. The space between them was close enough that Marsha could see the depth of the tiny lines etched at the corners of Mrs. Flores’ eyes.

“So,” Marsha began. “Pablo’s mother came to see me late yesterday. I’m afraid she’s taken his father and you off the visitors’ list.”

“What’s that mean?”

Marsha raised her eyebrows. “Well, it means you can’t see him again unless she puts you back on that list.”

The older woman’s eyes narrowed further. “What’s this all about?”

“You’ll need to ask her. I really can’t disclose details, but it has something to do with her being upset with your son.”

A snorting sound escaped Mrs. Flores. She looked away, then back to Marsha, and said, “His new girlfriend.”

Marsha pursed her lips and showed her palms.

Mrs. Flores shook her head and her shoulders slumped. “They should have never become parents,” she said quietly. “Either of them. They were just kids themselves. Still are.”

Marsha cocked her head in what she hoped was a sympathetic manner. The older woman’s shoulders slumped. “What happens with my grandson now? Who will be with him?”

“Our staff will check on him regularly. Care for him like they do all the other patients.”

“All the others,” Mrs. Flores muttered. “How many visitors do those others get every day?”

Marsha felt her color rise. She shrugged.

“I counted fifty-one beds here when my grandson was first admitted.” Mrs. Flores continued to stare at her, but the anger had been replaced by something new. “And there were four other names in the visitors’ log when I signed out yesterday afternoon. Four.”

Marsha nodded. “You’ve been very attentive to Pablo. I know you care for him deeply.”

“I do.” Mrs. Flores’ eyes brimmed, but no tears fell. “I love him.”

Marsha reached over and put a hand on top of the older woman’s. “I know that. We all do.”

“He’ll be all alone in that room. Hooked up to all those machines. Just whirring away.”

Marsha patted the rough back of Mrs. Flores’ hand, then took her own away. She said, “I hope you’ll talk to his mother, see if you can work something out. I hope you can.”

Mrs. Flores nodded, wiped the bottom of her nose, and sighed. The noise in the hallway had died down. Marsha thought about her own fiancée moving out the month before when she’d found out about his infidelity. She wondered if Mrs. Flores also went home to emptiness. She frowned at a faint scratching sound that came from beneath the table.

Mrs. Flores looked from her to the grocery bag, then lifted it onto her lap. “My hamster,” she said. “There’s a CNA here who told me she’d take it. Young, blonde hair. Works with Pablo sometimes at night. Can I speak to her?”

Marsha’s frown deepened. “I’m not sure who you mean. Staff rotations change. Even if I knew, I couldn’t go get her for you while she’s working.”

The older woman shifted the bag. “She said she’d take it. I can’t care for it anymore.”

“Well,” Marsha said. “Shift change is going on right now. If you wait outside, you might see her. Most of the staff getting off head down the ramp there towards the employee parking lot.”

Mrs. Flores nodded. “All right,” she said, standing. “Thank you. You’ve always been nice to me, kind. I appreciate it.”

“Will you talk to Pablo’s mother?”

She nodded again, and Marsha watched her leave, then stared out her open doorway. The hallway there remained empty for several minutes until a nurse in scrubs decorated with Disney characters pushed a med cart by. Marsha listened to the sound of it disappear down the hall. She stood and stepped over to her office window. Down below, at the foot of the ramp leading to the front entrance, she saw Mrs. Flores sitting on the bus stop bench. The older woman had her purse next to her with the grocery bag on her lap and was turned so she could see the overnight staff coming off shift as they descended the ramp. Marsha watched her smile and raise one hand in greeting, then saw a young woman with limp blonde hair in the middle of the ramp return the wave as their eyes met. Though neither was looking up her way, Marsha raised her fingertips as if to wave, too.

She sat back down at her desk and checked the time on her watch. She had ten minutes before she had to be on a conference call with the unit’s director and head of nursing. Afterwards, she had interdisciplinary team meetings for the rest of the morning, then two admissions to coordinate in the afternoon. But, before she went home, she intended to find time, like she often did, to stop by the rooms of a few of the children who rarely had visitors. Sometimes, she sat by their beds and snuggled them. That afternoon, she knew that she would include Pablo among her stops. She wouldn’t sing to him, but she’d tell him that things would be all right. Even if she couldn’t be sure it was true and knew he wouldn’t understand, she’d tell him that. What were the choices otherwise?

William Cass has had over 150 short stories accepted for publication in a variety of literary magazines such as december, Briar Cliff Review, and an earlier issue of Intima: A Journal of Narrative Medicine.  Upper Hand Press plans to publish his children’s book, Sam, in April 2020.  Recently, he was a finalist in short fiction and novella competitions at Glimmer Train and Black Hill Press, received a Pushcart nomination, and won writing contests at Terrain.org and The Examined Life Journal.  He lives in San Diego, California.