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Nick was alive, but not well. Rather than bouncing back from his latest brush with death, as he had so many times before, his condition began to deteriorate over the next day. He drifted in and out of consciousness, delirious from his dangerously high fever.

“He definitely has an infection,” Elizabeth told Dani after she had finished examining him. “Whether it’s from his central line, his arterial line, the ICD, or something else, I don’t know. It could take a few more days to get back the blood cultures from the sample you took yesterday, but I’ll try to snag some broad-spectrum antibiotics from the hospital after my shift tonight so we can start treating him. In the meantime, replace the administration set on his central line and take out the a-line. You can monitor his B.P. manually.”

Dani carried out her instructions, relieved that Elizabeth didn’t seem ready to let nature take its course and kill Nick for them. Perhaps she wanted to keep him alive so she could continue to torture him in front of Brian, or maybe she meant to orchestrate his death herself. Dani didn’t always understand the doctor’s intentions, but this time, she didn’t question them. She wasn’t ready to get rid of Nick yet either.

Around 7:30 that evening, Elizabeth left for her graveyard shift at the hospital. She had taken an intermittent family medical leave of absence from work under the pretense of “caring for her chronically-ill brother,” which allowed her to be available to watch over Brian and Nick while picking up the occasional shift so she could continue to procure supplies from the hospital.

Dani told Patrick to take the night off, not trusting him to take care of Nick while his condition was so precarious. Patrick had learned just enough to look like he knew what he was doing while posing as a nurse, but she wasn’t about to leave Nick’s life in his hands. Instead, she remained by Nick’s bedside, monitoring his vitals herself as he slept.

Although she had refrained from giving him any more digoxin, Nick’s heart raced, the occasional PVC appearing on the monitor as its rhythm fluctuated. When she listened to his chest with her stethoscope, she heard a murmur that hadn’t been there before. What worried her even more was the rattling sound of rales, a sure sign that fluid was accumulating in his lungs. His breathing had become labored; she watched his chest heave as he took rapid, shallow breaths, practically panting for air. She had taken him off the hypoxic breathing gas they’d been using to lower his oxygen saturation level and put him on pure oxygen instead, but it hadn’t seemed to help. His respiratory rate was still high, and his sats remained low. She wondered what she would do if he went into respiratory failure and required mechanical ventilation. They only had one ventilator, and it was already being used by Brian.

I’ll just bag him if I have to, she decided. She had done it before with Brian, when they had shut off the power. She could do it again to keep Nick alive.

But she was tired. So tired…

Dani dozed off in her chair and woke with a start to find herself doubled over with her head on Nick’s bed. Sitting up, she wiped her bleary eyes and blinked up the bedside monitor, squinting to make out the numbers. Nothing appeared to have changed much.

She stood up and stretched her body before slipping behind the bed to grab the blood pressure cuff. She wrapped it tightly around Nick’s arm and inflated it, listening to the faint sounds of blood flowing through his brachial artery with the bell of her stethoscope as she let the air out slowly. She didn’t like what she saw on the sphygmomanometer: his blood pressure had dropped since the last reading, which had already been low.

Replacing the cuff, she reached for the digital thermometer next and eased it into Nick’s ear. When it beeped, the number on the display was no better: Nick’s fever had risen to a frightening 104 degrees. His face was flushed and sweaty, and when she placed her hand on his forehead, Dani could feel the heat radiating from his skin. Despite this, his body was racked by chills.

Swallowing hard, she realized he was showing signs of septic shock. The numbers didn’t lie: Nick was critically ill, for real this time. If she didn’t do something soon, he was going to die. At the rate he was declining, she doubted he would even make it through the rest of the night.

In the back of her mind, she could hear Rob saying, “He has to die at some point. Kill him and be done with it.”

Dani knew he was right. The police were already onto them both; their names and faces were all over the news. Patrick was such a recluse, he had yet to be recognized from the airport surveillance footage they had been showing, but it was only a matter of time before he was identified, too. That would lead the police straight to his family’s former funeral parlor, where they would find Nick and Brian - unless she got rid of them first.

She didn’t even need drugs. With Nick in restraints and weakened by the infection ravaging his body, all she would have to do was hold a pillow over his face and smother him to death. Brian would be even easier to kill. Paralyzed by Pavulon, he was unable to breathe on his own. If she simply unplugged the ventilator, he would succumb to respiratory arrest in a matter of minutes. She and Patrick could put their bodies in the cremation oven, burn all the evidence to ashes, and be rid of them both, just as they had done with their other “patients.” Problem solved.

But as she looked down at Nick, Dani realized she didn’t want him to die. She had never really intended to kill him; she had only stopped his heart so she could have the pleasure of bringing him back to life. But now he needed more help than she could give him. Nick needed to be in a real ICU, not an understaffed film set filled with secondhand equipment. How could she get him to one without getting herself caught and arrested?

She weighed her options. She could call 911, ask for an ambulance to be sent to the funeral home, and run away, as Rob had… but then she would be leading the authorities straight to Patrick and Elizabeth. She didn’t particularly care about Patrick, but she wouldn’t sell out Elizabeth like that. Elizabeth was still a practicing cardiologist, a respected member of the community, and the only one who hadn’t yet been connected to either Nick’s or Brian’s disappearance. Dani was determined to protect her friend’s reputation if at all possible. That meant she had to remove Nick from the funeral home herself.

If she tried to take him to the hospital, she was likely to get caught. Even if she just dropped him off outside the emergency department, she would surely be seen by security cameras and possibly other people. She wouldn’t have much of a head start before the police came after her, and as there was only one way out of the Keys, they would inevitably catch up to her at some point. They wouldn’t even have to chase her; they could simply set up a roadblock further up the Overseas Highway to apprehend her as she tried to flee to the mainland.

Dani decided her only option was to dump Nick somewhere else and hope he would be discovered by a Good Samaritan, who could call for help or take him to the hospital. It wouldn’t be easy to move him by herself without being seen, but she had to try. If she didn’t, Nick would die, and this time, there was nothing she could do to stop it.

***


It was four o’clock in the morning when Dani wheeled a stretcher alongside Nick’s bed. Nick was sound asleep - unconscious, more likely - and didn’t so much as stir when she removed the tubes and wires that were attached to his body and unstrapped the restraints around his wrists and ankles. She used his bedsheet to slide him slowly off the bed and onto the stretcher.

She rolled him down the back hallway and into the garage, where a gleaming black hearse was parked. It had once belonged to Elizabeth and Patrick’s father. She loaded the stretcher into the back, using the locking mechanism to secure it before she slipped behind the wheel. She knew she was taking a risk in using it to transport Nick, as a hearse wasn’t exactly inconspicuous, but it would make it much easier for her to move him by herself. Besides, she couldn’t drive her own car - not only was it too small, but the police had her license plate number. They were also still looking for a silver Corolla, which meant she couldn’t take Patrick’s car either. The damage from Rob rear-ending it the day they had picked up Brian would probably attract even more attention than the hearse would. She just had to hope that anyone out at this hour on a Saturday morning would be too drunk or preoccupied to pay any attention to a hearse driving past them.

As an extra precaution, aware that there could be surveillance cameras near where she planned to dump Nick, Dani had put on a pair of baggy sweatpants and a huge, black hoodie of Patrick’s to hide her figure. She tucked the ends of the long, brown wig she had secured over her own short, blonde hair into the sweatshirt and pulled up the hood to obscure her face before she turned on the ignition. On the floor of the passenger seat sat a bag packed with as many clothes and supplies as she could carry. Neither Patrick nor Elizabeth knew it yet, but Dani wasn’t planning on coming back.

Her heart beat fast as she drove slowly towards a stretch of beach she thought would be deserted at this time of day. As she pulled off onto the side of the road, she was relieved to see that she was right. There were no other cars in the narrow parking lot, and just past it, the beach appeared to be empty. She backed the hearse into a space and shut off the engine. Pocketing the key, she climbed out of the car.

Outside, it was dark and quiet. The moon was a mere sliver in the sky overhead as Dani hurried around to the back of the hearse and opened the door. It was hard to maneuver the stretcher all by herself, but she managed to slide it out far enough to lower the wheels, which bore most of Nick’s weight.

Moving the stretcher across the beach was even more difficult. When the wheels sank into the deep sand, Dani gave up and decided she would have to drag Nick the rest of the way. She lowered the stretcher to the ground and rolled his naked body off of it. Grabbing him by the ankles, she hauled him toward the water, hoping to make it look like he had washed ashore with the high tide. She thought she heard a weak groan as his head bounced roughly over the rocky sand, but when she looked back, his eyes were still closed.

She left him lying on his stomach a few feet from the water, his head turned away from the waves so he wouldn’t get water in his mouth or nose. With any luck, he would be found by an early-bird jogger or fisherman when the sun rose in another two hours. By then, she would be well on her way to the mainland.

Before she headed back to the hearse, Dani knelt down next to Nick’s head, knowing it would likely be the last time she ever saw him. “I’m sorry,” she whispered, brushing his blond hair back from his face. His skin no longer felt warm and clammy, but cool and dry. She frowned, moving her fingers to the carotid artery in the side of his neck. She couldn’t find a pulse.

Her heart leaping into her throat, she rolled Nick over onto his back and lowered her head to his bare chest to listen for heart and lung sounds. She heard nothing. Somewhere along the way, his heart had stopped.

When? she wondered frantically, as she debated what to do. Should she call 911 and drive away or stay and try to resuscitate him herself? He couldn’t have been down for more than a few minutes; he was still breathing when she took him out of the back of the hearse. Had his ICD discharged while she was dragging him across the beach? With all the jerky movements she had been making, she wasn’t sure she would have noticed if it had. But one thing was clear: if she didn’t get oxygenated blood circulating through his body again immediately, Nick would be brain dead by the time help arrived.

With a heavy sigh, she pulled her phone out of the front pouch of Patrick’s hoodie and dialed 911. She put it on speaker as she bent over Nick’s body to begin CPR.

“Monroe County 911,” a dispatcher answered.

“I need an ambulance right away.” Dani described her location the best she could as she did chest compressions. “I was just walking by the beach when I found this man lying on the ground, unresponsive. He’s not breathing. I’ve started CPR. Please hurry and send help as soon as possible.”

Still pumping Nick’s chest with one hand, she ended the call before the dispatcher could ask her any questions. She knew she was being recorded; the fewer personal details she provided, the better. It was bad enough that she had been forced to use her phone. She had planned to get rid of it on her way out of town so it couldn’t be used to track her, but now the police would be able to trace the 911 call to her number. They would know she was the one who had placed it.

Dani tried not to think about that now, tried to keep her mind focused on the task in front of her. As she put her left hand back on top of her right, using both hands to push down repeatedly on Nick’s chest, she heard her phone ring in the background. It had to be the 911 dispatcher calling her back, assuming they had been accidentally disconnected. Dani ignored it, knowing she had given the dispatcher just enough information for the first responders to find her.

After thirty compressions, she tilted Nick’s head back to open his airway and gave him two rescue breaths. Tasting the briny tang of sand and sea air on his cracked lips, she was reminded of that day on the beach when she was twelve and had watched the drowned man being resuscitated. But she found no pleasure in giving Nick mouth-to-mouth, not this time. Far from a fantasy, this was turning into a nightmare.

“C’mon, Nick,” she panted as she continued compressions, pumping the oxygenated blood to his brain. “Don’t you do this to me now. Breathe, damn it!”

She finished five cycles of CPR before she paused to check for a pulse. She hadn’t felt a single shock from the ICD, which meant one of three things: either he was back in normal sinus rhythm and no longer in need of a shock, he was still in cardiac arrest with a rhythm that hadn’t responded to defibrillation attempts while she was dragging him across the beach, or he didn’t have a shockable rhythm at all. She hoped for the best, but feared the worst as she pressed her fingers to his carotid artery.

Still no pulse.

With a sigh, she went back to work on him. She was already getting tired, as the sleepless night caught up to her. Her breath came in short gasps, and sweat dripped between her shoulder blades as she began to overheat in the bulky sweatshirt. Her arms felt weak, but she kept pumping his chest as hard and fast as she could, singing “Quit Playing Games” in her head to help herself keep up the pace. “Help will be here soon,” she said aloud, more to assure herself than Nick, who was probably beyond hearing.

She knew if she left now, she might just be able to drive away before the ambulance arrived. But how long would it take the paramedics to find Nick in the dark? Those precious few minutes could make the difference between life and death… a complete recovery or permanent brain damage.

Despite the risk of being caught, Dani couldn’t bring herself to leave him. She was still doing CPR when she heard the sirens approaching. She didn’t stop until a paramedic dropped down to his knees on Nick’s other side and pushed her hands away. “I’ll take over now,” he said, placing his own hands where hers had been. “You did great.”

She wanted to laugh at the absurdity of his statement. If only he knew what she had done to Nick.

Dani stayed long enough to repeat the lie she had told the 911 dispatcher about how she had stumbled onto Nick’s body. Then, as the paramedics were working on him, she slipped away and snuck back to the hearse. She knew they would hear the roar of the engine as she started the car and see her red taillights disappearing into the darkness, but she hoped they had been too busy trying to reach the scene to remember any identifying details about the vehicle that had been parked there when they pulled up.

As she raced up the Overseas Highway, keeping a close eye on her rearview mirror, she turned on the radio. She hoped to eventually hear a breaking news report on Nick’s condition.

It was then that she remembered Brian, who had been left behind without anyone to give him more medication. His IV bag would be running dry soon. The Pavulon would probably start wearing off before Elizabeth got home from work.

“Not my problem,” muttered Dani with a shrug, hurling her cell phone out the window and into the sea as she drove on toward the mainland.

***