by Margaret Karmazin

When Amy Brennan arrived for her 7:00 pm ICU shift and read over the reports, her heart jumped to her throat. Was it him? The details fit. Right age, the accident happened four miles from where she knew he lived, or where his loathsome parents lived. Surely there were not two Aiden Chanlers in the area. 

But why was he home and not away at school? She had investigated his whereabouts and knew he was supposedly attending University of Pennsylvania in Philly. He definitely wasn’t a stupid kid, but also his parents were loaded and the father an alumnus from there. Most likely strings had been pulled. It was the middle of a semester and he shouldn’t have been home. Had he done something against the rules? That would be fitting for the piece of shit that he was.

“Are you okay?” Kenya asked. The two ICU nurses worked at the same desk and the room across and down one, was 215, the patient in question. 

“Uh, yeah,” said Amy, but in no way was she all right. “Kenya, what do you know about 215?”

“Not much. Tony was on when the kid came in. He rushed out, something about his dog – wife called all upset. Hopefully, he got all his notes in. I guess you’d better go check it out. Want me to come with you? My two ladies are sound asleep finally and everything running smooth.”

“No, but thanks. I think I’ll go on down there now.” She checked her computer and nothing was amiss, but only in the sense of no alarms going off. Undoubtedly, plenty was amiss.

The dark head was turned slightly to the left with half of the face bruised and swollen. He was on a ventilator, as were at least half of the other patients in ICU, surrounded by and hooked to numerous machines with their screen graphs moving peacefully or alarmingly. No one was with him – where were the parents? 

Was it the same Aiden Chanler? The age was right, hair color, general body shape and length. Of course, now three years later, he’d probably be a little taller, more filled out. She moved closer and looked at his face. Though it was hard to see past the swelling, she thought it was probably him. She needed to check the exact address. He must have had his license with him unless the police confiscated it for some reason.

For a long moment, she stared at him. She could feel her chest tightening up, sense the approach of a flood of emotion, coming sleepless nights, urges she might find difficult to control. 

Every part of her went on alert. As she watched him sleeping, she felt a tingling sensation that a soldier about to go into battle might experience. She checked his machines; Tony had set everything up correctly and the kid’s vitals were currently all right, though his blood pressure was high. The covering doctor had not left any orders about that. The thought shot through her mind, maybe he’ll stroke out. She thought this with some degree of sadistic glee. 

Back at her station, she checked for physician orders – nothing for the blood pressure. She picked up her phone and called the hospitalist who called right back. “Eight μg/min norepinephrine,” said Dr. Ahmad Bashar. “Transport will be there shortly. Blasio will meet him in imaging. Not my choice but he’s on tonight. This case looks pretty depressing.”

“Where are his parents? They didn’t come in yet?” Amy asked.

“I understand they’re in Asia or someplace,” he said. “They’ve been trying to reach them.”

She thanked him and went to the medication room to get the med.

Two hours later, the boy was returned to the ICU. She was more than curious about the results. Her stomach was in a hard knot and she had to make an effort to keep on top of her duties concerning her other patients. 213 did not vary much in her condition and needs. She, a sixty-nine-year-old, was in an induced coma and on the ventilator in response to severe pneumonia which had not cleared up with the usual antibiotics. She’d been there four days. Amy checked her vitals every hour or two and everything remained stable, nothing amiss on her screens. She had 214 to look in on but first she returned to 215 and started awfully when someone suddenly spoke behind her. It was the hospitalist.

She and Ahmad got along well. He was forty-two to her forty-six and as far as she knew, happily married with two children, a boy and a girl. A woman of her type would never attract a man like him, but they shared an unspoken understanding of some sort, as if they had known each other for years or even since childhood. Their relationship had been like that from the moment they met, like comfortable cousins. She’d been working at Brighten Community for twenty-two years and he since his residency. He had been very supportive during her terrible bereavement.

Without a word, he passed her his tablet and she scanned the MRI report. Afraid to speak lest she give herself away, after a quick perusal, she silently handed it back. 

Hailey had been the delight of Amy’s life. At almost sixteen, she was a quiet, shy child, though when with her best friend Zoe, they would laugh boisterously until they almost peed their pants. Hailey had liked spending time with a couple of other girls too and once in a while, they’d all enjoyed slumber parties together. But there had never been any boys around.

As a baby, Hailey was beautiful. Big round blue eyes, bouncy blond curls, chubby arms and legs waving happily. Her father had enjoyed her then, or seemed to, but soon lost interest. He was always at work, a medical device salesman, particularly orthopedic devices for joint replacement. Frequent business trips, away most of the time, in fact, with calls home coming less and less frequently and no attention at all paid to Hailey. Amy knew, without anyone having to hint to her, that Eric was unfaithful. After several years of intense pain over this, it dulled down and she stopped caring. In truth, she wanted to get rid of him, but also wanted to continue living in her house and, while she earned a decent salary as, at the time, a cardiac nurse, it wasn’t enough to give Hailey all that she’d hoped to give her, such as an excellent university education.

“Look, we really don’t love each other,” Eric said the morning after Hailey’s twelfth birthday as he was snapping his briefcase shut. “You’re not happy with me and vice versa. So why don’t we just end this?”

For a few moments, Amy forgot how to speak but then went crafty and brought up the money issue about Hailey, the house and college. Eric shocked her by revealing that she could have the house, that he had paid into a fund for Hailey’s education, and as long as it took place in the state of Pennsylvania, she’d have enough, at least for a state college. If she needed more, she’d have to borrow it or get scholarships. Amy was so grateful that she almost jumped up to kiss him but restrained herself and they parted amicably. He married someone else as soon as the divorce was final, moved to New York State, started a new family and never bothered with Hailey again.

She sometimes dreamed of inheriting money from an unknown aunt or uncle or some billionaire who had seen her doing something kind for someone and found out her name. Enough so that she didn’t need to work or just work part time in order to keep up her requirements up to date. On her days off, she would write stories for she certainly had many – all those people who came to the ICU and either left alive or died. Their loved ones hanging about with fear in their eyes. So many stories, though as time passed, they faded from her mind, quickly replaced by new ones. None of their stories were more difficult than her own.

Ahmad must have gone home but a resident from the neurology team, Lily Patel, arrived for a look at Aiden Chanler. “What’s going on?” Amy asked, sidling up behind her and causing her to jump.

“Oh!” the young woman said. “Sorry, sorry, I didn’t see you. He appears stable for now, but…”

“Will he make it?” Amy asked, almost rudely. She tried to remember her manners since she liked the young neurologist. She hoped the patient would not recover, hoped that he would writhe in pain and wake up and somehow recognize her. See who she was, this person who had total control over his life now. And then he would die painfully and terrified so that his arrogant parents suffered the same misery she had done. Speaking of them, why weren’t they here?

“Time will tell,” said Lily. “We need time. Aiden has severe spinal shock. We won’t know if he’ll be paralyzed yet or how much.”

“How much time?” asked Amy, though she had been through these cases several times before. Most did not end well, though there were exceptions.

“Up to twelve weeks,” Lily said. “Or way sooner.”

And Amy would have to take care of him, at least on her three-day shifts. Should she tell the charge nurse what the relationship between then was and be moved to another patient or should she just keep her mouth shut? If and when the parents arrived, they might recognize who she was and raise a ruckus. Though she had changed back to her maiden name since the incident, a different name from what Hailey’s had been. And she had lost thirty pounds and let her hair go gray and grow long, wore it in a pony tail now, stopped using contacts and wore large framed glasses. She looked like an entirely different person from the one they’d dealt with.

When Kenya had a moment at the desk, Amy asked her. “What’s the deal with 215’s parents? Why aren’t they here?”

“I asked Kevin and he said they did everything they could to reach them and the police went to their house but it was dark with no response. A neighbor told them the couple had gone on an extended Asian tour. He thought on a cruise ship. They’re looking into what tour that might be.”

“Relatives?”

“The neighbor didn’t know. Apparently, the Chanlers did not associate much with them. They ran with their own circle. Mr. Chanler retired early and was independently wealthy.”

Amy nodded. She already knew all that about them. The thought did cross her mind, what kind of parents leave their kid that long but then he was supposed to be at college, not driving around drunk at home in the middle of the semester. Didn’t they have cellphone contact? At least when in port? But then they’d just get no answer.

Why was she even thinking about this when the kid and the parents were monsters? She steeled herself and went to 214 where she had a seventy-four-year-old with an MI who’d arrested twice. He was lucky to be alive. His wife, who had to drive a distance, was staying overnight, attempting to sleep in a recliner, good luck with that. As long as she stayed out of the way, Amy didn’t mind though the staff didn’t encourage relatives staying. “Dave, are you still awake?” she said and the wife stirred. “They’re coming to take some blood in a few minutes.” The poor man’s arms were swollen pin cushions. He was still hallucinating from the meds but that should wear off soon. His vitals looked all right; nothing on the screens was amiss.

She moved to 215 and stepped into the room. The little prick was unconscious of course, with the ventilator doing his breathing for him. The question was how exactly could she do it? Could she do it? Was she willing to go to prison if caught? What was there to live for anyway?

She stood as if rooted to the spot, remembering.

How had she not noticed Hailey was suffering? Why hadn’t Hailey told her what was going on? Amy was her mother, the very person the girl normally shared intimate thoughts with, talked about fears with, shared her modest ambitions. The time Hailey was in a panic that she had breast cancer when it was just a little cyst, the time her friend was treating her oddly and they found out the friend had overheard her parents talking and that her father had ALS. When Hailey had had a crush on an avant-garde boy in her art class and later got over it after she learned he was gay. So many things Hailey had shared, but not this time, the most important one of all.

Her friend Zoe had known, indeed apparently everyone at school had, just not Amy, her mother, who, if she had known, would have caused heads to roll.

Another neurologist showed up, not the head honcho, but one she occasionally interacted with. Dr. Price, a nice young man. The kind she would have loved for Hailey to end up with. Former farm boy from Penn State area. “Any prognosis yet?” she said.

He shook his head. Like all of them, he said, “Only time will tell.”

“From your experience…” she said.

“He’s young,” said the doctor. “Young is good.”

“The parents?”

“Still haven’t reached them and no other emergency contact.”

“Weird,” she said.

He nodded and examined the patient. She watched. “Nothing to do but wait,” he said after a few moments.

“Any changes in the meds?”

“No, keep him as is.” And he took off at a brisk pace down the hall.

She had found Hailey in the morning, unable to awaken. Where she had obtained the drugs was a mystery; her friends had no idea. An investigation by the police had turned up someone from another high school who’d bought the pills from a dealer in Scranton. Fentanyl of course, in what looked like Xanax, a half bottle of pills. It would take Amy some time before Hailey’s friend filled her in on what had been happening before this.

Why, why, why had Hailey not told her? Why had she kept this all bottled up for months? Amy could have stopped it! Raised absolute hell at the school, publicized what was going on, gotten a lawyer, sued the shit out of his trashy parents! For that matter, if she had to, hired a thug to beat the little bastard to a pulp. If only she’d been given the chance.

Apparently, his had been a steady, thought-out plan to ruin Hailey and for what reason? Just for fun, one of his bratty friends had said, just to see if they could do it. Drive a person to suicide hands off, no actual violence, just steady mental torture! Using every social media platform they could, making her schoolmates believe that Hailey had sex with dogs, photoshopping her head onto porn actors, spreading the information that she’d lost control over her bladder, that she broke into houses and stole things, that she altered other students’ grades or ruined them on social media or by verbal gossip, that she stole from teacher’s desks and cars, that she threatened children or did things to them, that she sold drugs and set fires. A full-scale onslaught of this, after a while causing people, including some teachers, to believe it. And no one had contacted Amy. The school had told Amy nothing. 

She had left a note. “I love you mom, but it’s better if I leave. I love you.”

Amy would never get rid of the rage she felt when she learned the truth. And then the placid audacity of the monster’s parents who downplayed it all. The utter, detached uncaring about it all. A prank, that was all, so unfortunate that Hailey had been so sensitive.

The next evening when Amy began her shift, easy-going Monica was on as charge nurse.  “How are our patients?” she asked Amy. 

Amy who had been deep into her fury about Hailey, had to snap herself back to reality. “Oh,” she said, “214 is the same. I had to give him insulin again, but no major situation. Still hallucinating a little and still concerned about defecating. They’re bringing in someone for 212. Another pneumonia, I think.”

“How’s your boy doing?”

“What?” For a moment Amy couldn’t think of the monster as “her boy.” “Oh, same as usual. They won’t know anything for a while. Still haven’t located the parents.”

Monica nodded. “216 is ready,” she said. “ER is being hush-hush about a cardiac patient – said they are bringing him right up. Thank heavens we have the space.”

They got their answer in forty-five minutes when a giant of a man was brought in and they all went to help. He was African American, probably six foot five and three hundred pounds and had just suffered a massive heart attack. He was on a bariatric ICU bed.

“Holy shit,” said Monica, “I think I recognize him. Isn’t that Rodney Greene? Former lineman for the Eagles? That might explain the hush-hush.”

“I don’t know football,” said Amy. “Why would he be in Scranton?”

“Who know? Maybe he lives here now. He was famous the late nineties.” 

The resident with the crew filled her in. “He was visiting his sister in Clarks Summit when it happened. She’ll be in shortly. Chest pains, kept on going in the ambulance, straight to cath, three stents, an intra-aortic balloon pump installed in the RCA, and he is agitated. Might have to restrain him. You ladies might need football helmets.”

Amy sighed. She was five foot three and weighed a hundred and twenty-eight pounds. She had been hit by agitated patients in the head and face several times and none had been as large as Rodney Greene. Once again, she considered getting out of the ICU and into something more peaceful like Medical-Surgical.

“Look,” said Monica, “I don’t expect you to get beat up if it comes to that. Jeff is here tonight and he knows martial arts if need be. You watch 214 and 215 and help Chris with 213 and the rest of us will handle this for now.”

Not thirty minutes had passed when they called Code Blue. Rodney Greene was in cardiac arrest. 

The noise was intense, people running, Jeff yelling. Amy darted to the room and saw Jeff on the bed doing chest compressions. The whole thing would go on for some time, probably a good half hour or more. 

Amy’s immediate thought was: I’m alone. I can do anything I please to that piece of shit. Unlike their sister hospital, theirs did not have cameras in the ICU rooms. Would be possible to unhook his meds, refill a bag with plain saline and hang it back up. Or better yet, there were a few things she could inject him with: insulin, multiple air bubbles, bleach – there was some of that in the supply room…was she willing to take the humiliation and punishment for doing this if they caught her? Couldn’t she just press on his throat, cut off his fucking air? Screw with the ventilator? Even if caught, what did she have to live for anyway? 

She could hear the continuing uproar in 216, they were deep into it. Hadn’t they used the defibrillator? Why all the yelling? Unmoving, she stared at Aiden and felt the light flicker as someone else ran by the room. She had never felt such desire in her life, desire to kill, to obliterate, to turn to nothing a nightmare that had been allowed to continue when her love had not. Slowly, she moved toward his bed.

And then she felt something touch her shoulder, whirled around to see nothing there. What was it?

She darted out of the room, reached the desk and collapsed in her chair, breathing hard. What had that touch been? She was not religious, especially after what happened to Hailey and how the perpetrator had gotten off scot-free. That had finished any belief she might have had in a loving god or spiritual world. But she felt no doubt about that shoulder tap, it had been deliberate and no one visible was behind her. 

The racket continued in 216, then stopped. Jeff walked into the hall, hooked his finger into his scrubs neckline and pulled at it, as if to get more air. She locked eyes with him and he shook his head. The others, she knew, were in there unhooking wires and turning off machines and then they would turn off the lights, emerge and shut the door in wait for transport to the morgue. The sister had arrived; she could hear a nurse talking to her down the hall.

Monica sat down at her computer and looked at Amy. “You’re white as a ghost,” she said. “I know it’s unsettling when we lose someone.”

If only she knew the truth, Amy thought. She felt as if she had somehow avoided falling off a cliff or out of an airplane. Her heart rate was still elevated and she wasn’t breathing normally. Thank God, she had the next four days off. She wanted to escape into oblivion.

When she returned the following Monday evening, Ahmad was just leaving after his last rounds. “Aiden Chanler,” he said. “Not so good. Quadriplegic. Neuro thought it would take more time to tell but we know now. Sad for someone so young, sad for anyone.”

She felt nothing, not yet. It would take time to sink in. 

“Did his parents get word yet?”

“They’re flying in from Hong Kong, should be here tomorrow morning. The mother was hysterical.”

Amy nodded, too numb now to feel vindictive. It all felt just but at the same time, it didn’t feel right. 

“Is he awake?”

“No,” said Ahmad. “They’re having him transferred to Jefferson in Philly.”

She had gotten what she wanted. She called in sick for the next evening just in case they weren’t all out of there by then. Just in case.