Blinking, he lifted his pounding head and looked to his left. Brian was lying in the other bed, his body motionless but for the subtle rise and fall of his chest. Feeling relieved to know his friend was still alive, Nick turned his head to the right and found Dr. Elizabeth sitting next to his bed.
“Good morning,” she said with a smile that didn’t quite meet her eyes.
All at once, memories from the night before came flooding back into Nick’s befuddled mind, making him wonder whether they were real or imagined. He could picture Patrick on top of the dead woman’s body… but surely that had just been another nightmare, not something he had actually seen. As for Elizabeth sticking a needle into his neck… he must have had another cardiac episode, another near-death experience, and now he was confusing her real-life efforts to resuscitate him with what had happened in his head.
“Did I code again?” he croaked.
Elizabeth shook her head. “Not this time. You just passed out.”
Nick frowned. Because I really did leave my room and walk all the way down the hall? he wondered, still feeling confused. As he became more aware of his body, he realized he was completely naked underneath the covers. What had happened to his hospital gown? Before he could ask, he cleared his dry throat and swallowed with difficulty. Turning his head the other direction, he tried to reach for the pitcher of water on the tray beside his bed, but something held his hand back.
Looking down, he saw that his left wrist had been bound to the bed rail by a thick strap. His heart began to race when he realized his right arm was also in a restraint. He couldn’t see his legs beneath the blanket, but when he tried to raise his knees, he was met with resistance around both his ankles. His mouth dropped open as he looked back up at Dr. Elizabeth. “Why did you tie me down?” he demanded, giving her an accusatory glare.
“We didn’t want you pulling out your tubes or trying to get out of bed again,” she replied, raising her eyebrows at him. “You could have seriously injured yourself last night.”
So it really had happened. Nick’s mind reeled, remembering everything from the previous night. “You’re the reason I passed out!” he protested. “What the fuck did you inject me with?”
“Just a mild sedative to help you sleep,” said Elizabeth, maintaining her thin-lipped smile.
Nick scoffed. “Oh, a mild sedative, huh? Like what that freak Patrick almost killed Brian with?”
Elizabeth’s nostrils flared, but she kept her composure. “You’ve been through so much,” she said softly, “what with Brian-”
“BRIAN’S NOT BRAIN DEAD!” Nick shouted over her, his neck straining as his head popped up off the pillow again. “You didn’t even give me a chance to show you last night. He can hear us! His heart rate went up when I talked to him!”
The doctor looked down at him with sympathy. “You may notice more and more fluctuations in his heart rate as his body begins to shut down and his heart loses the ability to regulate its rhythm. It’s a normal part of the dying process and doesn’t change his prognosis.”
Nick shook his head, refusing to accept this explanation. “You don’t believe me? Well, guess what - I don’t believe you either.” He flopped back against his pillow, breathing somewhat harder than usual.
Dr. Elizabeth blinked, as if taken aback by his response. “Regardless of whether you believe me or not, I stand by the diagnosis I made yesterday: Brian is brain dead,” she replied matter-of-factly. “The sooner we proceed with organ donation, the better.”
Nick’s bedside monitor beeped rapidly as his heart hammered against his ribs. “You can’t take his organs without consent, and I don’t consent,” he spat, still glaring at her.
“Actually, we don’t need your consent to harvest his organs,” said the cardiologist gently. “By enrolling in the donor registry, Brian has already authorized the removal of any organs or tissues we deem suitable for donation. We’re only trying to reach his wife as a courtesy, not to ask for her consent. If you decide you don’t want his heart, it will go to another recipient.”
Nick’s mouth dropped open. “You can’t do that!” he cried, using all of his core strength to pull himself back up into a sitting position. “Brian’s not dead!” A warm flush was creeping up his neck and into his face. He could feel the veins in his forehead protruding as his pulse pounded and his blood pressure spiked. Calm down, warned a voice in the back of his head. Nick knew he needed to get his heart rate under control before it set off his ICD again, but at that moment, he didn’t care. “You know who is, though?” he continued, his voice rising. “That woman I saw Patrick with last night! Can we talk about that for a second? Do you even care about the fact that one of your nurses is a goddamned necrophiliac who fucks the corpses of dead patients?!”
Elizabeth heaved a sigh and hung her head. “I had hoped the sedative would help you forget what you saw last night,” she admitted quietly.
Nick stared at her in disbelief. “Forget? How the hell could I ever forget seeing something like that?! Trust me, I wish I could, but I’ll never be able to unsee it.” He shuddered.
Dr. Elizabeth didn’t say anything back at first. The longer she stayed like that, looking down at her lap in silence, the more disturbed Nick became by her apparent lack of concern over Patrick’s depraved behavior.
“How can you sit there and act like it’s no big deal - like I’m the one who has a problem, not him?” he asked incredulously. “What he did was perverted and disgusting, not to mention completely inappropriate, unprofessional, and probably illegal. You need to do something about it! I mean, what kind of hospital allows this to happen?!” He was breathing even harder now, his chest heaving as his heartbeat echoed like a bass drum in his ears. “You guys are gonna hear from my lawyers as soon as I get out of here - and that better fucking be soon. I don’t care about the risks of being transferred; I want both me and Brian moved to a different hospital. Do you hear me?”
“Oh, I hear you,” said Elizabeth, surveying him coolly beneath her arched brow. “You’re not exactly in a position to be making demands, though, are you?”
Stunned by this response, Nick felt his mouth drop open again. “I want a different doctor,” he declared. In spite of his effort to sound assertive, his voice wavered. He was starting to realize something was very wrong.
Elizabeth smiled in a way that made his blood run cold. “I’m afraid that’s impossible,” she replied. “Now that Dr. Rob is gone, I’m the only physician here.”
“THEN MOVE ME SOMEWHERE ELSE!” Nick shouted. “Hurricane or not, I still have rights as a patient - and as a human being! You can’t keep me tied to a fucking bed like I’m some kind of prisoner!” He yanked at his restraints, rattling the bed rails.
“Relax,” said Elizabeth softly, extending her hand toward him as if to hold him back.
“Don’t touch me!” Nick hissed, as she put her palm in the center of his bare chest. His skin crawled, prickling with goosebumps. He tried to pull away, but the straps around his wrists and ankles prevented him from scooting out of her reach. “Take these off me! Now!”
Elizabeth shook her head. “I can’t do that while you’re so agitated. You might hurt yourself.”
“I won’t pull out any fucking tubes or try to to get up again! I promise!” Nick pleaded, as tears sprang to his eyes. “Please, just take these off!”
“Oh, Nick,” sighed Elizabeth, still shaking her head sadly. “If you had only stayed in bed like a good little patient in the first place, this never would have happened. But no… you just had to go wandering. Now we’ll never be able to let you out of these restraints.”
Nick’s heart was thumping so hard, he was sure she could feel its vibration beneath her hand. “What are you talking about?” he asked hoarsely, his breath catching in his throat. “What the hell is going on here? Where’s Dani?” He knew Dani would understand he had only been trying to help Brian. She would take off the heavy straps that were holding him down and listen when he told her about Patrick. She would be horrified when she heard what he had witnessed.
“I let her sleep in,” said Elizabeth. “She’s been working so hard. She deserves a break, don’t you think? Today I’m going to give you your bath… your breakfast… your morning medication...”
He swallowed hard, his stomach turning at the thought of this unhinged doctor washing his body while he was tied down. What else had she done besides undress him while he was unconscious? Nick wondered with a shudder. He had never felt so violated.
Drawing in a deep breath, he called for Dani as loud as he could. “DANI! DANI!!!” As he bellowed her name, he fumbled for the remote control to his bed. He didn’t expect to find it within reach, but Dr. Elizabeth had left it lying on the right side of his mattress as usual. It was difficult to maneuver with his wrists strapped to the bed rail, but he managed to hit the call button with his thumb.
“Don’t expect her to respond to that.” Elizabeth took her hand off his chest and rose from her stool. “I told you, Dani’s not on duty today,” she said, as she walked across the room and opened one of the supply cabinets along the opposite wall. “It’s my turn to take care of you.”
When she came back over to Nick’s bed, she had a small bottle and a syringe in her gloved hands. “What is that?” he asked warily, his heart skipping a beat. “Lemme guess - another ‘mild sedative’ to knock me out so I won’t cause any more trouble?”
“Oh no, this is part of your prescribed medication regimen,” replied Elizabeth with a smile, showing him the label on the vial of clear liquid. “Digoxin. One of the oldest cardiac drugs still in use today. It comes from the foxglove plant, Digitalis lanata, which is highly toxic - so toxic, in fact, it can be used to stop a fetus’s heart during late-trimester abortions.”
Nick’s own heart flip-flopped painfully in his chest as he thought of Arya.
“However, in therapeutic doses, digoxin is an effective antiarrhythmic drug that can be used to treat both irregular heartbeats and congestive heart failure,” Dr. Elizabeth continued, filling the syringe with fluid from the vial. “It slows down the heart and slightly increases its contraction power, leading to improved circulation.”
“Who the fuck cares?!” he snapped.
Elizabeth actually looked surprised by his harsh reaction. “No need to be rude about it, Nick. I thought you might care to know something about the medications we’ve been using to keep your heartbeat under control.”
“Well, I don’t,” muttered Nick, rolling his eyes. “It obviously doesn’t work that well, or I wouldn’t still be getting shocked all the time.”
The doctor raised her eyebrows. “You didn’t let me finish. I was just getting to the interesting part,” she said, as she inserted the needle into the IV port in his neck. “Paradoxically, while digoxin is used to treat heart problems, it can also trigger them. The therapeutic range is quite narrow, you see, so it doesn’t take much to overdose.” She put her thumb over the plunger of the syringe, pushing it down slowly as she spoke. “The symptoms of digoxin poisoning are very similar to those of heart failure: fatigue, nausea, loss of appetite, swelling of extremities, shortness of breath, and arrhythmias - which, in severe cases, can even cause cardiac arrest.”
As she finished injecting the contents of the syringe into his central line, Nick felt a rush of cold. His racing heart began to pump even faster, forcing the drug through his veins before he had fully realized the implications of what she was telling him.
Dr. Elizabeth removed the syringe and dropped it into the sharps container on the wall. “I didn’t get a chance to ask how you were feeling this morning,” she said conversationally as she came back to his bedside, slipping her stethoscope into her ears. “Any pain or palpitations?”
Nick winced when she applied the cold end of the stethoscope to his chest. He wanted to twist away, but with his arms tied to the sides of the bed, he couldn’t go far. He had never felt more powerless than he did sitting there, watching Elizabeth’s face as she listened to his heart pound. He was used to seeing her frown through these examinations, but this time, her lips curved into a sinister smile.
“I’m hearing some extrasystoles,” she announced, her eyes alight with a look of anticipation. “The monitor’s showing PVCs, which means you’re probably having palpitations. Maybe a fluttering or pounding feeling in your chest, like your heart’s skipping beats?”
Nick stared at her in horror, but said nothing, not wanting to give her the satisfaction of confirming that he could feel his heart hiccuping out of control. His chest felt heavy and increasingly constricted, making it harder and harder to move air in and out of his lungs.
Relax and breathe, he could hear Dani’s reassuring voice in his head. He closed his eyes, fighting back feelings of panic and claustrophobia so he could concentrate on his breathing. He tried to take slow, deep breaths, inhaling air through the cannula in his nose and letting it out through his mouth, but even with the flow of supplemental oxygen, he felt like he was suffocating.
“You seem to be in some respiratory distress,” added Dr. Elizabeth, sliding her stethoscope from the left side of his chest to the right. “Are you having trouble breathing?”
Nick still didn’t answer. He was hyperventilating now, his breath coming in short, shallow gasps as his heart galloped uncontrollably beneath his rib cage. He had broken out in a cold sweat, and he felt like he was about to be sick. His eyes flew open. The fluorescent lights were blinding. The whole hospital room appeared to have taken on a bright, yellowish hue. He blinked, trying to clear his vision, but it didn’t help. Light-headed, he leaned forward. “I need a bowl or something,” he blurted. “I think I’m gonna-”
Before he could finish, an alarm went off on his monitor. Nick wilted back against his pillow, as another wave of dizziness and nausea washed over him. His heart was pounding wildly, its rhythm once again out of whack.
“You’re tachycardic, Nick,” he heard Elizabeth tell him, as his eyesight began to blur. “Your heart’s beating too fast.” She took hold of his clammy right hand, her fingers clamping firmly around his wrist, and turned it palm up. “So fast, in fact, your heart hardly has time to refill with blood between beats.” He felt her fingertips press against the artery on the inside of his wrist. “Your pulse is weak, which means your heart is barely pumping enough blood to the rest of your body.” She let go of his hand. “If you’re lucky, you’ll pass out from lack of blood flow to your brain before your ICD detects an arrhythmia and delivers a shock. But I doubt it.”
Nick had only seconds to absorb what she was saying and anticipate what was coming next, but there was no way to brace himself against the bomb that was about to go off inside his chest. He tried to prepare himself for the pain, but he couldn’t prevent the primal cry that howled from his throat when the defibrillator finally detonated, bucking his upper body off the bed with the force of the shock. A burning pain seared beneath his breastbone, as if his heart was on fire. He couldn’t seem to catch his breath. In the background, his heart monitor was going haywire.
I’m going to die here, thought Nick in despair, as darkness closed in on him from the corners of his eyes. The yellow lights were dimming now, the room fading away. He would never get to see his family or the guys again… never hold his newborn son or daughter.
He felt another explosion of pain as the ICD fired off a second shock, and then… nothing. Blissfully, Nick blacked out before he fell back onto the bed.
***
When he woke for the second time, it was Dani’s face he saw first. “Welcome back,” she whispered, brushing his hair back off his forehead.
Before Nick could respond, a rush of cool air flooded his mouth and nose. He began to cough as it was forced down his windpipe by a bulky mask that covered the bottom half of his face. Although his lungs inflated, he felt as if he were being suffocated.
A shock of cold followed, as a stethoscope was applied to his bare chest. “He’s breathing on his own now,” he heard Elizabeth say. “You can stop bagging and switch him to the non-rebreather.”
A pair of pudgy hands replaced the Ambu bag with an oxygen mask, slipping the elastic strap behind Nick’s head to hold it tight over his mouth and nose. Patrick, thought Nick with immediate distaste. He wanted to protest, but he felt too tired to talk, too weak to turn away. When Patrick touched him, Nick’s stomach turned with nausea, and his coughing fit gave way to uncontrollable gagging.
“He’s going to vomit!” Dani cried suddenly, but she was too late. Before she had time to tear the oxygen mask off Nick’s face, he felt the familiar burn of bile bubbling up into the back of his throat. He tried to turn his head, but there was no point - the puke had nowhere to go but into the mask. He started to choke as it splattered over his face, filling his mouth and nose.
“He needs suctioning before he aspirates,” Elizabeth said sharply.
“Hang on, Nick,” said Dani, as she eased the mask over his head. A moment later, she stuck the suctioning wand into his mouth and sucked the vomit out of his airway. “Will you get me a wet washcloth to wipe off his face?” she asked Patrick as she finished. To Nick, she said, “You’ll be all right now. Just relax and breathe while I get you cleaned up, okay?”
Nick knew he was far from all right, but he took a few breaths of fresh air, and the suffocating feeling slowly began to fade.
Patrick brought back a cool, damp cloth, which Dani used to remove the rest of the vomit from Nick’s face. “You had another arrhythmia,” she told him, dabbing at his upper lip, “but your ICD did its job. You were only down for a couple of minutes before it shocked your heart back into sinus rhythm.”
But I still could have died, thought Nick, convinced that he would have if Dani hadn’t come to his rescue. The realization was enough to make him start retching again, as another wave of nausea washed over him. Thankfully, there was nothing left in his stomach to come back up.
Dani raised the head of his bed and held a basin under his chin until he stopped dry-heaving. Then, making sure his nostrils were clear, she slipped an oxygen cannula into them. “There… that’s better,” she said, tucking the tubing behind his ears. “How do you feel?”
“Like an elephant’s been sitting on my chest,” muttered Nick. That wasn’t all he wanted to say, but he didn’t dare tell Dani the truth in front of Dr. Elizabeth or Patrick. He would have to wait until he had a moment alone with her to explain what was really going on.
“I know,” replied Dani sympathetically, rubbing his shoulder. “Just try to relax. We’re taking good care of you.”
Yeah, right, thought Nick, trying hard not to roll his eyes. He watched Elizabeth and Patrick circle his bed like a pair of vultures, playing their parts as they pretended to “take care” of him, while secretly waiting for him to code again. His skin crawled whenever one of them touched him, but he kept quiet and played along, fighting panic as he allowed Patrick to take his blood pressure and Elizabeth to check his pulse. He wondered if they could tell how he really felt by the way his heart was racing, his blood pressure rising.
“I need to draw some blood now, Nick,” said Dani, inserting another syringe into his central line. This made Nick nervous, but he knew she would never hurt him. When she withdrew the syringe, it was full of dark red blood. He watched her transfer it into a test tube, which she labeled with his name and the date, November twenty-third. Nick’s heart skipped a beat as he realized he had been stuck in this hospital bed for nearly a month.
“Can you take these off me?” he begged Dani, tugging at his restraints.
“Not right this second,” she replied apologetically, holding up his blood sample. “I have to get this to the lab.”
“No, wait!” he protested, as she started to leave. Both Elizabeth and Patrick looked up, but Nick ignored them. “I need to talk to you. Right now. In private.” Please, he thought, staring directly into Dani’s eyes. He hoped she would see the desperation in his. Please don’t leave me alone with them.
Dani seemed to understand. “Okay, sure. No problem. Patrick, will you take care of this for me, please?” She handed him the test tube. To Elizabeth, she said, “Can you give us a few minutes?”
Nick expected Elizabeth to come up with an excuse for why she couldn’t leave Nick alone with Dani, but after a moment’s hesitation, the cardiologist nodded. “Of course. Keep a close eye on his vitals, and come get me if it looks like he’s going to crash again.”
You wish, he thought, swallowing hard as his heart leapt into his throat.
“Will do,” Dani replied. She waited until Dr. Elizabeth had left, then sat down on the edge of Nick’s bed, twisting her body toward him. “What’s up?” she asked.
Nick took a deep breath, knowing he didn’t have time to beat around the bush. “Elizabeth tried to kill me,” he blurted. “She gave me an overdose of one of my meds to make my heart stop. Dig… digi-?”
“Digoxin?” Dani supplied, raising her eyebrows.
Nick nodded. “Yeah. And that’s not all.” He paused to take another breath before he proceeded, “Your friend Patrick? He’s a necrophiliac. Last night I found him fucking that woman who died here a few weeks ago.”
“What?!” Dani’s eyes widened at first, then narrowed as she frowned. “Nick, you’re not making any sense,” she said, cocking her head to one side. “Are you sure you didn’t just have another nightmare?”
“No!” he insisted, shaking his head emphatically. “I know what I saw - and they both know I know. Why else do you think they would strap me to the bed like this? Elizabeth drugged me last night to knock me out, and now she’s trying to kill me!”
“Why would she do that?” asked Dani. She sounded surprisingly calm, a stark contrast to how Nick felt. He stared at her, stunned and disappointed. Why didn’t she believe him?
“I dunno - to stop me from suing the hospital? To shut me up before I tell people about Patrick?”
Dani arched her brow again. “But why would Patrick want to fuck a dead body?”
“What does it matter why-?” Nick stopped mid-sentence, his heart dropping into his stomach as it suddenly hit him why Dani seemed so unbothered by his accusations.
It wasn’t that she didn’t believe him. It was because she already knew.
***
