Once I decided to kill her, I got pretty excited about it. There are so many ways to off someone. Think about it.
You could do it with your hands, like strangling, beating, or a karate chop. That one would be pretty funny, unless she knows karate too.
You could go totally hands-free and not be in the same room if you did poison or a fire.
I kinda like weapons like guns and knives. I even heard of using an ice pick.
Man, so many choices. It's like losing your virginity. You only get to do it for the first time once.
***
The phone rang twice that night, but both times, the caller hung up without leaving a message. I was too cheap to get caller ID, so all I could do was cross my fingers that Ryan would contact me before he left.
The next morning, I swung into the emerg nursing station and found a plain brown envelope propped against the printer.
DR. HOPE SZE. CONFIDENTIAL.
Mrs. Lee had written my name in indelible black marker. She'd printed her return address just as clearly in the upper left hand corner.
I lifted the envelope. She'd chosen the padded kind, as if she needed to insulate the documents within. It felt surprisingly heavy for a bunch of paper.
"Mrs. Lee dropped that off last night," said Nancy, the psych emerg nurse. Psych patients need a lot of one-on-one that the regular emerg nurses are too busy to provide, so they get their own nurse. I'd vaguely noticed Nancy sitting next to the printer when I rotated through emerg last month, but I'd never registered what service she belonged to until I sat in her chair one day and a doctor told me the error of my ways. "That's the psych nurse's chair," he'd told me. "She always sits there." Now I sat there with her.
This envelope was the first concrete sign that Mrs. Lee meant business. Last chance to listen to Tucker.
Forget Tucker. I started to rip open the envelope flap.
Nancy shook her head and waved a clipboard at me. "Hot off the press."
I reached for the chart and laid the envelope on the table, both disappointed and secretly relieved. "What've you got for me?"
"Reena Schuster. A twenty-nine year-old female who says she's depressed."
I was already scanning the triage note. Normal vitals, allergic to Haldol, nothing else remarkable. I hadn't done any psych-emerg before, but I'd done enough emerg last month to figure out the ER's no-nonsense approach to young, healthy, mildly depressed women: see if she's suicidal and if she's not, give her the boot.
In a nice way.
I could give her a prescription or tell her to make an appointment with her doctor for a change in medication. If she didn't have an M.D., I'd hook her up with someone. And I'd make a "suicide pact." It sounds like something teenagers do with loaded shotguns under their arms, but actually, it boils down to, "Promise you'll come back if you feel like killing yourself."
So I already had vague plans for Reena Schuster before I even met her.
Room 14, the psych room, was a white box, usually empty except for the bed with restraining straps. Today its lights were off, which was kind of weird, but the surrounding emerg's fluorescent lights brightened the gloom of the room.
A heavyset woman paced the room like a caged lion. Another woman, thin with bad blonde highlights visible even in dim light, sat on the bed and snapped her gum.
I knocked on the open door. The lion-pacer rounded the room to face me. She gasped and grabbed her chest so suddenly, her Medic Alert bracelet clinked against her watch.
Uh-oh. Ten-to-one, she was Reena Schuster, dramatic before we even started.
The skinny one narrowed her eyes at me without unfolding her legs from the bed. "Are you the doctor? You look way too young."
I forced a smile as I flicked on the light. We all blinked. "Hi, I'm Dr. Sze. I'm a medical doctor doing my residency training." I turned back to the lion-pacer. "Are you Reena Schuster?"
"Oh, God." she said instead of answering. "Oh. My. GOD." She threw herself on the bed and wrapped her head in her hands, rocking back and forth so hard on the edge, the gurney's wheels shifted. "It's fate. I know it is. I'm being punished."
"Reena. Chill," said the friend.
I cleared my throat. I'm not saying all patients love me, but was she really saying I was a punishment? Maybe it was the depression talking, although from what I've seen, truly depressed people don't have energy to pace or apply blue eyeliner like Reena. I tucked the clipboard under my arm, an uncertain smile pasted on my face.
Reena grabbed her own wavy brown hair with her hands and twisted it with her fingers until I saw her knuckles blanch. "Jodi? You see it too, don't you? We're coming full circle."
The friend, Jodi, put her arm around her. "Reena..."
"No. I know you think I'm nuts, but I'm serious. This is it. This is it!" Her voice rose to a scream. She dropped her hair and pounded her hands on her thighs.
I glanced at the door. I didn't dare close it. Rule number one: if you're worried, leave the door open.
Nancy stood behind the Plexiglas, frowning at us. So at least rule number two was covered: get help.
"Reena—"
"Don't say my name!"
Jodi drew Reena's head toward her chest and glared at me. "Could we get another doctor?"
It would look weak to go back without even asking one question. "I haven't done an assessment—"
Reena burst into noisy, messy tears.
"For God's sake, what do you want from her? She can't talk to you!" Jodi's voice was so hard, it cut through Reena's sobs.
Both Reena and I got very still.
I swallowed hard. Technically, I'm an M.D., but so many times, I just didn't know what to do. My instinct was to flee. I steeled myself against it.
Reena's crying softened. I hovered in the doorway. Maybe I could just wait her out. If, for some reason, I'd upset her, she could get over it and we could talk.
Still, I was relieved when Nancy's flats tapped into the room. "Is there a problem?"
"Her!" Reena said, pointing at me. Her red-rimmed, accusing eyes stabbed me from behind her curtain of hair.
"She hasn't even had a chance to talk to you yet, Reena. Would you rather come to the interview room? We've finished working in there and you're welcome to come in." Nancy offered her a tissue.
Reena blew her nose loudly. "I can't. Not with her."
"She's the resident on today, Reena, and you've already talked with me—"
"So why does she have to go through it again?" demanded Jodi.
"This is a teaching hospital. You know how it works, don't you, Reena?" Nancy's body language, her comments, were all directed at Reena. I realized part of my mistake was probably that I was trying to talk to both of them instead of concentrating on the patient. "We have medical students, residents, and staff physicians at St. Joseph's. It's part of the process."
"Yeah, but why her?" Reena's voice had turned more nasal, more whiny. My shoulders relaxed. I could handle brattiness, not hatred. Thank goodness for Nancy.
Jodi said, "Aren't we allowed to refuse?"
I gulped. Nancy said, "Yes, that's true, but we like there to be a reason. Do you have a reason?"
Silence. Jodi looked hard at Reena, who said finally, "I just can't."
Nancy glanced at me. "I'm sorry, Dr. Sze. Would you mind—?"
"No, no, that's all right." I handed her back the chart. Oops. I still had Mrs. Lee's envelope underneath. I tried to grab it back and flip it over, but it skittered off my fingers and landed on the floor, face up, with a bang.
I snatched it back, covering it with my body. "Excuse me."
Reena was already screaming, her hands welded into fists, her mouth one giant O, her body arched in misery, while Jodi yelled at me, "Get out, get out, get out!"