Silent Night

I shuffled back to the ward to see Joshua breathing shallow breaths, his tiny ribcage rising and falling rapidly like a fledgling that has tumbled out of its nest. He lifted his hand and tugged weakly at the nasogastric tube. His arm was splinted and bandaged so that the morphine could drip steadily and uninterrupted into the vein on the back of his hand. Each drip heralded by a loud beep on the intravenous machine beside his bed, like a clock ticking away the time. I knew then that he would not see the morning; that his body would give up before the night was through.

I read his chart. The cancer had spread to the back of his eyes. Crazed cells were stuck to his retinas with death glue. His vision was blurred. I had sent Joshua’s parents home to sleep earlier that evening. When their son was first diagnosed they accused the Devil, the World and God for his illness. Their son’s blood poured forth like wine from his body, sinking to the bottom of a test tube. But the high priest of the oncology unit, the Professor, had given them hope in those first weeks. Their first born boy, the saviour of their broken marriage, would live to see the winter come and watch snowflakes land softly on the ground. There would, after all this, be a happily ever after in their lives. But over the last ten days, Joshua began feeling tired. And tonight his blood told the true story, as blood always will.

Joshua, eyes sunken and hollow, stared up at golden tinsel draped across the ceiling and the walls. Then he turned and faced the monitor, his heart pounding like a little drum, tapping out tunes with its deathbeat. How easily I could quicken the tempo to allegro. Staccato drops of morphine driven to crescendo with the touch of one talon of my hidden claw. The wispy, smiling wooden Christmas tree angels filled the room. Soon it would all be over.

I stared through the window out into the night at the car park below, suddenly wanting to jump out of my body, leave this ward of purgatory.  I pulled the green surgical gown over my arms, unfolded the size 7, sterile gloves and prepared to perform a lumbar puncture on a dying child. The Professor’s orders.

My mother screamed down at me, breaking her deathsilence. She was calling me murderer, Judas:

You make your living out of death!

You learn your living out of books!

You worship false gods of Anatomy, Pathology, Pharmacology!

Why couldn’t you have been a lawyer?

Clinical practice guidelines. Hold the needle steady. Prep the skin and drape with sterile sheets. Five centimeters square is your window of opportunity. Two nurses will hold the patient down; keep the knees curled up to the chin.

Shouldn’t you call the mother?

She should be here to hold his hand.

Why couldn’t you have been a teacher?

I stabbed the exposed flesh of his spine. Bull’s eye, first time. I counted the drops of warm spinal fluid, clear as water, as they dripped into the glass vial.

Silent night. Holy night.

Come light the Menorah.

Joshua’s face was wrinkled and he looked like an old man. He was preparing to meet the dirt and rock, staring up unseeingly at the audience of mourners above. His mother would soon stand by the freshly dug grave. Promises lost. A year of violin lessons paid for in advance, but never used. I peeled off my gloves, threw my gown into the yellow biohazard bin and turned my back on his tears.

I felt like a musician, fiddle-dee-dee, as I turned up the speed of the drip, calling forth the angels to come, my own devil tail twitching under my long white coat. I had the power to free Joshua from pain. That night I realized that I had my true chance to heal..

Joy to the world, the angels sing!

Gather round the table, we’ll all have a treat

He was a child of the dark now. Alone with him in that room, I became both witch and priest. I could cast my spell and all would vanish before his eyes.  I was a bearer of gifts for a newborn King; deathflirt, miracle worker, voyeur of purgatory. And finally, I would be Shokhet – ritual slaughterer of the smallest angel.

Holy infant so tender and mild

Candles are burning bright, one for each night

Sleep in heavenly peace

I listened to Joshua’s heart. Swiftly, professional in my sterile technique, morphine turned to wine in his blood. I sat beside his bed and watched him on his way, his face smiling like a baby, dying unafraid.

“It’s getting cold,” he said.

“It’s OK Josh,” I  held his hand, “You can close your eyes now. I’ll make sure no one steals your presents.”

“Yo ho ho! What have we here?”

The matron’s voice boomed, and the white pom-pom on the end of her Santa’s hat swung from side to side as she sauntered into the room. She looked at Joshua and then across at me. She walked towards the side of the bed and fiddled with the intravenous machine, slowing it down so that the drops fell every ten seconds now.

“You know something, Doc?” she said, without looking at me again, “It was Joshua that helped lead you lot to the Promised Land. Now why don’t you go get some sleep?”

I sat in the chair and looked around the room at get well cards which were pinned up on the wall. A photo of Joshua’s family and his pug dog stood on the bedside table. As I left the room I looked back at his face, and at the teddy bear that he clutched in his hand. Its eyes were lopsided. Looking in two directions.

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