The Best American Mystery Stories 2015 (54 page)

It would be noted that Sister Mary Alphonsus was discovered to be unresponsive in her bed by the Unit D orderly, Francis Gough, who’d immediately notified the nursing staff. Time: 7:08
A.M.

Less certainly, it was determined that Sister Mary Alphonsus had died several hours earlier—Dr. Bromwalder’s estimate was between 3
A.M.
and 6
A.M.
This was a reasonable estimate judging by the temperature of the corpse when it was first examined by the doctor, in the absence of a pathologist. In the pitch-black of the early morning, hours before dawn, patients are most likely to “pass away,” for these are the hours of Death.

There was a death here today. Old woman in her eighties, in my unit. She was found dead in her bed—died in her sleep, they think.

Oh Francis! That’s so sad. I hope it wasn’t you who found her.

It’s okay, Mom. It wasn’t me.

Most mornings when the early staff began their rounds we would find Sister Mary Alphonsus fully awake and sitting in the chair beside her bed, a blanket over her knees and a missal opened in her hands, though after near seventy years of the Catholic missal, you would not think that the nun required an actual book to help her with prayers; or Sister might have her rosary of wooden beads twined in her fingers as she waited for an orderly to help her into her wheelchair. Her gaze would be vacant until you appeared—and like a raptor’s eyes the vague old-woman eyes would come sharply into focus.

If you greeted her with a friendly smile—
Good morning, Sister!
—she was likely to frown, and to make no reply, as if you’d disturbed her in prayer, or in some private and precious drift of her mind. And so I’d learned to say nothing to her, much of the time. What would be rude behavior with other patients had come to seem, to me, expected behavior with Sister Mary Alphonsus.

Sister Mary Alphonsus was one of those residents at Eau Claire who ate meals in the patients’ dining hall, not one whose meals were brought to her room. Despite the difficulty involved in delivering her to the dining hall, which was sometimes considerable, depending upon her medical ailment of the moment, Sister Mary Alphonsus insisted upon this.

In her former life, before “retirement,” she’d been a prominent figure in her religious order—for more than two decades, director of the Craigmillnar Home for Children. This was a Catholic-run orphanage about sixteen miles north and east of Eau Claire, at its fullest occupancy containing more than three hundred children.

In the dining hall, Sister Mary Alphonsus asked to be seated at a table with several elderly women whom she might have considered “friends”—of whom two were, like herself, retired Sisters of Charity of St. Vincent de Paul who’d also been at Craigmillnar.

You would think that the Sisters of Charity would speak of their shared past at Craigmillnar, but they hardly spoke at all except to comment on the food. Like elderly sisters who’d seen too much of one another over the decades, and who had come to dislike one another, yet clung together out of a fear of loneliness.

Though it was difficult to imagine Sister Mary Alphonsus as one susceptible to
loneliness.

Few relatives came to visit the elderly nuns. They’d had no children—that was their mistake. Beyond a certain age, an elderly resident will receive visits only from her (adult) children and, if she’s fortunate, grandchildren. Others of their generation have died out, or are committed to health-care facilities themselves. So virtually no one came to see these elderly nuns, who with other Catholic residents of the facility attended mass together once a week in the chapel.

Their priest too was elderly. Very few young men were entering the priesthood any longer, as even fewer young women were entering convents.

Though I’m not Catholic, often I observed the mass from the rear of the little chapel. “Father Cullough”—who made no effort to learn the nuns’ names—recited the mass in a harried and put-upon voice, in record time—scarcely thirty minutes. Once, the mass was said in Latin, as I know from having seen old prayer books in my family, that had been published in Scotland and brought to this country; now the mass is said in English, and sounds like a story for simpleminded children.

In the front row of the chapel the elderly nuns tried to keep awake. Even Sister Mary Alphonsus, the sharpest-witted of these, was likely to nod off during the familiar recitation. When the priest gave communion, however, at the altar rail, the old women’s tongues lapped eagerly at the little white wafer, the size of a quarter. My gaze shifted sharply aside, for this was not a pretty sight.

Once, when I was wheeling Sister Mary Alphonsus back to her room after mass, the wheelchair caught in a ridge of carpet in the floor, and Sister Mary Alphonsus was jostled in her seat, and lashed out at me—
Clumsy! Watch what you’re doing.

Sister, sorry.

You did that on purpose, didn’t you! I know your kind.

Sister, I did not. Sorry.

You will be sorry! I will report you.

Many of the patients threaten to report us, often for trivial reasons. We are trained not to argue with them and to defer politely to them as much as possible.

Think I don’t know YOU. I know YOU.

Yes, Sister.

“Yes, Sister”
—the elderly woman’s croaking voice rose in mockery—
we will see about that!

I made no reply. My heart might have leapt with a thrill of sheer dislike of the old woman, but I would never have said anything to goad her further. It was said of the former mother superior at Craigmillnar, by the nurses’ aides who were obliged to take intimate care of her aged body—
Bad enough she has to live with herself. That’s punishment enough.

Yet by the time Sister Mary Alphonsus was back in her room, her interest in reporting me to my supervisor had usually faded. She’d been distracted by someone or something else that annoyed or offended her. She’d have forgotten Francis Gough entirely, as one of little worth.

Not that she knew my name: she did not. While others called me
Francis
, Sister Mary Alphonsus could barely manage to mutter, with a look of disdain—
You.

She did know the names of the medical staffers, to a degree. She knew Dr. Bromwalder. She knew Head Nurse Claire McGuinn, if but to quarrel with her.

A care facility like a hospital is a hierarchy. At the top are physicians—“consultants.” Nurse-practitioners, nurses and nurses’ aides, orderlies—these are the staff. An orderly is at hand to help with strenuous tasks like lifting and maneuvering patients, including patients’ lifeless bodies; changing beds, taking away soiled laundry, washing laundry; pushing food carts, and taking away the debris of mealtimes; sweeping and mopping floors; taking trash outside to the dumpsters. (Trash is carefully deployed: there is ordinary waste, and there is “clinical waste.”) My original training (at age nineteen) was on-the-job at Racine Medical Center plus a weeklong course in “restraint and control.”

There were few violent patients at Eau Claire, but I was well prepared for any I might be called upon to “restrain and control.” You need two other orderlies at least if you need to force a patient onto the floor. How it’s done is you force him down onto his stomach, an orderly gripping each arm and an orderly securing the legs. It’s going to be a struggle most times—even the old and feeble will put up a considerable fight, in such a situation; the danger is in getting kicked. (When you’re the youngest you are assigned the legs.) In this position—which looks cruel when observed—the patient’s back is relatively free so he can breathe, and he’s prevented from injuring himself.

Unlike cops, who are allowed “pain” as an element in restraint and control, medical workers are not allowed “pain” and may be legally censured if patients are injured.

Despite my training, there have been injuries of patients I’d been obliged to restrain and control, both in U.S. care facilities and in the medical units in Iraq.

None of these were my fault. And yet, there were injuries.

The nurses were gossiping: Sister Mary Alphonsus had no close next of kin.

Or, if there were relatives of the deceased woman, they were distant relatives who had no wish to come forward to identify themselves.

Maybe no wish to associate themselves with the individual who’d been director of the Craigmillnar Home for Children, which had been shut down in 1977 by Oybwa County health authorities and the State of Wisconsin.

Just recently too, Craigmillnar was back in the headlines.

A full week after her death on November 11, no one from the Oybwa County medical examiner had contacted the facility. So it appeared Dr. Bromwalder’s death certificate had not been questioned.

The gauzy strip of “curtain”—unless it was some kind of nun’s “veil” or “wimple”—had disappeared from the premises. All of Sister Mary Alphonsus’s things had been packed up and removed from Room 22 and a new, unsuspecting arrival, also an elderly woman, had been moved in.

Yet the subject of the mysterious “head covering” continued to come up in Unit D. It seemed strange to me—I said so—that I appeared to be the only person to have seen Sister Mary Alphonsus fix something like a “head-shroud” over her head several times in the past. Some kind of cloth—might’ve been a towel (I didn’t remember it as white)—she’d drawn like a hood over her head, for whatever reason. I hadn’t asked the sister what she was doing, of course. She’d have been offended at such
familiarity.

One day our young consulting physician Dr. Godai asked me about this, for he’d overheard some of us talking.

So you’d seen the sister putting some kind of “cloth” on her head, or around her head, Francis? When was this, d’you remember?

Might’ve been a few weeks ago, doctor. Maybe two months.

How often did you see the sister putting this “cloth” on her head?

Maybe three times, doctor. I never thought anything of it, you know how old people are sometimes.

Dr. Godai laughed. He was the newest consultant on our staff, from the University of Minnesota Medical School. He had a burnished-skinned Paki look, dark-eyed, sharp-witted. Knowing that certain of the elderly patients and certain of the medical staff did not feel comfortable with him, as nonwhite, Dr. Godai was what you’d call forceful-friendly, engaging you with his startling-white eyes and smile sharp as a knife blade. Between Dr. Godai and me there flashed a kind of understanding, as if the elderly nun was in the room with us, helpless, yet furious, glaring at us in disdain and in hurt, that she could not lash out at us to punish.

Eccentric
is the word, Francis. A kindly word. For you wouldn’t want to say demented, deranged, senile—eh?

Dr. Godai and I laughed together. I wasn’t naive enough to think that Dr. Godai could ever be my friend, though we are about the same age.

I told Dr. Godai that each time I’d seen Sister Mary Alphonsus behaving in this way, putting a “shroud” on her head, I’d made no comment, of course. I didn’t even ask her if she was cold, or needed an extra blanket. Nor did Sister Mary Alphonsus encourage conversation with me or with others on the staff. In my memory it had seemed to me that the woman was just slightly embarrassed, and annoyed, by my having seen her with the “cloths.” And so out of courtesy I turned away from her, as if I hadn’t seen.

It’s a strange life, isn’t it, Francis?—I mean, the religious orders. Poverty, chastity, service, obedience these nuns swore to.

To this I made no reply. Dr. Godai was speaking bemusedly, and may have been thinking out loud.

Of course, I don’t understand the Catholics, maybe. Are you Catholic, Francis?

No, Dr. Godai. I am not.

You are an arrogant young man. I will report you.

I know YOU. YOU will not get away with this.

There are two categories of geriatric patient. Those who persist in behaving as if they aren’t elderly; or as if their current condition, inability to walk, for instance, is a temporary one; individuals who shuffle slowly, in obvious pain, leaning against walls, against the backs of chairs, out of pride. And there are those who have conceded that they are not “one hundred percent” but must use a cane, a walker, a wheelchair. (It’s possible to think that a wheelchair isn’t really “permanent”—it is always expedient, helpful more for the staff.) Each step you think is temporary and you will soon return to your real self, but that’s not how it goes.

Sister Mary Alphonsus had been in the second category. She may have been elderly but not
old-elderly;
and she would resent bitterly your behaving as if she were. Her hearing, like her vision, was impaired, but Sister Mary Alphonsus was more likely to blame you for not speaking clearly, or loud enough, than she would blame herself. In fact, Sister Mary Alphonsus would never blame herself.

If she spilled food, or dropped something, and you were present—somehow, the fault lay with
you.
At first I’d thought this was a sign of dementia, but later I came to realize it was the woman’s perception of
what is:
blame must be assigned, only just not with her.

Unlike most of the elderly women in the facility, Sister Mary Alphonsus hadn’t been what you’d call frail. Her body was thick, waistless; her skin was leathery; her eyes were suspicious and close-set; her legs remained heavy, especially her thighs, which strained against the polyester stretch pants she sometimes wore. Her most characteristic expression was a peevish frown.

Sometimes Sister Mary Alphonsus seemed annoyed by rain outside her window, as if it had been sent to provoke
her.
For there was a small courtyard into which we could wheel patients, in good weather.

Once, I’d wheeled Sister Mary Alphonsus outside into this courtyard and had to go away on an errand, and by the time I returned it was raining hard, and Sister Mary Alphonsus had managed to wheel herself beneath an overhang, by an effort of both hands.