The first call — from the Special Care Unit — was expected. Monica had died.

Monica, who had developed acute leukemia, came to the emergency room with pneumonia. the morning after admission to the hospital, she thrashed about in her bed, delirious and gasping for air. She was transferred to the Special Care Unit.

Later in the morning, chemotherapy was initiated because of the extreme changes in her blood count. the afternoon, she was on life support.

Her condition continued to decline, and she died on the third day of hospitalization despite all the measures designed to stabilize and treat her condition.

The second call — from Admitting — was unexpected. The secretary wanted to know if I had spoken to any member of Monica’s family. There was no record in the emergency room of any relative or friend bringing her to the hospital. The admission sheet on the chart declared Monica was Protestant, and divorced without children.

In the hospital, I had asked Monica about family. Between breaths she panted, “Nobody. I have nobody.” When she died, the hospital did not know to whom to release the body. Monica had suffered and died alone.

That day and for many days after, I was haunted by Monica’s plight: how tragic to be alone in desperate times.

At home I leafed through the Bible, looking for consolation for those who are alone. I looked to Psalms, the songbook of the Bible, since a number of the Psalms were written by David (1000 B.C.), particularly during a bleak period in his life as fugitive without friends or allies (“I have no refuge; no one cares for my life” (Psalm 142: 4)).

Newly anointed by the prophet Samuel to be the next king of Israel, David fled from Saul, the current king who would not surrender his reign and family dynasty. Saul pursued David throughout Israel and beyond its borders.

Alone and afraid for his very life, David sang out to God, convinced God was with him in all his physical and mental anguish: “The Lord is near to all who call on him” (Psalm 145:18).

In an earlier Psalm, David proclaimed God was with him not just in times of suffering but in all experiences: “O Lord, you have searched me and you know me. You know when I sit and when I rise. You perceive my thoughts from afar. You discern my going out and my lying down; you are familiar with all my ways” (Psalm 139: 1-3).

While many find the presence of an all-seeing God comforting when ill, they may feel his presence intrusive when healthy. David asks, “Where can I flee from your presence?” (Psalm 139:7)

Jean-Paul Sartre, one of the most famous 20th-century existentialist philosophers, remarked during his halcyon days in Paris that he did not want God to exist because he did not relish someone peeping through a keyhole watching all he did.

Later in life, as he struggled with progressive shortness of breath from failing lungs, Sartre shocked his atheist friends, including his mistress, stating that he could no longer believe in a universe without meaning and without a creator. During his days of desperation, Sartre found comfort in someone watching over him.

Like Sartre, Monica too was not alone in the hospital, as expressed by David in another Psalm, “The Lord will sustain him on his sickbed” (Psalm 41:3).

Was Monica comforted by the knowledge of God’s presence as was Sartre 30 years ago, or David 3,000 years ago? Monica’s condition declined precipitously. Within hours of her admission to the hospital, she was unable to communicate. Was her pastor notified, if she had one? Was there time to request a visit for Monica from the hospital chaplains?

Even if there was no one else in the hospital for Monica, there was God. I do not know if this source of comfort was expressed to her during her short and hectic hospital course.

It still saddens me, 20 years later, that some of Monica’s distress and suffering could have been assuaged by the affirmation of God’s presence. Perhaps, however, she realized God’s presence even before her admission to the hospital.

No patient should think that he or she is alone in the hospital without family or friends in attendance. No one should think that he or she is ever alone. As expressed by an old gospel hymn: “His eyes are on the sparrow, and I know he watches me.”


Dr. Delvyn C. Case Jr. is a hematologist/oncologist, writer and playwright, and consultant to the Department of Spiritual Care at Maine Medical Center in Portland.