himself, the sleeve of her housecoat slipped up her arm to reveal a swarm of florid red blotches where the tumor had seeded itself to her skin, and a sniff of decay floated down the back of his nose.
"I love a thunderstorm at the end of a hot summer day, don't you?" she said after assuring him she felt comfortable most days on her current drug regime. "It's so refreshing, and the air smells wonderfully clean afterward."
"Yes, I know exactly what you mean," he said. Her pleasant manner put him at ease. Normally having nothing to offer a patient but small talk made him feel awkward. "Do you have family?" he asked after a few seconds, mostly to reassure himself she knew someone who cared enough to keep her company. He couldn't imagine anything worse than being confined to a room, with no prospects of a visitor.
"Yes, one son. Donny. He owns a restaurant in Honolulu. I don't see him much, but next week he'll be here- a business trip to New York. And he taught me how to use e-mail." She pointed at a turquoise laptop sitting on her night table.
Pretty lonely, he couldn't help thinking, and tried to come up with something else to say. "Do you know the hospital chaplain, Jimmy Fitzpatrick?"
Her eyes beamed. "Father Jimmy? Of course. He's wonderful. Always says just the right thing to pick up a person's spirits."
Oh, does he now? Earl thought, still shaken by the hiding he'd received.
"Cracking jokes the way he does is wonderful," she continued, "but he can be serious when he wants to be."
"Tell me which you like best about him, jokes or serious." Maybe she could give him some pointers about the man's technique with the patients here.
"That's easy. He never wastes my time. No rubbish about doctors all at once finding a cure or me somehow getting better through a miracle. There's a relief in hearing a person tell bad news honestly and make no bones about what can't be done. It leaves him free to help me in ways he can."
"What are those?"
"Listening, talking about ordinary things, keeping me interested in the world- you know, making me feel I matter to him. Not that he's got a lot of time to do it in. There are so many others who depend on him as well."
Earl started to thank her, not much the wiser about specifics that made Jimmy so great at his job, but she laid a hand on his arm. "Know what's his real secret, now that I think about it?"
Earl waited.
"It's the way he looks you in the eye and says, 'I'm sorry you're going through this.' Twenty seconds face-to-face like that, and I feel he's given me twenty minutes."
The next dozen visits went a little quicker, but he found them no easier. Patients raised questions he couldn't answer and expressed fears he didn't know how to console.
"Why me?" some asked when he inquired about their pain.
"I'm afraid to die," others said.
Not that he hadn't heard those words thousands of times in ER. But there the confused hurly-burly of a resuscitation or the rush to line and intubate whomever he was working on allowed him to get away with brief reassurances. Here people looked him in the eye and expected his undivided attention along with a detailed response.
"I don't know what to say," he repeated over and over, bowing to a growing sense that on this ward, bullshit would be even less forgivable than his ineptness with words. "But I'm sorry for your ordeal."
Still, he pushed on with the rounds. Despite the emotional suffering he'd discovered, he began to wonder if Jimmy hadn't exaggerated his claim about patients being undermedicated, as most seemed free of physical discomfort.
Then they approached the nearest of a string of rooms where the nurses had closed the doors. The sounds he'd heard earlier emanated from here.
He quickly scanned the chart of the patient they were about to see.
Elizabeth Matthews, fifty-eight, terminal cancer of the ovary.
What had sounded like whimpering turned out to be a continuous high-pitched cry once they were inside. The lights were off and the