Fiction | Nightwatch by Dana Gage

Rane entered the room hesitantly; she didn’t want to enter at all; she had pleaded with the intern and then to the resident, who just shook his head and said it wasn’t up to him. The Chief Resident had ordered, had insisted upon it, that she see this particular child, work her up.

Rane’s protests had ended with a plea for mercy on the child’s behalf, earning her another demerit in the Chief Resident’s assessment of her performance: refusing an assignment. His list of complaints about her was long; she could recite them all: failure to work up an admission (even though she had done seven that night), failure to write her notes promptly (even though she was in class until 3 PM everyday), accusing her of simply copying the intern’s notes and finally, failure to attend Grand Rounds, when she had taken a child to CT scan when everyone else was busy. She no longer cared about his assessment; this was different.

So now it was eight o’clock and the only light in the child’s room was that reflected from a spotlight on the corner of the building. It shone mostly on the parking lot, the cars huddling like bears waiting for prey. As Rane approached the bed, there was stirring.

“Can’t you leave her alone?” the voice said.

“Ma’am?”

”What is it with you people? She’s just barely fallen asleep. What do you want with my daughter?

Rane stopped.

“Please don’t touch the bed. It hurts her so bad. Isn’t there anything you can give her for pain? Are you a nurse? Could she get more pain meds?”

“I’ll talk to them for you; just let me do this first. I have to do a physical exam, take a history. I’ve been assigned.”

”When you touch her, she screams in pain. Isn’t there anything you can do? Are you a doctor?”

“I’m a medical student. Assigned to her case.”

“Even if you are a student, can’t you see that my daughter is in pain? Surely you can get her something. She’s dying. Isn’t that enough? Can’t you see that?”

The last was a statement. Layed out. Bare. Rane looked at the woman huddling in the shadows, then at the little girl on the bed. She appeared to be about six. Her hair was gone and on her scalp, nodules protruded from the smooth surface. Her eyes were half open, glazed. Her arms and legs were also covered with nodules, bony, stretching the skin tight. The flesh around them seemed to have evaporated, as if all nourishment had given over to feeding them, leaving the child with nothing. The rest of her skin was pale and pressed shiny and smooth over her abdomen, filled with fluid, a ball of fluid pinning her to the bed. Her umbilicus pushed outward as if she were ready to give birth. With each shallow breath came a little moan, as if that small effort was more than she could bear. In the reflected light, Rane stared into the face of death.

“Yes, I can see,” she said, wondering how she could touch this child, what she could do, how she could justify such an invasion.

Outside the door she saw the Chief Resident approach; he stood watching, waiting.

She turned to the mother. “Why are you still here? It’s late. Don’t you want to go home and get some rest? Your other children, I saw them before.”

The woman nodded and Rand followed her gaze; two toddlers lay tangled together on a cot in the corner.

“Shouldn’t they be home?” she asked. “Your husband…”

“They want to be here. With their sister; they miss her at home.” She spoke firmly. “My husband? I haven’t seen him in weeks. We take turns. When he’s not working one of his three jobs to pay for this care she is receiving. The best. We wanted the best, the number one Doctor in this area. Ha! What did it matter? And now. Another round of chemo they say, just give it a chance; it might buy her some time, time to go home.” The woman bent over to muffle a sob. She looked at Rane again.

“Just let us go home,” she pleaded. “Why won’t they just let us go home? Why can’t she die in her own bed?”

“You still have hope, “Rane said. “There’s always that.”

The woman looked up suddenly and stared at Rane. “I know who you are; they told me about you, that you would be in here to see my daughter. You’re pretty special, I hear, doing your own bone research, already getting ready to publish a paper, only a freshman but cutting a notch for yourself. Number One, another Number One.”

“We all want to be the best at something.”

“And what do you have to offer my daughter? What new treatment plan? What new drug?”

“I’m not sure what they have planned.”

“So they sent you in here to learn from my daughter, who can’t bear to have someone breathe on her? They told you to come and examine her?”

“Yes, Ma’am. But I told them I wouldn’t do it.” Rane stopped and took a deep breath. “And they told me my career is on the line.”

The woman got up from the chair and took a washcloth from the bedside table, dipped it in a kidney basin of water. It was then that Rane saw the gravid belly, watched as the woman struggled to bend over her daughter and keep her balance. She took the cloth and held it just over her daughter’s forehead, not touching but close enough to diffuse the coolness onto her daughter’s flushed face, soothing by intention only. No direct contact.

Then she looked over at Rane. “Do you know what it is like to lose something so precious to you? Do you? Do you know what it is like to not be able to comfort your dying daughter in your arms?” She paused. “Isn’t there anything you can give her?”

“The medicine is so strong; they are afraid to give her more; it will slow her breathing, cause her to…”

“What? Die?” The woman began to laugh in a high pitched keen, rocking back and forth on her heels, then breaking into great raw sobs. When Rane reached out to her, she snapped back just out of reach.

“That’s the old medical stance, isn’t it? Can’t give the dying patient too much pain medication or it might kill them. Better to let them feel every moment of suffering along the way, let them suffer their death as long as they can. Tell me why it is necessary for this little girl to feel every moment of pain? Tell me. For what?” Again she started to sob, but cut herself short when the tangle of her other children started to stir.

“Well, I can tell you one thing, Miss Medical Student, Miss Number One in the Class. You are not going to touch my daughter; I don’t care if you flunk out of school. You will not lay one hand on her. Do you understand?”

“You’re right, Ma’am. I won’t. Now just sit down and try to rest. I will sit here with her until morning. Let me just check this IV rate and I’ll make sure her pain meds are running smoothly. You sit. I’ll be with her. And I swear to you that I will not touch her. Would you mind if I said a few prayers that my grandmother taught me. It might soothe her.”

Dana Gage is an Editor at The Intima