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A sleepy groan rumbled from underneath a disheveled pile of blankets and comforters. The room was dark, and the world outside was still.
A hand emerged from the cocoon of blankets, sluggishly searching for the obnoxious sound that infiltrated her dreams one too many times.
She felt her way around the wooden dresser, searching for the flat, freezing surface that was her phone. She located it with a hiss,
the cold making her flinch, but her fingers clumsily dismissed the alarm in a well-practiced motion. Her hand then retreated into the warmth and safety of the blankets once more.
Silence fell over the room. All was calm and peaceful. Until several minutes later, when the alarm went off yet again.
The steady rise and fall of the blanket cocoon were once again interrupted, replaced by a frustrated groan. Her hand shot out from under the blanket once more,
this time grabbing the ice cube of a phone from its perch and under the blanket with her. She brought the blinding screen up to her face,
squinting to check the time through her bleary eyes. 4:10 in the morning. Still early. Too early. Her eyes slowly began to close
as her phone screen brightness dimmed, then switched into sleep mode. As did she.
Her eyes shot open. She checked the time yet again. 4:20. Her brows furrowed in sleep-deprived annoyance, dismissing the alarm completely.
"Just shut up..." She grumbled angrily, burrowing herself further into her blankets and then blissfully drifting back to sleep.
She slowly opened her eyes once again. The world was still pitch black and her bed was so very warm.
She dreaded the thought of entering the biting chill of the world beyond. But when she closed her eyes in the hopes of catching a few more cheeky moments of sleep,
her mind did not submit so easily. That only meant one thing. She switched the screen of her phone on, nearly blinding her in the darkness underneath her covers.
With a bit of squinting and blinking to adjust her vision, she finally saw it. 5.30 AM. On the dot, as always.
Kirana moped to herself. "Why do they always put me on day shifts?"
After months of 7 AM starts, her body had gotten used to waking up in what she personally considers - unreasonable hours of the morning.
She was exhausted, but her body would not let her rest. She wanted to go back to sleep, but her mind was awake.
It was an obnoxious kind of healthy, like a rise-and-grind hustler who claims to have their life together and wants to sell it to other people.
And yet, she kept saying yes. Always saying yes to those shifts because she was 25, and it was only downhill from there, wasn't it? She needed to work while she was able,
because she was never going to have this energy and health again. But was this how she wanted to live the prime of her life?
When she was a fresh graduate, she thought it would get easier that all she needed was time to adjust and adapt. But that was 4 years ago,
and the only thing she really seemed to get better at was chasing down doctors for an incomplete medication order and stopping the IV pumps from going off
every time someone breathed on it too hard. But it was good money, and she always needed the money.
Warmed from the heat of her work frustration, Kirana found the courage to peel away the layers of her blanket cocoon and into the embrace of the biting cold.
She sat up on her bed, pulling her fluffy blanket tight against her body. January was chilly for most people native to Europe, but for someone from the hot, tropical climate of Indonesia,
she felt as though she was always on the verge of hypothermia. Not even the summers offered relief, as even the hottest days were to her - chilly at best.
Her body had adapted to Paris' climate during her university days, but Bougainville was further north, and even after years of putting down roots,
the cold never got easier. She slipped into her fuzzy slippers, careful to not touch the freezing floor, and shuffled to the bathroom.
She felt old and creaky. as she switched on the lights, the warm yellow bulbs gave her caramel skin a healthy golden glow
despite how decidedly unfabulous she felt on the inside. She observed her reflection in the mirror, assessing the damage from last nights sleep.
Her eyes were two pools of melted chocolate, gentle and sweet, like the eyes of a doe. Her face was small and heart-shaped, framed by long, dark hair that could
probably use a wash. She dreaded morning showers, especially in early January, but she knew she would feel grubby the entire day if she didn't. It didn't matter if she showered before bed,
it was a compulsion that she felt she had to indulge in. A cultural habit that she hadn't tried very hard to shake,
but she always wished she tried a little bit harder in the colder months. She sat on the toilet as she contemplated her next course of action,
running her fingers over her dry, chapped lips. She picked on a patch of dry skin on her bottom lip as she thought.
she was probably going to shower. A full face of makeup would seem like she's trying too hard, but maybe moisturizer and mascara would be enough? And she definitely needed better lip balm.
Did she still have eggs left in the fridge? She should make a list. Her body was on auto-pilot as she undressed and stepped into the shower,
and as soon as she switched on the hot water, her thoughts drifted to the K-Drama episode she watched last night instead.
She enjoyed the heat from her hair dryer as she hugged her fluffy bathrobe. It was completely unflattering to her curvy body type,
but it was the thickest, warmest robe she could find online. And it was one of her prized possessions. She brushed her teeth, then twisted her hair into its usual bun, pinning it in place with bobby pins
and a hair tie. With a quick application of moisturizer and, after a last-minute decision to follow up with concealer, she applied her mascara. The product smudged on her eyelid.
She checked the time. 6 AM. She sighed in frustration. Her hurry helped her forget about the cold as she pulled her scrubs on with practiced ease.
The garment was tight around her chest but too loose around the waist. Overall, it gave her the flattering silhouette of a chunky cereal box that didn't have its contents distributed properly.
But it was what it was. She pulled on a pair of thick socks and her usual coat: a tasteful, maroon affair that reached past her knees and was slightly too long at the sleeves.
She cinched in the belt around her waist, creating an hourglass figure that hadn't been there before, then made a beeline for the kitchen.
Her apartment was a cozy one-bed, one-bath rental. It was only enough for one, but it came with a living room and a full kitchen.
Something she wished she had back in university as opposed to the 10-bedroom dorms she was accustomed to.
Really, with the savings she had, she could probably afford something bigger. Bougainville was classified as a rural area, so housing was cheaper and there was no shortage of
empty houses left behind by tenants who had moved to Paris. But she didn't really want bigger. This was comfortable. This was enough. Every corner, every nook, and shelf
were occupied by plant life. Small ones, big ones, leafy ones, prickly ones, hanging ones, and aquatic ones that sat in bowls with little fish hiding in its roots. It was extra work,
but it made her apartment feel just a bit less lonely. A bit more like home. Her parents used to have plants all around the house too.
Their garden was a lush jungle she used to hide and play in. Now, she understood why. It must have been nice to have something to take care of that didn't run around or scream at you constantly.
Kirana found herself laughing, even though she had one croissant left in the breadbox and had just run out of her meal prep.
"Oh, this is a crisis..." She thought to herself with a pained smile. "Ok, maybe... Croissant for breakfast,
and then I eat out for lunch. But how much can I spend? Rent is almost due, and...
Ah, Mom said Maya needed new books for school and Siska just started dance lessons too..."
She agonized over the thought, then shook her head. She could work another double shift. And then work a weekend after that.
That should be enough. Extra shifts, that was all she needed. A croissant was a snack more than it was a proper meal to her, but she could make
it a bit more filling as a sandwich. Cutting it in half, she spread butter over the insides and filled it with a few slices of ham and pickles.
After a generous coat of honey mustard dressing, she wrapped it in butcher paper, grabbed her bag, pulled on her work shoes, and was out the door.
And then came back through the door when she realized she had forgotten her phone. Kirana ate her sandwich on her 20-minute bike ride to the hospital.
A car would’ve been a smart investment anywhere else, but Bougainville was small and tightly-packed, mostly connected through footpaths and alleyways.
It did not have many main roads outside of the central business districts and wealthier neighborhoods, so most people preferred to bike.
She could probably use the exercise anyway. The air was cool and the lazily drifting fog threatened to lull her back to sleep. It was always at its worst in the early hours
of the morning, but Kirana knew the cobblestone streets well enough to find the right way. Even while she was half asleep.
It was amazing how much your body could learn to do on autopilot. The food was gone before she knew it, and already, she could smell the unmistakable
aroma of fresh bread from the shopping district. It was her favorite area in town. The flower-lined streets that cycled with different flowers through the seasons,
the warm lights pouring onto the sidewalk from the storefronts and streetlamps, and the smell of fresh bread and coffee.
Workers had just begun to put out tables and chairs, changing the chalk signs for the menu of the day and sweeping dead leaves into piles. She said hello to a few familiar faces
as she rode through, but there was a tension that didn’t used to be there before. A slight edge to their smiles as they said hello back. She couldn’t blame them.
Rumors of wild, dangerous animals attacking people were all over the local paper, and she had seen the casualties firsthand. Kirana tried not to think too much about it. As long as they stayed in town, it was safe.
Right? Where the day had just begun for the shops in the shopping district,
it was closing time for the pubs, clubs, and bars in the entertainment district. Small boats of fishermen pulling into the river docks to drop off their catch for the local market.
Kirana’s stomach grumbled at the thought of freshly caught trout, roasted over a fire and sprinkled with coarse salt.
She crossed the northern bridge to the east side, where the houses had nicer gates and rolling gardens. The neighborhood was lusher and more orderly, with wrought iron fences around every yard and tree.
Sidewalks were lined with well-trimmed bushes and complex floral arrangements. This was the neighborhood you could only dream of affording.
Aside from the several houses that belonged to the Bougainvillea University for student housing, this was where the town elites lived. Doctors, professors, lawmakers, old money, and the vacation homes of the nouveau riche.
The chill of the morning frost bit more viciously here than the compact, stone houses in the west. The hospital sat at the edge of the neighborhood, in between the university and the central lab of
the Bougainvillea Foundation. The serene exterior of the hospital building grossly betrayed the chaos that so often occurred inside.
One that Kirana swore daily she would never subject herself to again, yet, she breaks that promise just as often. It was easier not to think about it,
to leave your thoughts at the door when you went home and pick them back up when you came back. She had gotten very good at switching off. Kirana left her bike in the bike rack by
the staff entrance, chained in place with her bike lock. She sat there for a moment, a haze still looming over her mind, and she slowly took a deep breath.
Time to switch on again. She brewed herself a cup of coffee in the staff room to shake the stubborn fog that occupied her mind.
Milk and two sugars. With a sip, the cloud started to lift. She needed all the strength she could get. She sat at the empty table staring blankly at the clock for a good while.
Unsurprisingly, the emergency unit was abuzz with nurses and doctors pacing tirelessly to-and-fro. People speaking all at once, phones and alarms going off every second. She entered the nurse’s station
and joined the other morning staff for scrum. She grabbed a copy of the patient charts, not that it was ever up-to-date in their unit, and sat next to Michelle,
a blonde young woman she knew quite well. They had started their careers in the hospital together,
in the same graduate program. She had once been a daisy fresh grad nurse just like her, too, but she was much more honest with her feelings now.
Kirana offered her a wan smile, and Michelle responded with a prolonged period of tired eye contact as she sipped her black coffee.
Their team leader that day was Juliette, an experienced nurse practitioner who looked only a few years away from her much-deserved retirement.
She was a tough woman; you had to be to work in emergency for as long as she had, and she was as blunt as a person could be.
“Okay, you know the drill. Keep the beds clean and empty. Remember to put something down for spills and please, for the love of god,
keep your wires organized. We already lost one monitor to frayed cables.” “Our bladder scanner is also missing, so someone is going to have to track it
down or steal one from MDU next door.” Louis, the night duty nurse added. He looked worse for wear.
“Of course! Why would we have everything accounted for anyway? S I G H
Juliette pushed her reading glasses up the bridge of her nose with an exasperated sigh. “We’ve had a few people come in for animal attacks overnight,
and we’ll probably have more coming today. A lot of lacerations and bite marks, so we’ve got med students coming in-“
A collective groan rumbled from the rest. “Hey, come on. They need to practice their sutures.”
“One of them ordered warfarin for a patient with hemorrhagic stroke. I told them I wasn’t losing my license today.” Michelle grumbled
quietly to Kirana, who balked in surprise. “You’re kidding.”
“Dead serious.” She stifled a snicker.
“Like the patient would’ve been.” “Seriously dead?” The two girls snorted, trying to hold back their laughter.
“Ok, before we wrap things up,” Juliette raised her voice, calling attention back to her “Carmine is out today and Louis is already over on his hours, so would anyone
be interested in working a double?” Kirana’s ears perked.
“What shift?” Michelle elbowed her in the rib, giving her a glare as she mouthed,
‘Don’t do it.’ Kirana remained unfazed.
“Night duty.” Kirana cringed. A morning-night double was brutal. Everyone who worked mornings
were usually fast asleep before the night shift even began and everyone who worked nights shift would be looking forward to sleep by the start of the morning.
But night duty paid more by the hour, and if she was lucky, the ward would be empty with only one or two admissions and she
can spend the rest of the night restocking and sleeping… Another nudge at her side. She glanced at Michelle who gave her a look that screamed,
‘don’t even think about it.’ Kirana glanced back to Juliette, and smiled.
“I’ll do it.” Kirana felt a sinking feeling when she returned to the hospital that night.
Her intuition was telling her that something wasn’t right, and it was very rarely wrong. It was a kind of intuition that all nurses develop as they gain experience,
and you quickly learn to trust it. It was the same unease she felt right before a patient crashed. The restlessness of sensing you were likely seeing someone for the very last time.
What was it about that night that sent all her alarm bells ringing? The atmosphere was heavy when she entered the emergency unit.
Most of the lights had been switched off, leaving only the bedside monitors and nurse station illuminated. The afternoon staff were packed and ready to take their leave.
Night shifts operated on a skeleton crew, and that night… It was just her.
She received her handover from the afternoon staff and saw them off. She was told there was a nurse helping out between wards, a doctor on call, and a doctor on duty. It didn’t
sound like it would be enough but she was assured that if things went down, MDU was ready to assist. Kirana placed her bag down in the nurse’s station,
switching on one of the computers and signing into her account to start her reports and progress notes.
The dark and quiet was oppressive. Eerie. It made the hairs on the back of her neck stand on end.
It had been a very long time since she last worked a night shift, and even longer since she’d worked alone. Ah, coffee. She needed coffee.
Even if she didn’t feel sleepy in the slightest. That feeling of unease still persisted. An hour in, she checked and restocked all the bedside trolleys and organized the stock room.
Two hours in, she counted the controlled drugs in the medication safe with the float nurse when she arrived Three hours in, and she had resorted to watching her drama shows on her phone,
eating a bag of chips from the vending machine. It was 2AM. 5 hours past her usual bed time and she was struggling to stay awake.
The seat was comfortable and the blankets that came fresh from the hotbox were delightfully warm.
Her eyes began to close. And then, the piercing sound of the station phone blaring to life jolted her awake.
She scrambled to answer, clearing her throat to shake the sound of sleep from her voice. “Bougainville General emergency unit, this is Kirana speaking.”
She paused, listening to the paramedic on the other end of the phone. “Ok, got it. I have a bed ready in bay 5.” She was up on her feet, rushing to bay 5,
one of the beds close to the station. She pulled on a pair of gloves as the paramedics soon arrived, rushing to unload the stretcher
and wheel it through the entrance. Kirana immediately smelled blood. The two paramedics spotted Kirana and wheeled the stretcher by the bed.
The person on the bed was covered with blood-soaked sheets, groaning incoherently. Kirana pulled the privacy curtains shut and helped the paramedics transfer the
patient onto the bed. Even though the unit was empty, privacy still mattered. She connected his leads to the heart monitor, applied the blood pressure cuff around his bicep, and clipped the oxygen probe to his finger like clockwork.
“John Deschamps, 30-year-old male with major bleeding in the lower left leg and central abdomen from an animal attack.” Kirana lifted John’s sheets, noting the dirtied, makeshift dressing around his torso.
The smell of blood hit her harder than before. In one hand, he clutched a green whistle and in the other, a shiny, metallic object.
Moving down the bed, she lifted the sheets covering his legs. Kirana couldn’t stop the gasp that escaped her lips.
His legs were full of lacerations and puncture wounds the size of 2-euro coins. She could only assume they were bite marks.
His right leg was relatively intact, but his left lower leg was completely mangled. It was almost unrecognizable as a limb, more akin to a slab of butchered meat. A belt was tied around his thigh
as a makeshift tourniquet, but Kirana wasn’t sure if it could be saved. “He’s a park ranger. Was on patrol when he was attacked by…”
The paramedic squeezed John’s shoulder, an attempt to keep him conscious. “What did you say you were attacked by?”
“Bear… I think…” He slurred, eyes rolling in his head. Kirana and the paramedic glanced at each other. There were no bears in the Pas-de-Calais.
But this was a park ranger. Surely, he would know that? “Responsive but disoriented. He went into VF and we had to defib,
then gave him something for the pain.” The paramedic continued, handing the chart to Kirana, who smiled tightly and nodded.
His blood pressure was far too low and his heart rate was breaching 200. “Thanks guys, I’ll take it from here.”
She said, hitting the red emergency button on the wall as the paramedics cleared out. The alarms blared to life.
“John,” She squeezed his shoulder, getting him to open his eyes and look at her. "Hi, John. My name is Kirana and I’m going to be your nurse tonight.
You’re in the emergency unit at the Bougainville Hospital. We’re going to help you, ok? Just stay with me and don’t fall asleep.”
A weak nod in response. “Great, I’ll ask you a few questions.
Try to answer them as best as you can, ok?” She knew she needed to keep him awake as they waited for help to arrive.
Ask him questions, keep him talking. She prepared some medication, opened some gauze and cannulation needles on the bedside trolley.
Things the doctor would likely ask for when he arrived. “Can you tell me your full name and date of birth?”
“John… Dsh…mps… s’xth ‘f th’ forth… ninet’n…ninety-three…” She almost couldn’t hear him through the pounding in her ears, even if his speech
hadn’t been slurred. This wasn’t her first code blue by far, but this was her first time facing it on her own. Normally, help arrived within seconds, but right now,
she was all alone in a dark hospital unit. She was the only person standing between the patient and his untimely death.
It was the weight of someone else’s life solely on her shoulders, but she was only one person. If she messed up,
with all the resources and training she had, then what good was she? If she failed, what was the point of her being there?
She was doing everything she could, but it just didn’t feel enough. She cross-checked the information with the one written on his chart as she drew up some saline into a syringe.
“Perfect. Any allergies to any kind of medicine? Latex?” A pause, and then a shake of his head.
“I know you’re sleepy John, but the doctors will want to talk to you, so stay awake, ok?”
She did her best to keep her voice even. Even if it betrayed so completely how she felt on the inside. With everything ready, she turned to face him.
“I’m going to take off those dirty sheets and see what’s going on, ok John?” It wasn’t really a question.
She peeled the sheets off and left it bundled at the foot of the bed. John was a stocky man still dressed in his ranger uniform, which had been reduced to ribbons.
She wasn’t sure if it had been the paramedics cutting through to access his chest, or if it had been the animal. “Alright John, I’m going to take down this dressing now.”
The ‘dressing’ in question had been nothing more than someone else’s ranger uniform. Perhaps his colleagues? She cut through it with a pair of scissors, unveiling the wound underneath.
Four massive oblique lacerations ran down the entire length of his torso, starting over his right pectoral down to his left pelvis. Whatever had attacked him had
shredded his skin to ribbons, deep enough to where she could almost see organs. Blood gushed out like a crimson river, running down his sides
and staining the sheets below. “Shit!” Kirana hissed under her breath
Help arrived as soon as she spoke. The doctor on duty, float nurse and several others from MDU. Kirana heard their collective gasps as they rushed in to help.
“Get the resus trolley! Let’s start TXA asap!” Kirana shouted. “I want two cannulas in and three bags of blood ready!”
“What’s the time?” “2:15. Patient arrived two minutes earlier. Blood pressure is sitting at 60 systolic and taking a free fall.”
Kirana said as she tightened a tourniquet around John’s forearm, and then searched for a vein on his hand. His pulse was worryingly weak.
Another nurse had also began cannulating his other hand. “I haven’t done a full set of vitals. He needs to get into theater.
I estimate at least 1 liter blood loss, he needs fluids right now.” “Call theater and get a table ready. I want him transferred and I want
fluids running NOW!” The doctor confirmed. It was organized chaos as nurses and doctors rushed about, writing up orders and charts,
hanging up bags of fluid and pushing through medication. A nurse was on the phone, organizing an emergency surgery while another called in an
order for bags of blood. Everything was done all at once and documented at the same time. Kirana grabbed a zip-lock bag from the bedside trolley
and began stripping his valuables to keep inside. Wallet, phone, keys. She disposed of the empty green whistle from one hand and unfurled the fingers on his other hand,
revealing a gold bangle in the shape of a coiling snake. The snake held a gem in its mouth that seemed to change color in the light.
It was mesmerizing. “He’s going into cardiac arrest!”
Kirana was broken from her trance. She stuffed the bangle into the zip-lock bag with the rest of his belongings before exclaiming,
“Stand back!" She slammed her foot into one of the bed pedals to bring the bed low to the floor.
Without another word, she climbed on the bedside and commenced chest compressions as another nurse tilted his head back and pushed out his jaw to open his airways. At that moment,
Kirana’s mind was still. The world seemed to quiet down as she counted her compressions and kept her pace.
‘Live.’ She thought. ‘I won’t let you die. Live!’ The team worked around Kirana to apply the paddles of the defibrillator.
They switched the machine on, and Kirana stood back as it searched for a shockable rhythm, and then delivered a shock. John’s body jolted from the bed,
then fell limp once again. His heart rhythm stabilized. “The OR is ready! Is he safe for transfer?” One of the nurses called,
having just gotten off the phone. Kirana observed John closely, watching his breathing, his face. He had regained some color,
and his breaths were even. It felt like they had gotten to the eye of the storm. There will be worse to come, surely, but for now, they had their chance.
As she looked up, she realized the doctor had been waiting for her input. Flustered, she nodded quickly, and the doctor turned back to the nurse.
“For now. Let’s not wait and find out.” They dislodged the portable heart monitor from its dock and plopped his charts right beside it.
Kirana hung the bag of his belongings on one of the hooks of the bed’s IV pole. As they wheeled the bed down the back corridors,
she realized belatedly that the bangle wasn’t there. Kirana returned to the emergency unit nurse station mentally and physically drained.
She could barely remember what she had said during the handover, but she hoped it was enough for the theater staff. For a while, she sat in a dazed stupor.
A combination of lethargy, fatigue, and the aftermath of a stressful situation sinking in. And that had only been one patient. If she had gotten multiple admissions…
She shuddered at the thought. Worst of all, that feeling of unease still hadn’t gone away.
She thought that completing the transfer would have relieved her, and yet she still felt on edge. Perhaps because she was alone, with no one to debrief with. No one to help her work through her thoughts and emotions.
Having to bottle it all up and keep it to herself. Like she did with her stress. Like she did with her money troubles. Like she did when her family asked for more than what she could give.
She smiled. Because that was all she could do. She still had patient notes to complete and a report to write up.
She could wallow in her feelings when she got home. In her own time. But as she lifted her gaze to the computer screen, what she saw instead made her blood run cold.
A massive python, draped over the counter and coiled around the computer screen, staring right at her with glowing eyes.
She screamed.