by SA Magnusson
“Headache. No history. She was screaming and went unconscious.”
“You think it’s a bleed?”
“A bleed. Herniation. All sorts of badness, probably.”
A monitor was connected to her and we confirmed she was in asystole. No heart rhythm. Flat line.
“Epi,” I said.
The cold grew more intense and I looked at the monitor as the epinephrine was infused. There wasn’t much that could be done with asystole. Forcing myself to slow down, to think of something other than magic, I thought through the underlying causes, thinking about the Hs and Ts I’d been taught in school and my ACLS courses. The only thing that fit was a magical attack, but how would that have caused this?
Val continued CPR and we repeated the epi, but I knew it wasn’t going to make a difference. “Should we try shocking?” she asked, stepping back as another nurse took her place.
“It’s not in the protocol.”
It was possible it was fine ventricular fibrillation, but unlikely. And I had the advantage that I knew nothing we’d do would change the outcome. I could feel it. Worse, power came with that sense of death, a kind of power I tried to ignore.
Death would win and would claim her, regardless of how long we continued CPR.
Minutes stretched out, five, then ten, and then fifteen. Even if she survived, she’d be brain dead, too deprived of oxygen for any real function. I was doing her a favor by calling the code and stopping CPR.
I glanced up at the clock. “Time of death is 14:06,” I said.
There was still another four hours of my shift. And I had no idea what had happened to her. Worse, I had no idea what was going on.
I stared at Ms. Jones. There had to be some way to learn what had happened to her, but I had a strong sense that a traditional autopsy wouldn’t make a difference.
Was there any way to understand the spell now that she was dead, a sort of magical post-mortem? If Derek were here, there might be, but I still had no idea what had happened to him and the longer he was gone, the more uncomfortable I felt.
10
I still hadn’t managed to find Derek.
It made me uncomfortable, but there wasn’t anything I could do about it. I tried calling his cell, but there was no answer. If he was still at work, that wouldn’t have been too surprising. There wasn’t enough down time to answer the phone most days. When an hour passed, and then another, and still no sign of Derek, I did what I thought needed to be done and went to his manager.
Elaine was in her fifties and had once been a good ER nurse from all reports, but time in administration had changed her. I didn’t have a lot of interaction with her—residents didn’t really deal with administration—but enough that I knew she got caught up in the minutiae and could sometimes miss the big picture. That was what I needed today.
She faced her desk with her back to the door, her office just off the main part of the ER. It was a shared office, and there were two others in it with her. I knocked.
“What is it?” Elaine asked without looking up from her computer.
“Hey, Elaine. I’m concerned about one of the nurses.”
I had chosen the words carefully. I didn’t know how much she would be concerned about her nurses, but if one of them suddenly seemingly abandoned their shift, it had to raise some red flags.
She spun in her chair, looking over at me with pursed lips. Her expression told me how little she cared for a resident interrupting her day, but I didn’t really care. “What happened?”
“It’s Derek. He’s—”
Elaine started to turn back around. “If you and he got into some romantic argument, I don’t want to know. You’re both adults.”
How often did Elaine have to say the same thing? I had a sense that she’d been through it before and considering what I’d seen from Dr. Roberts and his willingness to sleep his way through the nurses, I wasn’t terribly surprised. There were others like him and plenty of willing nurses. The ER could be a tense place, and that tension often needed release. How often did that release take place at work?
“It’s not like that,” I said. “He was here when I started my shift and we were taking care of that patient who arrested in radiology.” I figured she needed me to share that much to keep her interested. “I haven’t seen him since. I’m worried about him.”
Elaine started to spin back toward me. “You’re saying Derek disappeared during his shift?”
I hated the way this felt like a betrayal, but I hated the fact that he was suddenly gone. If something had happened to him, I needed to have others looking for him. “I’m not saying that. I’m saying I haven’t seen him since noon. I just wanted to know if he was okay.”
“I haven’t heard anything. As far as I know, he’s fine.”
It was more reason for me to be concerned. If Elaine didn’t know anything, then Derek had disappeared. We were near the end of his shift, so he should have been around, and the fact that he wasn’t… it made me uncomfortable.
I kept thinking about the Dark Council and how they knew about me, but they also knew about Derek. If they believed that he was somehow connected to what had happened to their people, what would they do to him?
Nothing good.
“Are you sure he’s not still here?” Elaine asked. “It’s possible he’s off somewhere working with another physician.”
I could see I wasn’t going to get much help from her. “Maybe that’s all there is to it,” I said. “Sorry to have bothered you.”
When I stepped out from her office, I watched for a moment, hoping she would started calling to see if there was something that might have happened to Derek, but she just returned to her computer and began tapping away at the keys, as if I had never stopped in with word that one of her nurses had gone missing.
There was still too much time left in my shift, but I felt the need to do something.
I tried calling Derek’s cell again, but once more there was no answer.
Who else could I call?
Gran and Gramps. They should know what happened to the woman and how I was certain it was a magical attack.
The ambulance bay was quiet. Most of the time, a rig or two was here, but today they must all be out between calls. I walked through the bay and out to the street, stepping off to the side and into an alley for a moment of privacy.
Dialing Gran got me nowhere. She didn’t answer, but then, she often didn’t answer her cell. I left a message before hanging up and calling Gramps.
He answered with one ring. “Hey, Katie. I thought you had to work today.”
“I do. I am. Something happened.”
There was a moment of silence. “What happened?”
Which part did I tell him about first? Derek or the patient?
The attack could wait. Until I knew what had happened with Derek, I needed to get them involved. “Derek went missing.”
“Missing?”
“He was working this morning. We had a patient I think suffered from a magical attack. He went to grab a medication for me and never returned.”
“And you think something nefarious happened to him?”
“That’s just it. I don’t know. With what happened last night…” He hadn’t been home, so if they had gone after him, they would have missed him. Would they have come after him at work?
“What do you mean by a magical attack?”
I told Gramps about the attack and what I thought it meant. I didn’t know whether there was anything he would be able to do, but if nothing else, he might be able to help me understand what had happened.
“Are you sure it was the same thing?”
I recognized the tension in Gramp’s voice. I’d heard it before. Normally, he was a pretty easygoing person, but when things started to fall apart, that all went away and he got quiet and serious.
“It was near enough. With the other guy, I could almost pull away the effect of the magic. This time…” This time I hadn’t been able to. And Ms. Jones had
died. That wasn’t my fault, but had I the strength to help, and to do more, maybe she wouldn’t have had to die.
“It wasn't your fault, Katie,” Gramps said.
“I know it's not. It's just difficult when something happens, and Derek was trying to warn me not to even go in with this patient. I think he was concerned after he learned about what happened last night.”
“You told him about what happened?”
“It didn't have any reason not to.”
“You had an attack on you by the Dark Council. That's reason enough not to share anything.”
“Derek has been a part of this, Gramps. When the first person came in, he was there with me. He even took the blame when the Dark Council thought to question us.”
Could that be what had happened?
Maybe it was my fault that something had happened to Derek. Could his willingness to step in and help be the reason that he had disappeared?
“I just need help figuring out what happened to him,” I said.
There was a moment of silence. It was almost too silent, and I suspected that Gramps spoke to Gran, debating what they would do. Where were they that she wouldn't answer?
“We'll look into it,” he said.
“Thank you.”
“Katie, if this is the Dark Council, you're going to need more help. You can't just stay at work, hoping you’ll be safe.”
I stared out at the street. The sound of ambulance sirens was racing toward me and I would need to get back to work, but part of me suspected that Gramps was right. If it was the Dark Council, there might not be any way for me to defend myself without help.
“Can you call Aron?”
“Oh, Katie.”
“It's not like that,” I said. “If anyone will be able to help get me through this, it'll be him.”
“I don't like it that you have been getting this close to that archer.”
“I don't like that my life has been placed into danger lately. He was there last night, Gramps. Had he not, I don't know what would've happened.”
Gramps breathed out heavily. “Fine,” he said. “I'll make sure that we send word to him and see if he's willing to come and assist you. I don't know that he’ll be willing—or able. He is an archer, after all. He might be off chasing demons somewhere.”
“Have there been any reports of demons?”
“Well, no, but… Katie, just be careful. The closer you get to this archer, the more you get drawn into things I know you don't want to be involved in.”
“Thanks,” I said.
“Don't thank me yet. I'm not sure that were going to be able to find anything out.”
“Thanks for your willingness to contact Aron.”
“You know we would do anything for you, Katie.”
“I know you would.”
He hesitated again, and it made me wonder what he and Gran spoke about. I could imagine them debating with each other how much to say to me and trying to figure out if they should say anything more, so that when Gramps came back on the phone, I was ready to hang up.
“Your grandmother made a call. I don't know if it will work to get the attention of that archer, but if nothing else, we’ve tried. If you want, we can come down there…”
“I'd rather have you looking for Derek.”
Gramps sighed. “You know, I would rather have you looking at Derek.”
“Is that why you asked him to keep an eye out for me?”
“That wasn't the reason, but he's a nice young man. We thought the two of you would get along.”
“He is a nice young man. And a friend. So if anything happened to him, I'm going to be upset.”
“Don't do anything too rash,” Gramps said.
“Why would you question me about that?”
“No reason. Only that when you're upset, you don't always make the best decisions.”
“How often do you see me upset?”
“Not very often, which is part of the problem. You don't know how to control your emotions.”
I laughed. Gramps was still trying to help me, and after all these years, I still appreciated his attention. “I'm an adult and I have had the opportunity to have to deal with my emotions a time or two over the years,” I said.
“I'm well aware that you are an adult. But you haven't had the need to deal with this kind of stress, and certainly not since your power has begun to reveal itself,” he said.
“You think it's only now beginning to reveal itself?”
“You had a handle on it before. Whatever's changed has made it so that you don't have the same control. That's all I'm getting at.”
I hadn't considered that possibility before. My power had always been there, but it had always been buried, knotted up deep within me. Since encountering Aron—really since encountering the demons—that power had begun to come out of me more easily. I thought it was due to nothing more than what I had experienced, and the fact that I had been forced to use it, but what if Gramps was right? What if this change meant something else: that my power was evolving?
If that were the case, then would it continue to change?
And why now?
“I'll be careful,” I said.
When I hung up the phone, I hurried back to the ambulance bay, noting that the EMTs were pulling a young black man out of the back of the ambulance. Blood seeped out of his side and a paramedic was straddling him, performing CPR.
“What happened?”
“Stab wound. We thought that we'd gotten to him in time, but he arrested en route, and we've been doing CPR for the last ten minutes.”
The boy was barely a teenager. Young enough that he deserved every chance to survive, and I thought that the lack of any sense of death meant that he would survive, but as I approached, checking his pulse and feeling nothing, I realized that he was already gone.
“How did it take so long?” I asked, helping wheel them into one of the trauma bays. None of this mattered, but I couldn't tell them that. He was young, and if I didn't have the connection to death, I would be doing the exact same thing as them.
“We had a traffic delay. An accident. Damned construction made us route a different way and…”
And the boy hadn't made it.
There was an intern who had followed us into the trauma bay, a Dr. Poulson, and he started ordering fluids and blood, things I knew wouldn’t make a difference. Had the boy not just arrived—and had he not been as young as he was—I might have intervened, but at this point, it made more sense to allow Dr. Poulson a chance to perform his assessment. He was young looking, the way that most new medical school graduates were, but even more so than was typical. He was a bright young doctor, still early enough in his career that he had to work through everything deliberately, and he talked through every step he took with the nurses.
I turned to the paramedic. He’d given over CPR to one of the nurses. “Do you know if he has any family?”
“There was a sister on the scene, and she was going to follow us.”
I didn't know if I had the necessary emotional ability to let some young woman know that her brother had died, but someone needed to do it.
Dr. Allen strode into the trauma bay. He glanced over at me for a moment before turning his attention to the dead young man and Dr. Poulson. “How long have you been coding him?”
“Probably fifteen minutes now,” the paramedic said.
Dr. Allen glanced over at me. “Fifteen minutes. What's your assessment, Dr. Michaels?”
It didn't really matter what my assessment was. But then, Dr. Allen didn't know that, either. “Dr. Poulson is running this trauma,” I said.
“I see that, but I'm asking you for your assessment.”
“He’s been down too long, but given his age, I think we should continue CPR.”
I could see the relief across the paramedic’s face. They didn't like to be responsible for calling a code, and the delay had probably meant the difference between this young man living and dying, enough that I susp
ected he'd take it personally when he discovered the boy wouldn't make it.
“Why don’t you go and get cleaned up,” I said to the paramedic.
He flashed me a look of relief, glancing down at his bloodied shirt. “Let me know what comes of it.”
When he was gone, I watched as Dr. Allen wheeled the ultrasound machine over and began performing a FAST exam. It was designed to determine if there was any specific area that we could focus on, and Dr. Allen began walking me through the exam, as if he thought this would be the first time I had ever seen it. I nodded, my mind going elsewhere, and everything sort of blurred together for the next thirty minutes while we continued to attempt to resuscitate this young man.
As I had suspected the moment I came across them in the ambulance bay, he didn't revive. There had been no change in his status the entire time, and at no time while attempting to resuscitate him had I felt the shifting cold along my spine that told me death was coming. The reason I didn't feel it was because it had already come. Death had claimed this young man before he ever reached the ER. Nothing I would do—or could do—would change that.
Dr. Allen stepped back, peeling off his gloves. He looked over at Dr. Poulson, and I could see the pain in his eyes. Seeing Dr. Allen like this made me respect how much he cared, even if there was nothing he could do. The fact that he tried—and continued to try—was more than enough reason to respect him. There were far too many attendings who were nothing like that.
“Dr. Poulson, I think his sister was going to be in the waiting room,” I said.
The intern nodded. He peeled off his gloves and wiped his arm across his forehead, smearing the sweat that had beaded there. “What do I tell her?”
“Tell her the truth. Tell her what we did, how we tried, but there wasn't anything that could be done for her brother.”
“I'll go with you,” Dr. Allen said.
The relief on Dr. Poulson's face was clear, and I wondered if Dr. Allen was disappointed that I didn't want to go, but I was far too distracted.
“Give me a minute?” Dr. Allen said. Dr. Poulson started down the hall and waited. Allen turned to me. “The patient had a brainstem herniation. CT confirmed it.”
