I’m not saying it stinks—well, to some people, it does. I remember the classmate who finished our med school OB/gyn rotation without ever delivering an infant. He delivered half of the head, and then the look on his face was so horrid that the obstetrician delivered the rest of baby.
I’ve got a stronger stomach than that classmate, but when I stepped into the delivery room at Montreal’s St. Joseph’s Hospital, it only smelled like sweat and a little blood. The odours would grow more intense once the amniotic fluid broke and the afterbirth emerged, but for now, I didn’t hold my breath.
My eyes adjusted to the darkness. The nurse had turned the lights off, except a small fluorescent lamp beside the bed. The baby’s heartbeat chugged along on the fetal monitor. Whump, whump, whump at 162 beats per minute.
Most of obstetrics is nice and normal. Even our C-sections tend toward planned events instead of crash OR’s. They screen out congenital abnormalities at our small, Canadian community centre.
“This is the only happy area of the hospital!” an obstetrician told me on my first day. “Everybody’s smiling!”
The black woman labouring in the bed wasn’t smiling. She was sweating. Which made sense. “That’s why they call it labour,” the nurse often says, while the woman recovers from the latest contraction. That’s normal too.
So I was pretty surprised when my obstetrics rotation transformed into a bone-chilling bloodbath.
But that evening of November fourteenth, I didn’t suspect anything except the fact that I might not get to eat the lentil casserole I’d stashed in the residents’ lounge for supper. I smiled at my newest patient, Ms. Beauzile. The nurse had cranked the back of the bed up so that the patient was half-sitting up, squinting at me from her pillows, with her legs bent at the hips and knees, and her thighs spread over a foot apart. Can’t say I’m looking forward to the indignity, should I ever get the chance to procreate. Especially if I had to labour solo, like this lady.
According to the electronic whiteboard posted in the nursing station, Ms. Beauzile was 28 years old, or only a year older than me. This was her first baby, and she was at six centimetres, or sixty percent en route to pushing out this passenger. She also had a low grade fever of 38.1 Celsius, but the med student had noted that they weren’t giving her antibiotics, because she had a runny nose and they figured it was a cold. Good call.
“Madame Beauzile, I’m Dr. Hope Sze. I’m the resident doctor on call for obstetrics.” I glanced at the top right hand corner to find the stamp with her first name. It was one I’d never heard before, and sounded Russian to me: Manouchka.
Now was not the time to inquire about how she got such an unusual name. Not when she clutched the white plastic bed rails, dragging herself forward with both arms, heaving herself to 90 degrees, and started to huff.
The nurse grabbed her hand. “Yes, Manouchka! That’s it!”
I took a step forward and said, “Yes! Keep going!” I felt slightly silly, since I was crashing their two-person party and didn’t really know how to encourage her.
But after half a minute, the patient sighed and settled back down in the bed. The dim, yellow light reflected the sweat on her deep brown forehead. The baby’s heart rate, which had only slowed down to 139, climbed back up again. The mini-contraction was over.
“Next time,” said the nurse, studiously ignoring me. OB nurses generally hate medical students and residents. You have to prove yourself. They’d rather you left them alone while they coach the patient through labour and handle, well, just about everything else.
This Asian nurse was shorter than me, which always gets me excited, since I’m only five foot two and a quarter. (The quarter makes people laugh, but it adds up to 158 centimetres instead of 157, and I’ve got to treasure every millimetre.) Her hair was a short bob, not unlike the cut I’d sported over the summer, until I decided to grow my hair down to my shoulders. Like me, she wore glasses. When I’m on call, I’m all about the glasses. Not only do they dry out my eyes less than contact lenses, but they’re also a built-in eye shield from bodily fluids.
However, the nurse was probably twenty years older than me, wearing fashionista-frightening purple scrubs covered in owls, and scowled like she’d rather push my face into a newly-delivered placenta than shake my hand. Too bad. Sometimes, I’ll meet another Asian and we’ll nod at each other in recognition, but not this time.
The speaker built into the wall at the head of the bed crackled with static. “Do you have a visitor in there?”
The nurse pressed the red button mounted on the wall. “No, it’s just the resident.” She had a way of biting off her words that sounded maybe Filipina.
“The junior obstetrics resident, Dr. Sze,” I called out. I tell people to pronounce it like the letter C.
The nurse snorted. Her flowery name tag, clipped to her already-blinding purple scrub top, said JUNE, but she seemed more like a porcupine, to me.
The intercom crackled, and the unit secretary’s voice quavered, “We’ve got a woman here saying that her friend is in one of the case rooms. Casey? Maybe she’s with Dr. Beeman?”
“I can’t help you,” said June, letting go of the red button and turning back to Manouchka.
My pager beep-beep-beeped.
I had a feeling it was Dr. John Tucker, so I grinned even before I turned the pager so that its little plastic face could tell me who called. I shouldn’t have been smiling. I should’ve been keeping my distance from him, since I’d officially contacted the University of Ottawa about transferring so that I could finally move back to my hometown and back to Ryan Wu, my past and present boyfriend, ideally before the end of 2012. And I usually yell at Tucker for paging me when I’m on call, when I’m already pulled in ten million directions. But he was also on call, albeit one floor up, and I could use a friend plus or minus benefits.
It wasn’t Tucker.
It was 3361. My senior resident, Stan Biedelman.
I’d have to answer it back at the nursing station, since the phone in the room belonged to the patient, and I didn’t want to use up my iPhone battery or my personal minutes. St. Joe’s was too cheap to give every resident a hospital phone. “Excuse me, Ms. Beauzile,” I said. “I’ll be back.”
She turned her cheek away from me, her face puffy with pregnancy. Her hair tufted against the pillow.
I hadn’t even had a chance to check her cervix. I don’t always, because the fewer hands travelling up the va-jay-jay to contaminate the amniotic fluid, the better.
Luckily, the delivery rooms, or case rooms, are lined up one after the other, on the right side if you’re heading down the hall, and mine was directly opposite the nursing station on the left. So it was less than ten strides to the nearest beige phone sitting on the counter. I punched the four-digit extension in and introduced myself.
“There’s a consult in emerg,” said Stan, who’s only a year ahead of me in the family medicine program. “Vag bleed at ten weeks.”
That was slightly unusual. Nearly all our emergency consults are for vaginal bleeding at five to seven weeks, from women who may be miscarrying. Ten weeks is a bit late.
“It’s Dr. Callendar on, so you know what that means,” said Stan.
I did. It meant that he hadn’t done a vaginal exam. Theoretically, the emergency staff should do a complete physical exam, but if they’re lazy like Dr. C, they’ll slog it off on the specialty service. Tonight, that meant me. The rash on my ankles started to itch under the cuff of my socks. I started playing with the tinsel on the desk so that I wouldn’t scratch myself or say something I’d regret.
“Page me when you’re done, and we can talk to her together.”
“Thanks,” I said. Still holding on to the phone receiver, I walked around the counter to eyeball the whiteboard mounted above the clerk’s head. They keep it inside the nursing station for patient privacy. We only had three patients, including Ms. Beauzile. If I was going to deliver any babies before supper, she was my best bet. I grabbed the mouse, right-clicked her name, and added my name beside Ms. Beauzile’s, so Stan or the medical student shouldn’t try to swoop down and steal her.
I’d only delivered two infants as a medical student—not so many more than my queasy med school friend—but I had to liberate at least fifty this month, because St. Joseph’s has an unofficial quota. For every month on OB, you’re supposed to check off at least fifty newborns. If it’s a less fertile month, tough. Elbow the medical students out of the way and try and get the other resident to take of the wards while you run to the case room a minimum of fifty times.
So far, I’d delivered two babies in my first two days. Not bad, but I’d have to step it up if I was going to make quota before December tenth. I remembered something else to tell Stan. “Oh, by the way, the clerk said someone was looking for you. I assume it was you, anyway. Dr. Beeman?” Sounded kind of like Biedelman. I’m used to people massacring my last name.
“If they need me, they know where to find me.”
“Three-three-six-one?” I said, citing his current extension.
“Yeah. You got my cell phone, too, but don’t give it out to strange men.”
“Strange women okay?”
“Yeah. Just don’t tell my wife.”
We both laughed, and I hung up, forgetting to tell him not to steal my delivery. Oh, well. He was probably too busy eating Cheetos while I slogged away, but it didn’t bother me. Much. The junior always does all the work. Or, as Jade, a second year resident, pointed out after a particularly terrible emerg shift, “Shit rolls downhill.”
The ER is sort of the mosh pit on the ground level where every man, woman, and child in Montreal ends up before we sort them out, and also where I want to work when I grow up. First, I had to get out of the labour and delivery area. I’m not sure why we call it the case room, because it’s basically a series of four rooms along the hallway, across from the nursing station. Up to four women can labour at once. If you continue past the case rooms to the end of the hall and turn left, along the bottom of a U shape, you’ll come out at the OR for emergency C-sections.
Instead, I forged a straight line in the opposite direction, toward the elevators. I passed a pregnant woman in a black burqa shuffling in the same direction. We often see women who wear head scarves—actually, I’m the one who gets them, because they invariably ask for a female doctor, and I often smile when I spot the trendy clothes underneath—so maybe this one would be my second delivery of the night. She was moving a little oddly, though. Not quite waddling, but kind of stiff-legged, although it was hard to tell because the fabric covered her head to toe. The hem swept the floor, and the material hung over her hands, with only a letter slot opening for the eyes.
I turned sideways to pass the two couples waiting for triage. The women’s glazed eyes flickered past me. They were already tired, even before going into labour and actively pushing. Neither of them wore that eager, first-time relish. These women and men probably already had a kid or three at home, and wanted to get this over with so that they could start a new routine.
Triage is a doleful spot at the top of the corridor, because patients are waiting for one nurse to decide if they’re far enough along in labour to warrant being assigned to one of those four room, or if they’re going to get told to walk around and come back later. We also do non-stress tests here, or NST’s. Sounds horrible, but it just means a pregnant woman is strapped up to a monitor and we check the fetal heart rate for twenty minutes, to make sure it’s okay
Usually, I’d sweep straight down to the emerg, the better to catch more deliveries. Instead, I glanced over my left shoulder. My potential new patient wore the most extreme sort of burqa, with a type of fabric grille over the eye opening. I couldn’t make out her expression, which freaked me out a little. Still, she was pointed toward triage, which was probably the right place for her, although it was hard to tell under all that cloth.
One lucky couple entered the triage room, leaving just the other couple in the hallway. Instead of queuing behind them, the burqa woman slowly passed them, following in my footsteps.
My eyes followed the burqa lady. My gut was trying to tell me something, although I couldn’t exactly tell what.
I had to finish the emerg consult before Manouchka delivered her baby. I should have shot straight downstairs, but that nagging feeling made me wheel back toward the burqa woman, and I found myself saying, “May I help you?”
The figure in black turned toward me without speaking.
The same uneasy vibe made my scalp tingle and my voice rise. I said, “Were you asking for Dr. Biedelman? He’s a male physician. If you want a female physician, I can help you. I’m the junior resident on obstetrics and gynecology.”
The woman in black looked me up and down, still silent.
I was trying to peer through the grille of the veil. I figured I had to be able to look in so that she could see out, yet all I could make out was a bit of pale forehead and some deep brown eyes. The eyebrows seemed a bit bushy to me, which could’ve been a cultural thing. Or she didn’t have time to groom her eyebrows while she was in labour.
The triage nurse called out from her room, “It’s okay, I already paged Dr. Biedelman for another case.”
“Okay,” I said. I didn’t know why I was trying to save Stan more work. I was already doing the emerg consult for him.
I spun on my heel, toward the wider hallway in front of the elevators. I narrowly avoided running into a pregnant woman with bright blonde hair, a well-cut navy coat, and enough bling on her hands to blind an army. She clung to her husband’s arm. He was wearing a good-looking suit and surveyed the queue in front of him, his forehead already pleated with exasperation. They looked like money. You don’t see that often at St. Joe’s. Not that we don’t have middle class, but a lot of people are immigrants adjusting to a new country, not the Kennedys slumming it.
A set of elevator doors binged open to my right, and Stan stepped through the candy cane-stickered doors, coming toward me. He’s a big guy, probably six feet tall, made a few millimetres taller by a yarmulke. I’m not good at gauging heights. For me, most adults fall into the category of “tall” and “taller.” Anyway, Stan’s hilarious. I prize anyone who can make me laugh when I’m on call.
I started to wave at him. He said, “If I don’t answer my page, it’s because I’ve got a woman in labour.”
“Who?” I said. “The one at six centimetres, I’ve got my name down on her.”
“Mine just came in. She’s full term and fully dilated.”
“I want her!” I said.
He smirked. “Not a chance. The nurse called me about her directly. She’s gonna push. And you’ve got the emerg consult.”
I clenched my hands into fists. He glanced down at them with a little smile, so I forced my hands to relax as I asked, “Stan, how many women have you delivered so far?”
“Let me see.” He pulled out his phone and pretended to check. “Oh. Eleven.”
“I’ve only got two. Let me have her, and then I’ll go right down to do the emerg consult. Please.”
“Forget it. I’ve got to get to fifty.”
“But you’re already over 20 percent of the way there! And we’re on day three. Come on, Stan.”
He waved. “Hey, enjoy Dr. Callendar. I did, when I was the junior. Now it’s my turn.”
Right. His turn to cherry-pick the women in labour. I steamed.
“Your turn will come. You said you had your name down on the six centimetre one. All in good time.”
With my luck, Manouchka Beauzile would deliver while I was in the emerg, at the exact moment when Stan miraculously stepped into the room. Then I could end up with zero deliveries during my night on call. I took a step toward him. “Stan.”
He waved me away. “See you later, Hope. Look, the elevator’s already open for you. Just ride it on down.”
As if on cue, the usually molasses-slow elevator doors slipped closed. Stan chortled.
I wanted to hit him. He was so smug. And anyway, I usually took the stairs, at least at the beginning of the night, while I still had some juice. The stairs were around the corner, closer to the ward rooms where moms cuddled with their newborns and a few women lay on bed rest, trying not to give birth to premature twins. I started toward the stairs, but the burqa woman said, in a muffled voice, “Excuse me.”
She stood before the single doorway to the case room, blocking Stan’s way in toward triage and the labour rooms.
Stan hesitated. “Yes?” He gazed over her head, down the hall, clearly already ticking off number twelve in his mind.
She didn’t have an accent, exactly, but she pitched her voice low. “What is the name of your patient?”
That was an odd thing to ask.
“Sorry, I can’t disclose any patient names,” said Stan, glancing at the triage line-up behind her.
“It’s important,” said the woman, crossing her arms over her shoulders, like she was cold and giving herself a hug.
“Just ask at the desk, if you’re a friend or family,” said Stan, starting to brush past her. I could already hear the triage nurse’s voice, raised in irritation at the blonde couple trying to cut ahead in line.
“Tell me,” said the burqa woman, louder now, with a strange note to her voice. The fabric billowed around her arms and chest.
“No can do,” said Stan, head down and bustling toward the case room and his next delivery.
The burqa woman pulled a big, black gun out of the folds in her robe and shot him in the back.
I screamed. It happened so fast. I’d never even seen anyone use a gun, except my dad fooling around with a BB gun in our back yard, and now Stan dropped to his knees before he caught himself on his hands, gurgling.
Behind him, the blonde woman and her husband ducked into triage and slammed the door behind them. Suddenly, only me, Stan and the gunwoman stood in the hallway.
“Call 911!” I yelled in the general direction of the nursing station, ignoring the gunwoman. The triage nurse had probably seen or heard enough to call for help, but it never hurt to sound the alarm.
Meanwhile, I’d focus on the A, B, C’s. Especially the airway and breathing. My eyes fixed on the bloody hole in Stan’s back, just below the point of his left scapula. Probably too far from the midline to cut his spinal cord, but right in “the box” where a shrapnel could pierce a heart or lung or both, depending on the trajectory.
Stan dropped on to his stomach, still breathing, so his heart probably hadn’t been hit. I have zero experience with gun shot wounds, but they say that after a heart attack, if you have myocardial rupture, and the heart bursts open, the person dies in a few beats. He’d already made it past that.
I fell on my knees beside Stan, who was barely sucking air into his lungs. Did he have a pneumothorax? The hole in his chest could still kill him within minutes.
My first instinct was to turn on him on his back, because that’s how patients always roll into the emerg on a stretcher, face up. Also, the exit wound in front of his chest would gape more than the relatively neat hole in back.
I stopped and grabbed the stethoscope hung around the back of my neck. Even with Stan face-down, I could listen to his breath sounds.
“Don’t touch him,” said the burqa woman.
I looked up.
She trained her gun on my face.
My hands stilled, slowly relinquishing the navy rubber tube of my stethoscope. It wasn’t that I’d forgotten her, but I had a higher calling here. I lifted both palms in the air. “Look. I’m a doctor. He’s a doctor.”
“I need Casey Assim,” the woman said. Her voice had descended into growl territory.
It took me a second to process that. Casey. That was the name the ward clerk had buzzed us about in Manouchka’s room. So Casey Assim must be a patient, a new one who hadn’t made it on the whiteboard yet. The one Stan had been on his way to deliver?
Stan tried to cough. He choked instead. The breath rattled in his lungs before he boosted himself on to his hands and started crawling on his hands and knees toward the open doorway. Toward the case room. Or the closed triage door. Or the nursing station. Any way you sliced it, civilization.
He knew where to go. His brain was still clicking. He had the strength to crawl. Should I try and distract the burqa woman? Maybe try and wrestle the gun away from her?
But that was an insane Hollywood move. And also, I couldn’t help noticing that Stan was deserting me while this woman held us at gunpoint.
I could distract her for the few crucial seconds while Stan got away, but I wouldn’t jump her.
I heard a nurse scream from further down the hallway. She tried to stifle it, which made it sound even worse.
From my view, at least thirty feet away, I could tell that they’d sealed all four case room doors, but the nursing station was an open desk area. The counter might protect you a little, but not the open table.
Maybe the staff would run toward the OR and back out the other side of the U, toward the ward. But could the patients run that fast?
The overhead paging system blared, “Code Black, Fourth Floor. Code Noir, quatrième étage.”
Then someone pulled the fire alarm. The high-pitched bell made my ears cringe.
“Is Casey the person you’re looking for?” I asked, raising my voice above the alarm. My arms quivered in the air. “I—”
The burqa woman looked down at Stan crawling and shot him in the back of the head.
The sound of the bullet echoed through the hallway.
His body flopped on the floor.
Blood coursed from the back of his skull.
I couldn’t make a sound.
I’d met murderers before. But they’d never killed anyone in front of me.
This was like an execution. And what had Stan done? He hadn’t broken patient confidentiality. He’d done the “right thing.” Now he was probably dead.
I didn’t want to die.
I really didn’t want to die.
I gazed down the case room hall, now empty of obvious human habitat, although I knew the triage room must be packed like Sonic dance club on the night of a full moon, and at least three out of four women labouring in the case room hadn’t made a break for freedom.
It was just me and the burqa murderer now.
The fire alarm shrieked overhead, a piercing scream that made my jaw ache and my arms tremble.
This couldn’t be happening.
Oh, yes, it could. I’d survived enough tight situations to know that real life could surpass any nightmare.
They call me the detective doctor. But it’s one thing to try and figure out any wrongdoing after the fact. It’s quite another to have someone a) pull out a gun, and b) shoot your senior resident in front of you.
“How may I help you?” I said, trying to sound civil, like this was normal. Like I wasn’t about to get whumped. I thought of my main man, Ryan. My first runner-up, Tucker, who made my toes curl. My little brother, Kevin. My parents. My grandmothers.
I love you. I’m sorry I never told you enough.
The burqa woman detoured to grab me from behind, her body a solid presence behind mine while she drilled the muzzle of the gun against my right temple. The muzzle was still cool after shooting Stan.
She’s right-handed, I noticed with the back part of my brain. Maybe it would make a difference, maybe it wouldn’t. But my shocked brain insisted on memorizing facts like this and noticing that she smelled like beer, tangy sweat, and something unpleasantly familiar.
“Get me Casey Assim,” she said. “Now.”
“I can get you Casey Assim,” I said, since at this point, I would have promised both my grandmothers. Not that I’d actually deliver them to this madwoman. But I’d lie up and down Main Street if it would buy me a few seconds. All was fair in love and at gunpoint.
“They just brought her in,” said the killer. “She’s in labour. It’s her due date. I know it’s her.”
Faulty logic, but my shoulders jerked as my hindbrain calculated, That’s a man’s voice. This is a man, not a woman. A man dressed in a burqa.
He was crazier than I thought.
I was deader than I thought.
“Okay,” I said.
“Get me to her room, or I’ll kill you, too.”
He wasn’t that much taller than me. Maybe five foot eight, but stocky, like a wrestler, with wide shoulders and firmly planted feet. And did I mention that gun?
“No problem,” I said, an expression my dad hates. He says, There’s always a problem. Why would you say there’s no problem? He had a point, especially when I was nose to nose (okay, back of head to nose) with Mr. Death.
Dad. I’m sorry. I love you.
I felt Mr. Death jerk his head toward the doorway. He knew that was the main entrance to the case room. He knew how to get there, but he wanted me to lead him, like a little Dr. Gandhi, while he kept the gun trained on my temple, the thinnest area of my skull.
He wanted me to play hostage.
Part of me thought, No. Run.
If only I’d run in the first place, when my subconscious brain must have recognized that the way he moved and the breadth of his shoulders didn’t gibe with a pregnant woman.
Now it was too late to run. The emergency department and hospital front desk had security guards. Obstetrics had nothing.
I must have glanced or somehow turned left, toward the elevator, because the bastard cocked his gun, and I felt as well as heard the hammer shift.
I don’t know guns, but I’ve seen enough TV shows to figure out what’s fatal.
I froze in place like an arctic hare dropped in downtown Tokyo.
I’ve actually listened to a podcast about what to do when an active shooter enters a hospital. Running is your best option.
But running with a bullet in your brain? Not possible.
Without taking my eyes off the gun, I took a step toward the doorway. Toward triage.
“That’s it, bitch,” Bastard whispered.
I gestured at Stan’s unmoving body, which lay five feet away from us, blocking the doorway. I could smell Stan’s blood.
I have a strong stomach, but I had to hold my breath and not-think, not-think, not-think if was going to survive even the next few minutes.
Bastard didn’t answer, except to keep his gun pressed against my cranium.
I walked with Bastard’s body cemented against my back. Have you ever had an unwanted guy grind behind you on the dance floor? Like that, times a billion.
I had to glance down as I/we stepped over Stan’s body, carefully picking my way to avoid his sprawled arms and the ever-widening pool of blood.
Stan’s yarmulke clung to his curly hair a centimetre above the bullet hole. I scanned the green felt for dots of blood and possibly brains. Then my eyes slid south. Was it possible that I glimpsed the pale, folded surface of cerebral cortex under the pool of blood dripping from the entry site?
No. Probably my imagination. I clung to the fact that his religious symbol remained intact. Maybe he and I would, too. I sent a brief prayer toward Stan and any available deity: Please.
People have survived gun shot wounds to the head. I’ve never seen it, but I remembered a neurosurgery resident explaining to me, in detail, how a high velocity bullet could hit a non-critical area of the brain and come out the other side, necessitating surgery, ICU, and a lot of rehab, but not a one-way ticket upstairs/downstairs.
The bullet had hit Stan in the occiput, so bye-bye occipital lobe. But I thought it was higher up than brainstem, which would have spelled instant death. So it was possible, if not probable, that he might pull through. But the longer he lay on the ground, the lower his chances of any meaningful recovery.
At least by drawing the gunman away from Stan, I was allowing the emergency crew to make its way toward him.
On the other hand, it meant I was drawing the gunman toward a bunch of defenseless pregnant women.
I might have yelled for them to run, but the fire alarm was doing all the screaming for me. The sound invaded my head, made it hard to think anything except Shut up.
My body walked anyway, with the diaphragm of my stethoscope banging a drum beat against my chest. I held my hands up in the air, both to calm down the gunman and so that anyone looking at me would immediately compute that something was wrong. Flee. Now.
The case room hallway looked deserted.
It didn’t feel empty, though.
First door on the right. Triage. I imagined all those exhausted pregnant women and men, plus the triage nurse, holding their breath and barring the door. I walked a little faster, hoping that Bastard wouldn’t pause and knock on that door.
Now we’d reached the nursing station on our left. The long, white counter hung with tinsel, which the elderly ward clerk usually sat behind, answering the phone with her crystal-studded acrylic nails, and which I stood in front to write my charts or answer my pages: empty.
Behind the counter, the communal wooden table and small alcove, where the nurses sat to chart and to watch the fetal monitors mounted to the wall, under Christmas balls dangling from the ceiling: empty.
Everyone had taken off. Or was at least out of sight, for the moment.
I tensed. He could easily yell, “Bring me Casey, or I’ll kill this chink!”
And then, if no one answered, he’d shoot me out of spite.
The alarm screeched on. Overhead, the hospital operator intoned, “Code Black, Fourth Floor. Code Noir, quatrième étage.”
Bastard’s left hand relaxed on my shoulder while he held the gun to my right temple.
Was he letting down his guard? I could try to break away from him now.
But which way should I run? Back toward the elevators and Stan? He’d shoot me before I got ten paces.
Around the hallway’s U shape to the OR and then the ward rooms? Much, much further. And at least fifty feet of hallway, where I could get shot.
Under the desk, so I could hole up like a mouse before he executed me?
So many bad choices, so little time.
The only thing I didn’t consider was running for a case room or triage. He’d whack me, then take potshots at anyone and everyone else in the room.
But he didn’t want me. He wanted Casey Assim.
The fastest way to figure out her location was by circling behind the desk to view the white board linked to the desktop computer, which faced away from the hallway to protect it from prying eyes. That information would lead him right to her room.
So many women are killed by their partners and ex-partners. Should I aid and abet a murderer, plus get caught in the crossfire?
“Where is she?” Bastard said. He was still so close that I could feel the shift of his head as he glanced up and down the hallway.
Hiding from you, you maniac.
The fire alarm cut off suddenly, leaving my ears ringing.
That, too, was strange. Usually, the alarm goes on forever, and everyone has to close the exam room doors until the Second Coming, or at least until the operator says, “Code Red, all clear. Code Rouge maintenant terminé.”
Was the police on the way?
“I don’t see Casey,” I said, which was true. I couldn’t see any living soul. Maybe if I acted useless enough, he’d leave me alone.
Or shoot me. This was turning into a Choose Your Own Adventure where 90 percent of the endings left me unconscious and bleeding. I was not a fan.
“Go get her,” he said.
How could I delay him?
Light bulb moment. I pointed to the beige phone sitting on the counter, its receiver slightly blackened and greasy from numerous hands. Less than ten minutes ago, I’d been answering Stan’s page on that phone.
That phone could be my lifeline to make contact with the outside world, if he let me.
My cell phone buzzed twice in my pocket. I couldn’t answer Tucker or Ryan or anyone else right now, but I wished them safe and far, far away. Tucker was just one floor above me, tending to his internal medicine patients at this exact moment. Strange to think of the fifth floor as a world away, and that I might never see him again.
“What if I called locating and asked if Casey’s registered?” I asked. “They might be able to give me a room number.”
I didn’t have to give him the room number. Well, maybe he’d rip the phone away from me and threaten the operator to get it. But first, I might be able to speak to someone who could call the cavalry, if they hadn’t already. And the more I delayed, the higher the chances that the police could storm in here.
Bastard shook his head. “I already tried that.”
Right. And he’d created enough of a ruckus that the clerk had asked for Casey in Manouchka’s room. They never do that. My first tip-off that something was awry.
“I’m a doctor,” I said. “They might give me more information, especially since I’m calling from within the hospital.”
Bastard snorted and glanced up and down the corridor. “I know she’s in here some place. I should just bust down the doors and shoot everyone.”
My heart thumped in my throat, but I tried to speak calmly. “You might hurt Casey by mistake.”
He stopped to think about that. I could tell from the stillness in his body, even though I was facing away from him and he was still covered in a burqa.
He took a step back from me. My heart leaped, but he was just repositioned the gun from my head to my T-spine, between my shoulder blades.
Still. He was giving me some space. That had to be a good sign. Also, my mother would be proud how straight I was now standing, trying to edge a few millimetres away from certain death.
“If she’s registered, we can just go to the right room. That’s all we need. Right?” Now I was promising him Casey’s head on a platter again. I could hardly speak, my mouth was so dry.
I could hear Bastard’s glower through his voice. “I don’t want you calling the police.”
“You can do the dialing. You can even hold the phone, if you want.” The more non-gun things he used to clutter up his hands, the better.
Then I thought I heard a sound. Was it from Manouchka and June’s room?
I tried to glance over my left shoulder, at their closed door opposite the nursing station, but the muzzle boring a hole in my spine reminded me not to move.
Nothing to see anyway. June had probably hurled the door shut at the first sound of gunfire. With any luck, she’d barricaded it.
The gunman noticed my head twitch, but instead of blowing me away, he said, “Is she in there?”
“What? No. Not the woman you’re looking for. It’s someone else.” I stared straight ahead at the wall above the nurse’s table, petrified that even a quick look could sentence someone else to death.
“I’m not. That’s the one patient I saw before you. Her name’s not Casey.”
“Casey. Casey Assim. That’s who I want.” He grabbed my left arm and jerked me sideways, walking me the few crucial steps so I was now facing the first case room door. Obviously, all he heard was Casey’s name and nothing else. He was like a missile locked on detonate. “Get her out of there. Or get me in. I don’t care. She’s gonna have my baby.” He placed the gun at the back of my head now, which made me think of Stan.
Stan. Dead Stan.
Don’t think that way. He might still make it. Come on.
At close range, I finally recognized that insistent stink emanating from Bastard’s pores as marijuana. Lovely.
I forced myself to speak in a low, well-enunciated voice. “She’s not there. Let me call the operator. I’ll find you Casey.”
He pushed the gun a little harder against my occiput. “Open. That. Door.”
I stared at the edging etched into the white wood of the first case room door. If he shot me, could the bullet drive right through the wood and hit Manouchka or June too?
My hand dipped toward the metal door handle, but a sound caught my ear.
Not just any sound. A whistle.
On our right, echoing off the empty hospital corridor walls.
Someone whistling in the midst of blood and terror. It was as startling as if a bluebird had launched itself above our heads in this hospital hall of horror, singing a tale of joyful spring in mid-November.
I knew that whistle. My nails cut into my palms to stop myself from yelling. My breath rasped in my throat, and I know this sounds strange, but my nipples hardened.
I even recognized the song, “What a Day for a Daydream.”
It was the stupidest, most inappropriate song for this scenario, and that would have told me the whistler’s identity even if I’d been blindfolded and gagged.
It was one man I didn’t want trapped with me.
I wanted to scream, Run, Tucker.
Instead, I kept very still and prayed Bastard wouldn’t notice the song.
Fat chance. I might as well wish on a star for him to shoot himself.
I heard the rustle of Bastard’s clothes as he shifted behind me, just before he jabbed the gun again into the base of my skull, but it slipped an inch and caught me on the neck instead.
I bit back a cry as my neck arched involuntarily, jerking my chin toward the ceiling before Bastard swore and re-took his first position. Namely, his body stuck close enough behind me to scrape the skin off my back and the gun transferred to my right temple, with the extra-special addition of his left arm hooked around my throat, embedding my stethoscope into my breast bone.
The whistling grew louder.
Was Bastard smart enough to understand that Tucker was offering the aural equivalent of a white flag?
Probably not. He probably didn’t know what aural meant. Took me a while to figure it out, too.
“Let’s go,” I managed to whisper through the arm lock. My hair felt like it was standing straight out from my scalp, under the pull of the world’s best Van der Graaf Generator. I didn’t know where to go. I just had to get us away from here.
Forget rocks and hard places. I was smushed between a closed door and a killer.
“Shut. Up,” said Bastard.
Since the gun in my temple was already delivering me a Mach 1 headache, and Tucker was in imminent danger, I decided to obey. Maybe if I were very, very quiet, Bastard could control his trigger finger. Tucker would just keep whistling his way on by.
That whistling paused, probably as Tucker encountered Stan’s body, but then it picked up again, growing more intense in my right ear.
I could feel Bastard’s breathing speeding up as he exhaled beer fumes on me. He didn’t know what to do. He probably didn’t have a Plan A, let alone B or C. I was practically pressed against the wood grain, with Tucker oncoming, yet no sign of the cavalry. Where was the fucking cavalry? I know we’re in Montreal, but come on.
“That’s my friend,” I said, so that Bastard wouldn’t freak out and start spraying bullets.
“I don’t give a fuck who that is. It’s not Casey,” he said.
Fair point. I had to try again. Bastard might execute me, Tucker, or both, but I couldn’t just stand here. “Yes. If you let me get at the phone—”
“Shut. Up,” said Bastard, grinding the muzzle close enough to my right eyeball that I closed my eyelid, as if a thin patch of skin could protect me from potential blindness.
Tucker’s whistle, as well as his steps on the beige tile floor, faded into silence. I couldn’t see his body out of my peripheral vision, which was blocked by a firearm and a lunatic’s arm, but from the sound, I would guess he stood about five feet to our right.
Way too close.
“I’m here to help,” he said, in that baritone I’d recognize in my sleep.
Hearing Tucker’s voice confirmed that one of the major loves of my life was stupid enough to run toward this maniac.
Not that I should point fingers. My own “May I help you?” retardedness had likely killed Stan and would now probably take out me and Tucker.
For the first time in my life, I wanted to faint. Just black out and let someone else take care of this mess.
Instead, I ordered, “Get out of here, T—”
The gunman slid his left hand over my mouth, silencing me, but also squashing my nose so that I could hardly breathe anything except his dirty flesh.
I choked. My body bucked.
Can’t breathe. Stupid way to die.
I was a microsecond away from biting his hand. Just chomping down on his flesh. HIV and hepatitis be damned. I needed air.
Bastard eased up slightly, and I drew in a desperate, shallow breath, already feeling light-headed, but still hearing him say, “I’m going in. Casey’s in here, having my baby. They better open it, or I’m gonna shoot this bitch.”
Love you, too.
“You don’t want to do that,” said Tucker. “Hope’s a famous doctor. She delivers babies.”
Well, that was sort of true. I was infamous. I was a resident doctor. And I have delivered babies. But I was on board for promising Bastard the solar system if he’d just let me breathe.
Bastard’s breath puffed while he mulled that over. His left hand drifted an inch away from my mouth, letting me gasp for oxygen while his right one stayed locked and loaded on my skull. “I gotta get to Casey.”
So he wasn’t a big thinker. More like the Hulk. Smash. Get Casey. Unh. I didn’t know if his idiocy was a good or bad thing, when he could blow our brains out in a quick one-two.
“You don’t need Hope at all,” said Tucker. “I’m a doctor, too. I can deliver Casey’s—”
Bastard tensed. I could feel it.
Tucker must have seen something, too, because he smoothly switched it to “—your baby. Why don’t you let Hope go, and I’ll get you in here.”
Oh, God. It was the most romantic thing Tucker had ever said, and also the stupidest.
I inhaled sharply to tell them, No. Casey’s not here.
Bastard clapped his hand on my mouth again. Not smashing my nose this time, so I could breathe, but definitely inhibiting my mouth’s ability to tell him he was barging into the wrong room.
Tucker said, “It’s okay. Let Hope go. I’ve delivered lots of babies. I’ll take excellent care of yours and Casey’s.”
“Casey,” said Bastard. Every time anyone said her name, he welded his brain to it and didn’t seem to register anything else. “Casey Assim. She’s having my boy. Get me in there, or I’ll kill both of you.”
“Then you’ll have no one to deliver your baby,” Tucker pointed out. “All you have to do is let go of Hope, and I’ll come with you. I’m an expert at delivering big, healthy baby boys.”
Tucker probably hadn’t delivered any more babies than I had, but he always put on the best show.
Bastard relaxed his chokehold slightly. “I don’t know who the fuck you are.”
“My name is Dr. John Tucker.” His voice grew louder as he approached us. I squeezed my eyes shut. I still had trouble breathing with Bastard face-palming me, but I didn’t want to watch Tucker laying down his life for mine.
I forced my eyes open. I’d have to witness everything I could, if we had any chance of surviving this. ’Course, all I could see was this darn door.
Tucker was still talking. His forte. He once considered a career in psychiatry instead of family medicine, but right now he was weaving a web of words around Bastard. “I have considerable training in obstetrics and gynecology. I would be honoured to deliver your son. Just let me take Hope’s place.”
“No one’s going nowhere until I get in to see Casey!”
“If you would allow me…” I spotted the blur of Tucker’s hand at five o’clock as he took a step forward to try the door handle. He said, “Hmm. They’ve locked it.”
“Stand back,” said Bastard. He let go of my face, which was a serious relief. My eyesight was starting to pinwheel.
I sucked in some more sweet air, trying to think through my haze. Maybe he was going to bust down the door like in the movies. And occasionally, in real life. Once I got an epileptic patient who’d had a seizure in the bathroom. The door was locked with the patient’s body wedged against the door. A police officer ended up breaking down the door.
Bastard dragged me backward by fastening his left arm tight around my throat and yanking me into the hallway.
I gagged, but I stumbled back with him like a dog dragged by its collar.
Dimly, I heard Tucker still offering to take my place.
Bastard shouted, “I’m warning you. Open this door, or I’m going to shoot it off. And then I’ll shoot one of these doctors, I don’t care which one.”
I held my breath. Even Tucker stopped jabbering, and that’s saying something.
Inside the room, quiet footsteps approached the door.
While we waited at door number one, Bastard kept his left arm wrapped around my neck in just under a chokehold, like a scarf itching to strangle me.
He also rammed his gun muzzle into my temple again. I supposed I should be grateful it was no longer attacking my eyeball, but the metal really hurt. Before this attack, I’d never thought about how just the brute force of a circle of steel, pressed into my skin, can bruise, even before the bullet performs a craniotomy at 1700 miles per hour.
So I didn’t tell him Casey wasn’t home.
I kept mum.
The approaching footsteps had stopped, but I thought someone hovered inside the front door. If I could’ve moved my head, I would have glanced downward to look for foot shadows shifting, but I couldn’t budge. I could only listen to the abnormally loud sound of my own breathing and wonder if this was it. My last few seconds on earth, cradled by a murderer.
The door handle clicked. My heart jerked in terror, in anticipation, I didn’t even know what anymore.
The door cracked open a centimetre. The inside was darker than the hallway, so I couldn’t see anything except a dark shape, but June’s clipped voice drifted out toward us. “Don’t shoot anyone.”
I wanted to say, Please. I wanted to say, Don’t hurt her. She’s just trying to protect her patient.
Her patient. Her patients, really, since the baby was almost making its way into the world.
What a way to be born.
Bastard’s body tensed. He didn’t want her giving orders. But instead of yelling at her, he launched forward, using me as a battering ram to slam open the door.
Instinctively, I threw up my hands to protect my face. I guess Bastard was having trouble juggling me, the gun, and propelling both our bodies forward, because even as he yelled, “No!” to me, he dropped me.
I ended up plowing against the door with both hands, and very nearly my teeth.
I bashed into it with my forehead instead. Like a hammerhead shark without the right equipment.
A dull pain encircled the rest of my skull in a throbbing, burning headband, but I fought through it, trying to figure out what was going on.
The door was giving way.
June had braced her body against the door, but when my body weight thumped against it, she only withstood it for a second, especially when Bastard hurled his body, too, using his arm to shove inward.
I remembered that June was actually a tiny woman, shorter than I was. She had no chance against our double onslaught.
Bastard had banged the door away from me, so I stumbled and smacked into the cool tile floor on my palms. The impact jarred me up to the shoulders, even before my knees banged down for extra impact. Greens don’t provide much padding.
“Get up, bitch,” said Bastard, grabbing my shoulder.
“No!” shouted June, trying to smash the door closed on both of us, and Bastard fired.
It happened so fast, I didn’t know what was going on. I was still on my knees in the doorway.
My ears rang. I smelled something, too, a burning smell that reminded me of fireworks.
All I knew was that Bastard had fired another bullet, and I didn’t hurt anywhere. Yet.
But someone howled—June, I thought, from the high pitch.
Then June’s small, shadowy body dropped to the ground, just beside the door she’d tried to guard, and I focused on her. My eyes were still adjusting to the dim light, but her face contorted in pain.
I shouted, “Tucker, get her out of here!”
Bastard snatched me by my hair. My newly-grown, long, straight black hair, which I don’t usually wear in a ponytail because it’s too uncomfortable after a few hours on call. He yanked it by the roots, piercing a thousand nerve endings, but that still didn’t block out the sound of him hollering, “Nobody move!”
Disobeying his own words, he starting dragging me deeper inside the room. By the hair.
Pain seared through my scalp.
Pale fingers flashed at the corner of my vision. Tucker’s hands, trying to grab me.
I tried to reach for him, too, but Bastard kicked him and said, “I’ll kill you if you come any closer,” and I could tell he meant it.
I stumbled over something in the narrow entryway. Something soft. Not a machine—we were still to the right of the countertop holding the fetal monitor display.
My chin managed to dip in response, even though it ripped more hairs out of my scalp, and I spotted June’s purple scrubs, so wildly patterned in owls that in the dark, I couldn’t tell where she was bleeding.
I opened my mouth automatically to apologize. I’m Canadian, I’ll say sorry in the middle of the Holocaust.
Then I realized that I’d run into her because not only had we surged forward, into the room, but June had crawled from around the door, toward us.
She was moving. She was alive. But for how much longer?
“I said, get the fuck out of my way!” Bastard yelled, and the hind part of my brain replied, No, you said nobody move, but I didn’t dare correct him. He was not the kind of person to award me a little gold paper star for my excellent memory.
We had to get June out.
She could easily die here, with just our stethoscopes and obstetric equipment to save her. June didn’t need a pelvic exam and an umbilical cord clamp. She needed a trauma surgeon.
Even if it went against every instinct to move her instead of helping her. That’s what we say to ambulances sometimes: stay and play vs. scoop and run. Right now, June needed to run.
I thought I could smell her blood stronger than Stan’s. Bad sign. I wanted to put pressure on her wounds, but just shifting my torso made Bastard crush down on me like he could squeeze my kidneys out of my carcass as easily as I’d squash a tube of toothpaste.
Still, I tried to lean into the room. The further we got away from June, the more easily Tucker could move her out.
Bastard let me take one tiny step, then another.
Yes, my mind hissed, even though I was marching toward my own doom.
I heard scuffling behind us. Footsteps. The police?
Bastard sucked in his breath and whipped me around 180 degrees so that he could cover the entrance, but his hair hand wrenched my head to the left so that I couldn’t assess anything except the delivery cart and the pain in my scalp.
But I could hear more quick, quiet steps. The shush of fabric rustling on the ground—June, still crawling?
I heard heavy footsteps. Someone was walking, someone bigger than June.
I blinked. Tucker?
Couldn’t be anyone else.
So Tucker was leaving me. I’d ordered him to, wished him safe and far away, but my heart broke anyway. I squinched my eyes shut, to try and block out the feeling. Feeling would kill me now.
The next split second, I heard sirens. Not the fire alarm, but real sirens screeching through the air and penetrating the hospital walls.
Police, ambulance, help, goddamn it, the cavalry making its way to St. Joseph’s at long last.
I wanted to cry in relief, except Bastard was yelling, “Nobody fucking move!” He jerked my hair again, yanking my chin back so that I stared at the speckled acoustic tile ceiling and still couldn’t make out much of anything, but I could feel him advancing toward the door, tearing my hair follicles.
“Police!” a male voice hollered from the triage side of the hallway, and I instinctively twisted toward that sound, my heart splitting with a surge of hope, even as pain blinded me.
Bastard muttered, “I’ll fucking kill you first.” He let my hair go, wedged his left arm back around my throat and nested the gun back against my bruised right temple, just above the earpiece of my glasses.
He danced me sideways, toward the door. He wanted to close the door, I realized. He wanted to imprison us in this tomb of a room.
I wanted to scream, “Over here!” at the police. I wanted to make sure Tucker had dragged June out to safety. But all I could do was the world’s worst four-legged race, staggering while Bastard’s gun threatening my brain.
Still. The police had come. Finally.
I’ve heard a lot of smack about police. I was scared myself, before I came to Montreal, because unarmed black men had been killed by the Sûreté de Québec, as well as everywhere else. But since the police had personally saved my skin three times before today, I was quite fond of them and now, terrifyingly grateful that they’d come.
Now I had hope. I don’t use that word lightly, because of my given name and all, but for the first time, I understood why my parents had named me that.
Not that I wasn’t grateful Tucker had hurled himself into the fray for me. I loved that guy. I could admit it now, with my own mortality shrieking in my face. But I didn’t want him or Ryan to die for me. Ever.
I’d rather die first.
If that meant I was alone with a madman, so be it.
From the corner of my eye, I saw the door swing closed. Its latch caught, sealing off the light and air from the outside world.
Melissa Yi wields a scalpel in her day/night job as a Canadian emergency physician.
In her off hours, she pens the acclaimed Hope Sze medical mystery series. Her fiction appears in Ellery Queen’s Mystery Magazine, Jewish Noir, and Sleuth Magazine. In March, Melissa became a Derringer finalist for the best short mystery fiction in the English language.