by H. G. Bells
“So who’s next?” I said, looking back at my secretary. Her eyes darted from me, to the man in the corner, to the list, where her finger tapped urgently at a name scribbled messily across the sign-in sheet.
“Mr. Glendale,” I said loudly, looking directly at the man in the corner. The name was not familiar, and I’d never seen him before. It was a time of random drop-ins, people of every sort filtering in to any doctor that was hanging the ol’ leaches’n’cane outside their practice.
The man’s leg bounced up and down, and he continued to stare out the window.
“Mr. Glendale?” I repeated, louder. He blinked and was shocked out of his stupor. He leapt from his chair and strode quickly towards me. The other waiting patients recoiled as one, each pressing back into their seats to avoid getting any closer to the man as he passed by them on his jittery way across the waiting room. When he arrived in front of me, all eyes were on us to glimpse the first hint of how it would play out.
“Doc, doc, you gotta get me some more of this,” he said with barely a pause between each word. He fished into his pocket. “It’s great. Some more of this, more of this,” he said, thrusting an empty bottle into my face. “More, more, it works, it really works-it-works,” he said in a continuous stream of run-on words.
Over his shoulder, I saw more than a few of the waiting patients perk up at this testimony. Something that worked was the holy grail in those first few scattered days. Their eyes turned from fearful to the much more dangerous fearful and greedy, and desperate.
“Well now,” I said, turning my full attention to the frazzled man, “come into an examination room, and we’ll have a little chat,” I said, casually beckoning him to go ahead of me down the hallway.
“No need. Just get me more of this. Now. More.” He shook the bottle up and down, and it was conspicuously silent.
“I can’t do anything out here in the waiting room,” I said, but he didn’t want to hear it.
“Look man,” he said, louder, “these things are helping keep my brain focused, let me think, think, more, awake,” he said quickly. His foot started to tap up and down rapidly, making his whole body shudder. I noticed that his shirt was soaked with sweat, a detail that had escaped me at first because it was so soaked that I thought the dark grey was just the color of it. A trickle of sweat ran down his forehead and dripped off the end of his nose. One of the closer waiting patients saw it too; her eyes went wide.
“Sir, you are not well,” I said urgently, hoping I could bring him away from the others before examining him, but he wouldn’t have it. He pulled away from my attempt to usher him down the hall, and he shouted.
“Just get me more of these!” he yelled. I growled in frustration and dropped him down onto the chair. I thrust my fingers against his neck. While he was dripping sweat, he was cold to the touch. He lurched away from me but I followed and kept my fingers pressed against his neck to feel his pulse. It was racing. He tried to get up.
“Mr. Glendale, you need to stay sitting down, you’re going to hurt yourself,” I said.
“More of these,” he said simply, his arm jerking up and down ungracefully, like a toy with karate-chop-action. I stepped back and spoke to Jen, though I kept my eyes on the man about to go into tachychardia before my very eyes. He stood up and began blinking rapidly.
“Jen, we’re going to have a Code 1 here in a moment,” I said, hoping it would be enough to rouse her from the inaction the frightening man had imposed on her. She hurried away to get the paddles for me. Outside, somewhere down the street, I heard smashing glass.
“No, look here,” said the man, his arm chopping up and down, up and down, while his foot tapped and tapped, his whole body jittering, his eyes blinking. “More of these, more, of, these,” he said, the words halting and difficult. His face started shaking up and down, and I caught him as he seized and collapsed.
“Jen!” I shouted. The other patients waiting were at last spurred into action, and had one of three reactions.
Immediately, several of them fled, rushing out of the waiting room and into the burgeoning chaos of the world. The first one to leave had the bright idea to push the wheelchair button, and the door stayed open long enough for the stream of panicked people to make their scrambling exit with at least a semblance of grace.
A second and much smaller subset of them rushed to help me with the man having a heart attack.
And lastly were those too out of it to even realize what was going on. They stared at the wall or at the floor. How did they even get to my office? What was driving them when it looked like nobody was home? I focused back on the man seizing on my floor.
His saliva was frothing at the corners of his mouth.
“Jen!” I shouted. I needed the defib machine. We had a little portable one just in the back, she should have been back, it wasn’t far. I stood and rushed to see what was keeping her and was met with a tall woman holding a kitchen paring knife to Jen’s throat. The woman’s eyes were wide and wild, desperate and deadly serious.
“Write me a prescription for Adderall, right now, or I kill her,” she said.
Goddamn Canadians; why couldn’t they just rob a drug store like any sane American would do? Like this woman: still so attached to the medical system that it hadn’t occurred to her to bypass the middleman. Well no one was thinking clearly I suppose, and using the systems in place must have seemed more approachable than striking out into new territory. She was tall, but she had thin fingers and a slight build; her eyes were wild but also frightened. She looked like a knitting instructor or something; definitely not versed in the art of crime. Her hand was trembling as she moved the kitchen knife closer to Jen’s throat.
“Ok now, you don’t have to do that. Let me just get my pad,” I said, reaching slowly into my pocket. Behind me, I heard thumping as the man’s limbs bashed the floor, his muscles contracting violently as his seizure intensified.
“Doctor!” shouted one of the other patients who had rushed to help. “What do we do!?”
“Name?” I asked the woman with the knife to Jen’s throat.
“Barb Higgins,” she said. I scribbled out a prescription and thrust it towards her.
“Now get out!” I shouted. She nodded and edged along the wall to the door.
“I’m sorry,” she said, looking at Jen. She fled. I turned to Jen.
“Jen, paddles,” I said. No time to parse what had just happened; I’d hoped the shock would be enough to at least get her through the next trauma, namely the man dying in our waiting room.
To her credit and my relief, Jen rushed to the back and reemerged to set the portable defib machine up next to where I resumed helping with the man. His mouth was frothing and all the tendons in his neck were taught as he shook, arms slamming down when they managed to pull free of my impromptu assistants.
I pulled the scissors from the machine and cut his shirt open. I attached the leads and the machine read his vitals, preparing to shock him.
“Stand clear,” said the device in a calm monotone.
“Nobody touch him,” I ordered. My helpers removed their hands and the man slapped his arms and legs against the ground, until the defib machine shocked him and he tensed in electrified rigor. It showed his heartbeat, which was fast and irregular, and it shocked him again. His heart stopped.
“Oh lord,” said the woman whose child was still sitting, eerily still, superhero shoes dangling limply off the chair, sitting, staring at nothing.
The machine jolted the man again, but he was gone. I turned it off and sighed.
“I’m sorry you had to witness that,” I said to those who’d stayed in the waiting room. As awful as it was, I took it as a teaching moment. Maybe it was good that they’d seen it. “He was on uppers, stimulants, trying to feel energized. That’s not the way, and I’m afraid I don’t have any help for you. I will not give uppers like this to people, you can see why,” I said with a nod at the dead man, final beads of sweat trickling down his slick skin and onto
the hard carpet. “And none of the medications are working to make people sleep, so I won’t do those either.” I looked from face to face, each with their own brand of resignation and frustration.
Over the years, I’d seen the look of “about to break” more than a few times. The psychological stresses of the rat race necessitated some to seek my medical advice (which was usually a referral to a therapist), and had provided me with a pretty good blueprint for the face of someone right on the cusp of losing it. As I looked from face to face, my patients waiting for something, anything more, I saw that look on more than half of them. It was all in the eyes. You can’t hide that kind of panic.
“Thank you for your help. I think we’re done for the day here. Unless anyone has anything non-insomnia related?” I asked, casting my gaze at each of them. All eyes averted, some despondent, some perhaps ashamed—for who in those first days didn’t think of doing something unthinkable to get that holy grail, something that worked? They filed out of my waiting room one by one, the first ones at a pretty good clip, rushing back out into the world to try their plan Bs. As the door shut behind them, I realized that there was the constant wail of faraway sirens. None of them were for a single doctor’s office which may or may not have had a problem, but constant all the same.
Everyone had left, all but one; the little boy in the super-hero print shoes was still there, and he sat still, staring, staring. I ran to the door after the people who’d just hurried back into the world.
“Someone’s forgotten a boy!” I called after them. A woman doubled back, a hand over her mouth in alarm. She couldn’t hide her panicked eyes, and maybe she’d hope I’d see them—she fixed me with a desperate glance as she passed me while I held the door for her.
“Oh god, I’m sorry, Ricky, come on now,” she said. She took his hand but didn’t lead him out of the waiting room. “You don’t have anything, doctor?” she asked, lifting up the boy’s hand. She let it go and his hand sunk slowly back into his lap, his eyes still fixed on nothing, no response, no sign of awareness. I shook my head. Fascinating, horrifying.
“I’m sorry,” I said simply.
“Ricky, come on now,” she said, shaking him by his shoulders.
“Mom?” he asked, blinking languidly. “Mom, why are there fish everywhere?” She looked up at me, desperate for something, anything, to help her. I shook my head again.
“Sleep deprivation causes hallucinations,” was all I could offer.
She led the boy out of the waiting room, and he stared down at the dead man on the floor. He paused at the door though, eyes coming to momentarily focus on my face with a soft sympathy that seemed to come naturally to his tiny face.
“It’s okay, Doctor, you couldn’t have saved him. We’re all going to die soon anyway.”
They left, but stood just outside while I locked the door to my practice after them, quiet except for Jen’s soft crying coming from behind the reception desk, and the sound of constant sirens. I sunk to the floor and stared at the dead man on my carpet.
But then, when I finally got back up, I saw that the woman and her boy were still outside, and something in me shifted.
“Jen,” I said, “we’re going to try something new. Now’s the time to leave if you don’t want to be part of blurring the line of medical ethics.” I looked at her. She sat up straighter, smoothed a hand down her shirt, and nodded.
I unlocked the doors.
“Ma’am,” I said loudly, “why don’t you bring him back in here.” She led the boy back into my waiting room. “Let’s see what we can do,” I said, starting down the road of desperate, but necessary, experimentation.
The memory lapses are the worst. Everyone knows that feeling of walking into a room and forgetting why you’re there, but every moment of every day is turning into that feeling. People are forgetting to eat, forgetting to take medication, forgetting where their babies are, that they even have babies. Take away our memory and we are becoming golems, only we have no masters to give us orders. Remember! Remember! Remember!
—Transcript from an unknown HAM radio operator, Stephen, Minnesota, United States
In some places, parents still brought their children to school. It’s amazing to see which parts of our daily routine were clung to until the bitter end. My class dropped by several students each day, but still we did our best. It wasn’t about education being essential, it was about no one else being there for those children. Kids would be kept home at the drop of a hat those days; it was amazing to see how useful routine started to become. So we had kids at my school. And from what I’ve heard, we were the exception, not the rule. Not that we stuck to the curriculum. And even though perhaps it was already more of our function than I’d be willing to admit, we truly became a glorified day care.
I didn’t want to ignore what was going on, so we talked about it. The students asked questions, so many questions. I tried to lead them to discover their own answers, because I had none. If it hadn’t been so dire, it would have been a marvelous teaching opportunity. I mean, it still was, but it’s rather grim to be talking about it when there’s yet another empty seat in the story circle, and often we were given no reason for the absence.
As the attendance dwindled, we conglomerated the kids from different classes.
I had been married once, but had no children of my own. I enjoyed the rolling stock, each year a new class to meet and care for. Some years I would go up in grade with them, just to hold onto a special group, or to foster something that hadn’t quite reached its full potential. Children are potential personified, and they never cease to amaze me. They were all my children. And for those last few days, I was, while not quite their mother, at least the person who stepped in when their mothers weren’t there.
My class was sixth grade; just on the precipice of puberty, jogging their minds into more advanced thought. They were more hungry for the truth, and more able to understand it, than the younger grades. So we talked about it.
We went over all the options. We watched videos on Fatal Familial Insomnia, videos on Bovine Spongiform Encephalopathy, and several videos about sleep and the circadian cycle. We watched the news and looked at social media to help develop a critical eye; what were the facts, what was conjecture?
We spent time talking about their own sleep cycles, from before, and made a chart of bedtimes. We learned all about sleep, charting the ups and downs of people’s sleep cycles as they went from alpha to delta wave sleep. We looked at the history of sleep, and how we even used to be diurnal, waking in the middle of the night for a few hours before returning to bed for the second sleep.
When the panic hit, about half of the kids in my class didn’t get picked up from school. The riots, and yes even Small Town USA had them, swept us up in hysteria. I kept the children at the school, as did the other teachers. We decided upon a good course of action, and we gathered together a dinner and some blankets so we could stay the night with the children at the school.
It would have been cruel to call it a sleepover.
But I made popcorn, and we watched movies all night, with breaks in between each to get up and move around.
The different archetypes of no-sleepers manifested themselves quite dramatically in the children. It was through them that we got a sort of early warning system as to what we, the adults, would go through. A cruel warning of things to come—to have the symptoms manifest themselves in the children first was enraging.
Children’s brains are all soupy. Their neural pathways are not fixed; they’re undeveloped. They can’t even see all the colors yet; not until we’re around eighteen do we have access to the full spectrum. Their brains are in a constant state of flux, trying to fit things together into who they are going to be. Habits are formed, people are solidified. That is why they were affected sooner. The stress of fighting against it, coupled with the devastating lack of sleep that would allow them to reinforce neural connections and repair damage, was just too much for a developing brain to handle.
> The first archetype I noticed was well into the panic, I think it was Day 5, when we were still managing to keep children at the school.
I was watching a classroom full, half of the kids that hadn’t been picked up that day, and another teacher, Mrs. Miles, was watching the other half of them in the grade four classroom across the hall.
We had just finished up watching Tangled, and most of the kids were okay, going through cycles of being grumpy and exhausted and sometimes inexplicably exuberantly awake and energetic as only children seem to be able to be. I poured glasses of juice for everyone while we took our break from the cartoons. A quick scan over their activities revealed that all was well, except for one of the youngest, Jarred, a grade two student. To be frank, Jarred had been a rambunctious little brat. But of course he was in grade two, and that whole mess must have been such a terrifying nightmare for him, for all of them of course, but Jarred got quiet pretty much from the get-go.
It was partially a blessing though, that some of the children sort of lost themselves. It was much easier to move them around, get them to do things, to stay put if need be. Easier to take care of them. So when Jarred started to be quiet and still, I’m sure his teacher didn’t mind. I didn’t either, but it started to get strange.
Like I said, we had just watched Tangled, and I did a scan over the class as I poured juice. Some of the kids were coloring, some were playing with pipe cleaners (already, a scale model replica of Rapunzel’s tower was emerging atop one of their desks). But little Jarred was still watching the TV, the TV which was now off, silent and black. I handed a cup of juice to Hannah, one of the older kids, and whispered to her.
“Hannah dear, could you please go invite little Jarred there to come get a cup of juice?” She nodded and did what I asked. I watched while I continued pouring juice. Hannah crouched down next to him and spoke in a soft voice. Jarred didn’t move. Hannah put her hand on his back and spoke again. Still nothing. She turned to look back at me, frowning. I nodded and beckoned her to come back.