The Sick and the Dead, by Anna DeForest

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From passages in A History of Present Illness, which was published last month by Little, Brown.

Churches are quiet, true enough. Old and cold and safe. There was one hidden in the hospital where I work that I had never noticed until the seminarian, Esteban, showed me. It was easy to miss. Newer additions had been built up all around it, swallowing its outline completely. It was round with old wood and dark bricks, stained glass windows with boards behind them so that light could not shine through. I didn’t know what happened there, but signs said everyone was welcome. find comfort here, said a paper taped to the wall, but do not sleep or eat!

Esteban said we don’t do things because of what we believe in, but we come to believe in what we are doing. He was glowing in a stoned way, just having come from a service where the churchgoers lined up and he and a priest, a woman priest in a plain white robe, used warm water and soft cloths and washed and dried everybody’s feet, one by one. He floated around like that for weeks after, with a glow in his eyes and a glow that you could almost see coming off his hands. He would walk around my little room blessing the books and the furnishings.

He was teaching me to pray, in a joking way: Give me good digestion, Lord, and something to digest. He told me a story about a missionary in a jungle who found a flipped truck by the dirt road with a man inside, crushed almost to death. He ran to pray with him before the man’s last breath, and the man became quite angry. He yelled at the missionary. I imagined his voice muffled in the wetness of the jungle air, imagined the blood on his body, his face. “Don’t try to save my soul,” he said to the missionary. “Please, just save my life.”

One time, Esteban asked if I would come see him preach. I told him I liked churches only when they were empty. But he set me up in the back row, behind a few pews of West Indian ladies in vivid little hats. His sermon was about what it meant that Jesus had a body. Like this: If you were deeply in love and you were seeing your beloved off on a steamship at a dock somewhere, you would want to hold every moment, to draw out every last second. But if you also had to take a shit, you would be miserable instantly, dying at once for that boat and your beloved to hurry up and leave. Those aren’t the words exactly. I do think he meant that we are wholly subject to our bodies, in all their gross immediacy. It made the churchwomen blush. And it was the first time I ever thought of a Jesus who would have to use the bathroom. I imagined Jesus in my little room with the toilet just taken away. So he has to run, run down the hall, past the doors of all his classmates, the pain in his gut making a white-hot burn all the way up to his teeth, and the pain made worse by his being so exposed, so close to losing stool in a public place. Humiliation—is human hidden in the root of that word? It comes up so much in humanity.

“World without end” is my favorite line to say when I push through a service at Esteban’s church. They write it all out for you, with stage directions even—when to stand and when to kneel, when to draw a cross over your head. Even in the darker days, world without end was what I wanted, more world, more life—I have wanted to see it in writing: that this world would stay, and I could stay here with it.

I didn’t know—a lot of people don’t—how few patients survive resuscitation, so I would rush to the codes in the emergency department, the one where I volunteered to stock carts and bring blankets, to watch for the miracle. A lot of people were brought in after being found down, meaning they had been alone when their hearts stopped, with no one to time how long they hadn’t been breathing. This is always bad. But they still got the works, got rolled into the trauma bay, got their shocks and chest compressions. On the hopeless cases, those who came in cold, the doctors offered to let me practice. It is true that the ribs break and true that you can hear it. Seventeen percent of them live to leave the hospital. We call these extraordinary results.

There are signs around the emergency department to prepare us for things you wouldn’t want to think about. We need to know what smallpox looks like, anthrax—in a patient, I mean—any illness that could be turned into a weapon. And then the ones that could just become plagues themselves, like the famous black death, which is still around but easily treated, I believe, with doxycycline.

Some of this is new, but a lot of us were raised on apocalypse. The church and conjoined school I attended made girls wear dresses, since pants were an offense to Jesus. We learned by heart that the wages of sin were death. Even worse somehow than the fires of hell, more fearsome, to me, was the Rapture. I would wake from nightmares and check the beds. The youngest children, it was said, were called up automatically, but I didn’t know the cutoff age and worried for a brother, the bodybuilder’s son, who was already coming out rough, running off and stealing and setting fires, once nearly burning down a neighbor’s attached garage. I was afraid it would just be him and me when the Horsemen came to fell the cities.

Eventually I got a place with Esteban, two rooms now, with no view of the bridge or the river. I listen at night sometimes while he prays quietly aloud, most often just a list of names. Mine, my mother’s, all of the brothers and sisters, his family, his patients. Some of mine. All lists are beautiful, I think, as, with attention, they take on a cadence that sounds like the songs we must have sung before we could speak, as monkeys in the trees. I pray, too, but only as a joke: Bless this Thai food, which we hath received from thy bounty.

Now Esteban is working as a chaplain in the hospital. He carries a pager that sounds whenever someone is pronounced dead. He comforts the grieving, holds them, or prays, or at least keeps the mothers from hitting their heads on the walls or the floor. The worst, he says, are the perinatal losses. There is nothing to hold on to when a newborn dies, nothing to reflect on or be grateful for. He calls this a pure void of grief. Other times his job is just to stay with the body, because some religions prohibit leaving dead bodies unattended. I always feel bad for the body. The ribs really break. You come to hate the sound of it. So he sits with dead bodies and prays what he prays until the rabbi or whoever comes to take over. It seems right to me. The doctors stream out fast after death is pronounced, leaving a wake of plastic wrappers and papers and tubes and empty saline pushes. Esteban says that sums up all his work in a way: staying with the body.

I sometimes join Esteban in church, though not often. There are parts I like, the colored glass, the bells, the confessions: Forgive us for the evil that we have done and for the evil that is done on our behalf. But the baptisms destroy me. I am destroyed and come back together. So I prefer the little church that is hidden in the hospital, where the services are rare enough to easily avoid.

The entrance to the hospital chapel is hard to find, industrial-looking, like a service exit. And then a little hall to larger doors, softened in old leather. A man in scrubs sits silently to rest or maybe pray. A couple in coats talk softly in a corner. The only word I hear at all is “terrible.” A woman in a white coat silences a sudden sound from a pager. An old man in a driving hat takes a seat by the altar, leans over, and ties his shoes. Outside, there is a garden. And light shines through the rose window, making it a muted kaleidoscope, orange and blood-red and yellow, that one deep blue you see only in shining stones. It shines most along the long wall, the colors dark and glowing.

The dark room is always warm. There are menorahs now on the edges of the inlet where a priest would prepare a sacrament. Muslims pray here, too, toward Mecca, which is a place in the world somewhere in the direction of the rose window. It must always be dark in this room; it must always hold the old smoke of incense and old robes. And what I am doing here? It is hard to know. Still, it looks like nowhere else in the hospital.

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