by Rada Jones
“She’s totally lost it. She’s never been great, but now she’s gone out of control. Soon enough she’ll start killing them, like Dr. Kevorkian. Stop their suffering, my ass! I can’t wait until they get rid of her.”
“You’ll make a great director, Dr. Usher.”
Ann laughed.
Vintage Ann. She must be low on her meds again.
4
Her heart pounding, her throat tight with anger, Emma locked herself in the bathroom to catch a breather. She washed her hands. She looked in the mirror. What a sight! My face is burning; my heart’s racing and my head’s about to explode. I want to crush Ann. I want to see her splattered, like a bug on the windshield.
She took a deep breath. She splashed cold water over her face. Again. Her pulse came down. Her throat softened, and she managed to swallow.
Thank God for bathrooms. That’s the only place I can catch a moment to reset. This is nothing but Ann being Ann. She’s a good doctor, but what a bitch! She has seniority, so she thinks she deserves to be director. She may even be right. Still, I can’t let this go, or I’ll lose the respect of the staff. I can’t afford that.
Back at her desk, she looked up the patient in Room 1. Ninety-eight. Nursing home. Alone.
I hope I die before I have nothing left to live for. Poor woman. I hope they made her comfortable and let her go.
She went back to running the board, a computer screen lit in every color, displaying the long list of patients, their rooms, their complaints, the staff’s comments, the things they waited for. The ultrasound for Room 9 was still pending, but the urine was back on Room 15. I need to discharge her.
She finished, just as the speakers coughed their scratchy command: “Code 99, Emergency Department, Room 5.”
Emma headed to Room 5. The scrubs parted to let her in.
Room 5, barely big enough for the stretcher and a chair, choked with staff. The rebreathed air was thick with human smells. Dr. Alex Greene ran the code, giving orders. Rudy, the tech, performed CPR. Good chest compressions. Good recoil, allowing blood return to the heart.
Like a well-oiled machine, they coordinated without talking. Ben, the nurse assistant director, got a second IV. Sal, the pharmacist, got the drugs. Dr. Greene gave the orders. They’re doing good, but this room is too small.
“How about moving to a front room?” Emma asked.
“Good idea.”
“Room 2’s available,” Judy said.
Emma nodded.
The doors clanged, opening wide. The stretcher, hidden under the cluster of scrubs like the queen under a clump of migrating bees, rolled to Room 2. Faith bagged. Amy carried the monitor box. Emma and Alex followed.
“What happened?” Emma asked.
“No idea.”
“What was she here for?”
“A broken hip. She fell. She looked fine. I called Ortho to admit her. Then, when the nurse went in to check on her, she found her pulseless.”
“Who’s her nurse?”
“Brenda.”
Brenda’s good. So’s Alex. If there was anything to see, they would have seen it.
The code ran, and ran. Nothing helped. Half an hour later she was still dead. Alex called the code.
Head down, shoulders slumped in dejection, he went to tell the family. He returned looking worse.
“They weren’t happy. They don’t understand what happened.”
“Neither do I,” Emma said.
“It makes no sense.”
“Heart attack? Stroke? Bleed? Alex, did you scan her head?”
“Come on, Emma. What do you think I am? An intern?”
“Sorry. I’m just trying to understand.”
“Me too.”
“What did you give her?”
“Not much. A little morphine. Toradol. That’s it.”
“It didn’t look like anaphylaxis.”
“No.”
“We’ll see what the coroner says.”
“Don’t hold your breath,” Alex said.
“I know. I’ve been here for fourteen years. I’m still waiting for him to offer us something useful.” Emma patted Alex’s shoulder and returned to her desk.
Between the VPM, Ann’s case, and the code, she was behind. Her patients were restless.
She tried to hustle, but something about this case bothered her.
This is the ER. People die all the time. For all sorts of reasons. Some obvious, some not. But this? Going from looking fine to dead, in minutes? That’s weird.
She shook her head and went back to work.
It took her a couple of hours to catch up. She took a deep breath and straightened her back. She sipped on her cold coffee. She shuddered.
She checked her phone. Two missed calls. One unknown number. The other one was Victor.
“Call me.”
5
Emma bristled. That’s all you have to say? Seriously?
Heart pounding again, she walked to the abandoned radiology reading room. A broom closet really, and just as glamorous. But it was the only place in the ER, besides the bathrooms, where she had privacy. She pulled the accordion doors behind her.
Victor, her ex-husband, was a cardiologist upstairs. He was just as busy as she was, and he wouldn’t call without a good reason. The only reason Emma could think about was their daughter, Taylor. And she was never good news.
He answered on the first ring.
“Emma?”
“No, Pope Francis. What’s up?”
“Are you at work?”
“Like I’m ever anywhere else.”
“Taylor.”
“What?”
“She’s gone.”
“Again?”
“Yes. They haven’t seen her since yesterday. They think she left last night.”
Emma’s heart sank. Taylor was in rehab. No more.
“She only had a couple of weeks left. She chose to go there. Why would she do this?”
“She changed her mind?”
“I’m getting tired of this,” Emma said.
“Me too.”
“Did you try Margret?”
Margret, Victor’s mother, was Taylor’s favorite person. A modern Southern lady, she drank both tea and bourbon, whenever she saw fit. She looked like a porcelain doll but was as tough as an old saddle.
“I don’t want to bother her. She’s barely recovered from her heart attack.”
“Do you have a choice?”
Victor sighed. “Any other ideas?”
“I’ll try Eric.” Eric, Taylor’s latest acquisition, was a nurse in the ICU.
“If only she was with him,” Victor said. “He’s a good influence on her.”
“He would be, if anyone could influence her worth a damn.”
Emma had coped with Taylor, mostly by herself, after Victor left. Taylor had been a difficult child, then a worse teenager. I thought she was getting it together. Silly me.
“Emma, don’t talk like that. She’s doing the best she can.”
“She’s doing the best she can to drive us crazy, like she’s always done.” As usual, Victor is cutting her slack. Emma’s cheeks burned. She wanted to scream. She didn’t. There’s no point in us fighting. Not now.
“I have to go. Why don’t you call Margret? I’ll find Eric.”
6
Angel
That was too easy.
They’ll never think of me. She wasn’t my patient.
I helped the old girl. She’ll never suffer again. But I’m running low on fentanyl.
I have to find something else. Quick, painless, untraceable.
Potassium? That burns.
Morphine? That’s a controlled substance. It’s hard to get.
Insulin? That’s easy!
How about a good old pillow? It’s quiet. It’s free. The old folks won’t put up much of a fight. It would be over in a minute. But I need to silence the monitors first. Nobody ever checks, we’re all too busy, but you never know.
That�
�s a plan!
Way to go, Angel!
7
It was dark by the time Emma got home and dropped her work Crocs at the door. Her bag, heavy with her always-there stuff—scalpel, flashlight, tourniquet, Magill forceps, drugs—went on Victor’s old chair, as usual. She bolted the door.
Her wine and the hot bath were the best part of her day. They cleaned her from the dirt and suffering that came with her job. And now that she’d gone off her food to lose weight, they were her only indulgence. She picked her wine carefully. Wine was her solace and her pleasure. It was also half of her daily calories.
Time to celebrate Vincent’s 9th.
She settled for an old favorite, Tres Picos 2016, a Spanish Borsao Garnacha. Most Spanish wines are sharp and full of dark corners, like Goya’s paintings. This one is smooth as silk.
The cork popped, liberating the wine. She poured it in a long-stemmed glass, unfit for the bathtub. She looked through it.
Garnet. Dark enough to appear black, but for the edges. Like venous blood.
She shook her head. This job’s messing with my brain.
She read the label. “Concentrated flavors of blackberries, strawberries with nuances of leather, vanilla and plums.” Leather? What’s leather doing in my wine? Oak is bad enough, but leather? What if I was a vegetarian?
She sniffed it, then swirled it for the second nose. She took a sip. She chewed on it, bathing all the taste buds. The ones at the back of the tongue, specialized in the bitter taste, and the ones on the sides and underneath. She allowed every single one to revel in the taste, then she swallowed it. It warmed her heart.
She sat on the deep green leather sofa in her scrubs, too tired to take them off. She’d skipped lunch to go see Eric in the ICU. She found him at his post, watching his patients and taking notes. His tired eyes and the five o’clock shadow made him look older than twenty-four. Emma smiled. Handsome kid! He sure looks better than the first time I saw him, pulseless on that stretcher. I’m so glad I didn’t call that code!
“Hi, Eric.”
His face softened when he saw her.
“Dr. Steele! Nice to see you. How can I help you?”
“Have you heard from Taylor lately?”
His eyes widened.
“I visited her just the other day. She was doing great! We had lunch, we walked, we talked.”
“Did you have a fight?”
“Fight? Not at all. In fact…” he glanced at his patients, then sighed. He looked back at Emma. “I asked Taylor to marry me. I know she’s only seventeen, but she’ll be eighteen soon. I really love her. I never felt the way I feel about her. She’s the girl of my dreams. I hope you don’t mind that I didn’t talk to you first, Dr. Steele. I wasn’t planning on it. She was so beautiful…and so kind. I couldn’t stop.”
“What did she say?”
“She cried.”
“And then?”
“I told her how much I loved her. I’ll wait for her to be ready, no matter how long it takes. There’s nobody else for me.”
“And?”
“She cried even harder. I gave her my bandanna to blow her nose.”
Emma laughed.
“We sat on the grass. We ate ice cream. I told her about the wonderful life we’ll build together. I told her that I want her to be the mother of my children. Then she started crying again. I said: ‘It’s all right. If you don’t want children, we’ll just get a dog.’ I thought she liked dogs. But she cried even harder. Then she ran back in. I think it was the surprise.”
“She’s pretty young to think about children.”
“I know. But she’ll get older. I will too.”
“Things change. People change. You may not feel the same way next year.”
“I will. There is nothing stronger than love.”
“How about hate?”
“Hate is love too. Just misguided. Hate is love in disguise.”
Emma smiled. “Maybe. Thank you, Eric.”
“Why? What happened?”
“Taylor disappeared last night. We don’t know where she is. I thought maybe you did.”
“Disappeared?”
“Yes. She wasn’t in her room this morning.”
“But…why?”
“That’s what I wondered. Why?” Now I know.
8
Angel
This poor girl has got to have cancer. She’s bald as a billiard ball, gaunt and yellow. That’s chemo. And she’s not that old. Forty? Fifty? I look at her patient bracelet. Thirty-three. She got a raw deal. She’s holding on to the edge of the stretcher, retching.
I push the second dose of Zofran for her nausea. “How are you doing?”
“Awful. I wish I was dead.” She bends over to retch again. “Chemo sucks. And it only buys me a few months anyhow. I wish I hadn’t started it. What’s the point of living like this? If you can call this life!”
“Why did you do it, then?”
“My parents insisted. I couldn’t say no. I didn’t know it would be this bad. I’d rather die. It’s awful for all of us. They’re suffering, watching me die a little every day.”
I get it. I’d wish the same if I was her. I need to help her. I have just enough fentanyl left.
On my break, I get the vial from my locker and I head back. Then it dawns on me.
I can’t go back. Not yet. Nobody goes back early from their break. I go to the cafeteria. The stench of grease cuts my breath. I get a cauliflower-cheese soup. It’s sickening. I want to puke.
I throw it away, and I go back.
She’s gone!
Gone? Did they move her? I check the board. No. She’s gone. She got a bed. They took her upstairs. It usually takes hours.
I’m livid. I was going to help her.
I do my circular breathing to calm down. Again. And again. My pulse goes down, and I start thinking straight. I was about to make a huge mistake. She was my patient. If she died, they’d look at me closely. I don’t need them looking at me, closely or otherwise.
That was a close call. I was lucky.
Careful, Angel.
9
Walking in from the ER parking lot that morning, Emma relished the breeze cooling her temples. She’d spent the night wondering about Taylor. Where she was. How she was. At the crack of dawn, she had no answers, but her head throbbed with a massive migraine, complete with nausea and blurred vision. I hope it starts slow today. I can’t even see well enough to suture.
She punched in the code to open the ER door. The door banged open. The noise hurt her brain.
“Code 66, Emergency Department.”
A blue shadow wheezed past. A posse of six followed, all running like the Olympics were on.
Emma followed.
They caught him in the hallway. They grabbed him by the blue paper scrubs. They ripped, exposing abundant pink flesh. Quivering like a hooked fish, he shook them off. He bolted.
They grabbed him again. Carlos pulled on his leg, sending the whole cluster crashing down.
“Let me be, let me be, let me be! You’re crushing me. Let me go, let me gooooo!”
Limbs entangled on the concrete floor. Hands grabbed on to body parts. In the wriggling mass of scrubs and bare human flesh, nobody knew who held whom.
“Stay still, damn it!” “Don’t bite!” “Ugh, I got his crotch.” “Let go, that’s my hand!”
“Let me go…let me go…let me go...”
An elderly woman shuffling by on her walker stopped dead, watching. A young mother froze in place, her eyes glued to the fight. Kids screamed. Security came, holding on to their Tasers. The cluster scrambled.
“What a circus,” Faith said, watching over Emma’s shoulder, her pupils swallowing her eyes.
“Yes. Get me a five-and-two, please. And a stretcher.”
The five-and-two, the classic “agitation cocktail” of Haldol and Ativan, was a shot given in the muscle, through clothes if necessary, to sedate dangerous patients.
“Sure.”
“He bit me.”
A thump. A scream.
“He broke my nose.”
Blood spurted red.
The old lady wavered. A security guard helped her to a chair.
The runaway cried. Strangled, childlike sobs, strange in a man that size. A dozen hands lifted him on the stretcher, holding him there. The fight was over.
“Where’s the five-and-two?” Emma asked.
“Here.”
Faith grabbed the patient’s thigh. She pinched a fold of flesh and cleaned it. In one smooth move, she pulled out the syringe from her pocket, uncapped the two-inch needle with her teeth, plunged it in all the way and pushed the plunger. She pulled it out and recapped the syringe.
Emma shuddered. What a silly thing to do. A needle stick means weeks, maybe months of testing, prophylaxis, and worry. I need to speak to her.
“Soft restraints,” Emma said.
Judy slid the padded soft cuffs around the patient’s ankles and wrists, and tied them to the bed. The man banged his head, crying, but his sobs got softer and softer. Minutes later he was asleep.
The fight was over, but the casualties were heavy. Roy was dizzy and nauseous after hitting his head. Alex’s glasses had carved deep gashes into his face before falling apart. Carlos bled from his broken nose. Ben got bitten. His swollen right hand had red tooth marks. The skin wasn’t broken, but he was white with anger.
“You! You let go of his leg! That’s why he bit me!” He scowled at Carlos.
Carlos wanted none of it.
“Really? He broke my nose because you let go of his hand!”
“I wouldn’t have, if you hadn’t brought us all down when you pulled on his leg, you stupid spic!”
Carlos turned dark. He charged, ready to punch Ben.
Emma stepped between them.
“That’s enough!”
Carlos glared at her. He opened his mouth to speak. He changed his mind. He turned around and left. Ben’s narrowed eyes followed him.