The Still Small Voice
The Still Small Voice
White-knuckled, Dr. Nell Cody gripped the steering wheel and fought for control as her car fish-tailed down a gaily decorated side street leading to Kenagami General Hospital. The car radio droned with announcements of road closures, weather warnings and a plea for everyone who could to stay home. Nell wished she’d heeded the warnings, but as Kenagami General’s one and only physician, she felt a duty to get to the hospital. However, she vowed to remain there until the weather and road conditions improved, even if it meant staying the night.
The rapid whap-whap of the wipers jarred her nerves, but still ice built into the corners of the windshield. A stop sign loomed out of the shadow and she touched the brakes. To her horror, her speed seemed to increase. The wheels locked. Completely out of control, her car slid straight through the intersection, missing a crossing truck by mere inches. Her heart in her mouth, she rolled the last few yards to the hospital parking lot, pointed the car at a snowbank and let the laws of physics bring her to a halt.
Heart pounding, her breath coming in gasps, she waited, too frightened to move, for five whole minutes before prying her shaking fingers from the steering wheel. When she finally got out of her car she noted the parking lot was nearly empty. Most of the staff, it seemed, hadn’t made it in.
She started toward the front steps of the old hospital, the brick edifice glistening like tinsel as light reflected from every ice-coated surface. She struggled up the icy stairs, her hand slipping uselessly on the ice-covered handrail, her boots sliding dangerously along the steps. When she finally reached the big doors, and the statue of St. Joseph that stood in a niche there, she was panting. “Nice going, Joe.” She gave the statue a mocking salute, her mouth twisted in bitter irony. Much as she admired the Sisters of St. Joseph who had founded so many of the early, outpost hospitals across Canada, she now considered their God to be as impotent as the stone replica before her. She opened the door and stepped thankfully into warmth and a non-slip floor.
She scowled at a Christmas tree in the lobby. Two more days and they could dispense with all the yuletide nonsense. She couldn’t wait. She hurried to her office and shed her outer clothing, thankful that the hospital had its own generator. If -- when, ice took down the power lines they’d still have heat and light in the health unit.
The distant wail of a siren sent her rushing toward the Emergency Room, heart thumping. The Klaxon crescendoed to a shriek then cut out abruptly. The intercom took up the call. "Dr. Cody! Emergency Room! Dr. Cody, ER!"
Fear shot through Nell like a bolt of lightning. Intuitively, she knew this call held a special urgency. Not another child she willed fiercely. Not another Tommy Blair.
When she’d fled to this little backwater 900 km north of Toronto, she’d imagined herself in a Christmas card town, with fluffy snow blanketing tall pine trees and skiers filling the village centre. She’d spend her days treating sniffles and sprained ankles while major cases were routed to the trauma centre in LaSalle. Mundane work, but safe. She hadn’t bargained for a small boy smothered in a snow fort.
She curled her fingers into her palms. Not only had she lost Tommy Blair on that fateful day, she’d lost any vestige of faith and she’d lost the Rev. Adam Ford, a volunteer fireman as well as a pastor. She’d fallen in love with Adam’s courage and compassion mere days after they’d met, but she couldn’t believe in a God who let little children die. All of Adam’s protestations about God’s wisdom and the need to trust Him, left her unmoved. She’d sent Adam away and every day since had been grey and cheerless. And the nightmare she’d come north to escape, visited her night after night.
"It's Sherry Masters" the desk nurse cried as Nell rushed past. "There's been an accident."
Nell's blood ran cold as she burst into the treatment room to see Sherry’s husband, Tim, ashen-faced, holding his wife's hand, urging her to hang on.
Sherry, a nurse, one of their own, lay on the stretcher, moaning in pain, blood seeping through the bandage on her head. Adam, in full turn out gear stood at her other side. For once, even he showed the tension and the fear that tore at them all.
Everyone turned to Nell, relying on her decisions, awaiting her orders, depending on her. Panic, worse than her fear in the skidding car, seized her by the throat.
"The baby," Sherry panted as Nell reached her side. "Save my baby." Nell knew how Sherry yearned for this baby. Knew the months of failed fertility treatments she’d endured. Knew the failure to conceive had nearly destroyed her love for Tim.
"Save my wife!" Tim’s harsh croak grated on Nell’s ear. She glanced at him, seeing his youthful face grow old and lined as he watched his wife suffer.
"The head wound is superficial," Adam stepped aside for Nell, "but the baby is starting."
"Get a monitor on her," Nell shouted to the nurse at her heels. "Sherry, tell me what's happening."
"The baby." Tears flowed down the girl’s face. "I'm losing the baby."
"Contractions?" Nell asked. "How often?"
"No," Sherry sobbed. "Just pain."
"Help her," Tim pleaded, anguish ringing through his voice.
"Uterine rupture," Nell whispered her thoughts aloud. "We have to get her to LaSalle."
"Not possible," Adam murmured quietly. "The ice on the road is what sent Sherry into the guard rails in the first place. The police won't let an ambulance onto the highway."
"Medevac!" Nell snapped, sending the nurse to order the helicopter. "Hang on, Sherry," she spoke gently to the frightened girl. "We'll get you through this." Sherry’s face had turned a sickly grey and her blood pressure was dropping rapidly. "I.V." Nell barked and fairly snatched the needle from the nurse's hand. "Where's that helicopter?"
"They can't fly." the night nurse dashed back into the emergency room. "They say visibility is too bad."
"They must," Nell shouted. Without immediate surgery both Sherry and her baby could die.
Already the internal bleeding was putting the baby into distress, restricting his supply of oxygen. Sherry herself was drifting into shock. If the haemorrhaging wasn't stopped she would bleed to death in front of their eyes. If she went into labour the contractions could tear the damaged womb wide open.
"Tell them they must," Nell shouted, increasing the flow of saline solution in the I.V. "Plasma!" She set up another intravenous drip.
"They absolutely cannot fly," Bonnie, the night nurse panted, racing back into the treatment room after her second consultation with Medevac dispatch. "They say it would endanger too many lives."
The room seemed to whirl before Nell’s eyes. Tim's agonized face, Sherry's pleading moans, the nurses' frightened gaze, the ominous beeping of the fetal monitor -- all pressed upon her. What should she do? Operate? Wait? Save the baby? Save the mother?
She shook her head, at the memory of Jane Doe, young, pregnant and terribly mangled in an accident. Jane Doe had waited for long minutes in the Toronto General ER while Dr. Nell Cody panicked, her mind a blank, her hands hanging uselessly at her sides. Another doctor had pushed her aside and taken control of the case. Later, a review board had found Nell’s hesitation did not contribute to Jane Doe’s death, but the finding did nothing to quell her guilt. In the end, she’d run away -- to Kenagami.
Now, it was happening again. A patient, a girl she knew and cared for, was dying in front of her eyes and Nell couldn’t move. This time there was no one else to help.
"Nell..." Adam's voice penetrated the fog around her brain. She looked at him, blindly, hopelessly.
"Nell," he said again, calling her by name. "Nell, you can do this. Go ahead."
"Yes," she whispered, her eyes clinging to his, seeking strength. "Yes." Valiantly she fought her panic. Two lives depended totally on her.
"We'll do a C-section." She tried to make her voice steady and calm. "Then repair the uterus. Tim, you'll have to leave the room. Sylvie, handle the anaesthetic. Bonnie, you assist me." She looked about for more help but no one else had made it in to the hospital through the storm. "Adam, scrub and gown up. You'll have to look after the baby."
As she scrubbed she frantically reviewed the procedures in her mind. A quick cut through the skin and adipose tissue would reveal a layer of muscle. Once through that the womb would lie exposed. A swift incision and the baby could be out. Then she could assess the damage to the uterus.
She looked about as the team rushed to do her bidding. Sylvie held the mask over Sherry's face, Bonnie stood at her side, gowned and masked, holding a tray of sterilized instruments. Quickly, Nell donned her own mask and pulled on surgical gloves. "Ready? Let's go." She took the scalpel from Bonnie's hand.
She stood poised with the sharp blade hovering above the exposed area of Sherry's abdomen. The fetal monitor beeped erratically, underlining the urgency of the moment. She could hear her own breathing, the beating of her own heart but her mind was blank and her hand refused to move. Frantically she tried to recall the procedure that had been so clear in her mind moments ago but all she could remember were her failures. The death of Jane Doe, the fruitless battle to save Tommy Blair. She was losing the battle again. Sherry and the baby depended upon her and she felt as useless as the stone statue she mocked.
She raised her eyes from the patient on the table, her agonized gaze colliding with Adam's. Above the mask that covered his mouth and nose, his eyes signalled to her, offering the calm assurance of his trust, the pledge of unconditional love. Adam had promised she need not fight her battles alone.
"Dear God," she prayed in desperate silence, her eyes fixed on Adam's, "dear God, help me, please." At once the fog about her mind lifted. In a flash of understanding she saw clearly and precisely what she must do, almost as though the instructions were laid out before her on the page of a textbook. The procedure, the instruments, the techniques -- all rolled out before her mind's eye.
With a calm, sureness beyond her experience, she gripped the scalpel more firmly and made her incision. Authority and energy surged through her mind and into her hands and fingers. Deftly, swiftly, with maximum skill and confidence she operated. Her commands to the nurses clear and crisp, her fingers never faltering in their tasks. In minutes the baby was out, the cord cut, the mucous cleared from her mouth and nose.
Clinically Nell observed the baby's poor colour and too quiet aspect as she handed the infant to Adam, but her first concern was Sherry. "Clamp," she muttered to the nurse beside her as blood spurted from the womb. Quickly she removed the placenta and placed it into the basin Bonnie held out to her.
Could the uterus be saved? A jagged tear about two inches long zigzagged across the womb above the neat incision of the C-section. The frayed edges presenting a surgical jigsaw puzzle.
A weak cry from the far corner of the treatment room brought her head around. Adam was holding Sherry's infant daughter, patting her back. The baby coughed and gasped, then let out an ear piercing wail. Tears of joy shone in Adam's eyes but beneath the mask Nell could sense his huge grin.
"Suture," she said, holding out her gloved hand to Bonnie, while her own heart leapt with joy. Once again, an unseen power seemed to guide her hands. She repaired the rough tear with neat, strong stitches, restoring the life-giving power of Sherry’s womb. When the last stitch was in place she released the clamps, watching carefully as blood flowed freely into the organ. The sutures held firm, circulation returned to normal. This time, she’d defeated Death. Smoothly, she completed the operation, suturing the layers of muscle and skin until finally the wound was closed and a gauze pad placed over the stitches.
Sherry was wheeled out of the treatment room and down the hall to a private room. Nell took the baby from Adam's arms and beheld a perfect little girl with a downy fuzz of red hair like her mother's. When Nell unwrapped the blanket to check that the umbilicus was clean and to place a drop of silver nitrate in her eyes the infant wailed lustily.
"That's all right, darling," Nell crooned, wrapping the baby snugly into a clean sheet and cuddling her. "You'll be fine, and so will your Mommy." She felt Adam beside her but sudden shyness kept her eyes averted from his. "Let's go meet your Daddy, shall we?" she murmured to the baby.
Tim, white-faced and drawn sat by Sherry's bedside, holding her hand. He gave no acknowledgement when Nell entered the room, all of his being centred on his wife.
"Tim," she said softly, her heart wrung by the dreadful fear in his face. "Tim, Sherry will be fine. And you have a daughter." She held out the tiny infant as Tim turned stunned eyes toward her.
"A girl?" Tim gasped as Nell placed his daughter in his arms. He gazed wonderingly at the tiny red face that peeped out from the bundle of blankets. "Sherry...?" All of his despair and love was tied up in that one word as he looked pleadingly at Nell.
"Sherry will be fine." Nell placed a hand on his shoulder. "It's all over now. See?" Sherry stirred and moaned. "She's beginning to come out of the anaesthetic already."
"Sherry?" Tim leaned over his wife's bed.
Sherry's eyes fluttered open. "The baby?" she whispered in a cracked voice.
"Right here." Tim darted a questioning look at Nell. She nodded and he held the baby up for Sherry to see. "We have a daughter." Tim’s voice filled with awe as the reality of Sherry's recovery finally penetrated the fear that had gripped him.
"A girl?" Sherry asked, trying to lift her arms.
"Can she hold her?" Tim looked toward Nell.
"Just a few minutes. Then she needs to rest."
Gently Tim placed their infant daughter into Sherry's arms. Nell watched for a moment as the tiny family gazed in wonder at each other, their joy and gratitude heightened by the near disaster they had come through. Tears stood in Tim’s eyes and Sherry wept openly as she held her tiny daughter.
Nell slipped quietly out into the hall.
"They all right?” Bonnie, pushing a cart loaded with clean laundry, touched Nell’s arm
"Yes." Nell beamed. "Sherry and Tim and baby are all, all right. Thank God."
"Rev. Ford is visiting another patient in room 2A.” Bonnie dropped a sly wink.
"Thank you." Nell barely checked her stride as she moved purposefully down the hall. There was one more thing she had to do before she was ready to face Adam. At the end of the hall down a short passage, was the nuns' old chapel Nell had seen it once on her initial tour of the hospital but had never gone in. Now she opened the carved wooden door and let herself into the dim quiet. The devout witness of the Sisters seemed to linger in the patina of the polished furnishings and the gleaming icons that decorated the altar. Gratefully, Nell sank into one of the curved wooden pews and let the peace and stillness of the place seep into her soul. At last, after her trial of doubt and denial, she opened her heart to the healing power of faith.
When Adam found her there some time later, tears glimmered on her lashes but the eyes she raised to him were free of fear.
"Oh, Adam." she turned and held out her hands, welcoming the firm clasp of his fingers on hers. "Adam, you were right all along. God is here, in our lives."
"Tell me about it," he whispered.
"Back there, in the emergency room," she jerked her chin toward the door, "with Sherry. I was so scared."
"I thought you did, yet you told me to go ahead. You were so calm, so sure. I've always envied that quality in you, Adam. When you spoke my name you gave me some of that confidence. Still, I could feel the panic rising, freezing my hands and numbing my mind." She stopped as though unable, even now, to understand what had happened in those moments.
"And then you looked at me and I felt the strength of your faith and I prayed for help." Nell shook her head, still bewildered by the miracle. "All at once, it was as though another person took over my body. Those were my hands operating on Sherry but a mind outside my own directed them. It wasn't me who saved Sherry and her baby, Adam," her voice quavered "there was an unseen power present in that room."
"It's called the Holy Spirit." He smiled into her rapt face. "The Holy Spirit, working through you, performed a life-saving miracle this morning. Several miracles, in fact."
"First, your knowledge, your training and your skill were freed to perform a life-giving procedure. Then your heart and mind were opened to God, and finally, my prayers were answered." He placed his hands on either side of her face and looked deep into her eyes. "Nell Cody, I ask you again, will you marry me?"
"Yes, Adam. With all my heart, yes.”
He leaned forward, sealing their promise with a kiss.
Much later, when the roads had been salted, the temperature had dropped, and a layer of snow made the world look pure and clean, Adam and Nell left the hospital, hand in hand. As they passed the statue of St. Joseph, Nell reached up to touch the foot of the sculpture. "We've a new baby, Joe," she murmured, all traces of mockery gone. "Keep watch over her."
“We’ll all keep watch over baby Noelle.”
“Named for Christmas.” Nell’s heart lifted. She raised her face to the softly falling snow and caught a snowflake on her tongue, held her arms out wide and laughed. “Oh, Adam, was there ever a better Christmas?”
“Only once, in Bethlehem.” He caught her hand in his as they dashed across the street, their laughter echoing off the hospital bricks.
A passer by in the street looked up and blinked rapidly. He could have sworn the statue of St. Joseph had laughed aloud. He shook his head and plodded on, head down. A trick of the snow, he thought.