Terminal Chapter 1

Work in progress currently being reviewed by my agent. Refer to the prologue posted previously. Dark work of fiction with strong adult content. Let me know what you think!


Have you ever smelled death?

I’m not being dramatic when I ask this. And no, it doesn’t reek like rotting flesh or festering excrement. There’s a sterile quality to the smell. A stale, sort of expired scent permeating throughout the air.

Don’t believe me? There are dozens of documented stories of dogs, cats, and even pigs become worked up in the days leading up to their owner’s sudden passing. There are the tales of hospice cats snuggling up to patients in their final hours, comforting them as they drift off to the big sleep. Some people think the animals have a sixth sense, but I think it’s simply the smell.

Working in a hospital makes you privy to it.

I think about this as I stare down at 406, his body gaunt and emaciated below a tangle of thick sheets. His chest rises and falls in shallow breaths as he awaits yet another day of bedridden treatment.

A day that shall never come.

The first time 406 met me, he squinted, eyes beady and distrusting as he said, “what are you, some type of spic?”

I informed him my dark features came from my mother, who is predominately Italian in heritage.

“So you’re a dago,” he barked. “A fucking w.o.p.”

At least he had his acronyms down.

406’s food was never warm or good enough, the bed was never in proper position, and his pillows were never quite fluffed to his liking.

“What took you so long?” he once demanded after repeatedly pressing the call bell. “Lazy bastards like you are what’s wrong with this country. We should send all of you Mexicans back to where you came from.”

“My heritage is Italian, well, only a part of it,” I corrected him.

“Shut up, greasebag,” 406 rasped. “And get me more pillows. These are as hard as rocks.”

406, like so many, wanted something to complain about. Some proclamation to be heard and respected. Some demand to make and someone to assert himself over.

A fleeting moment of control in a life spiraling out of it.

406 isn’t an isolated case. He’s a frequent flyer. These are the types who visit the hospital so much they should have their own reserved rooms. Honestly, some of the people are unfortunate, cursed with bad luck and genetic predisposition. A vast majority of the regulars, however, end up coming back as a consequence of their own choice.

Refusing diet and exercise despite a heart condition. Refusing to take medication appropriately even as symptoms worsen. Refusing to abandon carbs and sugars even as diabetes continues to wreak havoc on their body.

You know, unavoidable stuff.

406 has a given name, but in a hospital a person becomes a number, a set of duties and responsibilities. A temporary occupant in a bed until they’re shipped out.

Shipped out can mean one of two things.

406 lets out a ragged cough in his sleep, a wheeze so deep I hear it settling into his lungs. He’s deteriorating, and the affliction isn’t only physical. Sure, his feet have been amputated due to the complications from his diabetes, and yes, his hands are next, but there’s also something much worse wearing away at him.

A cancer of the soul if you were being poetic.

A shitty life if you weren’t.   

406’s family had been helping themselves to his social security checks while he wasted away in the hospital. They rarely bother visiting him, and when they do, it’s always about money.

See? It makes sense.

Pricks like him aren’t formed in a void.

Miserable outside and in, he wallows in bitterness, liver and kidney failing. At this point he’s near the end of his journey. His doctor says he may not make it out of the hospital again.

He’s right.

I take a deep breath. I’m holding a pillow and standing over him. The privacy curtain is closed around his bed. At 2:03 a.m. there is no one to bother us; the only other aide is on the other side of the floor and his nurse has no business with him at this hour.

I smile and wonder if the pillow is fluffed enough for him as I lean over and cover his face with it.

Trust me, he needs this.

This isn’t about revenge.

Well, not entirely.

406 is peacefully asleep for the first few seconds, then he springs to life. He thrashes in a desperate struggle to avoid the inevitable.

Call this expedition.

Call it deliverance.

“Shhh, I’m helping you,” I whisper.

406 doesn’t see it this way. He scratches at me, nails grinding down my shirt sleeve. I press my knee to his midsection to take the air out of him and keep him in place.

“This can be so beautiful if you’d let it be.”

Research indicates that many who experience severe medical trauma go through a “near death experience” which entails feelings of euphoria and peace, usually accompanied by a vision, either the classic brightly lit corridor or a pleasant memory. A sort of natural high occurs in the brain when this happens, and we’re transported to a state where there is only calm acceptance.

Your body’s coping mechanism.

About twenty percent of cardiac arrest survivors report this or a pleasing out of body experience. It can be such a magnificent thing, waltzing towards death, your body letting go of all ills.

406 doesn’t seem to get it.

“Mmmmrrrfffph!” he cries.

His screams are muffled by the pillow. His struggles are mighty at first but already start to fade. I press down on him with more force.

As 406’s chest heaves up and down his cells are going through a process called respiratory acidosis. This is when his cells are unable to remove their carbon dioxide and thus poison themselves with their own waste. With the delicate cellular pH levels thrown off, system after system begins to fail as cells melt away and die.

Crazy, isn’t it?

We self destruct on even the most basic levels.

One of 406’s legs nearly connects with me but the blankets hold him down, trapping him in a death cocoon. As he fights, I think about the state of his soul. I wonder if 406 thinks he’s going to Heaven or Hell, assuming he is a believer.

Purgatory is a state in between salvation and damnation, where those with hearts dedicated to God, but who may have sinned, receive spiritual purification before ascending to Heaven.

Think of it as detox for the soul.

Twelve step spiritual counseling.

A complete luxury spa treatment wiping away the grime and filth of your life.

As long as the person’s heart is dedicated to Jesus Christ, there’s a chance they’ll transition into Heaven. It’s not guaranteed, however, and there are many factors to consider. There are venial sins, mortal sins, sins against the Holy Spirit, ways of being accessory to sin…

Purgatory must look and feel like the DMV on a busy day.

406 thrusts up, his final major attempt at escape, but I have him corralled. The effort robs him of what little air he has left, and I hear him sucking on the fabric of the pillow.

Just imagine all of those cells dying.

You don’t actually have to.

There are a few weak coughs, his final proclamations to the world, but 406 goes still. I wait a minute before checking his pulse, putting two fingers to the damp skin of his wrist. The deed is done. I remove the pillow from his face, avoiding staring into his now glassy, doll-like eyes, and slide it below his head, fluffing and adjusting it for him one final time.

He finally looks relaxed.

I pull back the privacy curtain and exit the room. I’ll soon have to deal with the aftermath of a patient “coding” but I’ll take that when it comes. A patient of his age, in his condition, it won’t stir much of a fuss. Cause of death? Complications; we don’t have time to do an autopsy on a guy who was knocking on death’s door. Ship him out and drop another body in the bed.

This is just how things are.

I walk into the hallway, narrowing as my eyes adjust to the light, and think about why I did what I did, and why any of us do what we do. I come to a quick conclusion.

Everything we do is a symptom of the same illness. Our shared diagnosis: Life. The truth we all try to hide from is the outcome. Our shared prognosis: Terminal.


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