“Pain Management” by Nadja Maril

Flor splashes cold water on her face. She reaches into her purse to feel the smooth hard metal tip of her keys underneath her leather wallet. Yes, they are in the same place she left them last night.

She’s been losing things, but her purse and her car keys are in the same spot. The rest of the kitchen looks different, altered in some way. Shiny pots and pans sit on the dish rack, and a damp terry cloth towel is resting over the edge of the sink. The rose cutting inside the glass vase on the windowsill, hairy strands and tendrils stretching out into the cloudy water, is rooting nicely. She looks through the window towards the patch of blue sky. The sun is obscured by a cloud and maybe that is why the room looks different.

She puts the strap of her purse over her shoulder and tucks a stray silver hair behind her ear. She is wearing a skirt and knit top, the type of comfortable outfit she’d wear for golfing. The colors are crisp blue and green. Everything matches.

“I’ll pick you up at 10:00 a.m.,” she tells her daughter-in-law when she calls. Today, she is driving to the hospital to visit her forty-seven-year-old son Diogo. He is in intensive care. He’s had a massive stroke. He’s been there for three days.

He’s completely paralyzed, unable to speak. She’s been praying for a miracle, praying he might recover before she must go to see him, but she can’t put it off any longer.

Paralyzed. It’s the death she fears for herself, suspended like a fly trapped in a web. Better to put dark thoughts out of her mind and think pleasant thoughts; babies with dimples, glossy red apples, a new set of golf clubs, winning the senior women’s tournament in October.

Yesterday she’d been at Star Market in Gloucester, looking for the Portuguese Maria cookies, sweetened condensed milk and whipping cream, needed to make Bolo de Bolacha Maria—her family’s favorite summer dessert.  No baking required, just a skillful hand in making the creamy custard. Cookies soaked in strong black coffee. Her mouth had watered, imagining the flavors, when she’d run into Fran Santos. Fran, who lives down the street. Fran had been staring at her, standing in the check-out line holding the hand of her sweet little boy with bangs and a band-aid on his knee.

“How’s Diogo?” Fran asked.

“Diogo?” She cleared her throat and focused her gaze on Fran’s son. Fran’s little boy reminds her of her son, the young Diogo she sees in her dreams. “The doctors are still conferring.”

The Diogo in her dreams is a child with round pink cheeks and bloody knees, running too fast, tearing his dungarees as he scrambles over rocks and scrapes hard against stone. Waves crash against the boulders. She smells the sea. Diogo is running to catch up with his brother who is playing pirate with his friends. Worried she’ll slip and lose her balance, she grasps Diogo’s hand. He turns to look at her, “Why won’t Manny play with me?” he says.

“He’s a big boy,” she answers. “Has his own crowd.”

The Diogo in her dream is a little boy about five years old. He walks ahead on his own, undaunted by the blood on his pants, insisting he’ll be okay. She follows, producing an umbrella to shelter him from the rain. Flor puts her free arm around him, intending to kiss away the tears, but he turns toward her with a red angry face and she wakes.

She walks into the hall, readjusts the silk roses on the side table and reassures herself she wasn’t completely lying when she told Fran, “Yes, I’ve been to see Diogo.” Dreams are a form of visitation. She was merely bending the truth. How could she admit she hadn’t gone to the hospital yet, didn’t want to go to the hospital, dreaded seeing her youngest unable to move.

Her older son Manny is always telling fibs to cover up his mistakes. “Yes, I wrote her a nice thank you note,” when he hadn’t really done it—yet.

Fibs provided time to correct your mistakes. They protected people from things too painful to know or deal with in the present. Diogo, on the other hand, was an absolute stickler for the truth. He went out of his way to do everything right to prove he was the better son.

Her two sons, born five years apart, are not like her grandfather and his brothers who came from the Azores to work on the fishing boats. Her boys have never been good friends.

She turns the brass knob of the front door, feels the throb of pain in the joints of her thumb and fingers, pushes harder. Yes, God, make me suffer, but heal young Diogo. Make him well.

“I’m going,” she calls to her husband. He is in his recliner, reading the newspaper. He hasn’t left the house since Diogo went to the hospital. He says he has a cold.

She leaves the engine idling in front of Diogo’s apartment, honks the horn and waits for Rebecca to come out, press on the chrome latch to open the passenger door and sit down beside her. She thinks of her grandsons, Michael and Sam, building a town of Lego blocks populated by dinosaurs. She should have brought them something, the sweetbread they love so much, and given them both big hugs, but she prefers to stay in the car. The younger one looks so much like Diogo, same dark eyes inherited from her side of the family, and thick lashes.

Her daughter-in-law is dressed in pink and it looks like she’s washed her chestnut brown hair and tucked it neatly back into a bun, appearing better groomed and rested than two days earlier when she came to the house. Her daughter-in-law visits Diogo every day, sometimes twice a day.

How does she do it? Perhaps it’s guilt, because everyone knows she was driving Diogo too hard. It’s Rebecca’s fault Diogo had the stroke.

That afternoon, two days earlier, when Rebecca came to pick up the children, she’d looked as if she’d fallen asleep in her clothes. The circles beneath her blue eyes had been dark and pronounced. Flor had actually felt sorry for her. Pobrezhino, poor thing. This morning her daughter-in-law appears restored.

“Hello dear. You look nice. Pink becomes you.”

“I wanted to look nice for Diogo, to cheer him up.”

“Yes, he’s always liked bright colors. Asked me to knit him an afghan using every color in the rainbow when he was a child,” Flor says. “Don’t suppose you still have it.”

“As a matter of fact, we do.”

“Oh… really. That’s nice. Listen, we need to make a stop on the way at Dr. Sullivan’s office. It will just take a few minutes.”

Flor watches Rebecca adjust her seatbelt. Twist around and reach into her canvas tote, hears things in Rebecca’s bag rustle around, and sees her daughter-in-law bend down and pull from her bag a book with pieces of orange construction paper poking up between pages. Rebecca looks down as if to read. “I brought some stories for Diogo, a little diversion. Maybe some poetry.”

Flor has never liked poetry. When she reads, she likes romance novels. “I brought something too,” she says. “A green scapular blessed by Father António and a Saint Andrew Avellino medal.”

“Oh,” Rebecca scratches her leg and readjusts her tote for a second time.  “Is there a place for those sort of things— in intensive care?”

Why couldn’t he marry someone normal, someone who’s a good Catholic? It’s dubious this girl even believes in God and if she does believe in a God, it’s a Jewish one.

“I need to get some tranquilizers,” Flor says, feeling if she didn’t need them before, she certainly needs them now, in the company of Rebecca. “I’m too nervous to visit without them. Dr. Sullivan said he’d write me a prescription.”

Rebecca checks the pins in her hair and looks at Flor. “Florenca, are you feeling okay? Would you like me to drive?”

Why can’t Rebecca call her Flor like everyone else? The sound, the name Florenca, grates on Flor’s ears. Flor has always been a tomboy, has decided she should have a short crisp name.

“I’ve taken blood pressure pills, a diuretic since before I was forty, but I’m fine,” she says to her passenger, to her daughter-in-law. “Just need some tranquilizers.” She would have been better off coming by herself or with Manny, but her older son already visited yesterday and says he has business to attend to. Flor looks ahead down the road for the next street sign. The place to turn is coming soon.

“You’re lucky you have help with the children,” she says. “My husband was always at work and I was by myself, in the house with the children, alone.”

Flor slows the car and makes the turn into a parking space.

“Did you want me to wait in the car?” Rebecca says.

“Yes,” Flor replies, “that’s probably easiest.”

Flor opens the car door and steps outside into the summer heat and thinks about her garden, her lilac Asters drooping. They’ll need water. Will her husband even think to step outside and run the hose?

Dr. Sullivan is in one of the new buildings, where several doctors have their offices. The door is glass and steel and she has to pull hard on the lever to open it, swing back its solid weight as she walks inside the tiled hall and into his waiting room.

The red vinyl seats are all occupied. Many of the waiting patients are dressed in pastel colors and have golden brown tans except for one bald man, skin an angry shade of pink. Looks like a lobsta, she laughs to herself. She and her sister would point to tourists like him on the beach when they were children. She sees the beginning of brown freckles and peeling and perhaps a blister starting to form—that’s why he’s here. A child with curly hair in a yellow sun suit plays with a plastic truck on the carpet and a toddler in blue pajamas, the baby sister, is resting her head on her mother’s shoulder, softly whimpering and rubbing the side of her head. A thin man with a brown spotted face has a guttural cough and Flor tries to stand as far away from him as she can, leaning against the reception desk. The girl behind the desk is making copies of something and instead of stepping forward when she sees Flor is waiting, turns to go into the back of the office.

Flor stands, waits and practices in her mind how she will smile and how she will act pleasant and nice, when this young girl with black hair pulled back into a ponytail comes back. The ponytailed receptionist returns holding a steaming cup of coffee in her right hand and sets it down.

“What a pretty pair of earrings,” Flor says. “Those gold hoops look so nice on you.”

The girl’s eyes greet Flor’s with a look of recognition. “Hello, Mrs. Gaspar. How are you today?”

How does this girl know her name when she doesn’t remember hers? But so many of these young people look the same. “Do you have my prescription? Dr. Sullivan said he’d have it for me to pick up.”

“Yes, Mrs. Gaspar, I think it’s in this stack.” A file on the desk behind the counter contains several envelopes and the receptionist, who is wearing a nametag, reads to herself the names written in blue ink on their fronts. Flor squints to decipher what is written in white letters on red.

“Thank you, Peggy,” she says when the girl hands her an envelope and is gratified to see Peggy smile.

Flor opens the envelope to verify it contains her prescription. A man with salt and pepper hair entering the building, holds the door open for her as she leaves. First errand accomplished.

She hears some sort of humming when she approaches her white Pontiac, but the car is quiet when she opens the door. Rebecca’s eyes flutter open as Flor plops into the driver’s seat, as if she’s been napping.

“We’ll need to stop at a pharmacy,” she says after clicking her seatbelt shut. She hears her daughter-in-law taking deep breaths. She’s heard Rebecca talk about yoga classes and meditation. It’s all nonsense as far as Flor is concerned. She decides to ignore the breathing sounds.

“I think there’s one at the hospital,” Rebecca says.

“No, I need to fill it at Green’s where they have my card on file,” Flor says. “It’s on the way.”

“But, if we keep making these stops, we’ll probably get caught up in beach traffic. That’s why I asked you to pick me up at 10:00. Diogo is expecting us.”

“It will be fine, dear.”

She hears Rebecca twisting in her seat and taking more deep breaths but looks ahead, determined to focus on the road and the car in front of her and reaches for the dials to turn on the radio to her favorite station. Father McClary is discussing the relationship between Saint Paul and Saint Luke. He has such a fine voice; you can hear just a touch of Irish brogue. Her friend Matilde is married to an Irishman.

Traffic is coming to a stop at a red light. Out of the corner of her eye she can see Rebecca clasping and unclasping her hands, breathing slowly as if she’s counting. “I hate to make him wait,” Rebecca whispers. “It’s mid-morning now and he’ll expect to see me.”

“It will just take a few minutes.” Flor puts her hand on Rebecca’s knee, to reassure her, to let her know who is in charge. “They’re fast,” she says.

Inside the pharmacy, the line is long with tourists buying suntan lotion, insect repellent, beach toys, towels, and umbrellas; but Flor is going to the back, to see the pharmacist.

“Drink lots of water,” he says. “This stuff will make you thirsty. Be careful driving.” She considers asking Rebecca to drive on the way home, but not now. She’d rather be behind the wheel with something to do and besides, she won’t take the pills just yet. She’ll wait until they get there. Second errand accomplished.

Her feet are heavy and numb when she pulls into the hospital parking lot. The doctor calls it neuropathy. She does exercises for her toes with a coke bottle while watching television. Sometimes she feels pins and needles and other odd sensations. Just one of the many discomforts of growing old.

So many cars in the hospital parking lot, so many people. The last time she entered this brick building was to visit her friend Gertrude after that car accident when Gertrude had broken her pelvis. Gertrude had been fine, and she’d recovered, but Gertrude’s daughter Emily at age thirty-five had died of cancer. Gertrude still grieved. “There’s nothing worse than losing a child,” Gertrude had told her and Flor wants to repeat those words to Rebecca who keeps looking at her, waiting for her to start walking towards the hospital entrance.

She clasps together her hands and wills herself to turn towards Rebecca and smile. “Okay. Let’s go,” she says. But all the while she is thinking, I really don’t want to be here but I can’t put it off any longer.

What is more frightening, looking at the gaunt patients on stretchers and in wheelchairs hooked to IVs or imagining Diogo in a hospital bed? She’s never seen him in a hospital bed. He has never been sick, never even had his tonsils removed.

Rebecca walks ahead in her soft leather sandals, taking long even strides, and then waits for her to catch up. “We just need to go down this hall and take the elevator,” Rebecca says.

Flor walks slowly, looking down at the shiny tile floor. “I need to find a water fountain,” she says, “to take my pills.” Ahead of her she hears Rebecca taking deep slow breaths, each exhale creates a low whooshing sound.

“There’s the water fountain.” Rebecca points to the left as they exit the elevator. Flor starts walking, not wanting to look at Rebecca’s face, but hears her say, “I’ll be in the waiting area.”

Third task accomplished. Flor sits down on a square chair across from Rebecca and closes her eyes. They are the only two in this waiting room. To calm herself she mouths in the Latin learned in childhood:

Pater noster, qui es in caelis, sanctificetur nomen tuum. 
Adveniat regnum tuum. 
Fiat voluntas tua, sicut in caelo et in terra. 

She hears Rebecca get up from her seat, hears the bangles on her wrist clink and senses she is now standing close, in front of her. Flor keeps her eyes closed, holding on to the serenity of the Lord’s Prayer.

Panem nostrum quotidianum da nobis hodie, et dimitte nobis
debita nostra sicut et nos dimittimus debitoribus nostris. 
Et ne nos inducas in tentationem, sed libera nos a malo. Amen.

“Ready?” Rebecca says.

Flor keeps her hands clasped together and her eyes closed. “I have to wait, maybe ten more minutes for the drug to work.”

And then it happens. Pain. The impact of something smashing down into her right foot and the sound in her ear of a “Beeeeech!” It’s a screech, a high-pitched sound more animal than human, and before Flor can decipher what the word means or is meant to mean, she feels another wave of pain and she yells, “Ouch!” The sound of her “ouch” joins the last vibrations of the piercing screech.

The thin canvas of her sneaker cannot protect the bones, muscles, nerves of her two largest toes from feeling battered. “Ouch,” she cries again and opens her eyes to see Rebecca with her face flushed dark pink and she realizes the pain is from Rebecca stamping on her foot.

“I’m so sorry,” the girl stutters. “I must have slipped somehow and stepped in the wrong place.”

Flor bends down to feel her foot, to check if something’s broken. Can she move her big toe? The pain is brutal, a hard, burning sensation. She tries to wiggle her toes, and is relieved they move.

The shriek she heard, the exclamation came from Rebecca’s throat; but instead of owning up to it she pretends it was an accident, pretends she didn’t do it on purpose. Flor would have done the same.

“Why don’t you go in and visit now, dear. No need to wait for me.”

She watches Rebecca’s reaction as she says these words, watches Rebecca’s eyes widen and watches the girl bite down on her lip. Rebecca wants to say something, but is afraid to speak. Let her speak, if she dares, but words cannot be taken back. She will not give Rebecca comfort. Let her suffer. Let her get a taste of the pain she, Flor endures. A husband who is a philanderer. Two sons who are constantly at war.

You expect you’ll die before your children and not the other way around.

Rebecca stands before her, probably afraid to move. “Flor, are you sure you’re okay?”

Flor reaches out her right hand, palm open. “No really, you go ahead. I know you’re anxious.”

Their eyes meet and into her open palm, Rebecca places her hand, which feels cool and dry against the moist heat of Flor’s flesh.

Rebecca squeezes her hand gently. “It will be okay. He wants to see you.”

“Are you sure?” Flor whispers. “Last time we talked we had words.”

Rebecca nods her head. “If you want, sure I’ll go in first. When you feel ready just let the nurse at the front know and she’ll lead you in, third bed on the right.”

She looks at her daughter-in-law’s face, free of lines and wrinkles, lucky to be so young. “Rebecca, you’re a good wife.” And when she speaks the words, she believes them.

Rebecca lets go of her hand and turns away and Flor watches the outline of her daughter-in-law, the long print dress hugging the curve of her hips, grow smaller and smaller as she approaches the double doors leading to the ICU. Her whole life, Rebecca still has her life in front of her.

Flor closes her eyes. In her mind she visualizes her youngest son surrounded by white light, healed. Hail Mary, Full of Grace, The Lord is with thee, she prays, blessed art thou among women…

She imagines him, his muscles taut and strong, his long dark hair almost touching his shoulders, able to move his limbs and hug his children. She opens her eyes, shifts her weight to her feet, stands up and wiggles her toes. Most of the pain has dissipated.

Carefully, she walks towards the double doors. Inside the ICU she smells the disinfectant, urine, and sweat and adjusts her eyes to the gray fluorescent light. She walks past scurrying nurses and orderlies, looking straight ahead, not listening to labored breathing, alarms sounding, equipment being wheeled in and out. She knows where to go, past two beds, and push aside the third set of curtains to see Diogo’s eyes meet her own, his head propped up on pillows, tubes in his arms, machines beeping. Rebecca, her back to Flor, is sitting on the lower half of the bed humming a lullaby and massaging his feet. Flor feels inside her pocket for the green scapular and the Saint Andrew medal. Her fingers tremble as she reaches to grasp the medal’s firm edge and the cloth inside its plastic sheaf. She steps forward to place them beneath his pillow. Her cheeks grow wet with tears. She cannot stop them from falling. “Forgive me,” she says.


Nadja Maril is a former magazine editor and journalist living in Annapolis, Maryland, USA. She has an MFA in Creative Writing from the Stonecoast Program at the University of Southern Maine and her short stories and essays have been published in several literary journals and anthologies including the Scarlet Leaf Review, Storynews and Burning Love and Bleeding Hearts. She blogs weekly about writing and life during Covid-19 at Nadjamaril.com. Additional credits include two reference books on American Antique Lighting as well as two children’s books illustrated by her artist father, the late Herman Maril.