By David Liu
Gary donned a black suit, black gloves and a black soul. The effects of Gary’s actions were felt by every patient in the hospital. It was child’s play for him to fly under the radar. His actions were effortless, his crimes heinous. He did it again, and again, and again, and again. The great deception was that he rarely, if ever, got the blame. After all, there was always someone else that would take it for him.
Gary knelt down outside the hospital briefly and sifted through his briefcase of weapons, one-by-one. There was a rope named HIV, which he could use to slowly choke someone over several years. They wouldn’t find out until it was too late. Peter never knew what was coming. Underneath the rope was a knife that Gary used to dissect the layers of the aorta. The chest pain could easily be mistaken for a simple myocardial infarction if no one bothered to check the difference in blood pressure between both arms. Poor Robert.
Gary was spoilt for choice, but the shiny black revolver loaded with a particularly deadly drug-resistant bacterium had caught his eye today. He took it out of the briefcase carefully and walked into the hospital.
He slid into the ward like carbon monoxide. It smelt like a mix of coffee breath and chlorhexidine. It was those damn posters of senior doctors washing their hands with a smile. Unfortunately for today, Gary had to put away his pistol, stopped by mere glossy-print paper. Sometimes, when the hospital staff were less conscientious, he could use it. The best bullets were the ones that even the carbapenems couldn’t touch. But Bed 15 was safe for now. It’s okay, thought Gary. I’ll just wait until a medical student does an IV cannula incorrectly. I’ll be back another day. Just you wait.
Gary left Ward 4. Everywhere he went, there were more posters with smiling consultants diligently cleaning grime from their hands. Why do they always look so happy about washing their hands, anyway?
Regardless. He arrived at the post-op ward. Gary pulled out a tiny sticker from his black suit pocket. Blood cells liked adhering to that sticker and clumping together. The medical staff’s judicious use of heparin made it harder to put this sticker into people’s femoral veins, but nonetheless, Bed 3 looked like an easy target. After all, the patient’s clotting disorder hadn’t been diagnosed yet.
Gary reached into the vein, placed the sticker on the inside wall, and left it be. It would take a few hours, but eventually a clot would form, the leg would go red and swollen, and – hopefully – the clot would travel up into the lungs. Virchow made it as easy as one, two, three. Sometimes, Gary could get away with it effortlessly, especially if all the patient ended up having was a mysterious sinus tachycardia. Even if he couldn’t take the patient away completely, he could at least take a bit of their lung. Such were Gary’s joys.
After leaving Bed 3 to succumb to his fate, Gary started going towards his next destination. Gary took the stairs, health-conscious guy that he was, and went through the fire entrance door. Doesn’t anyone read the big red bold letters that say “DO NOT KEEP OPEN”? He glanced at a medical student heading towards him. The student clearly had had one too many chocolates in his life and was subsequently wide enough to disobey the other set of instructions on the door: “DO NOT OBSTRUCT”. This was the consequence of stress binge eating. Chocolate would not be able to save that student from the VIA, however. No matter how many boxes he ate. Gary brushed past the sweaty medical student, internally applauding him for his herculean stair-taking efforts.
Gary entered Ward 2. This was not a place for him to get up to mischief today. Instead, his intention was to go there to revel in yesterday’s exploits. He spied the girl working at the U-shaped desk… perfect. She was surrounded by staff, files, computers, and sadness.
Emma the resident felt awful. The patient that she was in charge of yesterday died. Emma had completely missed the ticking time-bomb that exploded inside the patient: an abdominal aortic aneurysm that she had not diagnosed.
The story was written all over her face, so Gary flicked through the chapters one-by-one:
Chapter 1: Loud Beeping Noises.
Chapter 2: Code Blue.
Chapter 3: Everybody Panicks.
Chapter 4: Patient Dies…How Will I Face His Brother?
Chapter 5: It’s All My Fault.
Chapter 6: It’s All My Fault.
Chapter 7: It’s All My Fault.
Chapters 5 to 7 were what kept Gary unseen.
The beaming cardiology consultant, Dr Felicity, walked in. Her aura radiated: she was a light bulb personified. She had worked with Emma when Emma was but a wee intern. “Brilliant girl! Worked so hard and was so bright! I loved her!” thought the consultant. The consultant remembered when she had been an intern once, too. Cynicism eventually got to her, as it did every consultant, but – strangely – it did not budge her optimism an inch.
The consultant sensed the heaviness surrounding Emma today.
“Emma, what’s troubling you?” asked the consultant. “You’re missing your usual perkiness.”
Emma looked up at the familiar face. “Dr Felicity…” she began, “I killed a patient yesterday.”
At this point, Gary smirked. He had gotten away with it… again!
Emma explained the situation in full detail. Talking about it agonised her. Dr Felicity nodded knowingly. When Emma finished her story, Dr Felicity landed her gaze softly on her.
“Emma, can I tell you something?”
Gary suddenly felt tense. Chapters 5-7 were about to collapse into a heap.
“Look,” said Dr Felicity, “it’s all very well and good for us to try to carry this burden on our own shoulders. That we “killed” someone because of our own negligence. That’s the plight of someone that saves lives, right? But, in all honesty, it wasn’t you that killed the patient yesterday.”
“What do you mean?”
The consultant then dug up a painful memory of her own. Her own kind boss had said something similar to her a great many years ago. It had made all the difference. Thinking back to it made her revisit all of the guilt she felt when she had thought she was responsible for her own patient’s death, too. How bitter that pill was to swallow, but how useful it was now.
For the next ten minutes, the consultant explained:
“It wasn’t your fault. It was Gary’s.”
Gary felt uneasy. The black suit, black gloves and black soul that he had worn today were falling to tatters, laying him bare for Emma to see. Ordinarily, it was child’s play for him to fly under the radar. His actions were effortless, his crimes heinous. He did it again, and again, and again, and again, because there’d always be someone willing to step up and take the blame.
But today, that person was not going to be Emma.
Featured image is Ward in the Hospital in Arles by Vincent van Gogh (1889)