Science Fiction & Fantasy

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Fiction

Remote Presence

As usual, Win was late to work. Since he hadn’t had time to eat breakfast at home, he arrived at his office—tucked into the old wing of the hospital, now a maze of ancient files and obscure personnel—clutching a styrofoam vat of cafeteria coffee, a donut balanced atop it. He wore jeans and hiking boots and a wrinkled pinstripe dress shirt, from which his ID badge hung crookedly. “Winston Z, MDiv, LCSW, BCC,” it read. In the badge photo, he was smiling. That had been a long time ago.

If he’d known that his boss would be waiting for him, he would have ironed the shirt. If he’d known that her boss would be waiting, he would have called in sick.

He’d been looking down at the donut as he approached his office, which meant he had no chance to duck down a stairwell. They’d already seen him. As soon as he looked up, his boss Sara—Director of Social Services—shook her head. Sara’s boss Roxanne, one of a seemingly infinite number of Vice Presidents of Regulatory Affairs, narrowed her eyes and glared. Both of them wore elegant suits and understated jewelry. Roxanne’s hair, tastefully highlighted and cut in sculptural angles, probably cost more to maintain than Win’s car.

Win did his best to smile. “Good morning. How nice that you’re here to help me get into my office. Hold these?” He handed his coffee and donut to Roxanne, whose expression didn’t change. Sara cleared her throat. Win unlocked the door to his windowless cubby and ushered them inside. “As you can see, there’s only room for my desk and one chair in here. One of us can sit and the other two can perch. Shall we draw straws?” He heard the thin edge of panic in his voice. He was sure they did, too.

They all remained standing, and Roxanne didn’t waste any time. She put the coffee and donut on his desk and said, “The JCAHO inspection begins tomorrow.”

“I’m aware of that.” He doubted that anyone in the building wasn’t; they’d all been barraged with memos, briefings, drills, obsessive reorganization of records, and streamlining of databases. Every three years, the Joint Commission on Accreditation of Healthcare Organizations conducted a weeklong on-site accreditation survey of each hospital in the country. The survey was thorough, merciless, and struck apocalyptic terror into hospital administrators.

Roxanne blew out a sharp breath. “We can’t have revenants in the building. That’s one of the requirements.”

“Yes, I know.”

“We also can’t have nonfunctional equipment in work areas.”

“Understood.”

“Which means we can’t have a ghost wandering the halls in a telepresence unit. That’s a valuable piece of hardware—”

“Which wasn’t working,” he said. Of course Roxanne only cared about the expensive hardware.

“If it wasn’t working, it should have been repaired or returned, not possessed! And don’t tell me you didn’t know about it. For one thing, you’ve already admitted that you do. And for another, the ghost was delighted to tell me all about nice Reverend Winston who lets her visit patients. What were you thinking?”

Win swallowed. Of course Maisie would talk. She loved being the house ghost—or would have if she’d realized she was dead—and she didn’t know she was doing anything wrong.

Because she wasn’t. But that wouldn’t cut it with Roxanne. “She needs time to transition,” he said. Roxanne snorted, her eyebrows rising into her perfect hairline.

“No. She doesn’t. She needs to be discharged from that machine and exorcised from the hospital, and it needs to happen by tomorrow at 8 a.m. when the JCAHO team shows up. Are we clear?”

“Yes, ma’am.”

Roxanne left. Sara stayed. She cleared her throat again, and Win saw that she’d been biting her nails. “So,” he said, “she left you with the dirty work of firing me?”

“Nobody’s firing you. Not until after the JCAHO inspection, anyway. They require us to have spiritual care, and you’re our chaplain.”

JCAHO mandated that each hospital have a chaplain. It didn’t specify a patient-to-chaplain ratio. Level One trauma centers, like the one where Win had trained, had to have spiritual-care coverage 24/7. Level One trauma centers had on-call schedules and twenty-four-hour shifts and hordes of sleep-deprived chaplain interns, nearly as overwhelmed and bleary-eyed as their medical counterparts, who comforted the survivors of multi-auto pileups at 4 a.m.

This was a midsized regional medical center that couldn’t afford trauma certification. When he first took the job, ten years ago, Win had thought it would be calmer. Now, as much as he’d hated the stress of his intern year, he looked back on those twelve months with the fierce yearning of combat veterans deprived of the camaraderie of the front. “Yes,” he said. “I’m the chaplain. For a 400-bed hospital with at least four times that many staff, not to mention families and other visitors. And the occasional ghost. We’ve talked about this.”

“Yes. We have. Everyone who works for me is stretched too thin. I do what I can. You aren’t helping anybody by being stupid.” Sara glared almost as fiercely as Roxanne had, and Win’s knees buckled. He sat down in his desk chair, hard, and reached for the donut.

“Look, can we discuss this after I eat my breakfast?”

Sara sighed and perched on the desk. “No. But we can discuss it while you eat your breakfast. Win, please. Just tell me what you thought you were doing.”

He looked away from her, at the place where a window would have been if he’d had one. “I was doing my job. I was providing spiritual care.”

• • • •

Like most events in Win’s workday, it started with a beeping pager. This one summoned him to the ER, where a scowling charge nurse looked up from her computer and said, “Oh, good, you’re here. We’ve got a ghost problem.”

“Down here? That’s unusual.” Five years ago, an ICU in Illinois had suffered a poltergeist outbreak. That unhappy spirit had specialized in bursting blood transfusion bags and kinking IV lines, resulting in five lawsuits, three graphic novels, a movie, a spinoff TV series, and the JCAHO mandate that every hospital needed a chaplain certified in social work and exorcisms.

JCAHO had overreacted. There weren’t many ghosts of any kind in most hospitals. Hospitals weren’t places where patients wanted to linger, either when they were alive or after they died. In the decade Win had worked here, there’d been only two ghosts: a neonate whose ectoplasmic wailing set off every alarm in the NICU, and an old man on the medical-surgical floor who’d died after a routine hernia operation and refused to leave his bed until his estranged son visited.

Being a hospital exorcist was like being a vet or a pediatrician; the families were harder to deal with than the patients. Ghosts needed love the way the living needed food; love gave them the energy to move on. The souls of the dying either had to be freed by the living who loved them, or welcomed by the loving dead.

The NICU preemie, abandoned at the hospital by an adolescent mother the staff suspected was a sex-trafficking victim, had neither. Navigating a minefield of confidentiality rules, Win finally asked the parents in the hospital’s infant-loss support group to help with a releasing ritual. The NICU quieted down, and the parents took comfort in putting their grief to tangible use. Sara had been pleased. “Win-win, Win.”

The old man’s case ended more bleakly. His son wouldn’t come to the hospital until Billing began charging him for the unusable bed. When he finally appeared, Win conducted an exhausting counseling session—using a Ouija board, since he wasn’t sensitive enough to hear ghosts directly—which uncovered good reasons for the estrangement. The son finally dredged up a grudgingly good memory of a childhood fishing trip; on the other side, the patient’s wife supplied a single positive story about their honeymoon fifty years before. All of that was barely enough to budge the old man’s spirit out of the hospital.

If ghosts were rare elsewhere in the hospital, they were especially unusual in the ER. Most patients didn’t die down here. If they weren’t DOA in the ambulance, ER staff put them on ventilators and sent them up to ICU. Ghosts craved attention, and there was too much background noise in the ER: crying babies, overhead announcements paging doctors or requesting EKGs, static-laden radio reports from ambulances. Today the noise was coming from a screamer, a few doors from the nursing station and probably drunk, bellowing “Get me the fuck out of here!”

“So what’s this ghost doing?” Win asked the charge nurse. “How did you find out about it?”

“We’ve been having trouble with Room 32. Climate-control problems, computer glitches. It’s creating traffic issues; we need that space. We thought it was wiring, had a call in to Engineering, but then Anita from Registration saw the ghost, and Vinod from Phlebotomy did, too. I guess they’re both sensitives. How can sensitives even work here?”

It was a good question. Empathy drew most people to the hospital, but too much could drive you mad. Win hadn’t met many sensitives among doctors and nurses—too much direct patient contact, he guessed—but there were a surprising number elsewhere. He knew a food-service worker who talked matter-of-factly about calling her daughter and saying, “You need to get that ankle looked at; I think it’s more than a sprain,” when her daughter hadn’t even told her about the injury. When Win asked her how she could stand working in the hospital, she’d laughed. “Oh, honey, there’s pain everywhere. At least here people are trying to do something about it.”

“I’ll need to talk to Anita and Vinod,” Win said. “And anyone who took care of the patient, if possible. Do we know who this ghost is? Do we have records?”

“Yep. Her records are all that will show up on the monitor in that room. Maisie Plymouth, died down here of a stroke at age eighty-nine, in the ER at least once a month before that with various vague complaints. I didn’t know her well—I’m too new—but lots of other people did.” The nurse waved over an EMT. “Hey, Dave, you knew Maisie, right?”

The EMT, who sported complicated tattoos and towered over Win—most male ER personnel struck him as people you wouldn’t want to meet in a dark alley, unless you were having a heart attack at the time—grimaced and nodded. “Maisie. Oh, God. Sure I knew her. Begging your pardon, Reverend.”

“No apology necessary,” Win said. Clearly there was a story here.

Over the next few hours, he ferreted it out. The records showed that Maisie Plymouth had no next-of-kin or healthcare proxy. Her last residence had been one of the shabbier nursing homes in town. He talked to a social worker who confirmed that Maisie was very lonely, but said that efforts to strengthen her support systems hadn’t worked. “She wouldn’t even come out of her room at the nursing home. Her doc put her on antidepressants, but they didn’t help. She needed people.”

He talked to Dave, who—between cleaning wounds and splinting fractures—confirmed that Maisie’s greatest medical need seemed to be human contact. “She just wanted to talk, you know? She said everybody in the nursing home was too old. They scared her, and the staff was overworked and had no time to sit with her. As if we do, right? But I’d chat with her when I had a few seconds, and when I had to take care of someone else, she’d grab my hand and start to cry. And then she had the stroke. She was in Room 32 because all the critical-care bays were full, and we were jammed in there with her and a shitload of equipment, and finally there was something wrong that we could treat, except we couldn’t, and her left side was paralyzed and she was struggling to talk. I think she was saying, ‘I can’t move.’ Whatever it was, she said it over and over, and we tried to understand her and couldn’t, and we tried to help her and couldn’t, and she died.” Dave shook his head. “Maisie. Oh, God.” This time, he didn’t apologize.

Win talked to Anita and Vinod, kind and serious young people—university students working their way through school—who reported that Maisie’s ghost just sat in the room, smiled and waved, and wanted to talk. What were they studying? Did they like gardening? Did they have cats? Maisie had had a cat, before she went into the nursing home. Maisie missed her cat.

Win thought immediately of the therapy dogs who came to the hospital. “What about dogs? Does she like dogs?”

Anita shook her head. “No. I asked her. She’s scared of dogs. One bit her when she was little.”

Damn. Cats weren’t allowed in the hospital, because too many people were allergic. So much for that easy fix.

Maisie was trapped by too little love. Well, of course she was. She was a ghost. Dave, who clearly cared about her, might be able to help, but he was busy with a heart-attack patient who’d just come in. So Win trudged upstairs, dug his Ouija board out of his desk drawer, and went down to the ER again. If he could get Maisie out of the room, the charge nurse would be happy, and Win and Dave could take their time with the releasing ritual.

There were quicker ways to do it. Win had been taught emergency methods, techniques that had nothing to do with love. Those procedures were what most people thought of when they heard the word “exorcism.” They were brutal and violent and terrifying for the ghosts. Win was glad he’d never had to use them. He didn’t plan to start now.

As he walked into the ER, he passed a CNA pulling a telepresence unit—a wheeled flatscreen with a mic, speakers, and webcam—out of a room. Win knew the things saved the hospital money; a lot of neurologists used them to assess ER patients from their own offices, and some psychiatrists did too. They gave Win the creeps. Hospital patients needed people, not robots.

“You have to pull that?” he asked the CNA. “Doesn’t it move on its own?”

“If somebody’s controlling it, yeah.” The CNA pointed to a toggle switch labeled “Wheel Lock” in red letters. “As long as the manual lock’s off. But we can’t get an internet connection on this one. Gotta send it back.”

Well then, they’d just have to have a flesh-and-blood person talk to patients. What a shame. Win continued down the hall to Room 32, where he set up his Ouija board.

It was slow going. Maisie seemed happy he was there; he could feel her as a bubbly benevolence in the room. But she thought the Ouija board was some sort of Scrabble game, and all he got from her was random words.

She’d just spelled out “xi, x on triple letter” when Win remembered the telepresence unit. The computer monitor here was already displaying her records, so she was comfortable with electronics. The unit in the hall was broken. The hospital wouldn’t approve of using it to house a ghost, but it would just be for a little while.

No one stopped him as he flipped off the wheel lock and rolled the ungainly thing into Room 32. He turned on the monitor and said, “Maisie? Here’s a window for you. If you look through this window, I’ll be able to see you. I’d like that.”

Nothing happened for a few seconds. Then the screen started to flicker, grainy pixels swirling into a face. Maisie Plymouth, white-haired and plump-cheeked, looked like the Platonic ideal of a grandmother. Her mouth moved, but Win couldn’t hear anything. He turned up the volume, and a soft, tremulous voice said, “Do you have a cat?”

“No,” Win said. “I don’t. Anita told me you miss your cat.”

Maisie smiled. “Anita’s a nice girl. And that young fellow, Vinny? The one with the needles?”

“Vinod,” Win said. “Your friend Dave is here, too, but he’s busy. Maisie, would you like to take a walk now?”

The pixels brightened. “Oh, yes! I haven’t been able to do that in a long time! But what’s your name?”

“I’m the chaplain. My name’s Win, short for Winston. Let’s go for that walk, shall we?”

The walk was nearly as slow as the Ouija board had been. Maisie knew all the staff. She greeted everyone. To their credit, they took the apparition on the screen in stride. “Hey, Maisie, how you doing? Nice to see you. How are you feeling now?”

“Oh, I’m fine. I feel so much better!”

“That’s wonderful!” came a voice at Win’s elbow. He turned to find the charge nurse, whose badge, he now saw, read Karen. “Maisie, I’m so glad you’re feeling well. We hope you can leave the hospital soon.”

“Oh,” Maisie said. Her smile vanished; the pixels darkened. “But where will I go?”

Win and Karen looked at each other. “We’re just going to discuss that,” Win said. “Maisie, let me talk to this lady for a minute. I’ll be right back.”

He and Karen walked a few feet away. He had no idea what kind of hearing range Maisie had. “Okay, so she’s out of Room 32.”

Karen laughed. “Obviously. Nice work.”

“So you have the bed back. But I think getting her to leave the machine will be harder. I’d like Dave to help; of everyone here, he seems the fondest of her. Is he still working on that cardiac patient?”

“No. That patient’s up in ICU. Dave went home. He just finished a ten-day run of shifts, and now he’s off five. Do you want me to call him back in?”

EMTs worked twelve hours at a stretch, and while working in the hospital was probably less stressful than being an ambulance paramedic, Win couldn’t imagine where they got the energy. Working ten of those in a row was incomprehensible. “I really hope that won’t be necessary. Let me go talk to her a bit more, see if there’s anybody she loves who’s already gone and might help out. She must have had family at some point. Parents, if nothing else.”

“Okay. I’m here until seven. Keep me posted.”

Win glanced at his watch. It was almost five: time for him to leave. He was on salary, such as it was. No overtime. But he’d chat with Maisie a bit and come up with some kind of game plan. He didn’t think she’d do too much damage overnight.

He turned back to where the telepresence unit had been. It was gone. He realized in a moment of panic that he hadn’t turned on the wheel lock.

Then he realized something else. The drunk down the hallway had stopped screaming. Win walked to the room; just outside the door, he heard the drunk say, “Yeah, my mom has a cat.”

Win looked inside. Sure enough, there was the telepresence unit. The guy in the bed—an adolescent, acned and scowling—looked up and said, “Is it okay if I keep talking to this lady?”

Win swallowed. “Sure.” He walked into the room to face the screen; Maisie was smiling, and he felt her kindness like heat from a tiny sun. No wonder the kid had calmed down.

The kid’s face bristled with piercings. His t-shirt read “Eat Shit and Die” in neon letters. “She told me she likes to visit people but can’t walk very well.”

“Ah,” Win said, nodding. That was one way of putting it.

“That’s pretty cool, that she can use this gizmo to talk to people. My granny needs one. She’s in a wheelchair.”

“What’s your granny’s name?” Maisie asked. “Does she live near you? She’s lucky, to have a grandson like you.”

Win looked at his watch. “Maisie, when you’re done here, I need to talk to you.” He looked at the kid. “I hope you feel better.” Then he went back outside and told Karen, “You know, I don’t want to bother Dave. I really think I can handle it on my own.”

• • • •

That night, eating dinner in his tiny kitchen, he talked to the bobblehead Jesus who stood between his salt and pepper shakers. He’d had the toy since his first semester in seminary. He’d been pious and certain then; now he was neither. His approach to faith was “Use what works,” and all he knew for sure was that love trumped law. Jesus had said that, but so had a lot of other people. All the major traditions said it, when they weren’t being hijacked by politicians and other fanatics.

He no longer read his Bible every day, and he could go for months without going to church, but he still liked his bobblehead Jesus. It had brown skin, which made it more historically accurate than most other depictions of Jesus, and its bobbing head conveyed expressions ranging from alarm to resignation to encouragement.

Just now, it seemed bemused, but Win supposed he was, too. “So I took her up to my office and settled her down in front of sixteen hours of training videos for chaplaincy volunteers. She should be safe there. The door’s locked, and the telepresence unit doesn’t have anything like hands.” He licked pork-chop grease off his fingers. “I don’t know if this is what you would have done or not, but they won’t give me student chaplains because that program costs money and we aren’t a trauma center, so it’s not mandated. They won’t give me volunteers because some candy-striper in Chicago got clobbered by an old guy with a cane and sued, so now any volunteer is a liability issue. Maisie needs to talk to people, and she definitely helped with that kid in the ER. And if it doesn’t work out, I’ll call Dave and we’ll do the releasing ritual, which I guess we’ll have to do anyway, at some point.”

The bobblehead Jesus, its face painted with a serene smile, jiggled noncommittally. Do the work, Win imagined it saying. Your job’s to visit sick people who are frightened and lonely. Love trumps law. It’s easier to ask forgiveness than permission.

He slept well that night.

The next morning he woke up earlier than usual, made himself a nice breakfast, and still got to work half an hour early. His office door was open. In front of it sat a mop and bucket.

Housekeeping. Of course they’d come in to clean the office, and they had keys. How could he not have thought of that?

Win told himself to calm down. He knew all the housekeepers. He liked all the housekeepers. Most were Hispanic or Filipina, and almost all were Catholic, and when they weren’t cleaning up one mess or another, they paid very close attention to patients. The housekeepers were part of what he’d come to see as his secret army, all the staff who weren’t strictly required to take care of patients but did anyway. A housekeeper would pass him in the hall and say, “Father, that poor lady in 722, you should go see her”—they all addressed him as a Catholic priest, even though he was a Methodist minister—or someone from Security would alert him to a distraught family member who might be calmed down by prayer, or someone from Admitting or Engineering would tell him about something they’d seen that he might be able to help with.

Administrators got most of the money at the hospital. Doctors and nurses got all the TV shows. But none of what they did would be possible without everyone else, the vast support structure that kept the place running. Laundry, lab, the medical library: all of them were essential. The hospital was almost as complex an organism as the human bodies it tended.

Approaching his office, he heard voices: his TV saying something about existential crisis, and Maisie saying something about catnip, and a softer voice, Spanish-accented, saying, “Here is my kitty. Can you see her?” He peered inside to find a housekeeper named Luz, one of his favorites, holding her phone up to the flatscreen. “That is Tulip when she was a baby. Here she is now. Look how fat she’s gotten!”

“Good morning,” Win said, and Luz turned, smiling. Luz was a sensitive. She wouldn’t have needed the telepresence unit. She’d helped calm down the ghost of the old man so Win could talk to him. Too many people, even after they’d died, were scared of chaplains. Tiny women with mops didn’t scare anybody, although Win often thought they really ran the hospital.

“Good morning, Father. We’ve been visiting.”

“Yes, I can see that.” He reached out to stop the video, which was droning on about the dying process. Did Maisie remember that? “Thank you, Luz.” He added her to his list of people who might be able to help release Maisie. But not now. Not yet. No hurry.

“You’re welcome,” Luz said, and left.

“Maisie, did you enjoy the videos?”

“Oh, yes. But I liked talking to that nice lady more.”

“I’m sure you did. Would you like to talk to some more people?”

• • • •

Sara, leaning on the edge of his desk, bit back a groan. “That was—when?”

“A week ago. Dave should have been back by now, but he got called out of town. A sick aunt, Karen said.”

“No, Win. This has nothing to do with Dave, and you know it. If you’d been doing your job, Maisie would be gone by now. You’re exploiting her.”

Sara’s voice was cold, and Win winced. Any hope of keeping his job evaporated. “I think that’s a little harsh. She and the patients both benefit—”

“You benefit. Maybe patients do. Maisie doesn’t. She needs to go wherever she’s going. You’re keeping her here.”

“I don’t think so. She doesn’t know—”

“Then it’s your job to tell her. Today. Right now. In fact, I’ll come with you.”

She didn’t trust him. He supposed he didn’t blame her. He suspected he had Maisie, plus the JCAHO inspection, to thank for the fact that he wasn’t being escorted out of the building by security. They needed him to fix the problem he’d created. He gulped the remains of his coffee, now gone cold, and followed Sara out of his office. He felt jittery and defensive, which he recognized, clinically, as evidence of guilt. Was he exploiting Maisie? The idea horrified him. Surely he was giving a lonely soul purpose and company after too long without both. But Sara was right. Maisie couldn’t have chosen freely to visit patients this way unless she understood where she was, and why.

“Do you know where she is?” Sara, three steps ahead of him, didn’t even turn around to ask.

“Probably ER. That’s still her favorite place. That or post-op.”

Sara gave the elevator button a vicious jab. “Post-op,” she said to the button. “Wonderful. All we need is somebody coming out of anesthesia and being terrified—”

“Sara, you haven’t met her. She’s about as terrifying as the Beanie Babies in the gift shop.”

“That’s not the—”

A beeper went off, sudden and shrill. This time, Sara did look at Win. “Is that yours or mine?”

It was hers. She dialed her cellphone. “This is Sara. You paged me? Right. Yes. Okay. I’ll be right there.”

She hung up and glared at Win. “Urgent ethics consult.” Win suppressed the urge to say, A lot of that going around. It wasn’t funny, even to him. Especially to him. “I have to go. The minute I’m through there, I’ll head down to the ER. I’d better find that telepresence unit vacated.”

“Of course,” Win said. Saved by the beeper. “I’m going to take the B elevators. They’re faster.” They were, but walking to the other elevator bank would also get him away from Sara.

He took the long way to the ER, through the waiting room, which was jammed with howling children, flu patients coughing behind surgical masks, and people vomiting into blue plastic barf bags. In the ER proper, he was met with a wave of stench, sweet festering rot. A doctor with two dabs of Vicks Vaporub under her nostrils hurried by, shaking her head, and said, “You picked the wrong time to come through here.” He knew the smell: gangrene, messenger of death or amputation, the ancient enemy of soldiers, diabetics, and the homeless.

Trying to breathe shallowly through his mouth, his breakfast threatening to come back up anyway, he made his way to the charge desk. His gut clenched when he saw Karen—someone else who’d lecture him, no doubt—but she only nodded and gave him a sympathetic grimace.

“So the jig’s up, eh? Sara just called down here. I’m sorry. We’ve enjoyed having Maisie around, now that we have the bed back again. She’s our ER mascot.”

“Thanks. Do you know where she is?”

“Follow your nose. Homeless guy, losing his foot as soon as an OR opens up. Maisie’s keeping him company. She’s the only one down here who doesn’t mind the smell.”

“No,” Win said, “she wouldn’t. Do you have any more Vicks?” The stuff didn’t cut the reek entirely, but it helped.

Somebody had cleaned up the homeless patient: gotten him out of whatever he’d been wearing, into the ER shower and a gown. His foot was uncovered. Win couldn’t look at it. The telepresence unit stood next to the bed. “We were talking about how sad it is when you can’t walk anymore,” Maisie said.

Bile burned Win’s throat. “I’m sorry this is happening to you,” he told the patient.

“Yeah. Trench foot, that’s what the doc said. Because, well, you can’t take your shoes off on the street, if you have any, because they’ll be stolen. I got a blister, and it got worse. So here we are.”

“He doesn’t know where he’ll go,” Maisie said. “Afterward. He’s scared.”

“People at the hospital will help you,” said Win. “You’ll get rehab and social services.”

“That’s what they told me, yeah. A group home or something. I don’t like those places.”

Win looked at Maisie, whose face was furrowed into a frown, and said, “We help people find places to go when they leave here. That’s part of what the hospital is for.” He took a breath. “No one can stay here forever.”

“I want to keep talking to Joe,” Maisie said. “Until the surgeons come. We were talking about our favorite places to walk. We both love the river: the people in little boats, and the babies and birds.”

Joe said, “I’m scared.”

“It’s scary,” Win said. He felt helpless, which was nothing new. He couldn’t imagine losing a limb.

“She’s making me less scared. She can stay, right? Until they come? I mean, I know there are all kinds of other people here who need her. But I think surgery will come soon. They’re just finishing up another operation, the nurse said.”

What would Sara do, if she were here? Win wished he had a video of this conversation to show her: Maisie, being terrifying. He thought of Roxanne. He thought of Karen, saying, “We like having her around.” He thought of the bobblehead Jesus.

Love trumped law.

If Sara wanted Maisie out of this room, Sara would have to kick her out herself.

“Maisie, you can stay until surgery comes for Joe, but then I have to talk to you, all right? It’s very important. Ask Karen to page me. Will you promise to do that?”

“I promise.” She looked frightened now, and the warmth from the monitor faded as if blocked by clouds. “Did I do something wrong?”

“No, you didn’t, but please have Karen page me.”

He told Karen what was happening. He left the ER, washed his face and hands in the restroom, and then went to the cafeteria. He felt utterly drained, the donut and coffee a lifetime ago. Halfway through a Caesar salad, he got Karen’s page.

He took Maisie upstairs to his office, put the “In meeting, do not disturb” sign on his door, and sat down at his desk. Never had he been more conscious of the closeness of the space. He found himself leaning into the monitor, as if to absorb Maisie’s glow, and forced himself to back off. He had no right to demand comfort of her. “Maisie, do you know where you are?”

“At the hospital.”

“Yes. Do you remember coming here? Can you tell me what happened?”

The face on the screen blurred a moment; when it refocused, it was tracked with tears. “I came here and everything went away. And then I was back, but I was in that little room. The nice young people talked to me. Then you came, and I could leave the little room.”

“Yes,” Win said. “Tell me about going away.”

Maisie was quiet for a very long time. “I was lonely. There was no one else there. Only people very far away. They couldn’t see me. I didn’t know how to get to where they were.”

Win rubbed his eyes. “Who were the other people? Were any of them people you knew? Your parents, maybe, or friends?”

“I don’t know. They were too far away. I tried to call, but they couldn’t hear me. I like being here. I like talking to people.”

“I know you do. Maisie, before you went away, what’s the last thing you remember?”

Her face blurred again, pulsed, sharpened. “Tubes? Tubes and needles? They were putting a tube down my throat. Is that right?”

“It’s not a test. I’m just trying to help you understand what happened.” Chaplains were trained not to use euphemisms. Call things what they are: Alarming rest results. Terminal diagnosis. Death. “Maisie, you died.”

“I did?” Her nose wrinkled; she looked for a moment as if she might giggle, and the flow of joy from the monitor strengthened a little. “But I’m not dead now. I’m right here.”

Win breathed in, treasuring air that didn’t smell like gangrene. “Your spirit is here. Your body died. You’re in a machine. It’s a screen on wheels that doctors use when they can’t see patients in person. I invited you into the machine so you could leave the little room, but now it’s time to leave the hospital.”

“I don’t understand.”

“Maisie, some people are coming to inspect the hospital tomorrow. They get upset if spirits are still here who shouldn’t be.”

Maisie’s image wobbled. “Please don’t make me leave. I like talking to the people here. The people here like to talk to me.”

“Yes, they do.”

“Don’t make me leave. I was lonely there. Why do I have to go?”

Because of my job, which I’ve surely already lost. Because of stupid rules. Because it isn’t fair. “Because it’s time for you to go somewhere else,” Win said. “It’s time to join those other people. You’ll like talking to them, too. You won’t be lonely anymore.” He had no idea if that was true. He certainly hoped so. “We all have to make that journey, Maisie. This is your time.”

“I don’t want to. Please don’t make me.”

“No, I’m not going to make you.” He couldn’t stand the idea of using the emergency techniques on her. But if he didn’t, Sara or Roxanne might call in someone who would. “Other people might, though. It will be much easier if you leave on your own.”

The tears were back. “I don’t know how.”

Win looked at his watch. Two o’clock. Technically, he had three more hours of work. He wondered when he’d get home tonight.

“I can’t leave,” Maisie said. “I told Joe I’d visit him after his operation.”

Joe wouldn’t be alert enough for a visit until tomorrow at the earliest. “Someday you’ll see him again,” Win said, “and I’ll visit him. I’ll tell him you wanted to say good-bye. Now, Maisie, I want you to remember someone you loved very much. Imagine that person at the end of a long tunnel. Can you do that?”

“There’s no one,” she said, and then the intercom crackled with a Code Blue in ICU. Someone had stopped breathing, or gone into cardiac arrest. A moment later, a beeper went off: definitely his.

“I have to go,” he said. He wasn’t grateful for the beeper this time. “Please stay here. Don’t talk to anyone. Can you do that?”

“What did I do wrong?”

“Nothing. I did something wrong, not you.”

His beeper went off again, shrill and imperious. Maisie said, “Will you come back soon?”

“As soon as I can, I promise.”

• • • •

As soon as he could wasn’t very soon. The ICU patient survived, but her husband asked Win to stay during a long discussion with her doctors, who clearly didn’t expect her to live much longer. The husband kept turning to Win and asking, “God will produce a miracle if we pray hard enough, won’t He?”

God wasn’t a vending machine. “We pray for best possible outcomes,” Win said, feeling the familiar ache of futility. In this case, the best possible outcome was a quick, merciful death, with viable organs donated to people in desperate need. But the husband wasn’t ready for that conversation, and might never be.

Win lied about having another meeting and wished the husband well. He had to get back to Maisie, but he needed a break.

He headed up to the nursery. The place had one of the tightest security protocols in the hospital, but as the chaplain, he got buzzed in right away.

The nurse who’d let him in frowned. “We didn’t call you, did we?”

“Nope. I’m here for myself.”

He looked at babies for a while. The mewling bundles always made him feel better. They were hope, the future, the best news the hospital offered. Fortified, he headed back to his office. Maisie was still there, although he didn’t see how she could have gotten out. The bigger danger was that Sara or Roxanne might have come by and discovered her.

“I have to visit Joe,” she said.

“Maisie—”

“I promised. He’s lonely.”

Win looked at his watch: 4:20. “He may not be able to talk yet.”

“I know.”

“If I let you see him, will you let me help you leave?”

“I promised.”

Which wasn’t an answer. He rubbed his eyes. “Okay. We’ll look in on him, but then we’re coming back here.”

Heavily drugged and still unconscious, Joe lay in a thicket of IVs. His roommate, closest to the door, was asleep. Maisie had rolled docilely along next to Win as they went in, but now she shot forward to station herself by Joe’s bed. As unsensitive as Win was, he felt the backrush of her joy. “Let me stay until he wakes up. Please?”

“No. He may not wake up until tomorrow. You need to be gone by then.” It was as brutal as Win had allowed himself to be with her.

“I’m not ready! I don’t know where to go! I told him I’d visit him.”

“You’re visiting him now.”

“He doesn’t know that. Please? I’ll stay in your office until tomorrow. I’ll be good.”

He looked at her fine-wrinkled face on the monitor. He wasn’t going to get her out of the hospital by tomorrow, not without using force, but he couldn’t put back her in his office, either. It was amazing he’d avoided Sara and Roxanne for the entire afternoon, but they were probably dealing with inspection crises in other parts of the hospital. He couldn’t be the only brushfire.

He thought furiously for a few seconds. “Okay, Maisie. I have a nice quiet place for you, all right? For overnight.”

“Where?”

It was one of the storage closets near his office. Maisie followed him inside; he pushed her against the wall, behind a bunch of brooms. “I’m sorry, but I have to make sure you stay here.” He flipped on the wheel lock, and then he turned off her voice. “If anyone comes in, don’t let them see you. They might hurt you.”

She looked terrified. She started mouthing something. “If you won’t leave,” he told her, “this is the only option. I’m sorry. Truly I am.” Feeling wretched, he turned off the monitor. Even so, he felt her yearning for contact, but he must be imagining it. The machine was off.

He went outside, into sweet fresh air with birds and sunshine and children in the park across the street. He’d left work a few minutes early. He didn’t care. He walked through the park, intensely glad that he was still alive and whole, even if he’d very soon be unemployed, and then he headed back to his car to go home.

• • • •

He couldn’t sleep that night. He’d gone over his finances after dinner. He had enough money to last three months, if he was careful. He could put the word out to local clergy, talk to people at other hospitals, maybe call some of the area nonprofits.

He yearned to get out of this game entirely, do something low-wage and physical. Construction. A warehouse job. But those were young men’s games, and he was no longer young. If he was lucky, he’d wind up at Home Depot helping people pick paint or carpet or drill bits.

Worrying, he stared into the dark until the sky outside his bedroom window lightened. All hope of sleep gone, he got up to make coffee. His eyes felt coated with sand. This was not the best condition in which to withstand a JCAHO inspection, or anything else the hospital was likely to throw at him.

He sat at his table as the face of the bobblehead Jesus wiggled back and forth, caught in some turbulence Win couldn’t feel. He had a brief fantasy of trying to get Maisie out of the telepresence unit and into the plastic statue, but he wouldn’t be able to talk to her there. She’d be even unhappier than she was now, and he had to keep her hidden for another week. Dave would be back soon, and Win had Luz, but he couldn’t risk a releasing ritual—which took time, and required space—until the inspectors were gone.

Some theologian, required reading in seminary, had said the essence of Christianity was that if you didn’t love, you were dead, and if you did love, the ruling powers would kill you. As a student, Win had found the idea shockingly cynical. Now it seemed like the bleakest realism.

He drained his coffee and stood on legs that felt like styrofoam. Time to shower.

• • • •

The JCAHO inspectors looked like Secret Service agents. Male or female, they wore white shirts and dark suits and carried clipboards; Win was surprised they didn’t sport sunglasses and earpieces. He spotted a set of them, moving purposefully down the long hallway that led to the ER, as he entered the hospital.

Sweating, he ducked into the lab waiting room, where a receptionist yawned and nodded in greeting. The inspectors hadn’t seen him. He told himself he was being ridiculous. They didn’t know him and weren’t looking for him.

Roxanne did and was. He found her waiting outside his office. Her usually flawless hair looked like something had been chewing on it. He wondered where Sara was, and was surprised when Roxanne gave him a faint smile. “You look as tired as I feel.”

Win suspected there was a lot of that going around. “Sorry to hear it.”

“I’m just here to make sure the situation’s been resolved.”

Win couldn’t bring himself to lie. “She won’t be bothering anyone.”

“Well, that’s evasive.”

No flies on Roxanne. Win felt his face tightening. “It’s the best answer I can give you.”

He expected her to start yelling, to fire him then and there, to whip out her cellphone and call an outside exorcist. Instead, she sagged. “Win, I know you think I’m the enemy. I’m not. If we lose our accreditation, we lose our federal funding, and if we lose our federal funding, the hospital closes, and if the hospital closes, this community loses 400 beds. None of us can let that happen.”

“I know.” Win’s precarious self-regard crumbled a little more. “I’ve done the best I could. I couldn’t bear to do an emergency exorcism. That’s a forceful eviction, and she’s lonely and in pain. She needs a releasing ritual, but I didn’t have the time or manpower.”

“You knew about the inspection. You knew you had a deadline.”

Win looked away. “I didn’t think things would get so complicated.”

“You didn’t expect to be found out.” Roxanne’s voice was tired and even. “All right. Where is she now?”

He led her to the storage closet. “I turned everything off. She’s behind a bunch of brooms. Do they inspect closets?”

“They inspect everything,” Roxanne said, as Win flipped on the light. “Where did you say she was? Behind those brooms?”

Win felt his bones go hollow. “She was behind those brooms, yes.”

Roxanne turned to stare at him. “Win—”

“I have no idea how she could have gotten out! I don’t even know who might have found her—oh.”

“Oh?”

“Luz. One of the housekeepers. Maybe. She cleans this part of the building, and she’s a sensitive.”

“So she’d have heard the ghost even with the tech disabled.” This time, Roxanne did take out her cellphone. “We need to page housekeeper Luz, please. Would you ask her to come to the chaplain’s office?”

How often did housekeepers hear themselves paged by name? Luz would be terrified. Win hoped she had nothing to do with this. Surely she needed her job even more than he needed his.

She was waiting for them when they got back to Win’s office. When she saw them, she raised her chin. “Are you looking for Maisie?”

“Yes,” Win said, relief mixed with fear. “Do you know—”

“That was terrible,” Luz said, her words thick with contempt. “Terrible!” Win had thought no one was scared of tiny ladies with mops. He’d been wrong. “Locking her up like that! She was crying, Father. She kept saying, ‘I can’t move. I can’t move.’ How could you?”

Win remembered Dave’s anguish. Her left side was paralyzed and she was struggling to talk. I think she was saying, “I can’t move.” His face burned. He had no self-defense to offer. Luz was right.

He deserved to lose his job.

“You let her out?” said Roxanne.

“Of course I let her out! But first I checked to see if Joe in 374 was awake, because that was where she wanted to go. And he was, and I pray to God that poor man’s all right.”

“Is she still there?” Win said. There was sure to be a JCAHO team in post-op.

“I have no idea. I’ve had work to do. I still have work to do, keeping everything spotless for your precious inspectors!” She came a few steps closer, her eyes narrowing. “And if they think Maisie is dirt, fuck their rules. We’ve been marked down before and passed reinspection. I’ve been here longer than either of you. I know.”

She straightened her back and swept down the hall, pushing her mop and bucket in front of her. Win looked at Roxanne. “She has a point.”

“She might, except that they’re extra jumpy about the ghost issue because of the Illinois lawsuits. If there’s an investigation, it will be clear we didn’t take appropriate steps. Did she say 374?”

“I think so. Why?”

“There was a code in 374 forty minutes ago. You didn’t hear it?”

“I wasn’t here yet.” Win looked at his beeper: nothing. “No one paged me.”

“Luz said she hopes he’s all right. That must have been what she meant. Okay, let’s go.”

Win hurried to keep up with her. He hoped Roxanne had misheard the room number. He hoped Luz had simply been wishing someone well after the traumatic loss of a limb. “Would the inspectors observe a code?”

“I hope not. I hope they’d let the code team work instead of putting them under extra pressure. But really, who knows?”

When the elevator doors opened on the third floor, they saw the JCAHO team, a clump of black at the nurse’s station. “They’re auditing charts,” Roxanne said quietly. “Good. That should keep them busy for a while.”

Win peered down the hall. He didn’t see the hive of people and equipment that always spilled into the hallway during a code. Whatever had happened, it was over. He had to fight not to turn and look at the inspection team as he and Roxanne walked by the nurse’s station. It felt like trying to escape the notice of a grizzly bear.

Safely past, Win and Roxanne glanced at each other. They’d become conspirators, but he knew she wasn’t really on his side. She’d throw him under the bus as soon as this fiasco was over.

Almost there: 368, 370, 372. Throat tightening, Win walked into 374. The telepresence unit stood next to the window. Maisie frowned down at Joe in the bed, but the other half of the room was empty. The first bed had been replaced with a jumble of EKG tickertape, latex gloves, and tubing. “Ah,” said Roxanne. “So the other patient coded. He must be in ICU, and they haven’t brought back the bed.”

What had Joe made of the code? Had he even been aware of it? Win walked over to look at him. Joe was too still. His monitor showed low BP, irregular heartbeat. A tech at the nursing station would be tracking all that.

Someone else hurried into the room: Luz. Win felt like he’d fallen into one of those movies where only three people live in LA or New York; the hospital staff seemed to have narrowed to him, Luz, and Roxanne. “They didn’t clean,” Luz said, “the code team, and the inspectors are coming! We have to get this straightened up. You—” she pointed to Roxanne “—you stand out there and if they come down the hall, do something, talk to them. Give me time to clean! And you, Father, you stay out of my way!”

Gladly. Win circled the bed and fell back against the wall, next to Maisie. She was saying something, pleading. “Joe, where are you going? Please don’t go away.”

Win’s mouth fell open. He closed it again. Joe was dying. Joe was on his way out.

Go, he thought. Take her with you. Please go. He was afraid to speak. He didn’t want to distract her.

If Joe coded, the room would be crammed full of medical staff again within a minute. They’d bring Joe back, and Joe would bring Maisie back. Dammit.

Win didn’t want Joe to die. Did he?

Luz swept furiously, muttering something in Spanish. Win heard Roxanne, outside the room. “I’m sorry you’re here when we’re so short on beds, but I’m sure we’re not the first hospital you’ve inspected with that problem.”

On the telepresence screen, Maisie’s frown had been replaced by a shy smile. “Oh! Yes, I see it now. It looks like a long way.” There was a pause, and then, “Do you know how to get there? It’s so far. But I’ll go with you, if you know.”

Win’s pulse skipped as the heartbeat on the monitor gyrated into the uncontrolled twitching of v-fib. Alarms began ringing. He heard the Code Blue on the intercom and squeezed himself into a corner, pulling the telepresence unit with him, as people in scrubs hurtled into position around the bed. Luz was gone; in all the frenzy, the JCAHO team surely wouldn’t scold anyone for the trash still on the floor. And with luck, they’d stay outside.

The telepresence screen showed the back of Maisie’s head, her bird’s nest of white hair, dwindling, surrounded by swirling darkness. He still felt her signature cheer, but it was receding. He wondered if the JCAHO team included sensitives. He’d be surprised if it didn’t.

A nurse was doing CPR, and the doorway was completely blocked by medical staff maneuvering equipment, handing IV bags and clipboards and syringes over each other’s heads. “Halt CPR,” someone said—a doctor—and Win heard “Clear!” and smelled the frying flesh that always followed the shock from the paddles. Joe’s ribs would already be broken from the compressions. All the medical personnel Win knew wanted “Do Not Resuscitate” tattooed on their chests.

At least there was no room in here for the JCAHO team. On the monitor, Maisie was still dwindling, but more slowly than Win would have liked.

“Clear!” said the doctor, and there was another burning reek and then, “Hey, he’s looking better.”

Maisie turned forward again. “Joe, where are you going? Didn’t you just say you saw your mother?”

Win cringed, but no one had heard her over the discussion of cardiac rhythms and blood values. He reached out and turned off the sound. Maisie didn’t seem to notice. Instead she smiled and turned around again. “Crap,” said the doctor. “Lost him. Okay, here we go. Clear!”

Again the reek, but this time, Maisie didn’t turn around.

The team kept working. Maisie was still receding, fragmenting into isolated pixels. But Win could feel her, however faintly. And then he became aware that the frantic activity around the bed had stopped.

“Does anyone want to continue?” the doctor said.

Silence and shaking heads. One of the nurses said quietly, “This guy’s a train wreck.”

“Bad room today,” said a tech.

The doctor sighed. “Yeah, okay. Thanks, everybody. Time of death, 10:15 a.m.”

Win looked at the telepresence screen. It still showed pulsing pixels. He’d turned off the sound, but he was afraid to turn off the unit completely, afraid that would somehow make Maisie panic and rush back. Afraid she’d feel trapped again, instead of freed.

The code team was leaving and the JCAHO team was coming in, although Win had no idea what they planned to inspect. Joe’s charred body? He heard Roxanne, still in the hall. “I’d really like to show you those statistics from last quarter!”

They ignored her. Win took a deep breath, pulled the telepresence unit to face the wall, and stepped out of his corner to face the team. “I’m the chaplain. I’d like to pray over this patient, please. Can you give us a few minutes?”

“Yes, of course, we’ll wait outside,” said one of the black suits. Roxanne, peering into the room, gave Win an unreadable look.

Win put one hand on the corpse’s forehead and offered a heartfelt, if formulaic, prayer for the repose of Joe’s soul, speaking more loudly than usual so the group in the hallway would hear him. Moving into the Lord’s Prayer, which he could have recited under general anesthesia, he reached out with one hand to tilt the telepresence screen towards him. Swirling stars, still. He could just barely feel Maisie.

He finished the Lord’s Prayer. He started offering a blessing, but the inspectors thought he was done. They were trooping back through the door.

Win closed his eyes and shoved the screen wallward again. He had to keep them from looking at it. How? What was the right thing to do here, the loving thing, his final stand in this job?

I’m not the enemy, Roxanne had said, and he supposed JCAHO wasn’t the enemy either. All of them were just trying to keep hospitals open and safe.

Stupid rules were the enemy.

Win squared his shoulders. “I’m the chaplain here. I really would have preferred to pray with this patient when he was still alive, when he might have taken some comfort in it. I didn’t get to do that because I’m the only chaplain in this hospital.” He paused; they stared at him impassively, but at least they were looking at him and not at the unit facing the wall. “You guys don’t mandate anything close to adequate spiritual-care coverage. Patients who aren’t in trauma centers still need spiritual care. All our staff—doctors and nurses and techs, even housekeeping—do what they can. But we need more chaplains.” He looked at their faces, at Roxanne’s face. He saw no reaction. “Will you think about that when you revise your guidelines? Or should I make a formal request? I could go through my professional organization, but you’re here now, and I know you appreciate efficiency.”

They squinted. He didn’t think almighty JCAHO teams were used to hearing complaints about their procedures during inspections. Then one of the inspectors blinked. “What’s a remote-presence unit doing here?”

Win wondered if they could see him sweating. “I don’t know. It was here when I got here.” The inspector walked to the unit and turned it around. Win’s stomach lurched, but the screen was completely dark. Win saw nothing. He felt nothing: no benevolence or joy or comfort or desire to comfort, no warmth.

A dizzying rush of certainty gave way to a bolus of tears in his throat. Maisie was gone. The crisis was resolved. He’d probably still lose his job, but the hospital wouldn’t get dinged by JCAHO. A burden of guilt he hadn’t even realized he was carrying fell away.

Grief replaced it. He hadn’t been able to tell Maisie that he was sorry, that he knew how cruel he’d been. He wondered if he would have been able to resist the urge to rationalize, to protest that he’d only been trying to protect her. Would she have understood that?

A fine job he’d done of being loving.

The inspector was still frowning at the telepresence unit. “It’s on. Can someone tell me why?”

“We’ll certainly find out,” Roxanne said. She marched to the bed and rang the call bell. A nurse showed up almost instantly: Welcome to inspection week. Roxanne said crisply, “Can you tell us why there’s a telepresence unit here?”

The nurse gave all of them a dazzling smile. “One of the surgeons was called away to another hospital, but he checked on this patient via remote. That was just before the first code, and staff’s been too busy to put the unit away. I’ll do that now.” She turned off the unit and pushed it out the door. Win saw Roxanne exhale.

“Will you think about what I said?” Win was talking as much to Roxanne as to the inspectors. “This patient deserved more spiritual support than we could offer. So do all our other patients, and their families.”

“We’ll take it under advisement,” said one of the suits. What had he expected? There’d be no official response to anything, including Win’s employment status, until at least the end of the week.

Time to go. The team members around the door parted for him. Unsure if he was crying for Maisie or Joe or himself, Win wiped his face on his sleeve. The hallway was very quiet. A few feet from the room, Luz leaned against the wall with her mop and pail beside her, and as he passed, she gave him a small, fierce nod. “Don’t worry, Father. They need you.”

Susan Palwick

Susan Palwick

Susan Palwick is the author of four novels from Tor Books and a story collection from Tachyon Publications. Her short fiction has appeared in a variety of SF/F magazines and anthologies, including several Year’s Best volumes. She has won a Crawford Award and an MLA Alex Award and been shortlisted for the Mythopoeic and World Fantasy Awards. Currently an Associate Professor of English at the University of Nevada, Reno, she has spent twenty years teaching writing and literature and ten years providing spiritual care as a volunteer in a local emergency room. This experience both informed “Remote Presence” and inspired her upcoming career change; in Fall 2017, Susan will begin full-time studies in the MSW program at UNR, with the goal of becoming a medical social worker. She and her husband live with their three cats in the foothills of the Sierra Nevada.