When people ask what I do for a living, “pediatric oncology” is often a conversation stopper. Many individuals cannot get past the initial thoughts of sadness to see the richness of the profession—or hear the wisdom of the children I am privileged to serve. I have been blessed to have many patients share stories and personal thoughts with me. I often feel God’s presence when they speak. When I commented on this to one young patient, he said to me that children “are the harmony.” When I asked what he meant, he said, “Kids are the harmony. We get your attention. You aren’t sure if we are off-key or not, but then you realize that we bring you around to the melody—a melody that God creates…a melody that is beautiful.”
This is a story about a harmony created by a teenager through the efforts of the Daughters of St. Paul and the Sisters of Mercy.
While I live in St. Louis, MO, most of my extended family lives in the northeast, and we often vacation in Connecticut so that our family can visit and catch up. The bungalow that we rent is a typical summer beach house—and small. With an extended Italian family, it was not unusual to have 20 or more for dinner, so daily trips to the store were in order. One day, I was hurrying to get things going as I had to take one son to the airport—he was leaving vacation early due to a business trip. I scribbled a shopping list on a paper towel, put some sauce on the stove, made an attempt at cleaning up the mess, and we were off. As I dropped my son off at the airport, he asked, “Dad, are you sure that you want to go to the store like that?” When I asked what he meant, he replied, “You look and smell like the loser on some cable TV cooking show!” I thanked him for his concern, but reminded him that we were 1200 miles from home. Why would I care???
So I arrived at the grocery store near the beach house, pulled out my list, only to have onion fragments fall on the floor. In my haste, I had grabbed the wrong paper towel. I hurriedly reconstructed my list, and as I looked up, I saw that a young lady was staring at me. (No one else was close to me—maybe due to the onions?) I thought that surely she couldn’t know me—I was 1200 miles from home. As I was thinking this, she came up to me and said, “You are Dr. Bob, from St. Louis.” Anonymity went out the window.
I stuttered, “Um….yes, but I am in vacation mode, and having trouble placing you.”
She laughed. “You’ve never met me, but I know you, and even have one of your old business cards.” With that, she opened her purse, and I saw a small prayer book with the Pauline Media logo on it. Inside there was indeed a business card that was easily about twenty years old. “My name is Jennifer. You’ll recognize my mom; will you wait while I go and get her?” I replied that I would certainly wait, unless the manager threw me out as a health hazard.
When her mother appeared, I did indeed recognize her. Her name was Karen, and I had last seen Karen when she was fifteen and a cancer survivor, experiencing some serious long term complications of her treatment. During the course of that hospitalization as I was caring for her in the hospital, I discovered that she was pregnant. I went to her room in the PICU with Kay, our social worker, and told her and her mom the news. Immediately, her mom exploded, “Now look, this is a mechanical problem; I’ll take care of it once you get us out of here. I don’t want any of your Catholic stupidity mucking things up!” Before I could respond, Kay’s pager went off. As Kay left the room, Karen’s mom followed her, emphasizing that we were only to treat “regular medical problems.”
As her mom left the room, Karen kicked me and said quietly, “Make me the last person you see on evening rounds tonight.”
Much later that evening, I returned to Karen’s room. Her mom had gone home. Karen was very direct. “You can see that my mom wants me to abort this pregnancy but I don’t want an abortion.” I asked what she wanted, and she replied, “I want to keep the baby.” I told her that this was not a Chia pet, or a dog that she could return when it was not housebroken in six months. It was not a matter of “keeping” but a matter of “mothering” a child. I suggested that she consider adoption, but she was firm in her decision.
Karen then went on to describe how her faith had been formed, how she had to keep it secret from her mom whom she described as a “militant atheist.” Her mom would destroy any material with religious overtones. Karen did have a Bible; apparently her mom was afraid to destroy that. But books, crosses—anything with even a vague connection to religion—was always thrown out. Karen was remarkably mature, and while that is not uncommon in children who have survived cancer, Karen was exceptional in the depth of her thoughts and feelings. One of the nurses that was with me during this and other conversations with Karen mentioned that there was this bookstore run by the Daughters of St. Paul which had “great books that would be an inspiration” for Karen. I gave the nurse some money and she purchased several the next day. Obviously, we kept them hidden from Karen’s mother.
After several long, late evening discussions with Karen, I was convinced that she really was ready to be a mother to this child. We made plans to tell Karen’s mother. For the first time ever—including her treatment for cancer—Karen was clearly afraid. With the overconfident ego of a young physician, I told her that things would certainly be okay. Karen’s quiet reply was that her mom “was going to be really mad.”
The next day, I told Karen’s mom about Karen’s decision. She wasn’t “really mad.” To this day, I have no adjectives that would describe the vile eruption that spewed forth from this woman. It was an inferno of hate. Her voice got louder and louder, and Karen started to shake. I was worried that Karen's mom would also upset other patients. I remember thinking, “Okay, God, what do I say now???” Then it came to me, and I simply told her, “SHUT UP.”
She looked as though I had slapped her in the face. “What did you say to me?”
I replied, “I told you to shut up. You have actually made this rather easy. I was prepared to launch into a discussion of your daughter’s medical and emotional health, but you have made this easy. This is a simple legal issue. Your daughter is old enough to deny consent. Before the end of the day, I’ll call the physicians that provide abortion services in the bi-state area, and tell them that even if your daughter consents in your presence, I will testify that the consent was coerced. They won’t put their licenses at risk. Go ahead—call your doctor—see what he says.” As she started to storm out of the room, I figured, well…in for a penny…. So I called out after her, “And you might want to call your attorney. Karen tells me you don’t allow her to have religious materials, which violates her constitutional rights. If you continue to do that, I have an attorney that will be happy to set you straight….” She called the physician she had planned to take Karen to, told him what I had said, and clearly did not like the response. She slammed down the phone hard enough to break it.
Things were icy to say the least. Karen’s mother was distant, and our communication from that point on was reduced to single word answers and occasional grunts. Karen continued to heal, and as we planned for her discharge, we tried to put resources in place for her pregnancy. Kay, our social worker, diligently worked on many different contingency plans for Karen—I am sure I was driving her crazy but she never complained. One day, Sister Mary Ralph, who was the director of social service at the time, came to the PICU. Sr. Mary Ralph had a laugh that could fill a football stadium. She reviewed what we had put in place, and told me, “Doctor, you cannot prepare for everything. Sometimes it is just a matter of faith.”
I started to say, “But I’m a doctor, I have to take care of everything…”
As if she read my mind, she said, “There are no ‘buts’—it is a matter of faith.” Of course, she was right.
It was finally time for Karen to go home. Normally, after a long hospitalization with a serious illness, the day of discharge is filled with laughter and smiles. Not this time. We were all concerned about what would happen to Karen once she was discharged. So we packed up her stuff, and she was sitting in a wheelchair with the books from the Daughters of St. Paul on her lap. As we started to wheel her out of her room, she stopped us and asked if it was true that she could keep religious articles now. I stared at her mother as I responded, “Absolutely.” She replied that she wanted a crucifix. I pulled the Mercy Cross off the wall of her room and gave it to her.
Her mother derided the cross. “What happened, are they too cheap to put a body on it?” I tried to explain the symbolism of the Mercy cross, but she waved me off. As they were about to exit the floor, they passed through some automatic doors. The mom stopped in the doorway, making the doors shudder. She looked back at me and said, “I will curse you every day that I am alive for saddling me with this bastard child.” She pushed the wheelchair forward, the doors slapped shut and they were gone.
At some point, when unanswered phone numbers became disconnected phone numbers, and several certified letters were returned as unclaimed by the post office, I recorded in Karen’s chart: “Patient and family lost to follow-up.” However, a child like that never leaves your heart, and is certainly always in your prayers. I never forgot Karen, and always prayed for her and the safety of her child.
My patients have also taught me that one cannot choose when or where God will answer a prayer. Obviously, neither my dishevelment nor odor mattered, because that “bastard" child was Jennifer, the young lady that recognized me in a grocery store in coastal Connecticut.
Karen had married and had two other children. Her husband had adopted Jennifer, who had graduated high school at the top of her class, and was carrying a double major in engineering at a nationally recognized university.
More important though, was everything else that Jennifer did. During high school she led fundraisers for a women’s shelter. She walked 15 miles for breast cancer, and rode 300 miles for MS. She tutored younger children and taught many to read. In college, she was a team captain for Light the Night. She was a leader for Relay for Life. “LIFE” was what Jennifer was all about. She celebrated it every single day.
In the grocery store, Karen told me that she had continued the “tradition” of gifting books from Pauline Books & Media to all of her children, hence the prayer book that Jennifer had in her purse. The Mercy Cross that I had given Karen just before she left the hospital was hanging in the mud room that connected their home to the garage. It was the last thing they saw as they locked the door to the house, and the first thing that they would see as they came home.
This story does not have a perfect happy ending. Karen and her mother never reconciled. That bitter, vicious woman never heard the wonderful harmonies created by the young lady she had labeled as a “bastard" child.
It was time to go. Karen gave me a hug, whispered, “Thank you again,” and started to tear up.
She immediately apologized and I replied, “Hey, I’ve been cooking all morning. I am sure it is because I smell like onions.”
She laughed, “Yes, let’s blame it on the onions.”
Jennifer came up and gave me a HUGE hug. She said quietly, “I thank God every day that I am alive and did not end up in a trash can. I know how precious life is….”
For me, this story is an opportunity to congratulate the Daughters of St. Paul and the Sisters of Mercy. Both groups of women followed their vocations, lived the charisms of their orders, knowing they were doing the right thing. As Sister Mary Ralph said, “It is a matter of faith.” They helped a young teenage mother create a beautiful harmony that brings us to God’s melody – God’s promise that he is always with us, especially as we celebrate his Gift of Life.
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