There are many kinds of darkness in the hospital. There are the inner darknesses of fear, despair, and sadness. There is the enveloping darkness of unspoken troubles. There is uncertainty and incomplete knowledge, the darknesses inherent in medical science. To patients, medical care itself is often shrouded in darkness, just as patients' and families' lives are dark to us. There is the quiet darkness of the ward at midnight where luminous insights are kindled from the flint of life's preciousness and the tinder of its mortality.
My grandmother Elsie is 96. She rules four generations as an empress whose powers are constitutionally limited though her herald still speaks with ancient authority. The calls come at night: another fall, a bloody stool, a sigmoidoscopy, an ulcerated ischemic colon. Her son and her daughter arrive in the early afternoon. As she has in the past, she declines surgery and repeats her wish