Page 94 of The Wild Beneath

Annie had been charting in the hallway before all of this.

It used to be paper and pen. She loved the simplicity: the firm hand required for triplicate pages, shaping the letters correctly. Lining up the vital signs in sequential boxes. With an actual chart in her hands, everything about the patient was organized onto one or two pages, like a story. It felt permanent.

Now she has to chart on a skinny computer tower. She drags it around room to room while the hard drive rattles like it’s dying. The wheels stick or spin in the wrong direction. Her AI scribe suggests notes in advance and tries to finish her sentences. She can never find the right tab and each task takes a dozen clicks. Her colleagues rarely look at the patients anymore; they type and scroll forever, glued to the screen and its demands, attached to it like an umbilical cord.

Annie has already seen two patients this morning. First: a septic-looking man in bed 8, hypotensive and tachypneic. His lips were flaky dry. When Annie pressed her stethoscope to his back, she heard crackles in both lung bases. Second: a cranky toddler burning with fever. She saw a flaming eardrum through the viewfinder on the otoscope. His third ear infection this year, his parents said. He’d need more antibiotics. The prescription pad was in her hand but she couldn’t find a pen.

In the middle of charting both patients, Annie heard Easton bark: “Bring the crash cart.”

8:04 a.m.

It’s well past the end of Easton’s night shift. She looks even more tired than usual. Her eye sockets are shadows; her eyes thin slits. Apparently Justine Easton chops an obscene amount of wood in her backyard after each shift and loves to sharpen her collection of axes, or so Annie’s heard. Justine hosts all the work parties and serves red wine with cuts of rare steak off an industrial-sized barbecue on her deck.

Annie never goes. They’ve stopped asking why. They’ve stopped inviting her altogether.

“Page RT again,” Easton says.

On cue, Jason from respiratory therapy jogs into the room. He works out. He likes to mention this to Annie often. His neck is ropy with muscle, nearly the same diameter as his head. He has a fresh crew cut.

“I’d like some breakfast,” Mr. Van der Zee says.

“He’s full code?” Jason asks.

“No intubation. Have the Airvo ready on your side in case. We’re short on ketamine. He’s gonna tank when I give him this propofol. MacLeod, get a central. Nurses can’t find a peripheral and he’ll probably need a pressor. Work your fucking magic.”

Easton swears a lot.

Annie mostly ignores her. After prepping the area for a line, she tears two hot-pink chlorhexidine sponges from their sterile foil packaging and paints it on. She doesn’t need the ultrasound to find the vein, even if everyone else uses it. Anatomical marking has always worked for her. The vasculature is a map she can trace, the pulse of it in her ears, under her fingertips.

“Just a pinprick, Mr. Van der Zee,” Annie says as she infiltrates the area with lidocaine.

8:06 a.m.

“You don’t want the vascular probe?” Revived, Amber has the ultrasound cart at her hip.

“Can you ask Maura to run my orders for bed eight,” Annie says as she palpates the skin with gloved fingers.

“She’s a machine,” Jason says. “Just watch.”

“He needs a gram of ceftriaxone and two IVs. Two litres of saline,” Annie says. She enjoys being a machine, the relief of her brain fully occupying itself; no nooks and crannies for grief or sadness or questioning.

“You can escape yourself,” is how her dad had explained doctoring, back when Annie was eighteen. They were resealing a leaky gasket and tossing around ideas about what Annie might do with her life. Mara was still asleep below; it was not a subject they discussed in her presence. “In the ER, it’s not about you. You don’t even have a body. You’re there to help,” he said.

“Why don’t you do it anymore?”

“Well... I met your mom.”

“And you love it out here.”

“I loved parts of that life, too. People can change. Take different roads.” He put the wrench down and made a snake-like motion with his hand. “You’re not glued to one path.”

Annie places the needle precisely into the river of the internal jugular. She’s in on the first try. She threads the line, inserts the catheter, flushes the tubing with saline, and sutures it all in place.

8:09 a.m.

“It freaks me out,” Jason says. “Do you ever miss?”

“He needs a non-rebreather.” Annie peels off her gloves and throws them in the trash. She turns the oxygen on the wall to 100 percent.