Last Call

Dr. Adams hated weekend duty.

Not because she disliked her work. Quite the opposite. She had become a doctor because she wanted to help people, and for most of her career she still believed that was exactly what she did.

But the oncology ward on a weekend was different.

Especially this weekend.

They were short three nurses, one doctor had called in sick, another had been sent downstairs to help in Emergency, and every telephone on the ward seemed determined to ring at exactly the same moment.

By five o’clock on Friday evening, Dr. Adams had finally lowered herself into the chair behind the nurses’ station and stared at the pile of charts in front of her.

Around her, machines beeped, phones rang, carts rattled over the polished floor, and nurses hurried from room to room.

There were happier places in a hospital.

The maternity ward, perhaps.

Even Emergency sometimes had its victories—broken bones repaired, children stitched up and sent home, frightened people discovering that the terrible pain in their chest was not, after all, a heart attack.

But this ward was different.

This was the place where many people came because there was nowhere else to go.

Some came for treatment.

Some came for more time.

And some came because their time was almost gone.

Mrs. Evelyn Hart belonged to the last group.

At least, everyone believed she did.

Dr. Adams opened her chart again.

Cancer.

Advanced.

Spread to several organs.

Severe pain.

Poor prognosis.

Medication upon medication had been prescribed to control her symptoms. Painkillers, sedatives, anti-nausea drugs, medications for anxiety, medications to counteract the side effects of other medications.

There seemed to be a pill for everything except dying.

Mrs. Hart had been admitted several days earlier.

She had made the decision herself.

“I don't want to die at home,” she had told Dr. Adams.

“Why not?”

“Because my family lives there.”

Dr. Adams had looked at her, unsure what she meant.

Mrs. Hart had smiled.

“I don't want their last memory of me to be watching me disappear.”

She was sixty-eight, small and thin, with silver hair that she insisted on brushing every morning even when she barely had enough strength to lift her arms.

“I've lived in that house for forty-two years,” she had said. “Birthdays happened there. Christmas happened there. Arguments happened there. My children learned to walk there. My husband died there. I don't want my daughter walking past the bedroom for the next twenty years thinking, That's where Mum died.”

So she had come to the hospital.

To die.

Dr. Adams closed the chart and rubbed her eyes.

She should go and see her.

There were twelve other patients demanding attention, two families waiting to speak with her, one patient whose oxygen levels were falling, and another whose blood pressure was doing something nobody liked.

Still, she walked down the corridor and entered Room 214.

Mrs. Hart was lying against the pillows.

“You look exhausted,” Mrs. Hart said.

Dr. Adams laughed.

“I'm supposed to say that to you.”

“Then we're both in trouble.”

Dr. Adams sat beside her.

“How is the pain?”

“Awful.”

“We'll keep you comfortable.”

“That seems to be everyone's favorite sentence around here.”

Dr. Adams smiled.

“It is probably in the hospital handbook.”

Mrs. Hart reached out and took her hand.

“You'll come back?”

“Of course.”

“Tonight?”

“I'll try.”

Mrs. Hart gave her a suspicious look.

“Doctors always say they'll try.”

“I mean it.”

“Then I'll hold you to it.”

Dr. Adams squeezed her hand.

“I'll see you later.”

That was Friday evening.

It was the last time Dr. Adams saw Evelyn Hart for almost three days.

Not because she intended to neglect her.

Because the weekend exploded.

At six thirty, one patient began having difficulty breathing.

At seven fifteen, another developed a fever.

At eight, a frightened family demanded to speak with a doctor because their father had stopped recognizing them.

At ten, someone fell trying to reach the bathroom.

Shortly after midnight, a patient died.

At two in the morning, another patient was transferred from Emergency.

Saturday was worse.

The nurses seemed to be everywhere at once. IV bags needed changing. Families needed reassurance. Medication rounds ran late. Doctors were called from one crisis to another.

By Sunday afternoon, Dr. Adams could no longer remember when she had last eaten a proper meal.

Coffee had become food.

The vending machine had become a restaurant.

Sleep was something that happened to other people.

And somehow, in the chaos of alarms, charts, emergencies and dying patients, Room 214 disappeared from everyone's attention.

Mrs. Hart didn't call.

Her call bell remained silent.

No family member appeared at the nurses' station demanding information.

No machine sounded an alarm.

And everyone assumed somebody else had been checking on her.

The nurses thought the doctor had seen her.

The doctor thought the nurses had seen her.

The day shift thought the night shift had handled her medications.

The night shift thought the day shift had already administered them.

It was the kind of mistake that should never happen.

But occasionally, in an exhausted hospital with too few people trying to care for too many patients, impossible mistakes become possible.

Monday morning arrived quietly.

At seven o'clock, sunlight began creeping through the hospital windows.

Dr. Adams was sitting at the nurses' station, staring into her final cup of coffee.

One more hour.

At eight, another physician would take over.

Then Dr. Adams intended to go home, turn off her telephone, pull the curtains and sleep for approximately a year.

She leaned back.

Something bothered her.

A name.

A room.

A promise.

You'll come back?

She sat upright.

Mrs. Hart.

“Oh my God.”

A nurse looked up.

“What?”

“Mrs. Hart.”

“Who?”

“Room 214.”

The nurse froze.

For one horrible second, neither woman spoke.

Then both of them started moving.

Dr. Adams hurried down the corridor.

Her heart pounded.

She tried to remember the last medication order.

When had Mrs. Hart received morphine?

When had somebody checked her blood pressure?

Had anyone checked?

Had she died alone while everyone else was rushing around the ward?

Dr. Adams reached Room 214.

The door was closed.

She stopped.

Her hand hovered over the handle.

She had opened many doors knowing what she might find on the other side.

But this felt different.

This was her patient.

A woman who had asked her to come back.

And she had forgotten.

Dr. Adams opened the door.

She stared.

Then she stared some more.

Mrs. Evelyn Hart was sitting on the edge of the bed.

Fully dressed.

Her silver hair was brushed.

She was wearing lipstick.

A small suitcase sat beside her.

Another bag was packed on the chair.

Mrs. Hart looked up.

“Oh,” she said. “There you are.”

Dr. Adams remained in the doorway.

“Mrs. Hart?”

“Yes?”

“You're…”

She stopped.

Alive seemed like an inappropriate word.

Mrs. Hart raised an eyebrow.

“I'm what?”

Dr. Adams walked closer.

“You're dressed.”

“I noticed.”

“Why?”

“Because I'm going home.”

Dr. Adams blinked.

“You're going home?”

“Yes.”

Mrs. Hart stood.

Not quickly.

Not perfectly.

But she stood.

Dr. Adams nearly grabbed her out of reflex.

Mrs. Hart waved her away.

“I can do it.”

“Wait. Please sit down.”

“I've been sitting down for three days.”

Dr. Adams stared at her.

Something was wrong.

Something was very wrong.

Except Mrs. Hart looked better than she had on Friday.

Much better.

Her eyes were clearer.

Her speech was stronger.

Even her skin seemed to have regained some color.

“How is your pain?” Dr. Adams asked.

Mrs. Hart shrugged.

“Not bad.”

“Not bad?”

“No.”

“On a scale of one to ten?”

“Two.”

Dr. Adams stared at her.

On Friday, Mrs. Hart had rated it nine.

Sometimes ten.

“What medication did you receive this morning?”

“Nothing.”

“When did you last receive pain medication?”

Mrs. Hart smiled.

“That is an excellent question, Doctor.”

Dr. Adams suddenly felt cold.

“When?”

“I believe Friday.”

“Friday?”

“Yes.”

“That can't be right.”

“Oh, I think it can.”

Dr. Adams grabbed the medication chart.

She looked at Friday.

Then Saturday.

Then Sunday.

Her stomach dropped.

There were gaps.

Too many gaps.

The nurse who had followed her into the room looked over her shoulder.

“Oh no.”

Mrs. Hart folded her arms.

“You forgot me.”

Dr. Adams looked at her.

There was no anger in the woman's face.

If anything, she looked amused.

“We didn't…” Dr. Adams began.

“You did.”

“I am so sorry.”

Mrs. Hart waved her hand.

“Don't be.”

“Don't be?”

“No.”

“Mrs. Hart, this is serious.”

“I know.”

“We need to examine you.”

“No.”

“We need blood tests.”

“No.”

“Scans.”

“No.”

“We need to determine what's happening.”

Mrs. Hart picked up her handbag.

“I already know what's happening.”

Dr. Adams stared at her.

“What?”

Mrs. Hart smiled.

“I feel better.”

“That doesn't explain—”

“Doctor, I came here because everyone told me I was dying.”

Dr. Adams opened her mouth.

Mrs. Hart continued.

“You gave me drugs because I was in pain. Then you gave me drugs because the first drugs made me sick. Then other drugs because those drugs made me anxious or sleepy or constipated or confused.”

“Those medications were medically necessary.”

“Perhaps.”

“They were prescribed to help you.”

“I know. And I'm sure everyone meant well.”

She looked toward the window.

“But then all of you became too busy to remember me.”

Dr. Adams lowered her eyes.

“And something strange happened,” Mrs. Hart continued.

“What?”

“I stopped waiting to die.”

The room became quiet.

Mrs. Hart walked slowly toward the door.

Dr. Adams stepped in front of her.

“I can't simply let you leave.”

“Of course you can.”

“You are a seriously ill patient.”

“Yes.”

“You may still be dying.”

Mrs. Hart smiled.

“So are you.”

The nurse coughed, trying unsuccessfully to hide a laugh.

Dr. Adams gave her a look.

Mrs. Hart continued.

“I'm not saying I'm cured. I'm not foolish. I know what the scans showed. I know what the doctors told me. Perhaps I'll die next week. Perhaps next month. Perhaps tomorrow.”

She placed one hand on her suitcase.

“But if I'm going to die, I would rather do it at home than spend another perfectly good Monday waiting for someone to remember I exist.”

Dr. Adams looked at her for a long moment.

“You should at least let us run some tests.”

Mrs. Hart shook her head.

“If you run tests, you'll find something.”

“Probably.”

“Then you'll run another test.”

“Possibly.”

“And then another.”

Dr. Adams smiled despite herself.

“That is more or less how hospitals work.”

“Exactly.”

Mrs. Hart reached for the suitcase.

“So I'm leaving before you find enough things wrong with me to make me sick again.”

Dr. Adams laughed.

She couldn't help it.

After seventy-two hours filled with pain, death, frightened families and exhaustion, the laugh escaped before she could stop it.

Mrs. Hart laughed too.

Eventually, Dr. Adams arranged the discharge against medical advice.

She explained every risk.

Mrs. Hart signed every form.

Her daughter arrived an hour later, confused and crying, then laughing, then crying again.

Before leaving, Mrs. Hart stopped at the nurses' station.

The weekend staff had gathered around.

Some looked embarrassed.

Some relieved.

One nurse hugged her.

Mrs. Hart looked at all of them.

“You know,” she said, “this may be the first time being forgotten ever worked in someone's favor.”

Nobody quite knew whether they were allowed to laugh.

Mrs. Hart solved the problem by laughing first.

Then everyone joined her.

At the elevator, Dr. Adams walked beside her.

The doors opened.

Mrs. Hart stepped inside.

“Doctor?”

“Yes?”

“You promised you'd come back Friday.”

“I know.”

“You're very late.”

Dr. Adams smiled.

“I'm sorry.”

Mrs. Hart pressed the button for the ground floor.

“That's all right. Apparently I wasn't going anywhere.”

The elevator doors began closing.

Dr. Adams suddenly raised her hand.

“Mrs. Hart?”

The doors stopped.

“Yes?”

“What are you going to do when you get home?”

Mrs. Hart thought for a moment.

“Make coffee.”

“Coffee?”

“Real coffee. Not whatever crime against humanity you're serving here.”

Dr. Adams laughed.

“And then?”

“Sit in my garden.”

“And after that?”

Mrs. Hart smiled.

“I'll see.”

The doors closed.

Dr. Adams stood staring at them.

She never forgot that weekend.

For years afterward, whenever someone spoke confidently about how long a patient had left, she remembered Evelyn Hart sitting on the edge of that hospital bed, dressed and packed, waiting impatiently to go home.

The cancer had not magically vanished.

There had been no miracle scan, no medical breakthrough, no scientific explanation tied neatly with a ribbon.

Mrs. Hart was simply not ready to make her exit when everyone expected her to.

Weeks passed.

Then months.

Dr. Adams occasionally received postcards.

The first showed a garden.

Still here.

The second showed the ocean.

Still here.

At Christmas came a card showing an absurdly cheerful snowman.

Inside Mrs. Hart had written:

Doctor, you'll be delighted to know that I continue to be terribly inconvenient.

The following spring another postcard arrived.

Apparently Heaven has a waiting list.

Dr. Adams kept every one.

Years later, after she had moved to another hospital, she received a birthday card from Evelyn.

The message inside contained only two words:

Still here.

Dr. Adams laughed so loudly that another doctor came into her office to ask what had happened.

She handed him the card.

He didn't understand.

There was no reason he should.

Some stories belong only to the people who lived them.

That evening, Dr. Adams went home later than usual. She poured herself a glass of wine and sat beside the window.

For some reason, she thought about all the things people called final.

Final diagnoses.

Final treatments.

Final days.

Final conversations.

Last chances.

Last goodbyes.

Doctors were trained to read charts and scans and statistics. They learned probabilities, survival rates and clinical signs.

But occasionally a patient reminded them that human beings had never been particularly interested in following statistics.

Dr. Adams lifted her glass toward the darkening window.

“To Evelyn,” she whispered.

Somewhere, she imagined, Mrs. Hart was probably sitting in her garden with a cup of real coffee, refusing once again to cooperate with everyone's expectations.

The world had made its last call for Evelyn Hart years earlier.

She simply hadn't answered.