Sister Mary Margaret slid an extra egg onto Sister Perpetua’s plate and whispered, “You’ll need your strength today, dear.”
Perpetua glanced at the chalkboard above the rostrum where decrepit Sister Simone droned the devotional. Neat pink letters exhorted the sisters to “Sow the seeds of Christ’s love today!” Sister Perpetua resolved to do just that.
They should fall on fertile soil in the emergency room.
After breakfast, Sister Perpetua left the convent through the kitchen door. The Reverend Mother excused her from housekeeping chores on class days, so there were no dirty dishes or piles of laundry to delay her departure.
A breeze ruffled the leaves above her head, but couldn’t penetrate the layers of her habit. Sweat trickled down her chest. The cool air of the emergency department would feel good after the muggy walk through the convent garden.
She entered the hospital through a glass door to the left of the soaring portico marked “Emergency.” A wooden lectern stood just inside. She wrote her name and noted the time on a long sheet of paper labeled “Student Sign-in Sheet. May 22, 1962.” The pen she had used dangled at the end of a once-white string as she hurried down the broad hallway toward her first taste of emergency nursing.
Sister Anthony stood behind the counter that separated patients from staff. She waved a sheaf of papers over the heads of Sister Perpetua’s classmates. “Sister! The last one here! I would have expected you to be the first. Where is your zeal for Christ’s work?” Perpetua and her instructor were the only nuns in the group.
She always expects more from me.
“I’m sorry, Sister.”
The older nun turned away, shaking her head. “Mary Livingston. You’ll be with Nurse Frankel today. Find her and do whatever she tells you.”
The student’s eyes lit up.
“Don’t do anything that you haven’t been checked off on, though.”
Mary’s face fell back into its usual expression of dull distaste. She slumped off in search of her preceptor for the day.
After dispatching the other four students, the stony nun turned to Sister Perpetua. “You’ll be with me today. We’ll work triage.”
The two women pushed through double doors that stood between the patient care area and the lobby. The emergency unloading area was visible through a plate-glass and aluminum wall. A steel desk and wooden chair stood in front of the doors as if guarding the staff from the hoi-polloi in the waiting room. Sister Anthony pulled the chair out and lowered herself into it. She gave Perpetua a curt nod. “You may kneel at my side.”
Sister Perpetua stared directly into the older woman’s eyes. She did not smile. Sister Anthony held her gaze for three or four seconds and then gestured toward the near-empty waiting room. “We must keep the chairs out there free for our patients and their families,” she said. Her lips turned up in a smile that left her cornflower blue eyes untouched.
Sister Perpetua sank to her knees by the desk, never taking her eyes from the older nun’s face. As she descended, she surreptitiously arranged her habit so that its folds formed a thin cushion between her knees and the gleaming floor.
Sister Anthony straightened a stack of blank admission forms. A bearded man in a shiny black suit leaned forward from a plastic chair directly across from the two nuns. His mouth formed a soft “O.” Perpetua met his gaze. He looked down at the newspaper in his lap before bringing it to his face in a gesture of forced nonchalance.
All morning, Sister Perpetua knelt and watched as her instructor sorted out the desperately ill from the slightly sick. Sister Anthony taught as she worked. Anyone with chest pain went straight back. Fractures got an ice bag, a pillow for the affected limb, and a seat in the waiting room. An admission of insurance coverage elicited directions to the private hospital down the street.
“We are a charity hospital. People with insurance just gum up the works,” the stern old sister explained. When Sister Perpetua raised her eyebrows, she added, “They wouldn’t want to be admitted here, anyway. We’d just have to transfer them as soon as they got to the ward.”
At eleven thirty, a dumpy brunette in a white uniform emerged from the patient care area. Her hazel eyes brushed past Sister Perpetua without changing.
Maybe the old witch makes everybody kneel like this.
“Sisters, I’ve come to relieve you for lunch,” the nurse announced.
Sister Anthony nodded at Sister Perpetua and motioned for her to rise. A smile played around the old nun’s mouth and spread to her eyes as Perpetua hauled herself up by clinging to the rounded corner of the desk. The sudden rush of blood into her legs felt like a thousand pinpricks, but Perpetua maintained a serene expression as she walked to the hospital cafeteria.
When the two nuns returned to their post after their meal, the waiting area was filled with patients. A line of people snaked from the desk to the far corner of the vast room. The nurse who had relieved them rose from her seat and Sister Anthony ushered Perpetua into it with a sweeping theatrical gesture. Then she stepped through the line in front of the desk and whipped a chair almost out from under a dowager in a tight red dress. The woman opened her mouth but then closed it without saying anything. Sister Anthony smiled sweetly while clutching her back with one hand as if it ached with the slightest movement. She scraped the chair’s legs across the floor for a few feet, still clutching at her back and bent almost double. A man took the chair from her and followed her back to the desk with it.
Sister Perpetua pursed her lips, but said nothing. A blond boy stood in front of her. He used one arm to hold the other motionless across his torso, a grimace distorting his face. The fingers of the motionless arm looked like sausages. A fracture.
“Let me get you an ice pack and a pillow for that arm. Then we’ll find you a place to sit until the doctor can see you,” Sister Perpetua said.
She had almost risen from her chair when her instructor put a restraining hand on her arm and said, “Oh, no, my dear. That arm looks broken to me. He’ll need to go right back.” She watched in stunned silence as Sister Anthony escorted the youth through the double doors.
Throughout the afternoon, Sister Perpetua could do nothing right. The old woman beside her overrode all but the most obvious decisions. By the middle of the afternoon, Perpetua was no longer sure of anything. Until the child came in. She was sure about the child.
It happened during a lull in the headlong rush that had characterized the afternoon. Thoughts of the retreat she was scheduled to attend over the weekend had begun to run through Perpetua’s mind when a blue station wagon screeched to a halt in front of the emergency entrance. A swarthy man jumped out from the driver’s seat, ran around the car, and helped a young blonde out. The woman hugged a toddler to her chest. As soon as the woman was on her feet, the man rushed to the glass entrance doors and pushed one of them open. He held it with his body as the woman carried the child into the lobby. The tyke’s screams filled the room.
Perpetua jumped up from the desk, nearly knocking her chair over. Ugly red streaks trailed down the child’s white shirt. The trio reached the desk before Perpetua could meet them. She turned to regain her place. Sister Anthony had gotten to her feet.
“We can pay! We have insurance!” the man blurted out.
Sister Anthony sat down. “You are in the wrong hospital,” she said. “Just down the street. Turn right when you leave our parking lot.” Her face was impassive.
The man’s mouth fell open. “What? We need help! He’s hurt!”
“You have insurance. This hospital is for charity patients. Sister Perpetua will help you out to your car.” She directed a stern glance at her student.
Surely she cannot mean what she is saying.
The man stepped to one side of the desk as if to barrel through the doors behind it. Sister Anthony stood and moved into his path.
“John, we’re wasting time here. Let’s just go. The other place is right by here,” the woman pleaded. Perpetua could hardly hear her over the child’s screams.
A look of uncertainty crossed his face, but the man put one arm around the woman and guided her back to their car. The passenger door hung ajar. Perpetua watched as they careened out of the parking lot.
Her mouth agape, she rounded on the older nun. Sister Anthony was seated again. She looked up from the papers she was shuffling. “Remember what I told you earlier about people with insurance? They go down the street unless they aren’t breathing.”
A yelp escaped from Sister Perpetua’s mouth.
Sister Anthony held up her right index finger. “That child was definitely breathing.” She motioned for Perpetua to sit at her side.
An ambulance pulled into the driveway. Both women went to help unload the patient it carried. The rest of the afternoon held time for nothing but terse commands and quick obedience. Finally, the shift ended.
“I know you think it was wrong to send that child away,” Sister Anthony said as the two nuns passed a tall oak on their way back to the convent.
She’s trying to placate me. I thought it was odd for her to walk with me. She knows what she did was wrong.
Sister Perpetua looked at the shell-covered path in front of them and didn’t speak.
Her companion continued, “Remember all those patients we sent back before the child showed up?”
Perpetua nodded without turning her head. Her steps slowed to keep time with Sister Anthony’s.
“That’s what the people in the back were dealing with when that child arrived. You think he would have seen a doctor any faster in that madhouse back there?” The old nurse stopped walking and turned to face her student. “He was better off going down the street, believe me.” She used one index finger to tip Sister Perpetua’s chin up so that she could look into her eyes. “You’re going to have to toughen up, you know. You can’t feel sorry for people and think straight all at the same time.”
Sister Perpetua turned her head to the right. “What you did was wrong. Maybe it made sense, but it was wrong,” she said and walked away, quickening her steps so that the older woman could not easily keep pace with her.
Sister Anthony caught up to Perpetua on the small stoop at the kitchen door. “Look, we can call Memorial and see how the child is doing. Maybe it will make you feel better if you know he’s all right,” she panted, her hand on Perpetua’s shoulder.
“Fine. Let’s do.”
They passed through the busy kitchen and went into the office where the head cook planned menus and ordered supplies. The room was barely large enough for the desk and capacious chair that were its only furniture. Sister Anthony took the chair. Fanning herself with one hand, she reached for the telephone with the other. Her lips were almost white. Before she lifted the receiver, she fished in the pocket of her habit and came up with a small bottle. She unscrewed the metal lid and shook a tiny white pill out, then popped the tablet into her mouth.
“Can I get you some water?” Sister Perpetua asked.
“No. I’ll just hold it under my tongue,” the older nun said, and relaxed back into the chair. One hand fluttered at her chest, then came to rest at her side.
Nitroglycerine. Her heart is hurting. It should!
“Do you want me to get help?” Sister Perpetua’s hand was on the doorknob, but Anthony waved her back into the room.
“No, it’ll pass in a minute. I’ll be fine.”
After a few minutes, Sister Anthony’s lips returned to their normal color. She lifted the heavy black receiver and dialed, spoke to someone on the other end of the line for a few moments, then hung up.
“He’s fine,” she said to Sister Perpetua. “They didn’t even admit him. Just put in a couple of sutures and sent him home. He was out of there before he would have even seen a doctor at our place.” Sister Anthony’s eyes glittered.
Perpetua lowered her head and made the sign of the cross. “Praise be to God,” she murmured. Then she excused herself and went in to supper with the others.
That night, the child’s screams echoed in Perpetua’s mind so loudly that she could not sleep. A shaft of moonlight cut through her stark cell. Clad only in her shift, she knelt with her elbows on the windowsill. “Lord of hosts, give me succor. Tell me how to still this memory,” she prayed. She waited in silence for an interminable time, but no solace washed over her. She returned to her bed.
Morning came, and Perpetua felt a dark heaviness in her soul. It was as if the child’s screams, the look in the father’s eyes, and the screech of the station wagon’s tires all conspired to weigh her down as soon as she woke. Memories of other patients played in her mind, too, but they weren’t like millstones around her neck.
At least we tried to help them.
Perpetua choked a bowl of oatmeal down and left the refectory before Sister Simone had finished reading the devotional. Her efforts paid off; she was not the last student to arrive in the emergency room that morning. Sister Anthony assigned her to Nurse Frankel and she experienced life on the other side of the intake doors. It was hellish. Patients lay bleeding on stretchers in the hall. A woman delivered premature twins before they could get her upstairs to the obstetrics department. One of the twins didn’t take a breath for what seemed like hours, but was in reality less than a minute. A drowning victim was dead when he arrived in their department.
At about eleven o’clock, Nurse Frankel, or Arlene, as she had instructed Perpetua to call her, said, “Go sit at the desk for a while and review our charts. Compare them to all those notes you’ve got on paper towels in your pockets.”
Glad for a chance to sit down, Sister Perpetua did as she was told. When her notes had all been transcribed, she thumbed through some of the charts in front of her. A blue admissions sheet always preceded the rest of the information. She glanced at the one for the woman who had delivered twins so quickly. It gave her name, patient number, insurance carrier…
Wait a minute. Insurance carrier?
The memory of Sister Anthony’s voice sizzled in Perpetua’s brain, “Remember what I told you earlier about people with insurance? They go down the street unless they aren’t breathing.”
The laboring woman had definitely been breathing when she was admitted. She’d been screaming.
Maybe imminent danger of delivery is the same as not breathing.
Perpetua picked up another chart and flipped it open. That patient had insurance, too. And the chief complaint was abdominal pain. She checked the charts of all the patients she’d been involved with that morning. About half had insurance. And every one of the ones with insurance had been breathing just fine when they arrived at the triage desk.
Arlene perched her plump bottom on the counter beside Perpetua’s charts. “You want some lunch?” she asked.
Arlene and Sister Perpetua sidled through the cafeteria line. Sister Anthony shuffled along just a few customers ahead of them, but she carried her tray to a large table already populated by older nuns, all members of administration. There was not an empty seat at the table after Anthony sat down.
Thank you, Lord, for small favors.
Sister Perpetua and her preceptor found a table for two in the far corner of the bustling dining room. Beige tiles lined the walls and escalated the din of the crowd.
“So did you learn anything new today?” Arlene smiled as she picked up the tube of saccharine tablets from its place by the sugar shaker.
“Well, I certainly saw a lot.”
“Yeah, ER is like all the other departments rolled up in a big ball and sliding down a hill.” The chubby nurse tapped a tiny white tablet into her palm and dropped it into her iced tea. “Anything you didn’t understand? It was so busy there for a while that I didn’t have much time to go over things with you.”
“No, I could relate most of it to class.” Perpetua watched Arlene stir her tea with a long spoon. She said, on an impulse, “There is one thing I don’t understand.”
Arlene raised her eyebrows.
Perpetua went on, “Yesterday, when I was in triage with Sister Anthony?”
Arlene nodded and took a bite of her salad.
“She said anybody with insurance goes to Calhoun Memorial. But there were patients back there today who had insurance. It’s not policy to send them to Calhoun?”
Arlene laughed. “No, Sister P., it’s not policy to turn patients away.”
She glanced over her shoulder and looked around the room, apparently making sure no one from administration was lurking nearby. Then she leaned forward and spoke. Perpetua had to lean over her sandwich to hear what she said. “Look. Anthony used to pull that stuff all the time when she worked in the ER. That’s probably why they took her off the floor and stuck her into teaching.” Arlene took a sip of her tea. “It used to drive Pious nuts.” Sister Pious was the ER department head.
“Isn’t it wrong to send people away like that? When they need help?”
“Yeah, I guess so. But you know when we’re swamped like we were yesterday?”
Sister Perpetua nodded.
“It helps when it’s like that.”
Sister Perpetua traced a line in the condensation that had formed on her tea glass. “If it drives Sister Pious so nuts, then how did Anthony get put back in triage yesterday?”
“I guess ‘cause we were so short handed. Carla called in sick, you know.”
The afternoon was busy. Patients in stretchers lined the halls, and still triage sent more back. At two o’clock, just when Perpetua thought her brain might burst open if she had to keep track of even one more patient, Arlene punched her in the arm and winked. “Wish your buddy Anthony was out in triage about now, huh?”
Sister Perpetua smiled and nodded, but deep down she knew that Anthony was wrong.
Perpetua left the emergency department in time for her class, “Core Issues in Trauma,” at four o’clock. As soon as everyone was seated, Sister Anthony handed out an exam. “You have the entire hour to complete the test,” she said. “Any student finishing early will leave the room after handing in her answer sheet.”
Sister Perpetua finished in thirty minutes. Thirty minutes of freedom. Perpetua walked out of the building and strolled to the cathedral on the corner. Confessions were being heard until five. There was no line. She slipped quietly into the dark womb of the confessional booth.
After the preliminaries, the priest on the other side of the grill said, “What is troubling you, Sister?” and the young nun blurted out the tale of the child who had been turned away.
“Didn’t our Lord say, ‘Let the little children come to me?’ and wasn’t what we did hindering them?” she asked.
“Child, child! Your sin doesn’t lie in redirecting that poor family. Didn’t you tell me that the boy was fine in the end?”
“Yes,” Sister Perpetua whispered through the grill.
“Well, then, your superior’s decision was obviously right. Your sin is disobedience. You are to learn from your teacher, not cast aspersions on her greater wisdom.” The priest shook his grizzled head and gave Perpetua the Stations of the Cross as a penance.
Perpetua made her way through the lengthy penance, but it didn’t quiet the child’s screams. They returned to disturb her sleep that night.
In the morning, Perpetua awoke before the bell rang and felt a familiar heaviness on her soul. She crept to her window and knelt to pray. “Oh Father! I have atoned for my disobedience, but what must I do to atone for my part in turning away one of your children?”
No answer came. Instead, the young sister pictured herself taking the boy from his mother’s arms and darting past the evil Sister Anthony, pushing the old witch to the floor in the process. Perpetua made one last plea, “Lord, give me a sign. Please, show me how to rid myself of this sin that only you and I can see!” Then she threw a fuzzy robe over her shift and hurried down the hall to grab a quick shower before group prayers in the chapel.
“Nearer, my God, to thee!” The off-key voice blended with the sound of running water to make a noise that was close to torture. Sister Anthony. She had a habit of singing Protestant hymns in the shower.
Lord, why did you give such a loud voice to such a poor singer?
Anthony had taken the stall closest to the entrance. Perpetua stepped past it on her way to a shower farther down the line. In her hurry to get away from the ear-splitting crescendo Anthony was belting out at that moment, Perpetua nearly stepped on a small brown bottle with a screw-on lid.
Anthony’s nitroglycerine. Perpetua picked the vial up from the floor and rolled it across her palm. The sign! Thank you, Father. Bending from the waist, she placed the medicine on a tile outcropping with the rest of Sister Anthony’s things.
After her shower, Perpetua climbed into her habit. I’m going to have to cut some calories. A giggle formed in her throat. The reduced calories would be part of her penance.
At breakfast, instead of using sugar from the container in the center of the table, she grabbed the saccharine tablets. She shook nine or ten small white pills into her hand. She stirred one into her coffee and absentmindedly dropped the rest into her pocket.
The Reverend Mother stepped up to the rostrum as soon as Sister Simone had finished reading the devotional. “Sisters! As you know, today we see some from our house off to the Woodland Retreat. To those of you who are making the journey: may our dear father in heaven watch over you today and always. To those remaining at home: please pick up any duties normally done by those going on retreat. Thank you.”
Perpetua’s bags were already packed. She carried them down to the front portico and waited. Sister Anthony and Sister Malachi stood beside her by the time Sister Pious pulled up in the parish van.
At Woodlands Retreat, the nuns were shown to a room with four beds. Sister Anthony took the bed closest to the bathroom. Sister Perpetua laid her bag on the one next to it and said, “I think I saw a buffet in the refectory.”
After lunch, Sister Perpetua read aloud from a mimeographed program. “Two until four. Free time. Sisters, I believe I will use my freedom to take a much needed nap. If you’ll excuse me?”
She stuffed the paper into her voluminous pocket and swept by her companions while stifling a yawn. Sister Anthony followed her up to their room. Once inside, they removed their outer garments and lay down without speaking. Their habits drooped from pegs hammered into the wall at the head of each bed. After only a few minutes, Sister Anthony tiptoed into the bathroom.
Perpetua jumped up and put her hand into the pocket of Anthony’s habit. Her fingers closed around the bottle she had hoped to find there. She lay back down with it in her fist and slid her hand under the pillow before Anthony returned. The bed next to her creaked as the heavy nun crawled into it. When Sister Anthony began to snore, Perpetua crept out of bed and took her habit into the bathroom. She hung the heavy gown on a hook by the shower stall. The nitroglycerine bottle went on the counter next to the sink.
Perpetua fished the saccharine tablets out of her habit. She placed them on the counter by the brown vial. Then she unscrewed the lid from the nitroglycerine bottle, dumped its contents into the toilet, and flushed. Water was still rushing into the toilet tank as she dropped the last saccharine tablet into the bottle and screwed its lid back into place.
“There, good as new!” she whispered before opening the door and slipping back into the bedroom. Sister Anthony’s snores were louder than the noise the door made when Perpetua pulled it closed behind her. It was no feat at all to slip the saccharine tablets into the old nun’s habit without waking her. Perpetua fell asleep as soon as her head hit the pillow.
After free time, the schedule called for retreat participants to walk in quiet contemplation.
“Care to stroll with me?” Perpetua said.
Sister Anthony glanced at her. “We need a third,” she said. Their order’s rule about no particular friends was seldom enforced nowadays, but older nuns hardly ever strolled in groups smaller than three.
“Come now, Sister Anthony! No one could take us for particular friends!” Perpetua held out her hand to the older woman.
“Well, that path down by the creek did look inviting.” Anthony started toward the door. Perpetua dropped her hand and followed her.
They walked in silence along a path that meandered with a sparkling stream. The two women did not speak until a fork in the path confronted them.
“Which way?” asked Anthony.
Perpetua said nothing, but took the fork to the left. It led them farther and farther from the retreat buildings and became rougher and steeper. Some sections were so steep that a handrail had been installed next to the pavement. Beyond the railing lay a beautiful vista. Sister Anthony stopped and looked out over the valley below. Her white lips drew back in a rictus of pain. She pulled the small brown vial from her pocket and unscrewed the lid.
“Sister Anthony, are you all right?” asked Perpetua.
Anthony didn’t answer. She just tucked a white pill under her tongue and eased herself down to the ground with her back against the rough bark of an oak.
“Sister!” Perpetua knelt beside the older woman. “Don’t move. Rest here. I’m going to get help.” Perpetua squeezed the ailing nun’s hand into a fist around the medicine bottle. “Take another one of these if you’re not better in a few minutes.”
Sister Anthony whispered something.
Perpetua put her ear close to the woman’s mouth. “What? Did you need something before I go?”
“Sweet,” said Sister Anthony.
Perpetua squeezed her hand again. “Oh, you’re a saint! To say I’m sweet when you’re in such pain!”
Sister Perpetua ran down the steep path. When she rounded a bend, her steps slowed. After a few minutes, she stopped and fingered the rosary that hung from her waist. Golden light spread across the valley below. The young sister began to pray as she gazed out over the vista. Not until she had said the entire rosary did her feet begin to move again, slowly at first, then faster and faster until by the time she reached the retreat buildings she was running.
After Sister Anthony’s body was brought down from the mountain, Perpetua did not speak for several hours. The Reverend Mother indicated that the community should give her time to work through the tragedy. She was relieved of household duties and allowed to skip class for an indefinite period.
Before a week was out–right after the Reverend Mother’s announcement that she had declined an autopsy for poor Anthony, in fact–Perpetua’s clear soprano voice rang out in the shower. That same morning, she requested an extra egg on her plate. When Sister Pious asked her how in the world she had recovered from the tragic experience so quickly, Perpetua’s lips curled into a beatific smile and she said, “I am simply certain that God’s will was done there on the mountain.”
Jan Melara graduated from Lamar University in Beaumont , Texas with a degree in nursing. After twenty five years of working in health care, she has retired to an idyllic lake in South Carolina . Her work has been published in Dew on the Kudzu: A Southern Ezine, The Dead Mule School of Southern Literature, The Battered Suitcase, 13th Moon, Demonic Tome, Monsters Next Door, and Dark Tales. She currently writes health care articles for The Columbia Examiner, an online information source.
© 2010, Jan Melara