The room went utterly silent, waiting.
Susan found her mind roaming to odd considerations. It amused her they still drew names out of a box when a simple random-generator program could do the job much faster and just as fairly. Yet, she realized, there was some comfort in watching each and every name get drawn from the box exactly one time. There could be no question about errors or fairness.
Dr. Mirschaum called out the first name, then the second, and Susan watched her peers claim the prime rotations. There was a strategy to the process, though it varied somewhat by the individual, particularly for the initial round. Everyone had to do a month on the same inpatient units, but the adult and Limbo units used two R-2s, while the pediatrics unit had only one. A resident who chose one of the double-staffed units first had to worry about who might partner up with him or her.
Five R-2s would work together on Hasbro’s outpatient psychiatry unit, which could mitigate any personal issues. While only four R-2s had open electives at the same time, they each had to choose a different one of eight possibilities. If a resident’s first choice disappeared quickly in any given round, he still had an excellent chance of getting it in a later one. It helped that not everyone wanted to do the same elective, because the outpatient electives required the most cautious strategies. Five residents worked them a month, in exactly five different locations. Some paid, while most did not. Others had better schedules or staffing, for various reasons. The patient population also varied, with some having personality disorders and simple neuroses, while others seemed plagued with psychotics. As their rotations were already psychosis heavy because of the inpatient work, the neuroses clinics tended to go fast, especially if they paid.
The Mole and the Emergency Room rotations allowed only one resident at a time, while the developmental-disabilities clinic and the addictions clinic took three. The dementia unit, a particularly dreary place, especially for a summer rotation, was staffed by two R-2s.
The next several picks went by without Susan’s name. On the tenth pick, Dr. Mirschaum called Kendall Stevens. Susan surveyed the board, smiling for him. The best slots were already filled: the top three outpatient clinics, the Mole, both ER positions, two open electives, and one of the Adult Inpatient Unit spaces. It still left Kendall with some great first-rotation options. He could pick a different elective if others had not already taken the one he wanted. He could select any of the three inpatient units, the PIPU alone, the first open Limbo space, or the second man on adult psychiatry. Several of her peers fidgeted or bit their lips, hoping but doubting their choices would remain by the time their names were drawn.
Kendall hesitated, then finally spoke, “I’ll take Dementia.”
It was the last thing anyone expected him to say, including Susan. Even Dr. Mirschaum paused to squint at him through narrowed, dark eyes. “Are you certain, Dr. Stevens?”
Kendall must have nodded, because Dr. Mirschaum pressed the appropriate button on the remote, and Kendall’s name filled the first blank beside the Dementia rotation. Susan turned to whisper a “Why?” only to find Kendall no longer at her side. She considered texting him, but supposed she would find it futile. He had a reason for his sudden disappearance as well as for his decision, and he clearly wanted Susan to figure it out on her own.
But Susan was in no mood for puzzles. She scowled in silence, watching as the next few names got called and the second Adult Psychiatry Inpatient slot, the first Limbo slot, two electives, and all five of the Hasbro Outpatient slots filled. Without intention, she found herself gradually working out the reasons for Kendall’s odd selection; even her subconscious found it impossible to resist a riddle. She tried to discern what the Dementia rotation afforded that others did not. The unpopularity of it had to serve a function other than shock value; his choice clearly had some positive purpose. It had two other features that might come into play: it took the resident away from Manhattan Hasbro and it featured exactly two slots per month. There were a total of two R-2s on call on any given day. The Mole handled in-house call five nights per week, while the two on ER rotations took the other two nights. The R-2s on the inpatient units rotated through call with the R-1s to serve only their own units. The ten R-2s on outpatient services took no call at all, those with open electives took call with their chosen services, and the eight assigned to the public facilities, including the Dementia unit, shared backup call, which consisted of being available to assist the in-house R-2s if they became overwhelmed. This rarely happened, but it did require the backup to remain available.
It all came together swiftly. Kendall clearly wanted a rotation requiring two R-2s working together. That he did not wish to work alone seemed obvious, and he could just as easily have chosen Development and Intellectual Disabilities or Addiction, equally unpopular but with three slots apiece. He had deliberately taken the one with only two openings. He wanted to work with someone and only that person, and Susan knew exactly whom he intended to join him on the rotation. The only question remaining was why he wanted her.
The answer came chillingly fast and, with it, the explanation for her own intolerable mood. Now it seemed so obvious, she wondered how she could have missed it. She had met Remington almost exactly one year ago to the day, had started their whirlwind courtship within a week, and had lost him less than halfway through her first rotation. As the anniversary approached, all the pain and anguish, all the anger and frustration she had finally managed to control, would come roaring back with a vengeance. She could think of nothing she would prefer more than a rotation as far away from Manhattan Hasbro’s Pediatric Inpatient Psychiatry Unit as possible, with the only other person who truly understood her ordeal. Kendall probably needed her as much as she needed him.
Then, finally, Dr. Mirschaum announced: “Susan Calvin.”
Susan studied the board, despite her firm decision. The choices had narrowed considerably. There was still an opening on the Provisional Care Psychiatry Unit (Limbo), two at Hasbro Outpatient, two on the least-popular outpatient electives, one elective, two spaces on each of the other public facilities, and the remaining opening on Dementia. Though she had not paid close attention, Susan could easily pick out the eight residents still waiting for their names to be called. They fixed their gazes on her and some displayed nervous habits, such as chewing at the side of a fingernail, fidgeting, or biting a lower lip. She did not leave them in suspense long. “Dementia,” she said confidently, pointing at the screen.
Several of the others loosed pent-up breaths as Susan backed away from the list to let those others study their remaining options. She suddenly found Kendall Stevens back at her side. “I was starting to worry your name wasn’t in the box. You have a knack for being first when last is better, and last when first is better.”
Susan forced a grin and noticed her hands were shaking, which irritated her. She did not usually demonstrate such obvious signs of weakness. Now that she understood her mood, she dreaded revisiting the agony of last July. If she had to do so, however, she was glad to have Kendall at her side, her father at home, and N8-C at Manhattan Hasbro. The positronic robot affectionately called Nate had helped her through the worst of times. “Thanks.”
“Thanks?” Kendall’s dark eyes slitted. “Thanks for what?”
Susan responded before he could deny his kind gesture and turn the whole thing into a joke. “Thanks for sacrificing your first rotation to be with me.”
Kendall snorted and rolled his eyes. “Yeah, that’s right. I sacrificed a chance to suffer torment alone to work with a brilliant and beautiful woman. I should qualify for sainthood.”
They both knew there was more to it than that. With her waveless mouse-brown hair and curveless body, she barely qualified as pretty, and that solely on the basis of youth. She could never be troubled to learn how to use makeup, and most of her fellow residents considered her a cocky know-it-all who deliberately showed them up at the most inopportune times. Kendall appreciated rather than resented her diagnostic acumen, and
he had pointed out that, unlike most of their fellows, his self-esteem stemmed more from clowning than competence.
“Well, thanks for understanding me better than I do.” Susan wondered if Kendall realized just how good a psychiatrist he was. He seemed able to read her like a book. “Thanks, also, for the undeserved compliments.”
“Yup, that’s me,” Kendall quipped. “Tossing around undeserved compliments like popcorn.” He waved a hand. “You never know when those nice things will just come flying out of my mouth unbidden.” He gave her a sterner look. “I need you this month as much as you need me. You would have done the same.”
Except she would not have. Or, at least, she did not know for certain she would. Steeped in her own miserable apathy, Susan probably would have taken whatever rotation she had planned during her more lucid moments, assuming this was not the time for deep consideration. Even now, though, she was dimly wise enough to realize saying so would not help cement Kendall’s trust. She could not deny that she truly appreciated what he had done, and she wished she could be sure she would have done the same if her name had come up first.
Chapter 2
Winter Wine Dementia Facility had a distinctive odor Susan finally decided represented a unique combination of body odor, urine, disinfectants, and 2-nonenal, the musty omega-7 fatty acid degradation product known in slang as “old person’s smell.” The front entrance brought Susan and Kendall into a clean waiting area with neat rows of chairs on a deep blue carpet, off-white walls, and an enormous desk surrounded by windows. Hallways branched off on either side of the desk, where a middle-aged woman dressed in white scrubs leaned over a pile of papers. She looked up as the residents entered, then smiled. “You must be the new doctors.”
“We must be,” Kendall said, striding forward with his right hand extended. “Kendall Stevens and Susan Calvin reporting for duty.” He jabbed his left thumb over his shoulder. “That one’s Susan.”
Susan let the door snap closed behind her.
Still grinning, the woman took Kendall’s hand. “Well, I certainly hope so, Dr. Stevens.”
Susan stepped forward. “Just call me Susan, please. If you say Dr. Calvin, I’ll be looking over my shoulder for my father.”
The woman dropped Kendall’s hand to take Susan’s and give it a brief shake. “Ah, so you followed in his medical footsteps.”
“Only if you consider robotics medical.” Susan reclaimed her hand. “He has a PhD in engineering.”
“Ah,” the woman said. “That kind of doctor.” There was a hint of condescension in her tone, which bothered Susan. She never understood why people gave less credence to university doctorates than medical-school graduates.
Kendall must have noted it, also, and came to the subtle defense of PhD’s everywhere. “I’m sure Dr. Calvin could diagnose what ails you, too. If, for example, you were an exponential assembly unit having difficulty with your kinematic influence coefficients.”
Silence followed the remark, during which the woman studied Kendall as if trying to determine whether he had insulted her. Apparently deciding he had not, she smiled again. “I’m Hazel Atkinson. I’m a CNA. Most medical receptionists are these days, so we can pull double duty.”
Susan nodded. It made sense for medical centers of all types to hire certified nursing assistants as receptionists so the front-desk personnel had at least a minimal understanding of medical terminology and could help in a crisis. “Nice to meet you, Ms. Atkinson.”
“Hazel,” she corrected, to Susan’s relief. It would seem entirely weird for the CNA to address the doctor by her first name while the doctor used the receptionist’s title. “Let me show you around.”
Susan appreciated that. She still suffered from suffocating ennui, and the July 1 date only made it seem worse. The sooner they jumped into medical work, even of a depressing nature, the better.
Hazel pointed to the hallway to the right of her station. “That’s the entrance to the foyer, where we take the families through to see their loved ones.”
Susan caught a glimpse of the same fresh blue carpeting and clean walls as in the entry room before being herded down the left hallway. Her soles clicked against worn tile flooring, and the walls, though the same color, looked infinitely drabber. Though well scrubbed, they had clearly not been painted for years. The odor Susan had parsed earlier grew stronger and more unpleasant as they wandered farther into the bowels of Winter Wine Dementia Facility, and the hallway opened into a small charting area filled with palm-prosses and larger computers. Currently, only a pair of white-scrub-clad nurses occupied the area, chatting softly with one another. As Hazel approached, they both rose.
Hazel made the introductions: “Doctors Susan Calvin and Kendall Stevens, this is Gray Halbrin.” The larger of the two men bowed and raised his head. He had dark curls, brown eyes, and a short goatee. The other nurse was a shorter blond with a broad baby face and brilliant blue eyes. “And this”—Hazel indicated the blond—“is Milan Penderghast.” Heads bobbed all around, and Hazel pushed open a heavy door to lead the young doctors deeper into the facility.
As the door closed behind them, Susan noticed a bright red sign on it reading CAUTION: DO NOT ENTER.
Noticing the direction of Susan’s gaze, Hazel explained. “That’s not for you. It’s to keep the patients from wandering outside.”
“Does it work?” Kendall asked.
“Quite well.” Hazel walked through a short empty space, more air lock than hallway. “Most of our patients can’t manipulate the heavy metal doors. If they do, we nearly always catch them in this area.” She gestured to the hallway, then pulled open the far door to reveal another hallway, this one broken by several doors. Again, Susan noticed a sign on the door they had come through, this time stating STAFF ONLY.
Several of the new doors also sported signs. Three had only numbers, one was labeled STAFF & VISITORS’ RESTROOM, and another WAITING AREA. Three others had no signs. Susan noted all the numbered doors had keyholes and sturdy twist knobs, which would make them more difficult to open. The others had handles easily depressed, even with full arms.
Hazel opened the door marked 3 and leaned against it to hold it open for the doctors. “Might as well start with the end-stagers.”
A blast of the smell Susan associated with the dementia facility assaulted them, partially covered by a rosy scent clearly intended to help mask the odor. They entered an enormous room filled with rows of hospital beds, the walls lined with chairs. Thick privacy curtains surrounded each bed, most of them fully open to reveal patients dressed mainly in pajamas and nightgowns. Most stared blankly at the ceiling or walls, their jaws working soundlessly. Others wandered aimlessly around the room or sat in one of the chairs. Susan saw feet beneath the few drawn curtains; staff working on patients in delicate stages of dress, or family members visiting. No sound emerged from these areas. Apparently, the fabric fully muffled conversation, keeping visits and medical interventions private.
Walking, sitting, or lying, the patients all wore the same blank stare, their faces wrinkled with age and confusion, their expressions neutral, their eyes dead. No real life looked out from them. They were automatons, emotionally empty, breathing from habit, without intention of any kind. Most had withered to pale, skeletal figures, as if they planned to gradually disappear, leaving no trace of body or soul. Their skin and lips gleamed with emollients intended to prevent cracking and sores. A sense of horror stole over Susan, and she found it difficult to breathe.
Multiple doors led off of this unit; several were labeled as toilets, a couple as bathing areas, and a few others bore no labels at all. Hazel opened and walked through one of these, and Susan followed gratefully. She could scarcely believe she was going to have to spend an entire month catering to patients who no longer had the capacity to care about anything, hopeless cases she had no means to help, people who remembered nothing and could not even recognize their own faces in a mirror.
The psychiatry residents found themselves in
another staffing room, this one with desks built into the wall, topped with cupboards, covered with palm-prosses and even a couple of old-fashioned desktop computers too heavy to move. A platter of chocolate chip cookies sat amid a clutter of paper and pens.
Hazel took a seat and flicked on a light attached to the underside of the cupboards. She snatched up a cookie and gestured for Susan and Kendall to do the same. “Winter Wine has three units,” she explained. “And you just saw the worst of them. It’s officially named the End-Stage Dementia Unit, or ESDU, but most of us just call it, DUm.” She pronounced it like “doom.” “If we discuss the possibility of moving there, and the patient responds in any way, they’re not ready for it.” She took a bite of her cookie.
Kendall took a cookie, but Susan found herself wholly without appetite. She had known patients with any type of progressive dementia eventually died from it, but she had never considered the detailed reality of those last few months or years. It seemed like nothing less than profound, unremitting misery. The lucky ones had weak hearts, so they could slip away to true oblivion rather than drag on in a state of living death. “They’re…zombies,” she observed.
“Except with less purpose,” Kendall pointed out. “Zombies, at least, have a goal.”
Susan could not imagine what he meant. She hoped he wasn’t working up to a tasteless joke. Though his way of dealing with stress, it seemed grotesquely out of place in this environment. She gave him a pointed stare.
“What?” Kendall surely understood Susan’s consternation but played ignorant. “I just meant to eat human brains.”
His explanation did not help the situation.
Hazel easily joined the morbid conversation. “Zombies are ambulatory. Most of our end-stage patients aren’t. They have no real consciousness, no self-awareness. And, for many of them, that’s a strange sort of blessing.”
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