by Magus Tor
She found it almost immediately, but continued with her physical examination to make sure. There was no point jumping the gun. Only after she had spent almost ten minutes examining the patient did she speak.
“Abdomen,” she said, turning to her trainer. “A large mass. Inoperable at this point. Presumably cancerous, though I'd need a CT scan to be sure.”
The trainer smiled. “Very good, based on the scan we’d done. It’s a large pancreatic tumor with mets to the liver,” he said, though he'd obviously been expecting her to do well. “Shall we proceed?”
Aurelia nodded. This woman was going to die, whether Aurelia injected or not. And if she chose not to inject, the woman would die in agony, a long and protracted death. The decision was an easy one.
The trainer fumbled in his pocket for a moment and then pulled out a locked vial. He keyed his personal ID number into the lock, and it clicked open. He held the vial out to Aurelia, who took it, her hand steady. Shaking out the syringe inside, she went through the motions of preparing it to inject the woman.
There was no need to roll up her sleeve, her arm was bare. Turning the elbow to allow easier access to the vein, Aurelia paused and look up towards the face. There, beneath the pale skin of the patient’s neck, was a small but constant movement. Beating, under the skin, like the flutter of a curtain in the breeze. A pulse. Aurelia swallowed. Who was this woman? What had she done? Did she have a pair-mate? Was she a qualified Worker? She had smiled, loved, laughed, cried. And now this.
“Ms. Cole?”
The Trainer's voice brought her back to the room. Aurelia placed the needle on the skin and in one, smooth movement, pressed down and through to the vein. Fluidly she depressed the plunger until the syringe was empty before withdrawing the needle.
There was silence. A loud, echoing quiet. For an instant, Aurelia felt the world had stopped turning. The room was empty. The life was gone, and all other living matter stopped for a moment in grief. Then that moment, too, was gone, and life continued.
“Well done, Ms. Cole,” said the trainer, tapping icons on his screen. “That will be all. Thank you.”
Dazed, Aurelia left the small room, took the elevator down to the ground floor, and walked straight out of the main doors of the hospital. Only once she was outside did she think that she had not even asked the woman's name. She cried.
She walked home, letting the soft air of the night dry her face. In her heart, she knew she had done the right thing. This time, but what about the next? Was this going to get easier?
Her father was waiting. He served her a warm cup of synth coffee before he spoke. “You did it.” It wasn't a question. He knew she had, for if she hadn't, she wouldn't be there. She'd be wherever it was they took the Failures.
Aurelia nodded, letting her cup warm her stone cold fingers. She felt icy all the way inside, like she had lost something, threw off a piece of herself by taking the woman's life.
“Will it be this way every time?” she wondered aloud. “Can I expect the process to always be this hard?”
“I hope so,” said her father, coming to sit beside her.
His answer surprised her, and she looked at him.
“As long as it's hard, as long as taking a life extracts a toll from you, it means you still consider life to be something valuable,” he said, quietly taking her hand. “And that's a good thing. It's when you feel nothing, when injecting becomes as easy as x-raying or fixing a broken bone that you have to be worried. Because it will mean you've lost your humanity, replaced your respect for life.”
Aurelia smiled. He was right. She should be glad that injecting was hard. Because then it meant something. She hugged her father tightly before exhaustion sent her to her sleeping pod.
It was their first night alone at the hospital. Year seven students worked full hospital shifts for three days a week, and Aurelia and Marnee had swapped shifts in order to work overnight together. Aurelia stretched. Her eyes were gritty with tiredness, and her mouth sour with the taste of synth coffee. It had been a long night, but only an hour or so more to go. They had a ward of ten patients between them, and Marnee was doing the walk around inspection.
“All good. Patient four has an elevated heart rate, but just a little,” Marnee said with a yawn. She threw herself down on a chair, stretching out her aching legs.
“Elevated?” Aurelia's interest was perked. “I'll go and check.”
“She's fine,” Marnee said. “Don't worry about it. It's just a little.”
But something didn't sound right to Aurelia. She knew the patient had received a dose of a new drug within the last half hour or so. Marnee saw the look on Aurelia's face. “Fine,” Marnee said. “These are my rounds. I'll give it a look-see again, okay? Be back in a sec.”
Aurelia smiled. She was grateful to Marnee for going. She didn't want to get up. The small staff room was pleasantly warm, and she could feel her eyes starting to close. With a jerk, she sat up. Gods, she'd almost been asleep—the cardinal sin on night shift. Rolling her shoulders, she looked at her time reader. Hmmm. Marnee had been gone almost five minutes. She only had to cross the corridor. Aurelia shrugged and decided she'd better go see what was going on.
The heart rate monitor jumped in spiky lines. Marnee held down the patient's shoulders, trying to stop her convulsions. Two strides across the room, and Aurelia had pressed the emergency button on the wall. “Allergic reaction,” she said to Marnee, whose face was white, all her energy focused on keeping the writhing patient safely on the bed.
Within seconds, a troop of med-A Workers had entered the room, but there was no sign of the qualified med Worker who should be there. Expecting Marnee to take charge, Aurelia took a step back. But it soon became evident that Marnee, eyes wide and almost crying at this point, had no intention of doing what needed to be done.
They'd drilled this, done it so many times that it was second nature to Aurelia now. She was a leader. All med Workers had to be leaders, and when the time came, you stepped into the breech.
“Intubate, anti-tox shot, anti-convulse shot,” she barked, pointing to three different med-A Workers.
No one questioned her authority as she took over care of the patient, ordering drugs, restraining the fitting woman, and slowly, slowly bringing her reaction under control. By the time the qualified med Worker ran through the door, still pulling on his uniform, the patient was again stable.
“Gods, I was sleeping,” said the male med Worker.
“It's all under control,” said Aurelia calmly. She'd done what needed to be done, but Marnee was nowhere to be seen.
Aurelia eventually found her in a toilet cubicle, crying, damp strands of blonde hair sticking to her cheeks. Wrapping her friend in her arms, Aurelia said nothing. There was nothing to say. Marnee knew she'd failed that night, but Aurelia was the only one who had seen. She'd get another chance, although what would she do with it? Aurelia stroked Marnee's hair. Medicine was no job for the weak, hardly a profession for those who lacked confidence. Guiltily, she wondered whether Marnee really had what it took.
She kept Marnee's secret, though she knew she should have reported the incident to their trainer. Maybe, she thought, Marnee would learn from this. Perhaps it was what she needed to learn how important leadership skills were. Maybe. Aurelia kept her fingers crossed, hoping she'd done the right thing. As it turned out, Marnee wouldn't have another chance.
Aurelia wasn't there when the accident happened, though she wasn't far away. Tending to her own patient, she was filling in charts. It was almost time for graduation, and the final test was a full patient experience. For all intents and purposes, Aurelia was this patient's med Worker, though her care was being overseen by a trainer, and Aurelia was determined that this patient would have the best care she could possibly provide. It was a scream that caught Aurelia's attention, a horrific, stomach churning yell resounding through the corridors of the hospital wing. Running as fast as she could, feet slapping on the smooth floors of the hallway, Aur
elia was there seconds after the event.
It was all so simple, so stupid, so awful. A wet floor. A med-A Worker who had taken a second too long to call a hospitality Worker from the com at the end of the hall to come and clean up. A rushing trainee, tired from night duty, sleepy eyes unobservant. A slip. As simple as that. Aurelia saw immediately what had happened, and almost didn't get close enough to find out any more. The trainee would be fine, because others were there to help after the slip. But something prodded Aurelia, and she approached the small circle of people.
Marnee lay twisted, her face white. There was no blood, which somehow made everything seem okay. Aurelia pushed a med Worker aside and crouched next to Marnee. Quickly, Aurelia felt for a pulse and pulled down Marnee's eyelids. The girl was out of it. Shaking her head, Aurelia looked up to see the med Worker she'd pushed. “She must have hit her head when she fell,” she said. No big deal. It happened. “Let's get her to a bed, we can scan her there.”
The med Worker nodded and called for two trainees to stretcher the patient. Aurelia got up, her knees aching from squatting. Only, Marnee could be so clumsy sometimes, and they had their final patients to attend to. Aurelia hoped this bang on the head wasn't going to put Marnee out of action for too long. Probably not, though. A scan, some pain meds, a night of observed sleep, and she'd be fine. Yet something was sitting uncomfortably with Aurelia, a doubt nagging her. She shook the feeling off and followed Marnee's stretcher into one of the private rooms.
Lying on the bed, Marnee looked small. She was delicate, always had been. The med Worker went off to arrange the scans, and Aurelia keyed in her ID number to grab a revival shot from a cupboard. The shot worked immediately, and Marnee's eyes blinked open to see a grinning Aurelia.
“Idiot,” Aurelia said, fondly. “You really need to watch where you're going.”
Marnee tried to smile, but grimaced in pain instead.
“Yeah, it's gonna hurt,” said Aurelia. “But you're gonna be fine. Vitals look good.”
Marnee moved her head a little in what was probably a nod.
“We're gonna do a scan, a couple more tests, and you'll be good to go. Okay?”
“Mm-hmm,” said Marnee.
Aurelia checked her friend's pupils again, which seemed equal, responsive to light, and generally perfectly healthy. “Move your fingers for me,” she ordered.
Marnee wriggled her fingers on the sheet, and Aurelia nodded.
“And toes.”
Nothing. Aurelia sighed.
“Come on, Marn. Wiggle your toes.”
“I am,” Marnee said, her voice cracked and hoarse.
Aurelia swallowed. Marnee's feet were perfectly still. There was no movement at all. Quickly, Aurelia decided to say nothing. “Very good,” she said, as though Marnee had done exactly as ordered. “Now tell me the date today.”
When the med Worker came back, Aurelia grinned at Marnee, grabbed the Worker and pulled him outside, sliding the door closed behind them so they wouldn't be heard.
“She can't move her toes. I've done pressure tests without telling her. There seems to be no sensation at all below the waist.” She was near to panicking.
But as a doctor Aurelia knew she shouldn't. The med Worker nodded, reading Aurelia's concern. “It's probably nothing,” he assured her. “Could be any number of things. Let me run the scans through, and we'll see what's what. I'll get an orthopedic down to check her, too.” He laid a hand on Aurelia's shoulder. “Don't worry, I can see she's your friend. But she's one of our own. She'll get the best care in the world here and be back treating patients before you know it.”
Aurelia gave him a watery smile, but she was clearly being dismissed. She was still only a trainee, and Marnee's care was going to go to real med Workers now. Once again, the doctor took pity on her. “Listen, go grab some coffee from the staff room, tend to your patients, and I'll come find you as soon as we know anything at all, alright?”
She nodded, grateful. He didn't have to tell her anything. In fact, given that she wasn't family, he wasn't supposed to tell her anything. He squeezed her shoulder again, then went back into the room. Aurelia watched the door close, and only then did she let the tears come.
It was Aurelia's trainer who came to tell her in the end. There was nothing that could be done. Marnee was asking to see Aurelia. She was offered a sedative patch but refused. She wanted to be clearheaded. She wanted to feel this, although all she felt right now was empty. Opening the door, she saw Marnee propped up on pillows. She'd obviously been given a pain shot, because she looked comfortable. Aurelia didn't know what to say. She had no words. She went to the bed, and took Marnee's hand.
“I want you to do it.” Marnee's voice was weak, but her words were clear. Both knew what she was talking about.
“Marnee . . .”
The young girl shook her head.
“I'm a med Worker. You taught me well, Aurelia. I know what's going on, and I need you. I want it to be you. Please.”
Aurelia bit her lip and closed her eyes. She couldn't do this. How could she inject her best friend? How could she take the life of someone she loved? Stroking Marnee's hair, she saw the girl's eyes were beginning to close. Her sedative was taking effect.
“Just promise me that you'll think about it,” Marnee said, her voice fading as she drifted into a drugged sleep.
“I promise,” said Aurelia. It was the least she could do.
The auditorium was packed with people. Even the parents who distanced themselves from their offspring were there. This was the final event. Afterwards, all children would be officially Workers. Parents would no longer have any authority, nor would they have any special treatment or rations. They would no longer have any responsibility, either. The echoing chamber was filled with chatter, and Aurelia threaded through the crowd, her mother and father in tow, looking for some place where they could all sit together.
“Here!” shouted her father.
He'd found three seats, all in a row, and was carefully guarding them. Aurelia smiled at him, as she and her mother joined him. It wouldn't be long now. The lights were already dimming. They were right on time. Settling into her seat, she found that both her mother and her father reached for her hand. Laughing quietly, she gave a hand of each of them and squeezed tight as the director of the medical institute walked across the stage to begin the ceremony.
She had the night to think about it. Her trainer had explained it was the best they could do. The extra time was only because Marnee was a med Worker trainee. For anyone else, the job would already have been done.
As always, Aurelia's father was working when she got home, a halo of gold light from his desk lamp surrounding him. She dissolved into tears as soon as she saw him, the sobs wrenching and hiccupping so she could barely explain what had happened. It was a long time before she could speak. She felt that she had been drained completely of emotion.
“And what will you do?” he asked.
Aurelia shook her head. “I don't know. I don't think I can do what Marnee asked.”
Her father nodded. “I understand.” He shifted on the couch, so he was facing her. “But I cannot begin to understand how you must be feeling. I know you love her, and this last request is a terrible and beautiful thing.”
“Dad . . . I . . .” She paused to regain control. “I know it will happen anyway. I know I can't prevent it. I can't keep her from going. But I don't know if I can be the one to do it.”
He pulled her close, wrapping her in his arms.
“Aur, I wish I could help you,” he whispered. “But there is nothing I can say that will give you any aid. You must obey your conscience. Do what you think is right. Trust yourself.”
They sat up long into the night, sometimes speaking, but often silent. Until the red gold fingers of morning stroked the windows.
She still didn't know. Walking into the hospital, getting into the elevator, opening the door to Marnee's room, she had no idea. Not a clue what she was to do. As her train
er had promised, there was a small unlocked vial on the table beside Marnee's bed. Aurelia tried not to look at it. It was not procedure for trainees to inject patients such as Marnee, and besides, Aurelia had already injected, had already passed the test. But an exception was being made. The trainer had used his own ID number to unlock the syringe, but had left it where Aurelia could find it. There would be no record of what she had done—or not done, as the case may be.
Marnee was awake, the pain drugs making her speech slower, but she was perfectly coherent. Aurelia sat on the edge of her bed, and the two talked. They didn't speak of the future, only the past, and for long hours, they reminisced, laughed, and cried only a little. Still, Aurelia didn't know. She had to trust herself, as her father had said. Trust.
The ceremony was brief, shorter than Aurelia had expected. She supposed that all the Workers here probably needed to get back to their jobs. From the way the director was standing, she could tell he was almost finished speaking. And then there'd be the rush, as the newly qualified med Workers ran to their training rooms to find their job postings. Adrenaline was already pumping through Aurelia's veins, ready to push her through the crowds to find what her posting was to be.
“And finally,” the director said, voice strong and carrying through the auditorium. “We come to the most prestigious part of our ceremony. Every year, the top cohort is given the ultimate posting: that of Lunar City Hospital.”
There was a collective intake of breath from the audience. Lunar City had the best hospital in the empire, and Lunar City was a city reserved for only the elite, those who were above Workers. Aurelia smiled, wondering which lucky soul was going to be taking the shuttle up to Lunar.
“This year's honor goes to one of the best students I have ever had the pleasure of teaching. Her natural aptitude, intelligence, and perseverance have persuaded all her trainers that she is deserving of this posting. The top student of this year's cohort is Aurelia Cole.”