Sister Mary Pius
A thick fog hugged the streets of St. John’s, the oldest city in North America. It had been surrounded by a bank of fog for three days. The cold damp air crept into your bones causing a chill that not even a hot cup of tea could thaw. This type of spring weather could last for weeks causing even the hardiest of Newfoundlanders to curse the damp cold and wonder why they didn’t move down south to a warmer climate. It wasn’t unusual for a person to develop anything from a common cold to pneumonia this time of year.
The Emergency Department at the Health Science Centre was alive with activity. Charles Horan struggled to carry Patrick Keating through the front doors
. of the
The elderly Keating was barely able to stand and continuously passed in and out
of consciousness. Horan wanted to call an ambulance, but Keating did not want
the attention the lights and sirens would have caused. The two men could have
easily been mistaken for father and son.
The waiting room was standing room only. The thirty-year-old hospital had hardly kept up with the growing population of the province. The once state of the art Emergency Department was in dire need of simple things like an updated seating area, a lick of paint and more space. The sniffles and groans of sick people filled the area. The sign on the wall said, Estimated wait time: 4 hours. There were three wickets at the front of the room, each with nurses taking basic medical information from patients and determining their level of priority.
Keating’s right arm was draped across Horan’s shoulders. Horan held the elderly Keating tight around the waist to keep him from falling as he carefully helped him sit in front of a wicket. Keating’s body melted into the chair. The perspiration on his brow was visible and his mouth sagged as if he was having a stroke. Horan quickly explained that Keating had been sick on and off for over a year. He had a flu that he could not get rid of. He told the nurse he begged the elderly man to go to the doctor, but Keating refused. His symptoms became worse over the past few months. He had an unquenchable thirst but found water bitter and turned his stomach. The thirst was followed by unstoppable nose bleeds. He had lost a considerable amount of weight but attributed this to stress and being over worked. He also had torturous pain throughout his body.
The nurse noted the symptoms and placed a hospital bracelet around Keating's wrist. She prioritized him as ‘urgent but not life threatening’. She brought out a wheel chair and with Horan’s help, lifted Keating on to the padded seat. By this time, Keating was starting to come to and began talking nonsensical. He was unaware of his surroundings and his speech slurred as he grabbed Horan by the collar and pulled him closer, whispering, "Don't tell them who I am. I don't want the media to get wind of this. I don't want any rumours or panic." Keating was winded and couldn't focus his eyes.
"No Patrick, don't worry about things like that now. You'll see a doctor soon and you'll be fine." Keating's head fell forward, and he passed out again.
Agatha Catania, the Emergency Department nursing supervisor, didn't care who he was. She was more interested in getting him into triage and assessed. With expert precision from years of crisis medical experience, she took Keating’s vital signs. His temperature was 101, his pulse was racing, his respiratory rate was laboured and his blood pressure was 180 over 95.
She wheeled him into an examination room and two more nurses assisted her, lifting him onto a bed. "We have to get him into a gown to be examined," she said, and started to unbutton his shirt.
"No, I'll do it.” Horan pushed her hands away from Keating’s chest. She shoved his hands back
"I am a nurse sir."
Horan decided to divulge their secret. "He's the Roman Catholic Archbishop for the province and I’m his assistant. We're both priests. Please, let me do it." Agatha felt like he was expecting her to bow her head and genuflect at the mention of his title.
Agatha was the first person in her Conception Bay family to get a university degree. Her father, a weathered fisherman, broke his back to ensure his only daughter received a good education. He never wanted her to work on the water. Her family had Italian and English roots but centuries of blending their accent with the local Irish dialect spoken throughout this island in the cold North Atlantic left its people with a distinctly townie or bayman accent. She was a bayman and a proud Protestant raised in the Church of England but often mistaken for Irish Catholic due to her thick bayman pronunciation of certain words. Four years of university and ten years of working at the biggest hospital in the province could not take the bay out of the girl. Father Horan’s assumption that she was a good Catholic girl was more than justified by her words and actions.
Putting this old man into a Johnny-coat was one less thing she had to do during this busy shift. She moved back to allow Horan to unbutton the shirt. "I am sorry, go ahead. The doctor will be in shortly." She walked out of the room allowing the two men their privacy.
By the time Dr. Luke Gillespie entered the examination room, Horan had the Archbishop in his hospital gown and a blanket pulled up to his chest. He was mopping his supervisor's brow with a cold facecloth.
"Your friend has a nasty flu from the looks of this," he surmised while reading the vitals from a clipboard.
"For some time now," Horan informed him.
"Let’s have a look." Gillespie took his stethoscope from around his neck and began to listen to Keating's heart and lungs.
"How long has he been sick?" he asked as he took the stethoscope out of his ears.
"He’s had the flu on and off for a little over a year. He just can't shake it.” Horan informed him. "It started getting worse a couple of months ago. He was tired all the time, he has lost a considerable amount of weight, maybe 20 to 25 pounds in a short period. He has fevers on and off and diarrhea.”
Gillespie folded his arms and pondered his patient’s predicament. "How old is he?"
"He'll be 60 in a month. One more thing," Horan added. "He has this incredible thirst for water, but every time he drinks it, he throws it up saying it's bitter and vile.” Horan’s face showed concern and fear. “He also has uncontrollable nose bleeds. He can bleed for hours. I've never seen anything like it and he complains of constantly being in pain. Sometimes the pain is so bad he cries, which is unlike him."
The doctor could sense his attachment to this man.
Gillespie tilted the Archbishop's head back until his mouth opened and placed a tongue-depressor inside. He shone a small pen light into his patient’s mouth. He was alarmed to see white spots and a thick coating on his tongue. He threw the tongue depressor in the garbage and felt Keating’s lymph nodes in his neck and armpits. They were enlarged.
The Archbishop began to come to and broke into a heavy cough. His throat was dry, he could not get his breath and his head fell forward. Horan put his arm under his Archbishop's shoulders and lifted him to open his airways. Without notice he broke into a harder cough that came from the pit of his belly. Suddenly blood spewed from his nose, splattering his chest. He coughed again, and the blood flew through the air. Gillespie instinctively jumped back but the projectile blood splatter reached him, dotting the top of his scrubs. Keating slid back into a trance. The front of his hospital gown was soaked in his blood. Horan propped up the pillows as the doctor laid him back down.
“I keep him elevated when he is like this, so he doesn’t choke on his own blood.” He stared at the doctor as if hoping for an answer.
Nurse Catania followed by two other nurses ran into the room ready to take direction. "I want everyone who comes in here to be wearing latex gloves, masks and gowns,” ordered Dr. Gillespie. “He is quarantined as of right now." The three nurses left and headed toward the supply cabinet to get suited up.
Father Horan was shaking, “Does he really need to be quarantined?”
"It's standard procedure when staff is exposed to blood. You'll have to go to the waiting area." The doctor pointed toward the door.
"Is he going to be alright? I have to notify some people of his situation." He took note of the concern on Gillespie’s face.
“Call whoever you need. We're going to run some tests now."
Dr. Gillespie felt a sense of panic come over him. He quickly scrubbed the blood off his hands and checked in the mirror to see if any landed on his face. It was clean. "Thank God for that," he whispered to himself.
Nurse Catania returned, covered in a mask and gown "Are you alright? What is it?" The look on his face stopped her in her tracks.
Gillespie hesitated. "I am ok. I am thinking of a few possible causes. I can't be sure till I get the tests back."
He looked at his patient unconscious in the bed. " I’ll write up a requisition for blood and urinalysis. Make sure no one else comes into this room and keep yourself covered."
"Do you think it's another wave of something like SARs?" Agatha knew she had a mountain of paperwork if it was.
Several causes were running through his head. "I am not sure, but I think it's more serious than the flu."
Gillespie looked at the chart again "Who is he? His name and face are familiar."
"Are you Catholic?" Agatha asked. He looked at her like he didn't understand what language she was speaking.
"I was born Catholic, but I haven't practiced in a long time."
"He is the Catholic Archbishop for the province. The other gentleman is his assistant."
"I haven't been to church in a long time. He wouldn't be familiar to me. Maybe my Mother," he added as an afterthought.
Gillespie shrugged "I don't care who he is. He's a patient to me. Money and power are no good to anyone in a hospital bed."
It took a few hours to get the x-rays back. Dr. Gillespie stood in the Emergency Room office, examining the test results and looking at the Archbishop’s x-rays displayed upon the wall when Nurse Catania approached him.
"What does it show?” She stood next to him looking at the screen.
Gillespie shook his head. "I don't know. I've never seen anything like this before."
Nurse Catania picked up the paperwork from his desk and read the results. "He has an infection. That's obvious."
"My gut told me to test for AIDS or HIV," he confessed.
Agatha looked at him with a smirk on her face "Really?"
He looked away from the x-rays. "The white spots on his tongue and the swollen lymph nodes in his neck and armpits gave me concern. I have to go with my gut."
Agatha laid the paperwork down on the desk "What about a disease similar to SARS?"
"No. Tests are clean for that too. As a matter of fact, according to all these tests, he is as healthy as a horse."
"I thought for sure it was going to be Tuberculosis, but his lung x-rays are clear," Luke was thinking out loud, "I am at a loss. I am really at a loss."
"I just checked on him before coming in here, he's still unconscious and he hasn't had another bleeding episode yet," she informed him. "So, what now?"
Gillespie was running symptoms and diseases through this mind like a computer searching for information. "He's not fitting into any one disease. It seems like he has bits and pieces of several diseases." A thought popped in his head. "Does his chart say anything about him being a hemophiliac?"
"I don't think so. I'll check." Catania left the room and returned a few minutes later with the Archbishop's chart. "No. Nothing about any type of bleeding disorder. Do you want me to test him?"
"Yes. Maybe we'll find a clue there."
Agatha returned to the main nursing station, retrieved the needle and rubber tourniquet to take blood from the Archbishop. The nurse at the counter informed her that Father Charles Horan was in the waiting room and wanted to speak to someone.
She put her supplies in her uniform pocket and headed to the waiting area. Horan was pacing in the hallway with a cell phone to his ear, speaking to someone about the Archbishop's situation. He said good-bye when he saw Nurse Catania coming towards him.
"Any news?" he was anxious, and his hands were shaking as he tried to put the cell phone into the holster on his belt.
"Not yet," she answered. "We are running tests. Can you think of anything that maybe causing this?”
Horan shook his head. "He was always healthy and active up until a little over a year ago. He caught the flu and couldn't shake it. He would often complain of pain saying he thought every nerve in his body was on fire." He shoved his hands in his pants pocket and looked worriedly toward the ceiling.
Nurse Catania wasn't sure if he was looking for answers or divine intervention. She noticed how young this priest was - he couldn’t be more than twenty-five. Yet the lines around his eyes made him look much older. He seemed too young to have the responsibility of caring for the head of the Church in this province.
"I have seen similar symptoms in a few other priests but not as severe as the Archbishops," Horan confessed.
"You told us when you came in that no one else around him had these symptoms," the nurse reminded him.
"Not as severe as his. The rectory is old. It's not unusual to hear people complaining about the cold and dampness in the rooms. It's easy to catch a flu there but no one has been as violently ill as the Archbishop."
Father Horan loved the historical structure of the rectory but knew it had to be brought up to code in many areas. The rectory was built behind the Basilica of St. John the Baptist. Its construction began after the Basilica was finished around 1855. The entire Catholic compound was constructed using limestone and granite imported from Galway and Dublin, Ireland, as well as bricks from Hamburg, and local sandstone quarried from St. John's and Kelly's Island in Conception Bay, giving the buildings their characteristic grey colour. The buildings are located on the highest ridge overlooking the city of St. John's facing toward the narrows surrounding St. John's harbour. They were purposely built that way to greet fishing vessels entering through the narrows. The first thing the sailors would see was the largest church buildings in North America at that time. Much of the church and rectory remained the same as when it was built except for the wiring. The cost of upkeep was staggering. The heat alone cost a king’s ransom. Declared heritage buildings, they had to stay true to their history thus drafty windows and cold stone walls kept their residents in a constant state of freezing temperatures even when it was hot outside.
"What about you? Do you spend a lot of time with him?" she queried.
"I've known him forever. He was the priest at my orphanage when I was a boy.” He turned to face her. “He's the reason I became a priest. After I was ordained I transferred back to his office to work with him. When he became Archbishop, he chose me as his assistant,” he ended, proudly.
"So, you're like father and son?" The question came out of her mouth before she could stop it. She never understood the Catholic hierarchy but knew it was inappropriate as soon as she asked it.
Father Charles Horan’s face took on a look of smug authority. "I am his assistant. This is not a father-son relationship. We are priests."
Nurse Catania had a feeling that he had answered this question before, maybe many times. She tried to cover her embarrassment by saying, "I need to know his next of kin for his record. He has your name listed, but does he have family who should be making decisions for him?"
“He doesn’t have family other than the church.” Agatha knew he was lying but didn’t know why.
“Ok, well he has you listed so I will let you know if anything changes.”
She turned and walked back into the emergency unit. She never looked back at Father Horan but could feel he was watching her. She felt like a school girl who had just been disciplined for talking back. Suddenly the hair on the back of her neck stood up and goose bumps formed on her arms. She felt cold and decided that Father Horan may be a man of God, but he gave her the creeps.
Archbishop Patrick Keating was peaceful in his bed when she entered his room. Agatha turned his arm over, tied the rubber tourniquet around his forearm, inserted a needle into his vein and proceeded to draw blood. She had just finished when he opened his eyes and looked up at her. "I’m taking your blood, so we can run some tests to find out what is wrong with you." Her voice was soothing. She was used to calming people down in the Emergency area.
"I am so thirsty." His lips were pasty and stuck together. He could barely get the words out.
"I can't give you any water just yet, but I'll get some ice chips. They will give you some relief." Agatha called out to a nurse who was walking by and asked her to bring ice chips for the Archbishop. She returned with a Styrofoam cup full and a small stick with a sponge on the end to help wet his lips.
Agatha wet the sponge and rubbed it along the Archbishop's lips until they were moistened. At first, he seemed relieved, then he licked his lips and began to gag.
"You've put vinegar on my lips!" He tried to spit the water out and wiped his lips with his sleeve. "You cursed woman, where is Charles?" He changed from peaceful to difficult in a matter of seconds. Agatha felt the same air of superiority that Horan had exuded.
They're certainly cut from the same cloth she thought. "It's ice chips. They'll make you feel better." She tried to calm him down.
"It tastes bitter like vinegar." She felt like a servant who had done wrong,
"Here, try the sponge yourself. It's soaked in cold water. You can suck on it like a lollypop." She took the sponge out of the cup and handed it to him.
He put it between his lips, spat it out, coughing and sputtering. "It's vile woman. Get me some water," he ordered her.
"This is water." She wasn't afraid to talk back to him
He hit her hand and the cup full of ice landed on the floor. "Get me Charles."
She stood back from the bed, collected her blood vials and turned to walk away. When she got to the door she turned towards him, "You’re quarantined. No visitors." She placed the vials in the collection tray she thought to herself, “I’m not Catholic, he can go to hell for all I care.”
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