The Monster Beneath Downtown Memorial

Thirteen-year-old Dora Veras arrived home from the second day of school with what she considered a most interesting assignment. With the September 11th holiday a week away, her history teacher requested each student interview their parents and if possible, a few co-workers, regarding their whereabouts and activities on September 11, 2001. Mr. Johnston enthusiastically explained in class, “This was tragically our generation’s JFK assassination. I guarantee they’ll immediately have a significant story to tell!”  

The Veras family lived in Hackensack, N.J., a short PATH train ride from downtown Manhattan, where her mother, Maria, worked as a nurse in the Emergency Room at Downtown Memorial Hospital. And while Maria was too young to have been working in the ER back in 2001, given the hospital was located less than a mile from the devastation, Dora knew she’d easily find other employees who did.  

Tuesday after school, Dora and her mother caught the PATH train to the city. From there it was less than a ten-minute walk before they arrived in the ER. Although she wasn’t scheduled to work that day, Maria was happy to support her daughter’s enthusiasm and introduce her to a few colleagues. Dora brought along a spiral notebook, a pen, and her iPhone to record the interviews. 

Upon entering the ER, which Maria noted was strangely quiet, the two headed to the nurses’ station, where a few of the older nurses, technicians, and clerks were more than happy to speak with young Dora. Almost immediately she identified how correct Mr. Johnston was, as each individual was able to precisely state where they were the moment they heard about the tragedy. 

“Sweetie, this place looked very different back then,” described the senior ER clerk, Flo Belvedere. “I recall there was a television in that alcove over there where we watched the first tower fall. Everyone was either in a state of shock or crying, however, we then prepared ourselves for a mass influx of patients to arrive. Sadly, there were few survivors and we mostly received inhalation injuries and first responders. You know who you should talk to? Dr. Connolly. He was a lot younger back then, but I do remember him working that day.” 

Florence pointed out Dr. Mark Connolly, who was sitting at a long desk at the nurses’ station, drinking a cup of steaming hot coffee. Maria Veras walked her daughter over to the sixty-five-year-old physician. He looked up from his coffee and graciously offered Dora a seat by his side. 

“I only have a few minutes until my break is over,” he said before concluding, “but those minutes now belong to you.” Maria and Dora both smiled before the younger Veras took a seat, and her mom gave them some space. 

Throughout his long and esteemed career, Dr. Mark Connolly had worked in Emergency Rooms throughout the city before settling into his position at Downtown Memorial twenty-five years ago. With decades of experience behind him, Dr. Connolly had seen almost everything and cared for every type of patient. Dora inquired about his whereabouts on September 11, 2001, and Mark Connolly explained that he wasn’t scheduled to work that day. He was out walking his dog, who was named “Mess” for multiple reasons, when banter in the street alerted him to the ongoing situation. By the time he ran back to his apartment, the first tower had fallen, and Dr. Connolly knew his place that day was in the ER. 

Similar to Nurse Belvedere, his main regret was the lack of survivors to pass through the doors of his ER. He graphically described the somber scene in which everyone waited and waited for their neighbors and friends to arrive, but regrettably, they never did. 

Dora expressed her appreciation to the older, physically fit doc who was wearing light blue medical scrubs and a long white coat. Before he returned to work, she inquired whether on any other occasion he’d personally witnessed a major historical event while on the job. And though his time was short, Dr. Connolly briefly recalled the heart of the COVID-19 pandemic, detailing the early months of hell in which vaccines and treatments weren’t available, and he was the captain of a ship which suffered more casualties than during the other forty years of his career combined.  

He concluded their conversation, explaining, “Those were the most physically and mentally challenging months of my life. I never thought I’d make it through. None of us did. Yet, those of us who didn’t become too sick or die from the disease worked every shift and gave it our all.” 

Dora looked upon the experienced doc with great reverence and appreciation. He extended his hand to the young woman and before rushing off to see the patient being wheeled in my EMS, stated, “I hope this helps your project. I’m glad we spoke. At the time I never considered the historical context of these events, but 911 and COVID would be the only two which qualify. Best of luck to you!” 

Dora gripped the doctor’s hand with a smile before she rejoined her mother and exited the ER. Dr. Connolly shifted gears and returned to the job he’d known since completing his residency nearly four decades earlier. And though in his mind he believed to have accurately highlighted the only two events in which he believed to have witnessed and had the potential to impact history, he could never understand how wrong he truly was. 

Unbeknownst to more than ninety-nine percent of the current and retired staff, since its inception, Downtown Memorial Hospital possessed a history and purpose of monumental importance. Dr. Kenneth Tepper became aware, as was retired pathologist, Dr. Charles Pendergrass. In fact, it was Dr. Pendergrass, who had learned of the hospital’s significant past from work in his office and the morgue on Lower Level Three, and later educated the up-and-coming administrator concerning this history. 

Upon receiving a long overdue promotion, Dr. Tepper invited the renowned pathologist to his new, tenth floor office which displayed stunning views of the city. And while he wasn’t sure whether the time was right, Dr. Pendergrass decided he could no longer carry a burden of such significance on his own. 

“Kenny, this is great. I believe I can see my apartment from up here. And is that the Hudson?” he congratulated his friend. “But unfortunately, I didn’t just come up here to toast your accomplishments.” 

“Oh, you didn’t. Well, my friend, why don’t you tell me the reason you decided to escape your home on Lower Level Three,” Tepper chuckled. 

The mood abruptly shifted, and Dr. Pendergrass inquired whether his friend was aware of what previously existed on the grounds where Downtown Memorial was constructed. 

“I’m not sure, Charles. I know the original infirmary dated back to colonial times, but that’s the limit of my knowledge on the subject.” 

“Well, you are correct. It is believed an infirmary was first constructed on this location during the Revolution. However, like all lands in our nation, the property which we now call Downtown Memorial, was owned by local indigenous tribes. In fact, it was actually a native burial ground before the English colonists decided it was a good place to build a hospital. Obviously, it has grown over the centuries to the building you and I have called home for many years now.” 

Kenneth Tepper refilled his glass. “Interesting, but why are you sharing this with me now? We could’ve had this conversation years ago.” 

Knowing his answer was unlikely to be accepted as truth, Charles hesitated. He formulated his thoughts before describing his first encounter with “The Monster.”  

“I know you won’t believe me, but Kenny, one day you'll find your way down to Lower Level Three and see for yourself. I can only fathom this being... this connection is related to the sacred grounds which were disrupted centuries ago and were likely located not far from where the morgue is presently situated.” 

“Come on Charles, I know you’re just screwing with me. But this has gone on long enough.” 

Dr. Pendergrass looked up. “I wish I was, but I can no longer handle this responsibility by myself. And one day I’ll retire or worse yet, the monster will turn on me and I’ll be its next victim.” 

“Fine, fine... So, Dr. Pendergrass. My esteemed friend and colleague. Do tell me why this monster continues to lurk beneath our hospital?” 

“That’s complicated. I’ve only been able to piece together a few theories,” he began to explain. “But I believe our hospital plays a vital role in balancing the population.” 

“Come on, don’t all hospitals? People live, people die...” chimed in Dr. Tepper before he was interrupted. 

“No, no... there’s more. In order to keep the monster quiet, it demands fresh souls. And at times, it can be very specific about the souls it requests. We’re not talking about a one-to-one trade. The numbers can fluctuate drastically, and even with the pandemic, natural disasters, and gun violence, it’s nearly impossible to keep up with a world population of a few billion people.”  

Noting the fear behind his friend’s eyes, Dr. Tepper attempted to clarify.  

“Fine, I’ll play along for a moment. So, let’s just say that your theory is correct, and this hospital is responsible for helping to equilibrate the world’s population. Even at our peak, we could never have enough mortalities to make the slightest impact. Everyday well over two hundred thousand people are born and maybe one hundred seventy plus thousand people die. What difference does it make if an extra five or ten people die at Downtown Memorial?” 

“Kenny, you’re not seeing the big picture. The monster doesn’t calculate life and death on a daily basis. It looks into the future. You’re being too concrete. When a person arrives in the ER, their survival or passing are not simply equivalent to one life. Each individual’s potential impact on the population must be considered.

For example, let’s take someone like good old Dr. Connolly. His saves lives on a daily basis and thus his death would result in a far more negative number than let’s say a teacher or plumber. But on the other hand, if a mass murderer didn’t survive, his future victims would outnumber his death and contribute to a positive number.” 

Although he wasn't buying what the pathologist was selling, Dr. Tepper was intrigued by the theory and his colleague’s passion.  

“Just one more question before I put an end to this for today,” Tepper proposed. “How can this so-called, ‘monster,’ know whether one of our patient’s survival or death will have a net positive or negative impact on the population in his or her lifetime? It would have to...” 

“Know the future,” completed Dr. Pendergrass.  "Exactly."

Having extended far beyond his intended scope, Charles knew the seed was planted and allowed his friend to return to his celebration. After Pendergrass departed for Lower Level Three, Dr. Tepper was unable to detach the pathologist’s wild tale from his mind. And while soon enough, he’d gather the courage and journey down to see for himself, today, while he sat in his new office and appreciated the view, he considered the patients in his hospital in a brand-new light. Before heading home, Dr. Tepper wandered to the ER and for the first time now appraised the potential of each person being treated. 

Beyond his interview with Dora Veras, Dr. Connolly went about his typical routine. By the time his shift was drawing to a close later that evening, he must’ve seen at least thirty patients. And though he no longer judged his days as good or bad since the deadly initial waves of COVID-19, today was for the most part, unremarkable.  

He saw his typical cases with headaches, backpain, dizziness. Three strokes. One cardiac arrest. Nothing out of the ordinary for a seasoned ER doc like Mark Connolly, or so he thought. After signing out, he was walking toward the exit when he happened to run into Kenneth Tepper, who he’d known from hospital board meetings and social gatherings. 

“Hey Ken, what brings you here so late? Oh, and I heard about the promotion. Well deserved,” congratulated Dr. Connolly. 

“Thank you. Very kind of you to say. No, I’m just passing through. Trying to figure out my new role in this place. Are you done for the day?” 

“Yup, just signed out. I have to be back in twelve hours to do it all over again,” explained the ER doc. 

“Well, I won’t stand in your way. But I was wondering... Did you happen to lose any patients today?” questioned Dr. Tepper. 

Mark Connolly found this to be an odd inquiry yet was immediately transparent. “Just one. Young guy. Maybe fifty. Cardiac arrest. Why do you ask?” 

“No reason. Just curious. Oh, just one more thing. Do you know what he did for a living?” added Dr. Tepper. 

Mark Connolly thought for a second before replying, “Yeah. Very sad case. He supposedly was involved with some important bio-medical research. I really thought we’d be able to bring him back, but I guess there are forces out there beyond our control... Have a good night.” 

“Oh yes, you as well,” said Ken Tepper, who then watched Dr. Connolly pass through the exit of Downtown Memorial. He then thought back to his conversation with Charles Pendergrass, pondering the impact of losing a biomedical researcher. When he, too, vacated the ER, Dr. Tepper returned to his office and performed a brief chart review of recent deaths from throughout the hospital. He became intrigued, realizing that for some reason a disproportionate number of these were seen by Dr. Connolly. 

Case by case, he attempted to identify a connection, yet none readily jumped off the page. The recorded causes of death ranged from cardiac arrest to suicide to sepsis. He next compared their ages, again hitting a wall. It was only when he came across these patients’ social histories that he believed he was again onto something. Doctors, fire fighters, police... 

“Wait a second. What do we have here?” questioned Tepper as he scrolled through the case of Cassandra Stillman, one of Dr. Connolly’s patients from two months prior. “City council, age 32.” 

He leaned back in his chair and contemplated the potential of the young City Councilwoman, along with the role Dr. Connolly played not only in this case, but with the population in general. Was it possible Connolly was incorrect to assume September 11th and the COVID pandemic were the only times he not only directly witnessed history, but also impacted it.  

Kenneth Tepper read through Dr. Connolly’s notes. 

32-year-old female biba (brought in by ambulance) s/p trauma. Pt was riding her bike when she was struck by a car making a right turn on 21st street. EMS found patient unresponsive with facial contusions. GSC (Glascow Coma Score) = 5... CT Head showed small bilateral ICH (intracerebral hemorrhage). After CT, patient became tachycardic and hypotensive. Patient subsequently went into cardiac arrest. Resuscitation efforts/ACLS protocol x 15 min, including defibrillation x 3 were ultimately unsuccessful. Time of Death: 3:52 PM. Wife notified. 

Dr. Tepper next Google’d “Casandra Stillman” and was surprised to have missed the tragic story of this up-and-coming member of the City Council. Sadly, she'd left behind two young children and a wife. The article also described her aspirations to run for Mayor or Congress. Kenneth thought to himself about Mrs. Stillman’s potential which would never be realized and questioned how this related to the nonsense spewed by Charles Pendergrass earlier that day. Noting the time on the silver clock on the wall, he then switched off his computer. 

“I guess no one will ever know,” he said aloud, picked up his leather satchel, and walked out of his office. 

But Kenneth Tepper and Mark Connolly were both wrong in their assumptions that day. For the monster knew exactly what the global impact of Casandra Stillman’s death would be, while at the same time, this was another prime example of the history which Dr. Connolly not only observed firsthand, but unknown to himself, was selected to alter.   

What the two doctors, along with the rest of the world were unaware of, was that while he didn’t cause her injuries, Dr. Connolly was party to the assassination of the future President of the United States. A future president, who through her policies to end modern warfare as presently constituted, would’ve resulted in a population net positivity which would have nearly been impossible for the monster to overcome. As such, unbeknownst to him, Dr. Connolly once again carried out the beast’s agenda. 

It was only years later that Kenneth Tepper was finally able to piece together Dr. Connolly’s role in the monster’s greater conspiracy. And while he was more easily able to identify those patients Connolly was unable to save, he postulated that there was an equally impressive list of those he did. On both sides, the profile was typically the same; younger patients with far ranging potential. The Oncologist on the verge of a major breakthrough. The judge with aspirations of one day altering the Second Amendment. The countless teachers, each of whom would one day educate an exceptional student with the power to change the world. And despite each of these remarkable people with the highest population altering potential, none ever came close to matching that of President Cassandra Stillman.