Photo Credit: Joey Cheung

In this medical fiction tale, a hearing-impaired hospital chaplain’s faith is tested and his fate intertwined with a homeless artist on an observation deck.

This medical fiction story is one of a collection that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies that appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. The technical details surrounding the event are drawn from real cases in the US OSHA incident report database or similar sources and are, therefore, entirely realistic, even if seemingly outlandish.

Harrold Beene was a highly accomplished and successful sleep therapist. As an Episcopal deacon, he delivered boring sermons with a voice so soothing and melodious that most parishioners were in slumberland within five minutes. This was not as bad as one might think, though. First, many people desperately need extra sleep, and his congregation benefited greatly from 90 minutes of slumber without disturbance from children or querulous family members. Secondly, the bulk of his weekday work was as a hospital chaplain, and being lulled into a slight stupor provided great benefit to many who sought comfort in the hospital chapel.

Harrold had grown up in a household of considerable privilege but had a father whose strong views on vaccination had resulted in Harrold ultimately joining the church. This series of events was triggered when his mother took him to a “measles party,” where, quite naturally, he contracted the disease. Without prior vaccination to mitigate this infection, Harrold became severely ill, developing a high fever and red eyes.

Following the illness, Harrold’s school performance worsened, but it was a year before one of his teachers realized that Harrold was partially deaf. Over time, Harrold came to learn that living with a disability earned scorn from many people and indifference from most of the rest. As an introspective little boy, this troubled him greatly and made him aware of how power and violence worked to raise some people and crush others.

Then, a second thing happened to Harrold.

Harrold’s Revelation

Harrold was crossing the street on the last day of high school and didn’t hear the moped rider speeding to deliver coffee and donuts to a nearby office building. The impact sent Harrold to the hospital. While recovering from broken ribs, a punctured lung, liver damage, and a broken jaw, he experienced a series of profound visions. In these visions, God revealed a mission to Harrold, a goal of ministering to the poor and unwell that was so clear, certain, and compelling that Harrold immediately enrolled in theology at the community college. In his path towards becoming a curate in the Episcopalian church, Harrold encountered many obstacles. One was his trouble with hearing and the ensuing embarrassment. Mishearing “apostate” as “a prostate” in a sermon delivered by the bishop led to confusion and a question that left the bishop perplexed and the rest of the congregation stifling giggles. For some time, Harrold was known as “the prostate priest.”

During his time as a curate, Harrold reconciled with his aunt. His father and aunt had become estranged over medicine and public health. Aunt Jo—Jo Gallegos, MD, FACEP—was an emergency medicine physician who thought her brother’s views on “natural immunity” were at best, misguided ignorance and at worst, outright criminal and homicidal.

When Harrold had been stricken partially deaf as a result of his bout with the measles, Aunt Jo and Harrold’s father had argued fiercely. Accusations of child neglect were made, insults exchanged, and curses shouted. Then, Harrold’s father pushed Aunt Jo against his trophy cabinet. She responded by slapping him so hard that he walked funny for three days and never quite heard right out of that ear again. The two parted in anger, swearing to never speak to each other again.

When considering career options in the ministry, Harrold had contacted Aunt Jo to learn more about hospital pastoral care. Aunt Jo had been delighted to hear from him and opened to him a world that gripped his soul. He soon discovered that the emergency department (ED) was a nexus between the worlds, a place where people in crisis mingled briefly and then returned to their own worlds. The wealthy woman with the heart attack was briefly on the gurney beside the unhoused man who’d ingested methanol. After triage, treatment, and stabilization, each temporary inhabitant of the ED was sent back to their own world. The rich IT baron would be sent to a clinic where the sheets were the finest linen, while the woman with three missing teeth would return to her tent under the overpass—assuming it was still there.

When this door opened, Harrold dove in. If he wasn’t attending lectures or studying, he was immersed in the universe of the ED. Here, he could give spiritual comfort, link people to shelters, or guide them to places that offered free meals, used clothing, sleeping bags, or footwear. Aunt Jo provided him with lists of free clinics and the names of doctors who might visit former ED patients without addresses. Harrold was infused with the busy essence of the ED and how saving a life was a daily—sometimes hourly—event, and he was almost content to play his role on the periphery of this action.

Although everyone in the church told him that his work was important—that saving eternal souls was a greater goal than temporarily saving lives—Harold felt in his heart that all these people who moved so efficiently around him were doing the real work. He smiled wanly when they joked with him that if he stuck around in the ED long enough, he would eventually save a life. This didn’t console him as much as it made him try even harder to be of service.

Seeing how much he committed to this work, Aunt Jo whispered in the ears of the trustees, and an outreach was made to the church. Once his time as a curate ended, he was placed in a position at the hospital and a parish that included the surrounding low-income areas. Harrold was responsible for the souls that flowed through the hospital, the adjoining hospice, several satellite clinics, and all those places where unhoused people dwelled. It was a spiritual explosion for Harrold; the sun rose to find him at his work, and he was never in bed before midnight.

Paula’s Story

Paula J. Harmon did not have many breaks in life other than a leg, an arm, and a rib. Her parents struggled with substance use, and while they loved her, and there was most assuredly never any abuse, there was certainly neglect. There were times when Mom and Dad were out of it, leaving little Paula awake and unattended. Those were the times she might fall down the stairs and break a rib or jump out a window wearing a cape made of a tablecloth and break an arm. Child services frequently called after such events; her parents were ashamed and mortified, and promises and commitments were earnestly but unreliably made. Things would be fine for a while, but then some setback would loom, and those pangs returned.

After the store where they worked had closed and the car had been towed for outstanding parking and license violations, Mom and Dad went on a week-long bender, and Paula was picked up for stealing eggs and a loaf of bread. When the cops brought her home, her parents were very obviously still chemically entranced, and a search had turned up a stash that exceeded the personal-use limit. That had triggered a court appearance, a custodial sentence for both, and a foster home for Paula.

Foster life had proven complicated. Paula was not accustomed to such close parenting and balked at the micromanagement of her daily life: when to sleep, eat, or use the restroom, what to wear, when to wear it, and how to wear it. The foster parents did not take kindly to her wearing a t-shirt as a dress or her use of eyeliner at age 13. Her skills with drawing and painting included grinding and mixing her pigments and applying them to her body as well as to canvases and sketchpads. At 15, Paula became pregnant and faced overwhelming pressure that finally resolved, to some degree, with the baby being adopted by a more grounded and equipped couple whose means could more adequately cater to the needs of an infant.

A Chance Encounter

But that experience tore Paula’s soul and broke something in her. By the time her sweet 16th birthday rolled along, Paula, now known as “Paul,” was getting accustomed to life on the street. Gone was the long auburn hair, along with anything else that signaled gender and might attract sexual attention. Cold, hard nights were met with layers of baggy clothing, stones heated on the fire, and cheap alcohol. Paul sometimes found herself in the ED, where frowning faces flickered by, careful hands were laid on her, and skillful minds countered the wood spirit that was pickling her organs. Sometimes, a fall, a fight, or frost caused a return visit, and many times she crossed paths with the priest as he trundled his half-hearing self from person to person.

A big change came when the hospital board approved the sale of a tract of land adjoining the main building. The cash inflow would allow long-overdue repairs, expand primary care services, and keep the ED open. The private equity group that bought the grounds planned to build an office block, shopping center, and upmarket apartments with a view of the river below and the craggy mountains to the west. They started with the office tower, a ten-story masterpiece in angled glass that sported an observation deck with a fabulous sunset vista.

Paul still painted, although more in her mind than in practice. She could make do without brushes or an easel, but canvases were expensive, and substitutes were poor. Once the office block was functional, she took the office tower’s glass-walled elevator up to the observation deck, capturing images in her mind of the sun setting over the peaks. When she had the means, she would sketch the mountains and the moon in charcoal on rough packing paper and sell them on the street, using the proceeds to buy a meal. She clung tightly to the chance to use the tower, knowing that as soon as the rightful inhabitants moved in, those vistas would be shut to the likes of her. She treasured those sunset moments when the light painted the mountains gold and crimson, and she stayed as long as she could before hurrying to the shelter.

Harrold also discovered the tower and mostly went there at dawn. There, he would kneel in the bays built for the sloping windows, immerse his mind in prayer, and worship the hands that crafted this weary world. Depending on his schedule and the needs of his parish, sometimes, he would trade dawn for sunset and take in the setting sun that fed this place.

It was a dreary season. Rain pelted the streets and muddled the building site for days. It had been a cold and dismal week in which Paul took refuge in the numbness of drink. Paul knew the tower could see above the grey, and the sight would transport her in a way that alcohol could not. The heavy rain delayed Paul, but the clouds moved on and thinned out at last. As the elevator rose, the dying light broke over mountains and spread across her. Preoccupied by the sunset streaming its gold and ruby rays into the observation deck, she did not notice the kneeling figure until she stumbled over it. The shock of another person so close in this private place sent her damaged heart racing, and she twitched and jerked on the uncarpeted floor.

With his diminished hearing making her shuffling footsteps inaudible to him, Harrold was no less surprised by the soggy person who fell over him, and he jumped upright, his prayer snapping off in mid-word. He stared momentarily at the figure lying at his feet, but—having seen this picture a dozen times or more in the ED—his eyes settled on the newly hung automated external defibrillator (AED) box on the wall. Harrold mimicked what he had seen in the ED many times, rolling Paul onto her back and pressing the button to start the AED.

Following the voice instructions, Harrold hurried to open the sodden coat and shirt to attach the electrodes but was stunned for a moment to see breasts peering back at him. Perhaps to avoid contacting them, he didn’t pull the soggy clothing far back enough and struggled to place the electrode pads. As instructed, Harrold shouted, “CLEAR!” in a loud and commanding voice. He pushed away an intrusive wet coat again, thumbing the button marked “Shock.” It certainly shocked. Harrold felt the convulsing surge of electricity seize his arms and knock the wind from him. He staggered upright, tripped, and faceplanted on the concrete floor. Staggering again to his feet like a damaged prizefighter with blood streaming from a wide cut above his eye, Harrold had the second biggest temporal lobe seizure of his life. While Paul moaned and slowly regained consciousness, the sunset on Harrold’s face was bent into a tunnel of light, and he heard a chorus of angels calling to him. In the grip of religious ecstasy, he launched himself into the celestial light and felt himself suspended in space for a moment.

The slanted observation window where Harrold had landed held for a second before sagging and bursting into a cloud of sparkling glass shards. Harrold felt a sense of weightlessness and flying and began to sing as he descended the ten stories in free fall.

Paul sat up, feeling dazed and beaten. Her chest felt like someone had punched her. She groggily closed her shirt and coat against a cool wind whipping through the open space. She took a moment to watch the final sunlight sink below purple and black peaks before hurrying off to the shelter, where she hoped there would be a warm cot and dry clothes.

Paul would never know that hers was the life Harrold had saved.