SISTERS OF MERCY | Eileen Valinoti
As a first year nursing student many years ago (or probationer as we were called then), I showed a clumsiness and ineptitude that put me in a class all by myself. I couldn't carry a basin of water to the bedside without spilling half of it, the beds I made all fell apart and whenever I had to give an injection, my hands shook violently. I didn't organize my work properly so I was always the last to finish. Still I had a willing heart. I liked nothing better than to sit with my patients holding their hands and listening to the story of their lives. I had little knowledge of counseling or psychology so whenever they seemed upset I simply said, "How about a nice cup of tea?" and I noticed that it never failed to cheer them up. My cups of tea made me popular with the patients. They didn't seem to care that the corners on their sheets weren't at sharp right angles or that my apron was askew- all the things that drove my supervisors mad.
During the second half of that first year at Mercy Hospital, we spent six weeks on various units. At the end of that time, we each received an evaluation called an "efficiency report." It was a long form with many criteria such as "organizes her work," "neat and punctual," etc., etc. Next to each category were three headings, "Average," "Above Average," and "Below Average." Alas, I often fell into the "Below" column. Some of the head nurses were sympathetic and added comments like "willing to learn" or "kind hearted and enthusiastic," taking some of the sting out of all the "below averages." I worried that a string of mediocre efficiency reports would stop me from getting my nurses' cap in June, an important milestone signaling the successful completion of the probationary period.
In April of that first year, I was assigned to the female medical unit, headed by the notorious Miss Regan, a heavy set middle aged blonde, who ran a "tight ship" according to knowledgeable sources among my friends.
"She hates the probies," my friend Cathy told me. "She blames everything on 'the kids.' " As she spoke, she flicked the ashes from her cigarette in all directions. We were sitting in the lounge in the nurses' residence known as "the smoker," the only place where smoking was allowed. The ancient mismatched furniture was pockmarked with cigarette holes, silent testimony to generations of students. The one amenity in the dreary room was a small black and white TV. Still we loved the smoker where we could hide from the nuns, who never crossed the threshold but only hurried by averting their eyes and sniffing the polluted air that drifted into the hall with distaste. "Just stay out of Regan's way," Cathy added, narrowing her eyes against clouds of smoke.
* * * * * *
Female Medical was a gloomy place, badly in need of renovation, the hospital's euphemism for a coat of paint. The unit consisted of corridors of semi private rooms which faced either a dark courtyard or the brick wall of the maternity building. Next to the nurses' station was a tiny lounge where the doctors had coffee with Miss Regan, off limits to lowly persons like myself. At the nurses' station I took my place behind the graduate nurses, as we listened to the night report. Female Medical had many aged patients; often the night nurse said "agitated" or "confused" in describing her charges. Perhaps this accounted for Miss Regan's grim expression as she took notes in a large black looseleaf folder on her lap. From time to time she interrupted the poor frazzled night nurse with some terse interrogation. She would say in an accusatory tone, "When did you take her temperature last?" or "What was her last blood pressure reading?" Listening, I felt intimidated, especially since I saw that I was the only student nurse on the unit without a friend for moral support or to share wicked jokes about Miss Regan. I sank deeper into my chair, trying to make myself smaller, or better still to disappear.
But my second day on the unit, I crossed paths with Miss Regan. I was in the kitchen, happily making tea for one of my charges, when she came storming in after me.
"Kelly," she said in exasperation, "I've been looking all over for you. We're all out of syringes. You were assigned to the sterilizer today."
I mumbled some excuse and mercifully she was called away. I was so absorbed in tending to my patients that I had forgotten the other tasks I was assigned, to clean the dressing carts and boil up the syringes. No one said it in so many words, but I sensed that on Miss Regan's unit, a nurse who spent too much time with her patients was considered suspect, even aberrant. Actually, I was only at ease with the patients. I often felt as lonely, threatened, and bewildered as they did. When they complained bitterly about the hospital, the heartless routine, the lack of all peace and privacy, I could only nod silently in agreement.
I often took refuge with Sister Anne, a Sister of Mercy with advanced breast cancer. She was fifty years old but looked younger, with a beautiful face with pale glowing skin and smiling blue eyes. Before her illness, she had been the Mistress of Novices; often the young postulants came to visit, bringing her their questions and problems, sometimes wearing her out.
"You run out of conversation," she once told me, rubbing her forehead wearily.
Sister had a calm maternal presence that had a soothing effect on my jangled nerves. Over a cup of tea, a faint color would appear in her pale cheeks as she spoke to me about her life in religion.
"I was in the world quite a while, dear. I went to business," she said with quiet pride. "I knew what I wanted when I joined the order."
Sometimes she patted my hand, offering a wordless comfort as if I were some homesick novice, which in a way I was. When I puttered about her room too long, she asked me worriedly:
"Is anyone looking for you, dear?"
Often someone was and I would scurry out, back to folding linens and scrubbing the utility cart, tasks I conveniently had forgotten. I wondered about Sister, how she never spoke of her illness. One day at lunchtime, I was alone at the desk with Miss Regan. The staff was busy getting the patients ready for lunch; there were the sounds of trays banging, the heavy rumble of the food carts, the noise of the ancient elevator doors opening and closing. Gathering up my courage, I asked her about Sister's prognosis.
"She ignored the tumor," said Miss Regan. "By the time she saw the doctor, it was too late. They removed it of course and gave her some radiation, but she already had nodes in the liver." She shook her head in disapproval. "She's only here for tests," she went on, bending her head again to her charts, "They'll be sending her back to the convent."
"Sending her back." The words had a sorrowful ring, as if Sister had been found unsatisfactory, a patient for whom nothing could be done, best discharged and forgotten. I pictured her alone in her room in the convent, while her fellow nuns carried on their busy lives. What would she do? Pray, I supposed. For deliverance.
But before the arrangements could be made, Sister's condition worsened. Her beautiful white complexion took on a yellowish cast, signaling the advance of the disease. She couldn't eat. Worst of all, she began to have periods of mental confusion. One night, she was found teetering at the edge of the stairs.
"Where is the Chapel?" she cried out in an agitated voice. "I've got to go to Mass." Another awful day she fell, narrowly escaping injury to her fragile bones.
"We'll have to keep her in bed with the siderails up," said Miss Regan. "We can't watch her all the time." Female Medical had other difficult patients, helpless stroke victims, frail cardiac cases, trembling unpredictable diabetics. We were run off our feet, racing up and down the long hall, trying to meet relentless needs.
Alone in her room, Sister tossed in a restless sleep. Sometimes she awoke with a start and tried to climb over the siderails, desperate to perform some imagined duty.
"The children are waiting for me," she would plead, gripping our arms with surprising strength, as we struggled to calm her.
Sister lay, as in a crib, imprisoned by iron bars. Sometimes she had lucid moments. Once when I brought in her lunch tray, she pointed to the guard rail and said tonelessly, "This- after twenty years in religion."
A mattress was placed on the floor by her bed in case of a dreaded fall, while we took turns checking on her whenever we could. Soon all the accouterments of normal life began to fall away; untouched food grew cold and sodden by the bedside, a pair of eyeglasses gathered dust on the bureau amid a heap of forgotten prayer cards, a rosary lay unnoticed on the floor where it had fallen. The paraphernalia of illness invaded the small space; an oxygen tank stood in waiting, bottles of salves and lotions of every description lined the windowsill, the air grew heavy with medicinal odors. Only the sound of Sister's labored breathing broke the silence.
Mother Superior came, wiped away sudden tears and ordered private duty nurses. The next morning, Rose Murray, a veteran St. Mary's nurse, appeared and began to put everything to rights. A thin wiry woman of late middle age, she had thick horn rimmed glasses and a determined air. She wore her nurses' cap high on her head perched atop an old fashioned gray pompadour, an arrangement that gave her an authoritative, even commanding look. She went into the darkened room and raised the shades, letting in the light. Out of her shopping bag, she took a hand knitted afghan and wrapped it around Sister's icy feet. At the bedside, she placed a small lamp to replace the glare of the overhead light. She swept the windowsill of its miscellany in one contemptuous motion and called the porter:
"Take this away at once," she said. Next she pushed the oxygen tank into the hall, not caring that now the hapless staff could fall over it. "Maybe if we got some air in here, Sister could breathe," she muttered to herself, opening the window. Seeing me in the hall, she called out sharply:
"Young lady, come here at once and help me lift Sister up." The patient had fallen into a sad little heap, hopelessly entangled in the bedclothes. Rose frowned. "Disgraceful... these night nurses," she said, as we raised Sister up on her pillows and smoothed her covers.
"There, dear, I'm here now," Rose murmured in her ear by way of introduction, brushing the hair from Sister's eyes with a soothing hand. The patient sighed and opened her eyes, as if revived by the homely gesture.
When breakfast arrived, Miss Murray peered critically at the tray and adjusted her thick glasses to take a better look, as if she couldn't believe her eyes.
"How can they expect a sick woman to eat this?" she said. She went down to the hospital kitchen, returned with fresh oranges and squeezed them herself. After that, she was on the phone to the dietician every day, pleading, cajoling, threatening. Each morning, she arrived with her own pet remedies- coca cola syrup to ease Sister's nausea, jars of homemade soup to tempt her appetite, camomile tea to help her sleep. "You're lucky to get water out of the taps here," she was heard to complain one day. Such remarks did not endear her to Miss Regan, who called her "the bag lady" behind her back.
"What did old Murray bring in today?" she would say to the other graduate nurses. "Her own cancer cure? The kitchen sink?"
But slowly, day by day, Sister Anne began to rally. Better nourished, she was more lucid. One morning, she sat up in a chair; her face was pale but radiant beneath the short white veil from which one golden strand of hair escaped, catching the light. The room too seemed restored; green plants stood in the window, pictures of saints adorned the walls and gazed down benignly. I stood with the rest of the staff in a small congratulatory circle while Rose Murray beamed. Dr. Tarsney, Sister's white haired physician, patted her back in silent approval. Only Miss Regan seemed discomfited, raising her eyebrows at the tea kettle that sang on a hot plate in bold defiance of hospital rules.
Miss Regan, less preoccupied with Sister's plight, now devoted her energies to me.
"She's like a hag from hell," I complained to Cathy. Miss Regan was after me constantly, checking to see if I cleaned the dressing cabinets, inspecting the beds I made and even scrutinizing my spelling when I wrote on the charts. One terrible day, I misplaced the key to the medicine cabinet, that holy of holies. I sneaked into the linen closet and emptied out my pockets, hoping against hope to see the key among the crumpled pieces of paper on which I had written little reminders, books of matches, a decayed looking comb.
I looked up to see Miss Regan in the doorway. She stared at the array of debris and memorabilia on the counter. I felt as if all the pitiful pieces of my personality were on display beneath her withering gaze.
"Kelly, when are you going to give out your medications?" she asked, checking her watch. She smelled trouble. It was almost two o'clock, when the medications were due. I was about to invent some lie when the cleaning lady appeared behind her.
"Miss Regan," she said, innocently holding out her hand. The key glistened in her palm. "I found this on the floor in the hallway."
I remembered the hole in my pocket. I had been meaning to sew it.
"How can you be so careless?" said Miss Regan. "What if the key got into the wrong hands?" In my mind's eye, I saw her pen making vivid strokes in all the "Below Average" columns.
"Do you think I can recommend that you get your cap?" she added icily. Then in an indignant rustle of starch she was gone.
"Will you stop acting like Jane Eyre?" said Cathy that night, when she found me brooding alone. Cathy took the long view. "We should be worrying about more important things, like getting the interns to notice us."
"All Regan does is sit around and drink coffee all day and flirt with the doctors, the old fool," I said bitterly.
Cathy's eyes glazed over. "Do you have any cigarettes?" she asked, rummaging through my bureau drawer. "You don't," she said finally in disgust. "C'mon," she said, pulling me by the arm, "Someone else will. Let's get out of here."
I followed her downstairs to the smoker where I found a fresh audience. A senior student listened and eyed me coolly.
"Wait till you work under Miss Bradley in Pediatrics," she said in a world weary voice. "She thinks nothing of waking you up at midnight to come back and finish your charts."
"She's a black hearted bitch," agreed an angelic faced blonde. "She wouldn't let me take my day off when my boyfriend was home from college." I felt chastened; Miss Regan was coming up short. She was a pain, but could be dealt with, was the consensus. "You can get along with her just as long as you pretend to follow all her silly rules," offered the senior student, buffing her nails. A diamond engagement ring sparkled on her left hand; no wonder she didn't care about tyrannical supervisors, I thought.
After that, I tried to put a better face on things. I had only three weeks to go, and my tenure on Female Medical would be over. And even I could see that my troubles were only a tiny drop compared to the oceans of misery on Female Medical.
Sister Anne, after her brief rally, was failing rapidly. The tumor had resumed its inexorable course, despite Rose Murray's fierce efforts. The flesh fell away from her bones as the cancer consumed her. The doctors came and shook their heads. "Keep her comfortable," they said in low voices.
Rose Murray refused to take a day off, though replacements were available. Her eyes became circled with fatigue; often her hands shook as she carried Sister's untouched trays out of the room. She was reluctant to go home and once there she pestered the night staff with nagging phone calls, reminding them to check Sister's oxygen or to make sure she was turned every two hours. The nurses had to stop their work to run down the long hall to answer the one phone on the unit. They complained to Miss Regan who pursed her lips and promised to speak to Nurse Murray.
One day, I came upon Rose in the treatment room, dissolved in tears. "Sister wants so much to live and to work for her order," she sobbed into her handkerchief. I stood by, mute and embarrassed. Even I realized that this was strange behavior. No self respecting St. Mary's nurse collapsed like this on duty, with a mere student watching.
"She's been drinking," said Miss Regan grimly, when I timidly asked her what was wrong. "Dr. Tarsney's been coming in early every morning to talk to her," she added, lowering her voice as the cleaning lady walked by. I could tell from her tone that she didn't have much faith in the early morning talks. I imagined Dr. Tarsney, stooped and white haired, with the demeanor of an elderly priest, ministering to Rose with humble forbearance.
"Sister Margaret Marie's been away on retreat," she added, seeing the question in my eyes.
Otherwise Sister Margaret Marie would surely be here at this very moment to banish Miss Murray to the ends of the earth. Sister Mary Margaret Marie was the Director of Nursing, a magnificent nun whom we all admired and feared. She had a long ascetic face and deep penetrating eyes, her most arresting feature. Her six feet in height was enhanced by her white veil and black hood, making her appear even taller. She was known to appear in the hospital unannounced at any hour whenever there was a difficult death or an inconsolable widow, as if in response to some mysterious telepathic summons.
"Sister's due back tomorrow," Miss Regan went on. As she spoke, she straightened the charts in the rack with a clattering motion. A sign in her precise handwriting was above the desk- PLEASE KEEP CHARTS IN ORDER.
"Then," she said decisively, closing her order book smartly, "Murray will be sent packing."
No one could fault the care Rose took of Sister Anne. She rubbed her swollen feet with sweet smelling lotions, hummed her songs and cradled her aching head in her arms. She hardly left the room at all except to eat. Or drink, I thought sadly.
Now Sister was isolated by impending death. Her eyes took on a distant look. She could barely communicate; only Rose understood what she said in her weak voice, the words slurring. The young novices had long since stopped coming. Sister's fellow nuns came when the could, but they had busy lives. Each day Sister turned her expectant face to the door to wait for Rose.
* * * * * *
Early one morning Sister Margaret Marie appeared on the unit. She raised a restraining hand as Miss Regan rose from her chair. No explanation was necessary; the murmuring had reached her. She would speak to the patient alone. Her face inscrutable, she went into Sister's room, closing the door behind her.
I held my breath. To my great relief Rose stayed on. She came on duty each day, white faced but composed. The phone calls to the night staff ceased. It was said that Sister Anne had refused a replacement. She knew Rose's problem, she said. It didn't matter. She didn't want anyone else. Only Rose. Please.
Sister Margaret Marie came unannounced each day to see the patient, gliding soundlessly down the hall in her rubber soled shoes, a feat she cultivated to surprise the unwary. She conferred with Rose in a tiny visitors' room at the end of the hall, her eyes piercing beneath the wide black hood.
Miss Regan kept her own counsel. She seemed subdued, her fierce energy gone. She stopped trying to improve my work habits; without the constant strain, I performed better.
Early one morning Sister died peacefully in Rose's arms. Red eyed and silent, she packed up Sister's meager belongings to ship back to the convent. She slipped a small crucifix into her purse. "She wanted me to have it," she said to no one in particular. Then she took her leave, hurrying down the back staircase.
My last day on the unit Miss Regan gave me my efficiency report. It was no better and no worse than the others I had received. Nor had Miss Regan mentioned the episode of the lost keys. I mumbled a "thank you" as she rose abruptly to leave, but she was already out the door and never heard me.
* * * * * *
It was a warm evening in June. The window was open; a moth fluttered against the screen. Cathy sat on her bed, winding her long hair into iron curlers. Finished at last, she collapsed back on the pillows with a sigh of relief. Her face looked pinched and drawn, as if she had pulled up some of her skin to be curled. How she slept on such murderous apparatus mystified me.
I stood in front of the mirror trying on a cap I had borrowed; the next day we would have our formal capping ceremony.
"It makes me look older," I told Cathy.
"You haven't even got it on straight. It's crooked for God's sake," she said, getting up and straightening it with weary patience. Cathy was only nineteen years old, one year older than me, but sometimes she acted like my mother. I submitted patiently instead of snapping at her as I usually did. We were both exhilarated; after tomorrow, we would be probies no longer. There would be a party after the ceremony and the interns were invited.
"If only we could get rid of the damn nuns," grumbled Cathy the next evening as we filed into the chapel. They wouldn't actually be at the party, but at the periphery, hovering, like dark clouds at a picnic. But even Cathy grew solemn as Sister Margaret Marie placed the caps on our heads and lit the candles we held in our hands. Then Sister approached the small pulpit to give her congratulatory speech. As she spoke, my mind wandered. I thought about my struggles this past year, the despair I had felt on Female Medical. I could still see Sister Anne, her eyes burning in her ravaged face, as she clung to Rose. Where were they now, I wondered. Sister must be in heaven, if heaven existed; I thought of all she had endured; the pills and potions, the mutilating surgery, the enervating radiation. In the end, only Rose had done her any good.
Sister's speech was almost over. I looked out into the audience where our families and friends sat at respectful attention. A cadre of the older graduate nurses were in attendance; some, of icon status, sat in the first row behind the nuns; the operating room supervisor who had rapped my knuckles for dropping an instrument; our nursing arts instructor who had told me the wrinkles on my patients' sheets would break their backs. I averted my eyes; surely given a chance, they would snatch the cap off my head.
Finally Sister finished, and we filed slowly out of the chapel. Outside in the lobby a small exuberant crowd of well-wishers surrounded us while a photographer from the local newspaper snapped pictures. Out of the corner of my eye, standing alone at the edge of the crowd, I saw Rose. She was dressed in a neat navy suit and a festive flowered hat was perched on top of the gray pompadour. She looked frail, her blue suit hanging on her, the gay little hat with its bright red roses in stark contrast to her haggard face. I thought of those heady days when Rose had first appeared on Female Medical in her blazing white, the peaks of her starched white cap rising like wings. I wanted to approach her, but I was too shy; what could I say? Then Cathy nudged me towards the door; the party was starting. When I looked in her direction again, Rose was gone.
Eileen Valinoti BSN, M.A. is retired after a varied career in oncology, nursing education and school nursing. Her essays have appeared in the following journals: "Hospital Corners" in Pulse, "First Day on the Wards" in ARS MEDICA, "A Mysterious Illness" and "Accident" in The Yale Journal for Humanities in Medicine, "Medication Nurse" in Blood and Thunder, "Night Duty" in The Healing Muse, and "The Cancer Unit" in Confrontation. Several pieces were included in the following anthologies: "First Day on the Wards" in Body and Soul: Narratives of Healing from ARS MEDICA, "A Silent Woman" in Meditations on Hope and "Hospital Corners" in Pulse- Voices from the Heart of Medicine: Editors' Picks: A Third Anthology.