LATE | I. Cori Baill
Late at night, a long time ago, when Sandi was an OB/GYN intern, before electronic health records and much use of personal electronic devices, back when a beeper was a big deal, and when it was rare for anyone in Baltimore to have one unless a doctor or a drug dealer, Sandi was a night owl. Others in her residency class happily woke early every morning. Then, at the first long shadow of the day, they were ready to find any soft corner, or even a not so soft spot for a nap. Not Sandi. That was when she felt the lethargy of the day lift- as if sunshine and daylight were thick blankets to be tossed aside. She felt enlivened as the day retreated. Her step lightened and her posture eased.
In those days every hospital ward had chart carts. They resembled the book carts that to this day inhabit library stacks. The four-wheeled grey metal chart racks had large rubber wheels and were put to hard work like so many mine mules. In the fluorescent glow of the late shift, when the generously proportioned night nurses began unwrapping their various bags and boxes of supper and treats; and poured drinks brought from home from their thermoses, when rustles and crinkles accompanied their shared dinner and gossip, Sandi filled an empty grey cart with her patients’ 5-ring blue vinyl bound charts. Back then there was no dictation service for the residents, no Dictaphones, nor tablets. They used pens and paper. She selected the cart least used and unlikely to be missed due to a wonky left wheel. She was pleased it no longer squeaked thanks to a stray can of WD-40 she had found found in the back of a janitorial closet. And while the other residents scribbled away in the last of the day, Sandi never had.
Instead, later, when night was settled, and shadows had disappeared into the darkness she would careen down the hall of the gyn-oncology ward. There, finding a family sitting vigil, she wished them a good evening. She’d point to the charts and say, “I have hours of work here. Go home and shower. Change your clothes. I’ll stay with your Aunt Noreen,” (or a sister named Millie, or a mother named June…). And she did.
Many times, a whisper slipped from one or two of the group as they stirred and gathered sweaters or fleeces, purses and magazines. “How much longer?” they would ask. “She’s suffering,” they would say. “Help her,” they might plea.
Sandi always promised to do what she could to keep their loved one comfortable. “But that is all I can do.” She said this clearly and firmly while wrestling her cart into the room. She settled herself in the hard plastic covered hospital issued recliner next to the bed and pulling a chart from the rack, began to write.
She knew a simple truth, one that spoke to her as did the night. Her presence was a comfort that came with no ties. Patients, she had observed, even those deeply unresponsive, those with only a toe remaining in the mortal world, avoided departing in the bustle of the day, doubly so when a loving vigil crowded the room and engulfed their soul like a snug camisole. She imagined that it weighed just enough to tether that last small digit of their being. So, Sandi came late in the night to keep uncomplicated company while scribbling through one chart after another, occasionally flipping from section to section to check a lab or to look up a study. She sat quietly by the beloved’s bed. Sometimes she sat by the bed of one alone but unlikely to recover yet hanging on night after night. They, she thought, might be afraid to take the final step from this world all alone. She was unsurprised when between the fan of pages, a patient would slip away.
Hours later, rarely more than two, or three, the family returned. Most often they were filled with gratitude the final vigil had ended. “Thank you,” they would say as she wheeled the wonky cart out the door. One or another might add, “We won’t say what you did.” Often a hug or a clasped hand was offered. It might even be a night nurse who thanked her, rounding after supper was packed away. She never bothered to explain that there was nothing to tell.
I. Cori Baill, MD is a board-certified OB/GYN and a Professor of Medicine at The University of Central Florida College of Medicine (UCF COM). She is the author of a children's picture book—"Why is Mommy Crying?”—explaining early pregnancy loss to young children." Baill is enrolled in Columbia University's Certificate of Professional Study in Narrative Medicine and it is her goal to further incorporate narrative medicine into faculty and student activities at UCF COM. Her interests include menopausal medicine, nontraditional student education and limiting government interference in reproductive healthcare.