31 Oct Short Story – DCB
Happy Halloween, friends.
I got extremely caffeinated this afternoon and blew through this short story. Props to all the medical workers out there going through challenging times without the supernatural to deal with. Please excuse my spelling and grammar.
Thanks for reading.
I can’t smoke here, huh? I’ll tell you what I tell my patients when they want fuckin’ crystal therapy or they think the doctor is stupid or whatever. I tell them “this is the way we’re gonna do it. You don’t like it, I’ll get your discharge papers.”
That’s what I thought.
Why am I smoking? Good question. Kinda funny thing for a nurse to do, huh? I mean, I’ve seen all the shit smoking does to your lungs, I’ve seen people cough ‘till they bleed. I guess I’m smoking because I like it and any little thing that brings me joy I’m kinda hanging onto with both hands right now. When I leave here chances are pretty good I’m stopping for chicken nuggets. My choice, right? Isn’t that what they say?
So, let’s get this over with.
I’m the nurse that did it. I’m the nurse that let it out. I’m the nurse that’s responsible for all those people dying.
A hundred and four, if you need to know the exact number. Some nights I think about trying to memorize the list as, like, a penance, but I’m not that invested in my own pain, I suppose. Not directly, anyway. I mean…hello! I started smoking again after that night. I’m definitely don’t think I am innocent in all of this. I know I’m not.
The man…can I say his name? I mean, you know it, right? OK. For the record. Giovanni Aloisio was admitted to our hospital at around 3 pm on August 9th. Male, early 30s, white, no significant history of illness. I don’t have the chart in front of me but that’s what I remember. I also remember he was in bad shape when he came in – his vitals were unsteady and fluctuating, his blood pressure was not good. I remember he looked pale and was this weird color, but I had seen people colored like that before. It usually meant an extremely low blood oxygen level so we started oxygen through a mask but that didn’t help. Not his color, anyway.
Mr. Aloisio, he barely spoke English, being from Italy. He ended up in my ER because he had attacked someone on a plane and they’d brought him here directly from the airport but we didn’t know that at the time. No police came in with him. Someone fucked that up, I’m not sure to this day who, but I think about that person a lot. If they had given us that piece of information we could have still treated him but put him in restraints. I’ve done it before. It’s not the best way to work on someone but you can do it and it’s a damn site better than a patient grabbing a scalpel or something and jabbing it into your chest as you try to get their oxygen going.
Anyway, Mr. Aloisio was thrashing around and didn’t appear to be violent, necessarily, so we did what we always do – our job. Not to go off on a tangent but my job…that’s all I ever do. I swear to Christ, people think their treatment is personal every single time and I guess it is personal to them but I do not give a shit who you are, what you do, what stupid shit you believe or anything about you. To me, you’re a treatment plan and a set of numbers and, most often, a box to check on my way to the end of a 12 hour shift. I mean…I care, but I don’t. Does that make sense? When you’ve been on the job 15 years you can’t care all the time or you won’t do the job for 15 years. Simple as that.
Right. So. This guy is thrashing around and he can’t be doing that if we want to get an IV in, which definitely has to happen, so we give him a muscle relaxant and…it works so we start the IV and work to figure out what the hell is wrong with this guy. Oxygen is way down, pulse is way up and there’s a lot of strange things going on. Like, he was dehydrated but sweating. His potassium levels was way up for some reason. I am not going to bore you with the medical bullshit, mainly because I don’t remember it all that well, but you get my point. The doctor was kind of scratching his head and we sure as shit weren’t going to make recommendations to him. Doctors tend to not like it when you think you know something.
So, we stabilized him, treated his injury…oh shit, yeah. He had a big wound on his shoulder. At first we thought it was a bite but it was bigger than that. Probably some sort of animal. It was infected and you could actually see it move when his heart beat, which is not as uncommon as you think, especially in deeply infected wounds. I had to clean it and…express it. Make sure all the puss was out, which I thought was going to be a big job but wasn’t. Usually with a wound that size there’s enough puss to fill a shot glass – that little comparison is just for you, enjoy it – but the wound was just sort of…big. Hard to explain but I cleaned it up with alcohol and the doctor recommended antibiotics which made all the sense in the world and we admitted him.
I want to stress, at this point no one was with Mr. Aloisio. No one gave us any sort of history, no one warned us about shit. He was just another case. We didn’t even here until we admitted him that he had an insurance card but they were having trouble running it because it was in Italian. Not my monkeys, not my circus, right? I was already onto the next one.
A couple hours later I got back to Mr. Aloisio and his numbers had plummeted. You remember that scene in The Matrix where the guy is looking at computer code and goes “after a while, you just see blondes, brunettes, redheads” or whatever the hell he said. More than a decade on the job has given me that sort of insight. I can look at numbers and tell you, with a pretty high degree of accuracy, what’s going to happen and it was pretty clear Mr. Aloisio was on the way out. There was the beginnings of organ failure in a few spots, he wasn’t responding to treatment, his temperature was spiking. Long story short, whatever we were doing wasn’t working and whatever was killing him was doing a pretty good job of it.
Holy shit, you actually brought me chicken nuggets? Look at you! I swear, this is the kindest thing anyone has done for me in a while. You fuckin’ rock. Thank you. Pass the honey, please.
OK. Mmm. Let me chew for a second.
So, homeboy is dying. Doctor isn’t sure what’s happening. And my shift ends. I go home and, I promise you, I don’t give Mr. Aloisio another thought that night. I think I may have finished whatever show I was watching and went to bed because I was, like, 7 hours away from another shift. Nursing is like that. Go home, breath for a second, come back. You get used to it or you flame out.
Another thing…mmm, those nuggets hit the spot. Sorry. Another thing you get with experience is the ability to tell what the day’s going to be like by your walk into work. If it’s quiet on the outside, chances are pretty good it’s quiet inside. If ambulances are pulling up and people are shouting and patients are screaming, then hike up your big girl panties and get ready to get hit because it was coming whether you like it or not. As I start my walk into the ER, there’s an EMT crying in one bin, there’s an empty unit in the other bin and I can see chaos inside. I thought “hike ‘em up” and went in.
Chaos. Not since the heights of COVID have I seen such lunacy. The shit has spilled everywhere. The intake desk was nuts. The waiting room was packed. Everywhere you looked was bad news and in that scenario, the only thing to do is jump in with both feet. Here’s the weird thing – it wasn’t any one thing. It wasn’t a plane crash or it wasn’t a natural disaster or an outbreak or anything. Just…a lot of things went very wrong for a lot of people all at once. It happens. The word we use is “confluence”, right? A confluence of factors. You just start clearing the board as best you can.
After 8 hours in the chaos pit, I tried to check in on my patients from the day before and that’s when it happened. Keep in mind, I was fried at that point. It had been a day. That’s when I got to Mr. Aloisio.
When I got to his room he was sitting, bolt upright and yelling at me in Italian. I can sneak by in Spanish but he might as well have been screaming at me, like, literally screaming at me for all the sense he was making and how angry he seemed to be. Just AHHHHH but, you know, in Italian. So, I check his numbers. They’re worse than before, a lot worse. Like, he shouldn’t be conscious bad. Like, “call it” “stop treatment” “call the funeral home” bad. But there he was, very animated, very Italian. So, I figured, DCB, right?
DCB? Dead Cat Bounce. It’s an inartful medical term that describes something you see all the time. Let’s pretend you have someone who has, COVID-19, for example. A lot of times they’ll come in, they’ll deteriorate, they’ll get worse and worse and worse and then, they day before they die, they take a big upswing. It happens a lot. A couple times I’ve had cancer patients put on their coats and insist they were ready to leave the hospital even though their numbers were cratering. Then, of course, when they crash they usually die. We call it DCB. The less I describe the idea of a dead cat bouncing after a long fall, the better, as far as I’m concerned, OK?
Can I get another cigarette? Those nuggets were so damn good I need a smoke afterward. Yeah, you get me.
Usually with a DCB you try to keep people calm. “Let’s just keep you in bed a few more hours” and the, of course, they inevitably crash. I could tell I was going to have trouble with Mr. Aloisio. He was not having anything I was saying, not trying to understand me. He was just screaming and screaming and he’s not tied down. Apparently, I was the first medical professional I had seen since his…improvement, I guess, so once he’s screamed at me like Mario in a threshing machine, that was all he needed to get up and move.
Here’s the thing. I could have called the techs who can deal with patients like that. I could have called the front desk. I could have done a lot of things, but when he got out of bed and shoved me out of the way so he could leave, I was about done, at that point. Just done. If the screamin’ Italian wanted to go die in the street, go die in the street, I guess. I mean, I had every intention of filing a report and telling the front desk but I was still in the middle of a confluence. Still dealing with a river of shit. So, after he shoved me I let him go. Because I’m a human being. That’s what I tell myself.
The only thing I remember that was weird was when I watched him leave, he was still wearing his hospital gown, the kind that hangs open in the back. And I saw lividity in his back. The blood had pooled like you seen in the dead because the blood doesn’t circulate anymore. I blinked real hard because that didn’t make any goddamn sense and then got pulled in another direction. And that was that.
It’s a strange feeling, knowing that one very human, very simple mistake led to what it led to. He was the guy. The guy who bit that other guy who bit that other woman who bit that old guy and then…well, you know. Blood in the streets. People being eaten on camera. The National Guard going door to door shooting people. Guts in the streets. We’ve all seen it, we’ve all lived with it for a while. We’ve dissected it a thousand different ways but, he was the guy. And I was the nurse that let the guy go and no matter what I do in this life, no matter what I achieve or what else I do, that will be the lead in my obituary. The thing I did in this life was let the living dead walk out of a hospital.
So, yeah. Cigarettes and chicken nuggets and lots of Netflix and intense, powerful and unending regret. That’s the way it’s gonna be, apparently, and if I don’t like it, well, I figure I can find a way to discharge myself. But it hasn’t come to that yet.
There are a lot of chicken nuggets left in this world.