Tyndall got up when Jean O’Donnell entered the room. She had done it tentatively despite having been told to ‘go right in’. She still thought it right to tap gently on the door with her knuckles and put her head round first. Tyndall smiled and got up to shake her hand. Sarah noted that the smile was just right, not so broad as to indicate that everything was going well but not so wan as to suggest that it was just a social nicety. The smile was that given to a confidant, someone who understood and knew the score. Tyndall shook hands with Joe who followed behind and then with Ryan Lafferty who came in last and caused Tyndall to raise his eyebrows.
Lafferty explained, “Mrs O’Donnell asked me if I would be present this afternoon, if that’s all right with you, Doctor?”
“Of course,” replied Tyndall. “Do sit down.”
Sarah exchanged smiles with the O’Donnells, and with Lafferty who said to her, “Don’t you ever sleep, Doctor?” Sarah replied with a smile.
Tyndall took off his glasses and laid them on the desk in front of him. He said gently, “It’s best if I come straight to the point. We have carried out a full range of tests on your daughter and, frankly, the news is not good.”
Tyndall paused and Jean and Joe drew closer together. Sarah noted that Jean was outwardly calm but she saw that she was holding Joe’s hand so tightly that her knuckles were showing white.
Tyndall continued, “We have been unable to detect any indication of brain activity in Mary, using a wide range of tests and the most sensitive equipment available to medicine. None at all.”
Sarah noted that although the delivery of the words was sympathetic, the substance was quite brutally frank. Tyndall had taken no time at all to get to the point. Mary was brain dead; there was no hope for her.
“Couldn’t she just be in a coma, like?” asked Joe after a short pause. His voice sounded rough and uneven compared to Tyndall’s well modulated tones. It seemed to fracture the air in the little room.
“No. I’m afraid not,” said Tyndall. “To all intents and purposes I’m afraid we have to conclude that Mary is brain dead.”
Jean looked as if time had stopped for her. Her expression froze, leaving her eyes as the mirrors of a deep sadness. Joe’s face, on the other hand, took on a sudden flurry of animation, seemingly registering surprise, dismay and anguish all at the same time. “What exactly does that mean?” he asked. “Brain dead?”
“It means that your daughter cannot recover. She is beyond saving. I’m most terribly sorry.”
“But she’s still on that machine isn’t she?” said Joe. “There’s time yet surely. I mean you read every day about people coming round after being unconscious for years even?”
Tyndall shook his head and said, “I’m sorry, that’s different. These people still have brain function despite being unconscious. Mary has no such function. She is in reality, dead. The machines are keeping her respiration and her circulation going but these are simple mechanical processes. Mary will never be able to do them for herself again.”
“But...”
Joe started to protest but his eyes were filling with tears and he kept shaking his head as if trying to free himself of the facts.
Jean took his hand up to her lips and kissed it. She was crying herself but she said gently, “Mary’s gone love, we have to face it.”
Lafferty chose to stay in the background. He wanted to help, but the couple were comforting each other. He wasn’t really needed.
After a few moments, Jean O’Donnell said to Tyndall, “You’ll want to turn the machine off then?”
Tyndall nodded gently.
Sarah again thought the gesture absolutely right. Potentially this was the most emotionally agonising bridge to cross for the parents but Tyndall had led them gently and sympathetically over it; he had almost made it appear a technical after-thought.
Jean and Joe held each other and nodded their assent. Lafferty remained as a spectator.
Tyndall put his hand to his head as if uncomfortable and said, “There is just one other thing I have to ask you.”
Sarah took a deep breath and held it.
Jean and Joe O’Donnell looked at Tyndall attentively but did not speak.
Tyndall continued as if the words were causing him pain. “It is just possible that Mary could help some other patient.”
The O’Donnells looked puzzled. “Help?” asked Jean.
Tyndall paused then said, “Her organs...”
Joe O’Donnell’s face hardened and his eyes took on an angry look. “No way!” he stormed. “No one touches my little girl. Is that clear?”
“Perfectly,” replied Tyndall gently. “If you don’t want it then there is no question about it. Your wishes will be respected.”
Joe calmed down almost as quickly as he had flared up and Sarah thought that Tyndall might have another go at getting transplant permission but he did not. He obviously considered it a lost cause.
“Could we see her just one more time?” asked Jean.
“Of course,” said Tyndall. He turned to Sarah, “Would you?”
Sarah nodded her agreement and led the O’Donnells through to where their daughter lay. She felt a lump in her throat as the couple took what was to be a last long look at their daughter. Joe O’Donnell turned to her at one point and asked in a hoarse whisper, “She won’t suffer, will she?”
“No,” replied Sarah, fighting back her own tears. “She’s beyond all that.”
Sarah could sense a potentially awkward situation looming where neither of the O’Donnells would want to leave their daughter, knowing it would be for the last time. She herself was not sure how long she should give them before suggesting it herself. In the event, Tyndall solved the problem for her. He joined them and said gently to the O’Donnells, “I’m afraid there are a few formalities we have to go through.”
He led the parents away leaving Sarah on her own. She was joined almost immediately by Ryan Lafferty who saw that she was about to lose the battle to contain her tears.
“The Lord giveth and the Lord taketh away,” he said.
“Sometimes I hate this job,” said Sarah.
Lafferty put his arm around her and the first tears started to roll down her cheeks. “Look at me,” she sobbed. “I’m supposed to be a doctor and I’m behaving like a silly schoolgirl!”
“Caring was never a crime, Doctor,” said Lafferty. “The world could do with a lot more ‘silly schoolgirls’.”
Sarah dried her eyes with her handkerchief and recovered her composure before nodding to Lafferty and saying, “Thank you.”
It was time for Lafferty to take his own last look at Mary O’Donnell. The next time he ‘saw’ her would be at her funeral service.
“Would you like me to leave?” asked Sarah.
Lafferty nodded without turning round and Sarah melted away.
Lafferty felt the lump in his throat as he looked at the young face of Mary O’Donnell, so pale and peaceful. He read the ID card on the end of the bed. Mary O’Donnell, d.o.b. 13.1.78. Nineteen seventy-eight seemed like only yesterday. The passing of time seemed to accelerate exponentially as you got older, but fifteen was still very young.
Lafferty noticed the Greek letter in the bottom corner of the card and he remembered having seen it somewhere before. It had been on the card that John Main had placed in the centre of the Ouija board in his flat. At the time he couldn’t remember what it was called. Now, however, it came back to him. It was the Greek letter, Sigma.
Lafferty commended the soul of Mary O’Donnell to the keeping of the Lord while Joseph and Jean wept and Sarah bit her lip. Murdoch Tyndall switched off the respirator and Mary’s chest fell for the last time to remain at rest. There was a moment when the silence seemed almost unbearable but Tyndall quickly filled the gap and ushered the parents out of the room.