First Do No Harm Read online

  That kind of tension was coming from the room ahead.

  Slowly, the door came into view.

  I saw the numbers “191—” before I closed my eyes.

  I kept them tightly shut as I went by. Vertigo nearly sent me tumbling as I passed the door.

  I didn’t care about the possibility of walking into a wall. I kept my eyes closed for a long time after that.

  Miraculously, I didn’t hit anything.

  When I finally opened them again, it was 3:27.

  Twenty-four minutes to go.

  That’s when the hand tugged at my back. “Can you please help me?” squeaked a terrified voice from behind.

  I stopped walking. I considered my options.

  Then I continued forward.

  “Wait!” he cried. “Please, I’m really hurt and I need your help!” He grabbed my shirt again and started crying.

  I wiped both eyes and moved onward.

  The greatest challenges make us grow. But that feat is achieved through forcing some small part of us to die. Children only have the energy and drive to play outside because the world hasn’t yet extracted its inevitable due.

  I knew that I had to obey the rules, but doing so killed a little piece of my soul. I’d become a doctor because I had believed that I could give all of me to a cause and keep getting out of bed each day without a diminished sense of purpose.

  But as I listened to the child walk behind me, crying loudly and begging for help, I accepted the fact that part of me was never coming out of that God-forsaken burn unit.

  I passed the heavyset nurse again. Her eyes bulged as she saw the boy. “Doctor!” She yelled. “You need to help that child!”

  I walked past without acknowledging her.

  “DOCTOR!” She screamed. “What is wrong with you?”

  I ignored her in the same way that I dismissed all the nurses, doctors, and patients who gawked at the boy in my wake. No matter what they shouted, I pretended not to hear them as I moved onward.

  “What HAPPENED to him?”

  “Him? What happened to HER? How could anyone ignore a child in that state?”

  “Should we help him?”

  “No—the boy is HER responsibility.”

  The tears wouldn’t stop, no matter how many times I wiped my face.

  A long, horrible-looking scar ran from my left shoulder to my left wrist, and I would see it every time I used that arm to dry my eyes.

  It reminded me that I was just as ugly outside as I was within, so I did not try to hide it from myself.

  I passed a doctor and another janitor. I recognized them as the people who had extracted Myron from the O. R. They stared, arms folded, judging me as I went by.

  “Figures,” the doctor explained to the silent janitor. “She wasn’t there for her little brother, either.”

  I broke. I let my body double over and cried openly. Deep, ugly sobs heaved from my diaphragm, convulsing my frame as my mind teetered on edge.

  But I didn’t stop walking. Doctors can compartmentalize when facing issues of life and death, and my life depended on constant movement.

  The boy clutched my shirt as I wailed, and we walked. For no less than three miles, I endured the most bizarre trial of my life.

  A sudden change in the acoustics prompted me to look at my watch.

  3:51 a. m.

  47 minutes had passed.

  I allowed one, final, shuddering sob. Then I stopped and looked around.

  I was in familiar territory.

  The first friendly face was Lydia, a nurse that I knew was from this world. I wanted to wrap her in a bear hug and scream in delight.

  She stared at me, her face contorted in horror. “What the fuck is that thing behind you?!”

  My body temperature surely dropped five degrees as I felt a familiar tugging on my shirt.

  I froze.

  Panicked footsteps came rushing my way. I stared in their direction instead of looking behind me.

  Dr. Scritt was in full sprint. “Dr. Afelis!” She yelled.

  She was the consummate bitch, but in that moment, I wanted to see her more than anyone else on earth.

  “It’s been 47 minutes,” I heaved in a shaking breath, “should I look at it?”

  Dr. Scritt stopped a few steps away from me.

  She nodded somberly.

  I swallowed, then slowly turned around. I told myself that nothing is ever as bad as we picture it, because reality is bound by rules that imagination is not.

  I was wrong.

  Imagine a pizza with the cheese stripped off. A lumpy mass of marinara is occasionally interrupted by chunks of sizzling meat that sit atop a mound of globby, yeasty dough.

  Now imagine that the pizza is a person, that person is a child, and one eyeball is hanging from an empty socket.

  And that child has no hair, because all the skin is gone from his scalp, and that he has a gaping hole where a nose used to be.

  “Help me,” he whispered. “Hel—”

  His jaw fell to the floor, scattering teeth in every direction. The boy’s tongue dangled from his open throat, flopping aimlessly like a dying fish.

  Then he squeezed my arm in a vice-like grip, screamed, and fell to the ground.

  I looked down at the motionless puddle of flesh that had once been a child. “Dr. Scritt,” I breathed, “is he—”

  “Don’t be an idiot, Dr. Afelis, he was dead long before you brought him here.”

  I stared at her in sudden realization. “Like—more than 120 minutes before?”

  “Did your inane chatter suddenly achieve the ability to carry a body to the morgue, Dr. Afelis?” she asked as she bent over the corpse.

  “Um. I’ll… find a gurney…”

  “No one signs up to be a doctor because she’s afraid of getting blood on her manicure,” she snapped as she lifted the boy’s shoulders. “Grab the damn legs and let’s hope his body has more structural integrity than Jell-O. This cadaver’s not going to walk itself to the crematorium.”

  Dazedly, I bent down and picked up the boy’s ankles. My stomach turned as his skin shifted under my grip like the flesh of barbecued chicken.

  Compartmentalize.

  Lydia calmly held the door open for us as we carried the boy down the stairs, through the morgue, and into a corner where I had never needed to venture.

  I knew that the incinerator was there, but I had had no reason to use it.

  “It’s too small to fit his body inside,” I explained as I gasped for air. Dr. Scritt was clearly in amazing shape; she had nearly sprinted across the morgue, and I struggled to keep pace while hauling the body. “What can we—”

  She grunted as she snatched the corpse from me and shoved his feet inside the incinerator. “If you’re going to bore me to death with ridiculous conversation, Dr. Afelis, then hurry up and make sure I’m dead before 120 minutes is up! Either that or fucking help me!”

  It’s amazing what we’re capable of doing when an imposing figure informs us that we have no choice.

  Side by side, we forced the boy’s body into the narrow opening of the incinerator. When he got stuck, we just pushed harder. Both of us groaned with effort as his charred, melting flesh sloughed off like the skin of a rotting peach. Lumps of meat dropped to the floor as we peeled layers off the boy.

  But he was going in.

  We were pushing his shoulders through when his eye opened.

  CHAPTER THREE:

  HEAT

  TOC

  Doctors see shit that would make your skin crawl. Sometimes it involves literal shit. Occasionally some skin nearly does crawl, though “melt” is a better term for what necrotizing fasciitis does to a person.

  But no textbook could have prepared me for the moment that I stood shoulder to shoulder with the chief of medicine, forcing the decaying body of a charred kid into the incinerator as his one functioning eye glared back at us in hateful judgment. He was wedged in the narrow door at the shoulders, with only his head sticking out into the room with us. His jaw had long since fallen off, and the rotting tongue danced above his inverted face like a charmed snake.

  “Dr. Scritt,” I whispered in a quavering voice, “what are we supposed to do? We’re bound by primum non nocere, so don’t we have to—”

  “You’re bound to help the living, Dr. Afelis, which includes me and possibly yourself if you help me out right fucking now.” She grunted this while moving her hands to the top of the boy’s head. As she pushed, the entirety of his scalp slid off like a flaky scab ripped from a wounded leg. A fresh, clean, white skull gleamed from underneath as the boy’s torn skin dropped to the floor like so much ground beef.

  “They’re easier to grab without the skin. Push down on its head.” Then she batted his tongue away like an annoying fly and pressed deeply into his shoulders. Her fingers disappeared into his flesh like a boot into thick mud.

  Dazed, I pushed against the boy’s exposed bone. I was shocked to realize how cold it was, and how it twitched as he fruitlessly tried to bite me with a jaw that didn’t exist.

  “I hate to give away the ending of this story, but you’re going to be awfully surprised what this thing can do in about ten seconds if you continue fondling it with the restrained intensity reserved for jerking off an octogenarian. Push!” she yelled as she leaned in.

  The body slid into the incinerator with the gentle resistance of a bowel movement.

  Once inside, the boy screamed.

  Dr. Scritt shoved me violently aside, slammed a padlock into place, then spun the dial.

  I looked back at her in shock. She was a bitch, for certain, but she’d never touched me before.

  Still, I was a first-year intern. The chief of medicine could pretty much force me to eat pus and call it ice cream.

  “Dr. Scritt,” I asked shakily, “why did you put a padlock on the inciner—”

  The shrieking from beyond the lock was loud enough to shake the floor.

  “Turn it on!” she commanded me.

  “Where are the—”

  She pushed me away once more and frantically clutched at a series of buttons that had been behind me.

  “Dr. Scritt!” I yelled in response to the shove, “Why are you—”

  Slam. Slam. SLAM!

  The padlock bounced as the incinerator door was hit from the inside.

  A chill settled over my body even as the temperature grew noticeably warmer.

  “This is a custom incinerator,” Dr. Scritt explained as she grabbed my arm and pulled me away from the door. “It will heat up very quickly, so stand—”

  SLAM SLAM SLAM SLAM

  The pounding from inside the incinerator grew more forceful. I briefly wondered if the padlock would hold. It flailed wildly back and forth with the rhythmic hitting.

  CRUNCH

  “It’s at 200 degrees!” Dr. Scritt called as she looked toward the gauge. “We need it to get to two thousand!”

  My head swam. “Most medical incinerators can’t even get that hot!”

  CRUNCH

  Dr. Scritt turned to face me. “You’re right, most can’t.” She looked back. “500 degrees.”

  I gaped at her. “Is it really heating that quickly?”

  She betrayed no emotion in her response. “Can’t you feel the change in the room?”

  For the first time, I realized that I was sweating profusely. “How am I this hot? We’re standing ten feet away.”

  “So we’d better back up,” she continued. “1,100 degrees.”

  SLAM

  With a light tinkling, a tiny screw fell to the floor and rolled away.

  “Dr. Scritt,” I breathed quietly.

  “I know you’re sorry that it took so long to get the boy here.” She paused. “We’re all sorry.”

  CRACK

  “Dr. Scritt, the door to the incinerator—”

  “1,500 degrees.”

  A wave of heat squeezed fresh sweat from every pore.

  “—I don’t know if it will hold—”

  CRACK

  “Seventeen hundred degrees!”

  “—the padlock is bending; the metal will melt!”

  “That’s why we keep hundreds of padlocks in reserve.”

  SLAM CRUNCH CRACK

  We both stopped breathing.

  A hand-shaped indentation had slammed into the metal, warping it from the inside and leaving a seemingly impossible mark.

  We waited.

  “One thousand, nine hundred and thirteen degrees.”

  We waited longer.

  Nothing happened.

  Sweat stung my eyes so badly that I couldn’t see. When I wiped it away, I found that my arm was even saltier, rendering the pain worse.

  “I think,” Dr. Scritt uttered in a voice just above ‘inaudible,’ “that I stopped it.”

  She self-consciously pulled her coat sleeve closer to her wrist as I stared through the shimmering heat waves radiating from the incinerator. Clumps of shorn flesh lay on the ground nearby. The smell of roasting carrion wafted through the air and gently tickled my gag reflex.

  I released the breath I had been unconsciously holding. “So… we’re safe?”

  The door to the morgue slammed open, and another intern sprinted inside. I recognized him as J. D., a nervous guy who looked like he was in perpetual shock. “Dr. Scritt!” he called across the room. “It’s Dr. Brutsen—Rule 10!”

  Despite the heat, a chill settled over the room that could have frozen my ass cheeks together.

  “Prepare an O. R.! Now!” she shot back authoritatively.

  He quickly disappeared.

  She turned to sprint out of the room.

  “Dr. Scritt!” I called back.

  She wheeled around and faced me.

  “What should I do about the incinerator?”

  She stared back like I had a dick instead of a nose. “You should learn to know when things are dead, Dr. Afelis. Enough haunts our lives without us carrying those who have left us behind.” Then she turned around to rush out of the room. “If you want to provide a modicum of usefulness, you can take a gurney out to Court Street. The roof is a long way from here.”

  With that, she disappeared out the door.

  What the fuck was Rule 10?

  My hand flew to my pocket.

  It was empty.

  Fuck, fuck, fuck. The list must have fallen out while I’d been hauling the human mush into the incinerator.

  I’d needed a classmate to die before I could see the list of rules. But once it was so easily accessible, I’d just taken it for granted.

  I swore to learn a lesson from this, and knew that I wouldn’t.

  I’d read the rules once. Why would I need a gurney?

  I decided to sprint outside and find out what was happening first.

  The chilly night air latched onto my cold sweat, sending chills into every crevice in my body.

  I ran.

  And—I saw nothing.

  There was no traffic. There were no people. I looked left, right, and left again.

  Then I looked up.

  Oh, shit.

  That was Rule 10.

  Dr. Brutsen was standing a few feet from the edge of the roof. In the nearly full moon, I could see his body jittering like it was held by marionette strings. The entire scene was wrong. How, and why, could his limbs be moving like that?

  He was moaning softly.

  No, that wasn’t it.

  He was crying.

  Nausea took hold of me as I realized that he was dancing closer and closer to the edge.

  I nearly collapsed as I remembered what the rule demanded. Either wait for an extraction team to find you, or jump four stories to the sidewalk on Court Street.

  “Wait there!” I screamed at him. “Dr. Scritt is coming to get you!”

  “No, no, please!” Brutsen screamed, although I don’t know whether he was talking to me. “Don’t make it angry, make them go away!”

  “Hold on!” I hollered back. “You’re almost safe!”

  He wailed. “I’m sorry, I tried to lock them out! Please, please don’t do this!”

  His body bounced and flailed like an electrified fish. It was so bizarre, so wrong to watch this man spasming out of control in the rooftop moonlight, that I nearly cried.

  A door on the roof slammed open with such intensity that I could hear it clearly on the ground below.

  “NO!” Brutsen wailed in response. “No, please stay away, I’m sorry, I’m SORRY!”

  Then he stepped away from the edge. I heaved an enormous sigh of relief.

  That relief evaporated when I realized he had only moved back to allow space for a running start.

  I watched in horror as Dr. Brutsen—my coworker, my peer—ran forth and leapt into the night. He fell, arms and legs spinning, toward the concrete where I stood four stories below.

  CHAPTER FOUR:

  PRESSURE

  TOC

  Being a doctor destroys the assumption that certain things are impossible.

  Most people carry around an unconscious belief that the human body is sacred in a way that protects it from an uncaring world.

  This is not true.

  Imagine the last object you witnessed break unexpectedly. Did a dinner plate shatter into granules and shards when it slipped out of your soapy fingers? Perhaps you saw a watermelon roll off the grocery store display, splattering its fine, sticky goo across a ten-foot radius.

  A human body can do that.

  A person you love can be so damaged.

  Yet I hoped, foolishly but passionately, that whatever unnatural force had breathed into the corners of St. Francis would show mercy to Dr. Brutsen as he flew to the ground.

  That was, of course, a stupid hope.

  The full moon illuminated each detail as he slammed against the cement with an ugly splat. His feet hit first, pathetically unable to reduce any momentum as his ankles bent and he undoubtedly shredded both Achilles tendons. His knees followed, crashing into the ground and shattering both patellas. Dr. Brutsen’s body pitched forward and fell all at once, with his head bouncing back like a rubber ball. A light spray of solid objects hit my ankles, and I knew right away that his teeth had blown from his head like popcorn.