Mercy

by Rada Jones

  “Yes.”

  “She’s back today, and now she’s completely altered. Her urine looks better, but her other labs are off. Yesterday her sodium was 135, her baseline. Today it’s 160.

  “Is she dehydrated?”

  “Why should she be? She was fine yesterday. She’s not vomiting, no diarrhea, she’s drinking OK. Why would she be dehydrated?”

  “Is she on Lasix?”

  “They all are. They must put it in the water at the nursing home. But she’s been on it forever.”

  “Anything else weird?”

  “Nothing yet. I re-sent the labs to recheck.”

  “What are you thinking?”

  “I’m wondering about a med error. What if somebody gave her hypertonic saline yesterday?”

  “That’s weird. Why would they? How could they? We don’t even have that in the pixies. We have to order it from pharmacy. Who was her nurse?”

  “Ben.”

  “Ben wouldn’t make a mistake like that!”

  “Of course not.”

  “What are you saying, Alex?”

  “We’ve had strange things happening lately. A stable patient found dead. A non-diabetic with a glucose of 12. Now this. I’m wondering if there’s a unifying explanation for all this.”

  Emma knew what he meant. She’d been wondering about that too. She couldn’t believe it. But she couldn’t ignore it, either.

  “Give me her name. I’ll look.”

  “Thanks. Let me know.”

  24

  Halfway through her shift, Emma sat alone at the corner table in the cafeteria drinking tea. She was taking a rare break. She didn’t want tea. She wanted wine. She wanted to go home. She needed sleep. But she still had hours to go, and she needed to speak to Victor.

  The lunch hour hustle was long gone. Just a few scrubs reading segments of the same newspaper at different tables, looking lonely and bored. I wish they served wine here. The staff would be happier. Patients and families too. French have wine with lunch and they are more productive than we are. Italians give their kids a splash of wine in their water as soon as they can drink from a glass. It removes the mystique. It makes it normal and ordinary, instead of hidden and attractive. That’s why they have no binge drinking like we do. Never heard of college students dying from alcohol poisoning in Italy!

  She took another sip of tea, trying to ignore the conversation behind her. Out of all places, they had to talk right there. She recognized Carlos’s soft Hispanic accent. The female was familiar too. Judy. She tried to hide, but she didn’t need to. They were too busy to notice her.

  “He sent that urine sample. Without gloves. Then stopped by the break room and dug into the pizza, without washing his hands.”

  “Really?” Carlos said. “Disgusting. What a piece of shit.”

  “Be careful, Carlos. He has a lot of friends.”

  “I don’t care.”

  “Hi, Emma.” Victor hugged her and kissed her cheek. With his curly gray hair covering his ears, his John Lennon glasses magnifying his eyes, and his jeans instead of a suit, he looked like an aging hippie rather than a cardiologist. He sat, smiled, and took her hand in his.

  “What’s up, Em? I hope it’s not bad news.”

  “Nope. Taylor is back.” Emma took back her hand and rested it on her knee.

  Victor sighed. His shoulders softened.

  “Thank God. Where is she? What happened?”

  “She left the rehab and hitchhiked home.”

  “Why?”

  “How much time do you have?”

  “Not much. I’ve got the pager.”

  “Eric proposed to her.”

  “Proposed to her? She’s only seventeen.”

  “For another month or so.”

  “Still, she’s far too young…”

  Emma shrugged. “Either way. He proposed to her. She took off because she had lied to him. She didn’t tell him.”

  “Tell him what?”

  “Well…she’s pregnant.”

  “Again?”

  “Still.”

  “Still?”

  “Yep. That day she went for an abortion, she didn’t get one. She changed her mind. Then, when they started dating, she didn’t tell him she was pregnant. Now that she started showing, she had to tell him. She ran away instead.”

  Victor sighed. “Is she OK?”

  “She looks OK. She doesn’t want to see a doctor.”

  Victor smiled.

  “I mean an OBGYN. I’m not her doctor, I’m her mother!”

  “You’re still a doctor.”

  “Well, you know how we ER folks are about family…”

  “I do. Remember when you sent her to school for a week before you got an X-ray to find her broken wrist?”

  “It was just a buckle fracture. There was nothing to do about it anyhow.”

  Victor laughed. “That’s so you!”

  “That’s so ER.”

  “Is she OK?”

  “Not bad. She’s upset. She didn’t call Eric. I told her that if she didn’t, I would.”

  “Have you called him?”

  “Not yet.”

  “Emma, let her be. Give her time.”

  “I did. She’s been back for three days.”

  “Yes, but…”

  “No but. She needs to grow up. She is responsible for her relationships. She needs to get straight with him. He deserves that.”

  “But Emma, she’s just a kid…”

  “She’s about to be a mother. She needs to grow up. Fast.”

  “You’re always so hard on her!”

  “And you’re always so soft! No wonder she’s spoiled rotten!”

  “She’s your kid, Emma! Be kind!”

  “You’re kind enough for both of us! Someone needs to hold her responsible!”

  “I guess you’re right. I am too soft with her.” Victor took off his glasses and started wiping them with the bottom of his shirt, like he always did when he was thinking. “Now what?”

  “It’s up to her.”

  “I’ll stop by to see her later. Or tomorrow. No, not tomorrow. Amber’s going out with her friends. I need to get home early to watch the kids.”

  Emma smiled. Ten years ago, it had been heartbreaking seeing Amber take her place. Now it was fun to watch.

  Victor cleared his voice. “You know, Emma… I…”

  Trouble in paradise?

  “I miss you.”

  What?

  “I never thought things would turn out like they did. I missed you as soon as I left. I still do. I wish I didn’t do what I did, ten years ago. I wish things were different.”

  What are you saying?

  “I never loved anybody the way I loved you.”

  Yep. That’s what you’re saying. Seriously? Has Amber dropped you? Or you’ve gotten tired of working your ass off to pay the bills?

  “I wish we could go back,” he said, his voice almost a whisper.

  Oh no, we’re not going there. Never again. Emma smiled her best smile.

  “Wouldn’t that be nice? But we can’t. Life is what it is. Going back is not an option. Don’t worry about me, I’m OK. And you have Amber. You have your two beautiful girls. And Thelma and Louise. You have a full, beautiful life.”

  Victor’s blue eyes embraced her.

  “I’m not worried about you…”

  “Great. I have to go now.” Emma stood.

  Victor caught her hand. “Emma, I…”

  His pager rang.

  Thank God!

  “Bye, Victor. I’ll tell Taylor you’re coming.”

  She took off so fast that the napkins followed in her wake, and she didn’t look back.

  I’ll be damned!

  25

  Taylor didn’t know where to go. She walked and walked. Her right hand, in her pocket, held the gun. She looked for the place. A good place. A quiet place.

  No such place downtown. Everybody was out, having a good time. Everybody but her.

&n
bsp; She walked, her shoulders carrying her life burden. She didn’t care for the breeze caressing her face. She didn’t feel the sun warming her. She didn’t even need to pee.

  She only felt the rough, firm grip of the gun. The gun, heavier than the ammunition in her left pocket, unbalanced her gait, but she didn’t notice. She was too busy looking for a good place to die.

  She left the town behind. The forest started. The old pines shielded her in silence. Incense-like resin cleansed the air. Her feet sunk into the soft carpet of pine needles. The quietude embraced her. No birds, no flowers, no grass. Just peace. And dusky green light, one hour before sunset.

  This was it. She walked into it like she’d walk into her shroud. She looked for the right spot. She found it. A fallen tree covered in moss, surrounded by saplings. She stopped to listen to the silence.

  Inside her head, the voices started.

  “I’ve never loved anybody like I love you. Nothing you can do will make me love you less.”

  “You need to tell him. He may leave. Or not. You must tell him. He’ll find out anyhow. He’ll leave. Not because of the baby. Because of the lie.”

  “You’re my lovely little angel. You can do no wrong.”

  “Maybe if I wait, he’s going to love me enough to not care that I’m pregnant.”

  “You can’t build your life on a lie. You need to tell him!”

  The voices taunted her. Lied to her. Tortured her.

  She took out the gun and set it on the trunk. She loaded it carefully, like her father had taught her. They used to shoot together, just the two of them. Before Amber came. Then Iris. Then Opal.

  She rolled her jacket and made it into a pillow. She laid the loaded gun on her chest and rested her hands on the moss-covered bark. She thought about her good days. Not many. Shooting with her father. Laughing with Eric. Her mother dropping her at the rehab.

  Father will miss me. But he’s got Opal and Iris to love instead. And Amber. Funny, I’ve never been jealous of Amber like I am of Mother. I’ve always felt the need to compete with Mother. That’s a nonstarter. She’s always right. She knows everything. She sees through people.

  Taylor didn’t like that. Inside her, it wasn’t pretty. She was selfish and manipulative. She would do anything to have her way. Nobody knew it. Not Father, nor Eric, not even her, most of the time. Nobody but her mother. We don’t love people who make us feel small.

  Eric said he’d love her no matter what. He abandoned her, only minutes later. He’d be sorry.

  She envisioned her funeral. Mother, dressed in black, her eyes dry. Father, crying, wiping his glasses with his shirt. Eric, sobbing and throwing himself over the casket, covering my hands with kisses. I’ll be cold and beautiful in my blue dress. Like a Madonna. They’ll be sorry.

  But will Mother know which dress? And how to do my hair? She wished she’d left instructions. She took out her cell phone and started an email. “Blue dress. Mascara. Sapphire earrings. Peacock feathers bag.”

  She sent it to herself, knowing they’d find it. She laid back. The moss was moist and soft, vegetal velvet smelling like the forest. She listened to a rustle in the branches, wondering what it was. What if something eats me before they find me? What if there’s no cold white hand for Eric to cry on, and no eyelashes for mascara? Even ears for the earrings?

  She shuddered and sat up. There are no wild animals here. But what if I rot before they find me? What if the birds eat my eyes? A wave of nausea. She bent over to retch. She took a deep breath, then another. Who cares? I’ll be dead. I won’t see it anyhow. So what if they do a closed casket? Eric can cry over my picture. I bet he will.

  She rearranged her jacket and lay back. She took a few cleansing breaths. She picked up the gun. She placed the barrel against her right temple. It was cold.

  It’s going to blow up my face. There’ll be no Madonna to look at.

  She thought about putting the barrel in her mouth, to blow off the back of her head instead. That wouldn’t show as she laid on her back in the casket. The smell of the gun made her nauseous. There’s nothing like puking as you try to shoot yourself.

  She moved the gun to her heart. The angle was awkward. Her wrist wouldn’t flex that far. She’d have to pull the trigger with her thumb. She found the space between her second and third left ribs. She sat the barrel right there, perpendicular to the chest. Her right hand shook. She steadied it with her left. She took a deep breath.

  Something moved. She froze. It moved again.

  Deep inside her, the baby was moving. I can’t believe it.

  She put down the gun and cupped her swollen belly with her palms. Like a butterfly fluttering his wings, he waved again.

  “I’m here, remember?”

  She choked. She covered her face with her hands and cried. She cried until she ran out of tears.

  She unloaded the gun. She put it in her pocket and headed home. She was somebody’s home. She had no right to die.

  26

  Angel

  Disgusting. He called me disgusting. Me!

  That piece of shit impotent jerk called me disgusting.

  I want to crush him. I want to break his neck. I want to set him on fire. I want to destroy him.

  How?

  Killing him would be easy. But it doesn’t hurt enough.

  I’ll make him lose what matters most to him. I’ll destroy him little by little. I’ll take away everything he’s built. He’ll be sorry he was ever born. His friends will despise him and his parents will wish they never fucked.

  Better than breaking his neck. I’ll break his spirit.

  They say revenge is better served cold. I’ll start cooking.

  You’ll be sorry you were ever born, motherfucker!

  Where do I start?

  Then it comes to me.

  Life is good.

  Death is better.

  27

  Her shift almost over, Emma finished examining the back pain in Room 5. Her back was hurting too. She looked forward to going home to lie down and think through the events of her day, from her talk with Alex to the funny meeting with Victor.

  The patient looked fine. Good strength, no numbness, no red flags. It’s just a strained back. What is it with these people that they can’t resist moving refrigerators?

  She put in orders and told Carlos, “Let’s give the guy in Room 5 some Toradol and Valium. I wrote for some morphine too, but please don’t give it with the Valium. He may never wake up.”

  Carlos grumbled.

  Emma shrugged. He’s mad that I told him something he already knows. Too bad. It’s better than killing somebody. She went back to running the board. There was a new chest pain in Room 4. Emma went to see her.

  The room was a screaming cacophony of alarms. Monitors beeped at a pulse of 160. The blood pressure was low. Gray and shriveled, her eyes closed, the woman gasped for air. By her side, a man held her hand, his eyes wide with fright.

  She’s fixing to die.

  “I need a nurse. Now,” Emma called.

  Carlos rushed in.

  “Let’s move her to a front room. IV. Pacer. EKG. The whole nine yards.”

  The scrubs poured in. They pushed the stretcher down the hallway to Room 2. Carlos stuck on the pacer pads, front and back. Judy looked for IV access. Amy struggled to make the monitor leads stick to the skin, but they wouldn’t. The skin was slick with sweat.

  She’s diaphoretic. Her heart is way too fast. And irregular. She’s in atrial fibrillation. The blood pressure’s soft. She looks like crap. I’m afraid to give her anything and drop her blood pressure even more. We may need to shock her out of it, and that rarely works in A-fib.

  “What do we have for IV access?” Emma asked.

  “I got an 18 in,” Judy said. “I’m working on a second.”

  “You’re a champ. Let’s start fluids.”

  Emma listened to the lungs, making sure they weren’t already drowning. “I need an old EKG. And a cardiologist.”

  �
��EKG coming,” Amy said.

  “Blood pressure?”

  “It’s too low to measure. I’m getting a manual. 68/42.”

  Crap.

  “Get ready to cardiovert. Get Sal. We need push pressors.” They should increase her blood pressure enough to let me use some drugs.

  Sal materialized as if she’d summoned him.

  “Push pressors.”

  “Which one?”

  “Phenylephrine. That should increase her blood pressure without messing up the pulse even more.”

  Sal produced a 10cc syringe out of his pocket. “How much?”

  “2 cc every three to five minutes.”

  “The code cart’s here,” Carlos said. “You want to intubate?”

  “I can’t. I’d drop her blood pressure. That would kill her. I have to wait. Let’s try 25 of fentanyl.”

  “Twenty-five of fentanyl given,” Judy said.

  That’s abysmal, but it will help a little with the pain. I don’t have enough pressure to sedate her.

  “Let’s try 100 volts.”

  Carlos charged the defibrillator. “All clear?”

  They stepped back. He pushed the button.

  The current went from pad to pad, across the skin, through the chest to get to the heart and shock it out of its crazy rhythm. The power of the current lifted her off the stretcher. She screamed. She fell back.

  The rhythm didn’t change.

  I hate A-fib. Nasty, stubborn SOB. At least the pressors helped the blood pressure. A little.

  “Let’s do another 25 of fentanyl. Charge at 150 this time.” What the heck? Why cook her slowly? May as well do the best we can, right now. While she’s still alive.

  “Let’s do 200.”

  Carlos moved the button to 200.

  “Everybody clear?”

  The scream splintered the air. The woman levitated above the stretcher, then fell back, limp.

  Silence. The heart had stopped.

  Emma stared at the monitor. She waited a few seconds. Nothing. The monitor line’s flat as a pancake. She’s in asystole. Damn!

  “Start CPR.”

  Carlos took a deep breath and clasped his hands together to start CPR. He leaned over the stretcher, just as the monitor beeped again. The heart restarted at 120 beats per minute.