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After a strange, glowing red light hones in on Ruby as she stares out the window at work, she blacks out. Upon awaking in a strange room, strapped to a metal.
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People can be pretty agitated, so best to check with me or one of the nurses before you go into a room alone. Zainab follows my eyes, hangs off my words. I was the same. It was the most exciting place I had been. Only a couple nurses, little monitoring. Long waits, small problems.

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Well, to us. To the person, worst day of their life. Make sense? Something exciting is happening. I look through the remaining charts. Confused, registered at hours. Shortness of breath, A preference for the sickest, though. The triage nurse makes a first fast pass, glancing at the vital signs, heart rate, blood pressure, temperature, but also how the body is held, the clothes, the worry, asks a few critical questions about chest pain, how suddenly the weakness started.

Short of breath then gulping for it, the confused turn unconscious. A person tells the story a third time to me, about how they came to be hooked to all these machines. Some get frustrated, but I need to hear it myself. I must be forever suspicious, trust no previous information necessarily, at least not more than what I can gather. I have diagnosis and treatment in mind, decide who gets discharged or referred for admission, the middle and end of their emergency department story.

In the eyes of the law, my mistakes matter most, so I ask two questions in enough different ways that the answers are as clear as possible: what exactly are you here for, and why, exactly, today? Then I look at their shoes. In truth, I probably look at them first, and if they have none, their feet. It tells me how much money they have, what kind of care I can expect them to afford their body once they leave.

Are night shifts killing me?

Regardless of which bed they start in, the sickest win their way to the front, and we see them first, then everyone else in the order they come, as fast as we can. I drain the rest of my coffee. One of the nurses turns the lights down. Some of the patients Tom saw are numb, drowsing, morphine washing through their brains, waiting for admission orders to be written by the resident with his head on the desk. It is our one superstition.

I walk past the man in bed 1. He breathes easily. A body in bed 6 clicks and whirs on a ventilator, paralyzed and unconscious. Space is being made for her in the intensive care unit. What a surprise. Around the ER, in major, intermediate, minor, in bright rooms, 20 families sit, anxious. For them, hours of waiting.

Michael F. Haspil Excerpt: Graveyard Shift - Criminal Element

For us, a series of five-minute encounters until morning. I stand outside the bed of the confused man.


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I have seen so many people pass through this bed. Seizing ones. Bleeding ones. A man yelling, bug-eyed, high on amphetamines, while security strained to hold him down. He looks older. He is alone, his eyes closed, mouth drawn over empty gums. His face is freshly shaven. Who did it? I wonder. So careful. Not even a nick. I lean closer. The smell of aftershave. No stridor. Oxygen in his blood was good, at 98 per cent. His heart tracing is slow and regular on the black screen.

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He could wait minutes. I shuffle the next chart forward. Bed Shortness of breath.

ARE YOU AFRAID OF MANNEQUINS? - Midnight Shift

I draw its curtain back, and the face of a man I have seen half a dozen times looks up. He sits, shirtless, legs dangling, sharp shoulders rounded forward, heaving up and down. His nose flares as he draws in a breath, cheeks blow fat as he puffs it out past the edges of an oxygen mask connected from his face to the wall. Using your puffers? I scribble an order on his chart for inhaled medicines, a steroid pill to shrink the inflammation in his scarred lungs.

In an hour, he will walk out of here with an inhaler in his pocket and a prescription for more. Same every time. He always says he needs more. He must have a hundred of the things. I drop the orders off at the nursing station, walk back to the bed of the confused man.

Why no raids at night?

I move to his ear. I rap his chest. No response. He grimaces, moves his hands to mine. Something is infinitely better than nothing. I feel for a pulse in the arm that clutches mine. The skin at his wrist is paper-thin.

Skin does that as we age, fades, its fat and elastics grow loose. Sometimes older people come in after bumping their shins and the skin will just have peeled away. Putting it back together is like sewing wrapping paper; the threads just slide right through. I look more carefully at the chart.