Dustin Thomason - 12.21

“So what now?” she asked, deadpan.

“Soon as the nurses are done in there,” Stanton said, “we should try to get Volcy to tell us all the dairy items he might have had in the last month or so.”

“I’ll do my best,” she said, “but I’m not sure he completely trusts me.”

“Just keep doing what you’re doing.”

STANTON WAS SURPRISED to find no one standing outside Volcy’s room. Mariano, the security guard, was nowhere to be seen, and no replacement had arrived. Every guard in the building must have been called down to control the crowd from the freeway accident.

Inside, Stanton and Chel found nothing but an empty bed.

“Did they move him?” Chel asked.

Stanton flipped on the lights and scanned the room. Seconds later they heard a hissing coming from behind the bathroom door. He put his ear to it. “Volcy?” The hissing was high-pitched and sounded like a leak, but there was no answer.

Turning the doorknob, Stanton found it unlocked. Then he saw Volcy. The man was facedown on the ground as if he’d been cold-cocked. The room itself was destroyed: drywall everywhere, the basin of the sink detached from the base, copper pipes protruding from the wall and leaking water onto the floor.

“ Masam… ahrana… Janotha …” Volcy mumbled.

Stanton dropped to the ground and touched the patient’s shoulder.

“Are you okay? Can you hear me?”

No answer.

He pulled the man’s arm around his neck to lift him up. Stanton could feel how distended Volcy’s body was; the man’s arms, legs, and torso all looked like they had been pumped too full of air. Like they were desperate to be punctured. The skin was cold.

“Get the care team!” Stanton yelled to Chel.

She seemed paralyzed.

“Go!”

Chel darted, and Stanton turned back to the patient. “I need you to hold on to me, Volcy.” Stanton tried to get him back to the bed, where they could put him on a ventilator. “ Come on ,” he grunted, “stay with me.”

By the time the rest of the medical team got there, Volcy was barely breathing. He had ingested so much water that it was overloading his heart, and he was close to cardiac arrest. Two nurses and an anesthesiologist joined Stanton at the bedside, and they began to inject drugs. They covered Volcy’s face with an oxygen mask, but it was a losing battle. Three minutes later, Volcy’s heart stopped.

The anesthesiologist applied a series of electric pulses, each stronger than the last. The defi brillator paddles left scorch marks as the patient’s body arched up. Stanton began chest compressions, something he hadn’t done since his residency. He threw his weight down from his shoulders and delivered a series of rapid pulses to Volcy’s chest, just above the sternum. The body rose and fell with each, one , two , three , four…

Finally the anesthesiologist grabbed Stanton’s arm and urged him back from the bed. She said the words: “Time of death twelve twenty-six p.m.”

MORE AMBULANCES SCREAMED from the 101 freeway toward the ER. Stanton tried to block out the sounds while he and Thane watched the orderly team lifting Volcy’s corpse into the body bag.

“He’s been sweating for a week straight, right?” Thane said. “He must have been dehydrated.”

Stanton looked down at the blue, bloated corpse. “This didn’t come from his kidneys. It came from his brain.”

Thane looked confused. “You mean like a polydipsia?”

Stanton nodded. Patients with psychogenic polydipsia were driven to drink excessively: Sinks had to be disabled, toilets drained. In the worst cases, like this one, the heart failed due to fluid overload. Stanton had never seen an FFI patient do it before, but he was angry at himself for not considering the possibility.

“I thought that was a symptom of schizophrenia.” Thane was rummaging through the man’s chart, trying to grasp what had happened.

“After a week without sleep, he might as well have had schizophrenia.”

As the orderlies zipped the body bag, Stanton imagined Volcy’s horrific last minutes. Schizophrenia caused abnormalities in the perception of reality; FFI patients exhibited many of the same symptoms. Stanton had often wondered if sleep was all that kept healthy people out of insane asylums.

“What happened to Dr. Manu?” Thane asked.

“She was here a minute ago.”

“Guess you can’t blame her for freaking when she saw this.”

“She was the last person to talk to him,” Stanton said. “We need her to write down everything he said as precisely as possible. Track her down.”

The orderlies lifted Volcy’s body onto the gurney and wheeled it out. After the corpse was prepared, Stanton would meet the pathologists down in the morgue for the autopsy.

“I should’ve been here,” Thane said. “I got pulled down to the ER. They’re sending way too many critical patients here from that accident. It looks like an Afghan fucking field clinic down there now.”

“Nothing you could’ve done,” Stanton said, pulling off his glasses.

“Some asshole falls asleep in his SUV on the freeway, and the rest of our patients suffer,” Thane said.

He walked to the window, moved the curtain aside, and gazed down below. A siren blared as yet another ambulance pulled into the ER bay. “The driver that caused the crash fell asleep at the wheel?” he asked.

Thane shrugged. “That’s what the cops said.”

Stanton focused on the flashing lights below.

IT WAS PAINFUL FOR HECTOR GUTIERREZ TO LIE TO HIS WIFE about the trouble he was in and even more painful to think that, if he got caught, their little boy probably wouldn’t even recognize him by the time his father got out of prison. Hector thanked God he’d already emptied the storage unit before the cops had raided it. But he was sure his house was next. His source at ICE who’d tipped him off (and been paid handsomely for doing so) said they’d been gathering evidence against him for months. If they found everything, Hector could face up to ten years.

Maria wasn’t working on Monday, so he couldn’t move the goods out of the house until the next day. Instead, he took Ernesto to Six Flags, where the two of them hurtled around on old roller coasters. It made Hector happy that his son had a blast, but he was convinced someone was following them, tracking them through the park. There were shadows in the funnel-cake lines and lingering faces at the arcade. He sweated anxiously all day, despite the fact that winter had finally come to L.A. By the time they got back home, he’d soaked through his shirt and socks.

That night, he cranked up the air-conditioning and watched an hour of sitcoms with Maria, desperately trying to figure out how to tell her what was going on. By two a.m., she’d already been asleep for hours, blissfully unaware, while Hector was still wide awake in front of the TV and covered in sweat. Not since his teenage love affair with cocaine had he felt so on edge. His ears stung with every noise: the hum of the cable box, the teeth-clenching sound Ernesto made when he slept, the cars out on 94th Street, each of which sounded like it was coming for him.

Past three, Hector climbed into bed. His mouth was dry, and he could barely keep his eyes open. But still he couldn’t sleep, and every turn of the clock was another reminder of how little night was left—he had a huge day of moving everything out of the house ahead of him. Finally he woke his wife in a last-ditch effort to tire himself out.

Even after the most electric sex they’d had in months, he couldn’t sleep. Hector lay naked next to Maria for almost two hours, soaking through the sheets, flesh and fabric glued together by sweat. He rapped his head against the mattress. Then he got up and surfed the Internet, where he found pills from Canada that promised sleep within ten minutes. But of course you had to call during regular business hours.