There’s blood on the wall.
It stands out starkly, a crimson slash of color streaked against white sterility. It’s easy to train my eyes on it, easy to focus on that one spot rather than the bloody mess beneath my hands.
People like to think that death is peaceful, that it’s calm, that it’s beautiful. But from my experience, it’s not. It’s bloody, it’s hectic, it’s full of shrieking machines and fluorescent lights and chaos. It’s not pretty.
“Dr. Cabot! It’s been six minutes.”
Lucy looks up at me amid the blood-spattered chaos, elbow-deep in intestines, and with what appears to be brain matter on her brow. Her dark eyes are resigned because she’s been a nurse long enough to know what we have to do.
So do I.
It’s the story of my life.
I pause and the defibrillating paddles in my hands suddenly weigh a million pounds apiece. The fluorescent lights are bright and blinding, washing out everything around me but for the blood and the blue curtain circling the gurney. This moment swirls and stands still amid the hospital smells and beeps, and I think of an ancient story from Greek myth.
The Fates—three old women who spin the thread of life, measure the string and then decide when someone will die by cutting it. In this moment, I’m one of them.
My next decision will determine a life.
I’m one of the Fates and I’m measuring the thread and I’m cutting it.
Snip.
I take a breath and stare down at the broken boy in front of me, the one whose life I’m snipping away.
In my head, I know that none of this is my fault. It wasn’t my fault that he decided to drag-race down the Dan Ryan and endanger a hundred lives other than his own. It wasn’t my fault that he chose to slam five beers in five minutes beforehand. It’s not my fault that he’s only eighteen and his mother is anxiously waiting on the other side of the double doors, waiting for me to save her son.
It’s not my fault that I can’t.
He stares at me now, but his blue eyes are vacuous and unseeing. They’ve been that way for six long minutes. His blond hair is plastered to his face with blood, and it’s splattered across his Live For Today T-shirt. The back of his skull is smashed in because he wasn’t wearing his seat belt, and jagged bone erupts from his hair like bright white arrowheads. Safety glass isn’t kind when a human body hurtles through it.
This boy had his whole life in front of him, and because of one stupid decision, it’s done. He won’t be living for tomorrow... Today was all he had.
He’s gone, and it’s time for me to wield the scissors.
Snip.
“Time of death, 5:57 p.m.,” I say tiredly.
I set the paddles down and take a breath. The boy’s bloody hand dangles over the side of the gurney, so I pick it up and place it on his chest. His fingers are naturally curled inward. I straighten them, my gloved fingers lingering on his before I move my hand to close his eyelids.
I feel relief when he isn’t staring at me anymore.
“Go to the other one,” Lucy tells me. “I’ll talk to his mother.”
I nod, because that’s the right thing to do, because I’m one of only two doctors in the ER right now, and the other boy is waiting for me, and he’s not beyond help like this one.
As a physician, I’ve had to learn how to compartmentalize my emotions, to turn them off at my whim and shift gears, to go from one scenario to the next to the next, all without missing a beat. It’s a skill that I learned long ago, beginning in that god-awful house on that bloody night.
I slide the curtain to another room open, and the boy inside is scared, his eyes wide and frightened and alive. He’s tall and thin and gangly, although his cheeks still have baby fat, softening the curve of the jaw that will someday be manly.
“Am I going to die?” he asks me, and his voice is so young. He’s a little boy in a man’s body, and his hands are shaking.
“Not today,” I tell him, shining my penlight into his eyes. “What’s your name?” He’s got blood smeared on his cheek, and I wonder briefly if it is his or his friend’s.
“Tyler.”
“Well, Tyler, where do you hurt?”
He shows me, both with his words and with unspoken gestures, and I take note. He’s beaten up for sure, but not mortally wounded, although we’ll definitely check for internal bleeding just to be sure.
“Is Jason okay?” he asks quietly, and his hand taps the side of the gurney nervously, tap tap tap.
I hesitate.
Tyler sees the grim answer on my face, and I don’t have to say a word.
“Jesus.” He gulps for air and I grip his arm.
“You’ve got a concussion,” I tell him. “I’m sending you for a CAT scan. Your collarbone is broken. I can see it poking through your shirt. Based on your level of pelvic pain, I think your hip crest is fractured. We’ll get you x-rayed. I don’t think you’ve got internal bleeding, but because of the rate of impact, I’m sending you for a sonogram just to be on the safe side.”
He nods and his hand clutches his hip. “It hurts.”
“I’m sure it does,” I agree. “It will take a while to recover from a fractured hip. You’ll have physical therapy, too.” I pause. “Apparently, you boys were doing a hundred miles per hour down the Dan Ryan, and not only that, but you were filming yourselves. What were you thinking?”
He closes his eyes and drops back against the bloody sheet. “We weren’t.”
“You were lucky,” I tell him. “You’re going to be okay.”
“Jason’s not,” he all but whimpers.
I shake my head and my gut contracts. “No. He’s not. I’m very sorry.”
I honestly am. I know people make mistakes. I know they have moments when they don’t think. I see it every day right here in this room. These walls have seen thousands of people at their lowest moments. Some of them, like Tyler, get lucky. Some of them, like Jason, do not.
“He’s been my best friend since kindergarten.” Tyler’s hands shake as he speaks. “We did Scouts together. We were both going away to Caltech next year. We were going to share a dorm.”
Were. Past tense.
Tyler’s eyes meet mine, and his are full of shock, of pain, of disbelief.
I don’t want to tell him that the real grief is yet to come, when the reality of death sets in, when the absence of his friend is so pronounced that it rips a giant hole in his life. I don’t need to tell him. He’ll discover it soon enough.
“I’m sorry for your loss,” I tell him sincerely, and there’s suddenly a lump in my throat because it never gets easier. I’ve been an ER doc for years now, and death is not something I’ve ever gotten used to.
It’s at this moment that shrill screaming rips apart the ER, a long wail filled with angst and torment. I know who it is without even checking.
It’s the poignant grief of a mother, the pain in the scream unmistakable. Jason’s mother’s sorrow is haunting and raw, and it echoes into my bones, where it vibrates my core.
The sound lodges in my heart, and for a minute, I allow myself to feel it, to know that in a way, I caused that pain. I couldn’t save that boy. That mother’s life is irrevocably changed. His father’s, his family’s, his friends’. The wife he might’ve someday had is gone, the kids, the life.
It’s not your fault, I tell myself, like I always do.
But that doesn’t change the fact that his life dangled in my hands on a string, and I had to cut it.
Snip.
“We’ll get you fixed up,” I tell this boy, the one who is alive. “Don’t drink and drive again.”
Tyler shakes his shaggy head. “I won’t. Can I see Jason?”
I shake my head. “You don’t want to right now. Trust me. Wait until he’s been cleaned up.”
And the mortician has patched his skull back together.
Tyler nods and closes his eyes, and Jason’s mom continues to wail in the background.