Wednesday, July 3, 5:30 a.m.
When his phone alarm went off, Mitt could hardly believe that seven hours had passed since he’d turned off his light—it felt like only an hour or two at best.
With great effort, he swung his legs out over the side of the bed and sat up to allow the cobwebs in his mind to clear. Unfortunately, it had not been the rejuvenating night’s sleep he’d counted on; he’d been beset with the same disturbing, inexplicable, and exhausting dream he’d had two nights ago. Again, he’d been chased down endless, two-toned yellow-tan corridors with curious rounded pilasters and arched ceilings, the likes of which he’d never seen in real life. To make the experience more disturbing, he never did get to see who or what was chasing him, so he had no idea of what he was running from.
Immediately recognizing that he didn’t have the luxury of pondering the meaning of his recurrent anxiety dream, he stood up, allowed a wave of dizziness to pass, and hurried into his bathroom. There was no time to spare, as he’d purposefully set his alarm for as late as possible. In the future, allowing himself to sleep till 5:30 would be a rare pleasure. Dr. Kumar had specifically said that he and Andrea were expected to have seen all their assigned patients prior to the beginning of surgical rounds at 6:30. The reason Mitt thought he could get away with sleeping so late this morning was that he currently had only one postoperative patient, Bianca Perez, and checking on her progress would take only a minute or two, he assumed, since her surgery and immediate postoperative course had gone so smoothly.
As Mitt rapidly shaved, he indulged in a bit of black humor, a defense mechanism he’d learned as a medical student: The good side of having three out of four patients die meant that his personal rounds were going to be remarkably easy and brief.
Mitt glared into the mirror and silently reprimanded himself for such a thought. Black humor notwithstanding, that the idea of a “good” side to three deaths had even occurred to him was an embarrassment that made him wonder if he was losing his humanity. A second later, Mitt shook his head to acknowledge he didn’t have time for such philosophical ramblings and went back to shaving. What he preferred to believe was that the first two days of his surgical residency had to have been a totally aberrant set of circumstances, pure chance, a kind of trial by fire, and that the current day, and indeed the entire rest of his residency experience, would be completely different. With that reassuring thought in mind, he finished his morning preparations, dressed rapidly while eating a banana, and five minutes later was out his apartment door, pulling on his white coat as he descended the open central stairs.
Outside, it was light but barely, and the air was still heavy and misty with summertime humidity. While Mitt hurried east there were no warm rays on his face like there had been on Monday morning, as the sun had yet to top the buildings lining First Avenue.
Mitt sprinted the last fifty feet or so to make the traffic light on First Avenue. As he crossed, he could see that the avenue was already full of traffic. But when he got to the east side of First Avenue and turned south, he slowed. Once again, he eyed the sad and decidedly spooky Bellevue Psychopathic Hospital building. It was like a huge, haunted house smack-dab in the middle of New York City. He wondered with an ironic chuckle if the building had some paranormal power that resisted the wrecking ball. Eyeing the building also reminded him of what he had read the night before in Pendleton’s article about Dr. Clarence Fuller being a lobotomy advocate. Somehow Mitt knew he had to find out if that was true. He didn’t know how he would do it, but he was intent. If it was true, he’d have to find a different box in his brain for Clarence to occupy.
Despite being pressed for time, Mitt couldn’t help but stop yet again at the chain-locked front gate to stare at the decorative but dilapidated entrance. The moment he did so, the same wave of paresthesia he’d felt Monday morning came back in a rush, particularly the hairs standing up on the back of his neck, which made him shiver despite the warm morning. At the same time, he again imagined he’d heard the very distant sound of crowds of people crying out in distress. He heard these voices despite the competing sound of the traffic behind him, recognizing it as the same auditory hallucination he’d had while brushing his teeth the night before, only on this occasion he assumed it was from forced incarceration and not the pain of surgery without anesthesia.
“Oh, come on!” Mitt murmured out loud, angrily addressing his own imagination. “Give me a break and turn the hell off!”
With force of will, Mitt pulled his attention away from the derelict building and rejoined the swelling number of fellow pedestrians. Hospital row was a busy place. As he hurried toward the Bellevue Hospital entrance, he ordered his imagination to stand down. He was determined to have what he would consider a normal day—nothing at all like his first two days.
It was a little after 6:00 a.m. when Mitt entered through the outer door of Bellevue Hospital along with a sizable press of other people coming and going. He was surprised at the crowd just as he’d been Monday morning, particularly when he got into the lobby-atrium that also served as the hospital’s busy outpatient clinic. He assumed most of the people were part of the five-thousand-plus employees who allowed the hospital to function, but there was also a healthy mixture of patients and what he guessed were homeless people taking advantage of the public bathrooms and perhaps even the air-conditioning.
Mitt’s intent was to hurry across the multistory expanse toward the marble archway and on to the bank of elevators, when he suddenly stopped in shock. Thirty or forty feet away, off to his left in the middle of the throng of people moving in both directions, he caught a glimpse of the young blond girl dressed in the off-white shirtdress he’d seen twice before up on the fifteenth floor. In contrast to everyone around her, she was stationary, so she went in and out of Mitt’s line of sight. But it was the same girl with the same clothing for certain. The only thing different from his previous sightings was that there was no accompanying debilitatingly horrid smell. It was also daytime with other people around.
Recovering from his shock at seeing her, Mitt immediately changed direction and started toward her. He was intent on talking with her to find out who she was and whether or not she was an inpatient. But reaching her was not as easy as he would have liked.
“Excuse me, excuse me,” Mitt was forced to repeat as he tried to navigate through the crowd in her direction. To make matters worse, the young girl, upon seeing Mitt’s approach, turned and fled away from him as she’d done previously. To his surprise and perhaps due to her diminutive size, she seemed able to make more progress than he; instead of the distance between them closing, it widened. Then, when Mitt finally emerged from the seething crowd, she’d vanished just like she had the previous two times he’d seen her.
For a moment Mitt stood there dumbfounded, allowing his eyes to sweep back and forth around the immediate area, searching for the child. Not seeing her and totally confused, he looked back over the amorphous crowd, trying to figure out how he could have missed her. But then he wondered if he’d even really seen her, making him worry that this day wasn’t going to be all that different from the first two days. Perhaps he was more stressed than he realized, especially if he was already hallucinating.
Returning to the center of the lobby-atrium, he joined the crowd surging toward the archway entrance while keeping his eyes peeled. As he passed beneath the arch, he experienced the same pins and needles he’d felt the other day. Once again, he didn’t know what to make of it, but he didn’t stop on this occasion, and by the time he got to the elevators it had passed.
Although Mitt was particularly eager to meet up with Andrea to find out how her first night had gone in comparison to his, he didn’t try to locate or even text her. Instead, he went directly up to the fifteenth floor to do a rapid check on Bianca Perez prior to rounds. He thought he’d be able to rendezvous with Andrea in the surgical conference room a little before 6:30. In contrast to his usual time-efficient modus operandi—he made it a point to arrive at meetings exactly on time—Andrea was always early, so he hoped to spend a few moments with her before rounds began.
When Mitt got off the elevator on the fifteenth floor, he remembered the terror he’d experienced with the Benito Suárez disaster and shivered, making him wonder if that was always going to be the case throughout his five-year residency. As traumatic as the episode had been, he thought the chances were good.
After hesitating for a few moments to regain his emotional equilibrium, Mitt set off at a quick gait toward Bianca Perez’s room. His plan was to chat with her briefly and check her incisions, which he knew would be easy since each was merely covered with semi-transparent paper tape. Following that, he’d head to the nurses’ station and use a monitor to skim through the night-shift nurses’ notes and check the patient’s vital signs that had been recorded during the night. Of course, he could have accomplished the same thing the other way around, which made more sense from a medical perspective, but he didn’t care. He was eager to see the patient eye to eye just to reassure himself that she was doing fine. Either way would provide the information he’d need to present the case at surgical rounds.
At that time in the morning, the whole hospital seemed asleep, and as Mitt passed the various patient rooms, he saw the curtains on the windows and around the beds were drawn. Breakfast wouldn’t be served until after 7:30. Bianca Perez’s room was the next to the last on the north end of the east hallway, and Mitt headed to it without slowing or stopping. He passed a few tired-looking nurses near the end of their shifts. He still felt out of place and vulnerable, so he avoided eye contact as he went by, concerned that one might stop him and ask a question he couldn’t answer.
The door to Perez’s room was ajar, and Mitt walked straight in. His patient’s bed was on the left in the middle. He remembered it well because it was where he’d done her admission history and physical Monday night. But when Mitt pulled back the privacy curtains, Perez’s bed was empty.
For a few beats, Mitt stared at the made-up but vacant bed with mounting concern, trying to fathom why she had been moved and where. He even glanced in at all the other occupied beds in the room to be sure she wasn’t in one of them. She wasn’t.
With growing unease because of what had happened to his other patients, he turned around with the intention of heading to the nurses’ station to find out where Bianca Perez was. But as he reached the hallway, he remembered that a few single rooms near the nurses’ station were reserved for patients who might need closer attention. Mitt immediately felt better and thought there was a reasonable chance she’d been put in one of them since her surgery had been so late in the afternoon.
Just around the corner, he ran into a nurse heading in the opposite direction. He stopped her and asked if she knew where Bianca Perez was.
“Oh, yes,” she said. “I certainly do. She’s down on ten in the surgical intensive care unit.”
“What?” Mitt stammered. “Why the ICU? What happened?”
“As far as I know, she apparently bled out into her abdomen. No one had any idea until her blood pressure suddenly went to zero. We called the on-call doctor, who immediately called the second-year resident. The patient ended up being rushed down to surgery. Then we heard she was going to the ICU after she left the recovery room.”
“Good God,” Mitt voiced.
“I wasn’t the nurse on the case. That was Elenore Williams. She’s back at the nurses’ station at the moment, and I recommend you speak directly with her if you want more details.”
“That’s okay,” Mitt said, suddenly feeling weak. Although he certainly wanted to find out more about what happened last night, he specifically needed to learn what Perez’s current status was so he could present the case at the upcoming morning rounds. As a major complication, it was obviously going to be one of the most important cases to be discussed. Without another word, he turned on his heels and hurried back toward the elevators. As he ran, he felt an overwhelming sense of unreality, as if he were in a dream. This was his fourth patient, and it sounded as if she might be in extremis. The nurse had said bled out. Could that be possible? He didn’t know, but he needed desperately to find out.