Cassie Alexander: Nightshifted

“Meaty, any word?” I asked, as Mr. November switched gears and tried to reach his ET tube, one millimeter at a time.

Meaty gave a negating grunt. While Meaty was likely not Meaty’s actual name, he or she was Y4’s charge nurse, which meant they were the resident expert on all nursing-related chores, the general patient coordinator, and our physician liaison. With an androgynous face and an abdominal drape that almost reached the floor, Meaty brought scrubs from home to accommodate his or herself, the bathroom in the locker room wasn’t sexed, and I hadn’t had the balls yet, metaphorically, to ask.

Frustrating as it was, it wasn’t Meaty’s fault the doctor hadn’t called back. They probably wouldn’t ever call back, and Mr. November would be squirrelly all night.

“Damn.” I flipped through the nursing chart to write another note on the restraint form, choosing “restless” and “continually pulling” for Mr. November’s past hour of activities. Too bad there wasn’t a form for my opinion on the state of things—I would have written “bleak” and “undersupported by other hospital staff.” I hoped the call had woken the doctor up.

Even though he’d been here for a few days, Mr. November’s chart was mostly empty, except for his tox screen. The emergency department here surreptitiously checks people for various conditions—such as “porphyric hemophilia” (likely vampire-exposed), “leprosy” (likely zombies), “rabies” (likely were), and “sisters of junkies who were suckers” (me). Everything else, all of our plans, treatments, and patient response, was unofficial. But surely some actual records were kept somewhere, if only for accounting’s sake. The drugs we used alone must cost a fortune. And even if my fellow nurses were getting paid just as poorly as I was, someone was footing our bill. The only thing in other charts that gave me any clues was the patient information page saying patients belonged to a health insurance group I’d never heard of before, the Consortium.

But not Mr. November—we didn’t even have his real name. Hence being named for the month. He’d been found outside, dehydrated, with a kicking case of pneumonia, too run-down to move. He looked eighty. Thin white skin hung in empty folds around his sharp features, like ice melt off a glacier, so thin that lifting tape wrong would tear it. During my assessment I could smell the bad breath of a body going metabolically awry. He had a central line going into the femoral vein on his thigh, channeling in medications and, of course, blood.

Not because he’d bled out—but because technically he’s almost a vampire. Not a full one, but a “vampire-exposed human,” some real vampire’s daytimer.

Despite all the legends about instantaneous infection, it usually takes repeated exposure to vampire blood for it to change you—assuming you weren’t allergic and didn’t just die instantly from anaphylactic shock.

Mr. November had been exposed to a lot of vampire blood at some time. His fanglike canine teeth, which I could see now as he tried to work his ET tube out with his tongue, meant he had to have come close to changing. I wondered why nobody had ever finished the job and wished they had; it would have saved me this night of work. Because now, even though he was probably three hundred and twelve, vampire blood having life-extending properties, he could still die on my watch. People who’ve been exposed live long, but they aren’t full vampires, and they don’t get to live forever. As if fighting this fact, Mr. November started leaning forward in bed again.

I went back in the chart to see what medications I could give him. He was maxed for now, but come four A.M. if Dr. Turnas hadn’t called back, I planned to reintroduce him to my friends lorazepam and oxycodone in a big, big way.

Charles walked over from his side of the ward. His patients were asleep or quietly watching TV. “Need any help, new kid?”

I was fairly sure Charles knew my name by now, and just as sure that it wasn’t worth letting it get to me. “Not unless you’re hiding an extra bag of fentanyl,” I said. He laughed. Charles was my height and older, with brown hair turning gray. I’d noticed that no matter how hectic the night felt to me, Charles never let it show. I was jealous of his ability to keep his act together, but I’d like him more if he didn’t pretend I was twelve.

“You’ll be fine, new kid,” Charles said, but he wasn’t looking at me. I followed his gaze to see Mr. November making plucking gestures with his right hand. I thought Mr. November was reaching for his IV despite the pillow I’d placed in his way, until all but one of his fingers curled inward, leaving only his pointer out. He started to move it deliberately. Spelling things. I groaned.

“Stay out,” Charles advised. Mr. November didn’t stop.

“He’s trying to communicate,” I said.

“Just because he’s trying to doesn’t mean he can.”

Which was true. Most times patients would scribble off the page and onto themselves, if they had enough reach. But then again, a few could tell you if they were cold, or hot, if they wanted the lights on or the TV off. You’d be surprised what people can obsess on when they’re doped up and have nothing else to do. Once a guy told me in Spanish that he wasn’t getting enough aire. I did a blood gas to check, and he’d been right.

My patient, my call. I grabbed paper from the copier, a Sharpie, and a clipboard, and suited up to see.

Because working on Y4 is like being in a hybrid ward for biohazards, trauma, and psych, isolation gear carts sit outside each room. They’re equipped with gowns, face masks, hair nets, and gloves, just like every other isolation cart you’d find in County, until you get to the CO-propelled tranquilizer rifles loaded with suxamethonium chloride darts in their top drawer. During training when I asked why we didn’t have garlic and crosses, I was told that garlic doesn’t work, and the Consortium doesn’t allow vampire-specific discrimination.

I pulled my gloves on and gave Charles what I hoped was a sorry-for-ignoring-you shrug before walking in.

The same badge that granted access to the elevator and locker rooms triggers the light set over Mr. November’s door, so Meaty will know where I am if there’s a lockdown. Charles knows where I am too, and is unimpressed, leaning on the doorway behind me.

“Okay, sir. Do me proud.” I removed both the restraints on Mr. November’s right hand, positioned the pen in it, then braced the clipboard upright for him against the pillow. “Are you in pain?”

I couldn’t imagine that he was, but he was still awake. He ignored my prompt, and began working on a laborious capital A.

“Do you need to have a bowel movement? Want the TV on? Lights off?” I ran through my routine, while he made three—no, four— n ’s in a row. Typical intubated patient. I sighed. I glanced over my shoulder and saw Charles smirking.

I launched into my stock speech number three.

“It’s two A.M. in the morning on Sunday, November twenty-ninth.” And I’d been working straight through since Thanksgiving, courtesy of being the newest nurse and having a desperate need for holiday pay. “I know it’s frustrating when you can’t communicate, but you’re in the hospital. We’re taking good care of you.” I reached out and patted his arm. “Save your strength and rest.”

He finished another letter, a lowercase a. I took the clipboard from him.

“Annnna … Anna?” I sounded out aloud, and he nodded, tubes and all. A small triumph, potentially imaginary. “I’ll see if we can contact her for you.” The light of human connection—or whatever passed for it here—flashed in his eyes and his lips curved into a smile. If I didn’t know he had fangs and was getting a rhino-killing dose of narcotics, he’d look like any other elderly patient. I took the pen from his hand and his eyes closed.