Hektoen International

A Journal of Medical Humanities

We Love the Garden, It is Heaven, But We Cannot Stay

Karen Youso
Minneapolis, Minnesota, United States


Below the Mayo Clinic is a maze of tunnels. Not the dark, dank tunnels one might expect, but wide bright hallways. Tall ceilings. Recessed lights. Artwork on the walls and carpet under foot. Miles and miles of pristine carpet.

It is called a subway, a pedestrian subway.

Along the subways are shoe stores and toy stores, candy shops and coffee shops, bars, spas, and even a sunken cafeteria. Elevators can whisk you up into hotel lobbies with their fancy restaurants. Or you can rise into a Catholic church with its rows of thick, white candles and waiting wicks costing five dollars a piece but lasting for days.

In this underground city occupants are safe from the elements. Outdoor temperatures vary from 95 degrees Fahrenheit to 15 below zero. Rain, snow, and ice, even tornadoes, can plague the land.

Sprawling above this warren-like space is a campus of a thousand doctors, scientists, and medical specialists (that’s what the brochure says) and their rooms, offices, and labs. There is an undergraduate school and a medical school both specializing in the training of the next generation of healers who will employ the latest in medical technology at two hospitals flanking the Clinic: Methodist and St. Mary’s.

Say, one winter morning, your son calls. You suspect the ring in his pocket is now on her finger and he’s engaged. No, he is sick. The family doctor suspects he has appendicitis, but a body scan at the local hospital reveals he does not.

There are two masses in the young man’s liver. Large masses, one the size of a soft ball the other a person’s fist. You are confident they are benign because he has had no symptoms, no problems until this bout of belly pain that turned out to be a stomach virus and went away in twelve hours. Besides, all his yearly physicals have been normal. All the usual tests of the blood and urine were normal, normal, normal.

But other tests, invasive needle tests, reveal things are not normal. The liver masses are not benign. Your son has cancer. A rare form of cancer, so rare that this is the first time the staff at this hospital has seen it. And the news gets worse. The liver is not the source of the cancer. It is metastasized from somewhere else in his body, and they cannot find where. They have no existing protocol for treatment in this situation.

With the ring shoved deep into his pocket, he goes to the Mayo Clinic because they specialize in the weird and difficult.

The Mayo has treated his kind cancer before, with surgery. No other treatment works on this type cancer – not chemotherapy, not radiation therapy – only surgery. Your son has a chance, but it is not a very good chance. This cancer creates tumors that excrete a chemical that destroys heart tissue. Indeed, heart tests reveal damaged valves. Your whip-thin athletic thirty-year-old has the heart of a sick seventy-year-old. He may not be able to survive the surgery.

Away he goes, anyway, on a Methodist hospital gurney to operating theaters and out of sight.

You walk the twisting confusing subways and think about Steve Jobs. A similar cancer killed him despite all the money and power he had.

You think about what the cardiologists said. “By the amount of damage done to the heart, he probably had this cancer for fifteen years.”

You think, fifteen years? That means he went through high school with cancer, graduated college with cancer, survived law school with cancer, and ran the Boston Marathon with cancer. The cardiologist just shook her head at that one.

Was all this possible because he is the youngest known person to get this kind of cancer? Does he really only have a twenty percent chance of making it, of living five years?

As you walk and think, your heart sinks. You did not protect your child – for years. Guilt pierces your sinking heart. You start reading the hallway signs as you put one foot in front of the other. To give purpose to your movement, you decide to find the Mayo Clinic because you have not seen the famous clinic yet. You have seen hospital conference rooms and the surgical waiting room, but not the actual Mayo Clinic.

As the endless hallways twist and turn, divide, and divide, again, you are reminded of space travel. One childhood summer, you decide to read all the books on a shelf in the public library. When your spinning ends, your finger is pointing at a shelf of science fiction. (To honor your commitment, you read most of the shelf that summer, but you will never perform such a stunt again.) Several of the books feature space journeys where colonists live on a ship through many lifetimes before arriving at a new world.

This underground domain is just how you imagined those vessels to be. This is how it would be for people hurdling through space. So, it is easy to imagine this is a space ship and the people you encounter are your fellow passengers and the crew going about their day. You can do all the things you did on Earth: eat and play, work and shop, sleep and dream. Passengers are never bored on the ship because it is so big, and they do not miss the outdoors because of the gardens. You remember that well from your readings. All the ships had gardens. A place with greenery and high ceilings, with a bubbling fountain and people strolling about in the simulated sunlight, or sitting and listening to music floating out from a nearby café.

You turn a corner and stop. The place in your recollected imagination is now manifest in front of you: a wide bright atrium three stories high filled with people. Many are bald, like new babies, just as you expect would be the fashion in some future world. Some are seated. Some are milling about. Some are pushing wheelchairs. Like bees in a garden, they go here and there and then move on.  Sunshine pours in through the glass ceiling illuminating the space, and faces turn like blossoms toward the anointing sun. Soft voices combine with the gentle echo to create a murmur like that of water down a fountain and in the distance, there is faint music. This is a refuge, a garden. You glance at the sign on the wall. You have found it, the Mayo Clinic, the place that treats the weird and difficult.

The surgeon appears in the waiting room. Your son’s surgery is done. He made it. All the cancer they could see and feel is out. He lives – for now.

For the next week, you lower by elevator from your hotel, your spaceship accommodation. You traverse the underground city to another elevator that lifts you to a hospital room. With a lump in your throat, you spend your days with the wired and beeping shell of your son. He is as near to death as anyone you have seen who has not gone on to die.

Each day while he sleeps the garden beckons, so you make a visit. The garden is a place of peace and hope between two worlds – between sickness and health, and what was and what will be.

On the night before this fragile reed of a young man stitched from blossom to root is sent out into a changed and uncertain future, you set out to visit the atrium one last time. Silently you pad the deserted corridors past the wheelchairs folded like accordions and lined up by the dozen. Quickly you pass the benches, the art work and the shops closed for the night. What was once a confusing maze, no longer is. It feels familiar, like home – or a really long voyage.

You come to the atrium, the garden. It is dark, now, empty, and hushed. You stand motionless. It occurs to you that you do not want to leave this place. You do not want to remove yourself from this calm space between two worlds, between hope and uncertain reality. You want to stay here, right here, suspended between what was and what will be. You want to remain on the spaceship to live out your days and not face the new world, the unknown – the future.

But everyone must leave. Someday.

So, in your mind, you fashion a plaque for the garden. A brass plaque on a short pillar so it is easy for all to read. People like you who do not want to leave when the waiting is over, who do not want to venture out and deal with what comes next.

We Love the Garden, It is Heaven, But We Cannot Stay
Go Now and Take Peace and Hope with You.

And that is exactly what you do, because the ring is on her finger and there, is love.


Title credit

  1. Kazim Ali, Fasting for Ramadan: Notes from a Spiritual Practice (North Adams, MA: Tupelo Press, 2011), 47.



KAREN YOUSO is a retired journalist. The Minneapolis mother of three spent thirty years writing for the Star Tribune Newspaper and producing the syndicated column, Fixit, which answered questions about everything household.


Winter 2018  |  Sections  |  Personal Narratives

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.