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About More Voices

Every month More Voices invites readers to contribute short nonfiction prose pieces of 40 to 400 words on a healthcare theme.



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4 a.m.

If I wake up in the middle of the night, that’s what time it will be, give or take 15 minutes: 4 a.m. No matter what the season, it’s dark at that time of night, it’s lonely, even the cats are snoring. If a window is open, I can hear if an owl, a coyote or, rarely, a whippoorwill or chuck-will’s-widow is crying into the night. If it’s a warm autumn night, I can hear if passing whitetail bucks grunt or click while tracking does.

I’ve learned that if I get up and read or sit outside, it precludes any chance of falling asleep again.

I’ve learned that if I don’t get back to sleep by 4:20 a.m., the whistle of the freight train going through town will reach me.

I’ve learned that if I lie in bed and try to empty my mind of prospective test results, of biopsies waiting for cells to stain, of spinning machinery sorting blood, of a perplexed or gloomy radiologist sifting through images in a room as dark as mine, then I can rarely dispel the associated fears. And then I fret until Homer's "rosy-fingered dawn" arrives and the only thing left to do is get up and force myself into the day.

I’ve learned to distract my thoughts from that path (and from pathology) by praying a penal rosary, as my Catholic Irish ancestors did for centuries, during the time of the Penal Laws. My need of my father’s small, 11-bead rosary and its ring is not due to fear of banishment or of sentence of death by court lest I be caught with a full-sized rosary, but rather because it is easier to manipulate under a pillow or quilt. If I can shift my focus from the crowd of repetitive fears to the solitude of prayer, then many nights, sometime during the fourth or fifth decades of the rosary, enough peace descends that sleep creeps back to its rightful place.

And I’ve learned from conversations when the sun is shining that I am not the only one awake in the 4 a.m. darkness. Many patients, especially fellow cancer survivors, are all too familiar with the fears that pervade the dark. They know the drought of peace that spreads under the stars between moonset and sunrise.  The coping strategies change, but the camaraderie of fear never does.

Sandra Shea
Carbondale, Illinois