Apocalypse Hearts

Chapter 1- The Last Shift

Rain had been falling over Metro Manila since last night. Today, Sally Rivera is walking to the hospital where she is working as a trauma nurse. She is wearing water slippers because the road is now ankle-deep. It is really an advantage to live just two blocks away from where you work, and that is what Sally intended when she first landed a job in the city.

Sheets of rain beat the ER's glass entrance. Every few minutes, an ambulance arrived from EDSA through the curtain of rainwater, its siren rising and fading. Security guards rushed to the ambulance door with umbrellas, helping patients and relatives enter the hospital lobby. The ER was already alive with relatives lined up in the reception area, clutching their admission papers, looking tired and sleepless. Several orderlies wheeled patients through brightly lit white corridors from room to laboratory and back. Cardiac monitors produced steady electronic rhythms. The air smelled of antiseptic, alcohol, metallic scent, and instant coffee.

For Sally, it was just another Monday morning. She immediately changed into fresh light navy blue scrubs and dry "duty" shoes, secured her ID badge to her chest pocket, and joined the incoming nurses for the morning endorsement. After a few minutes, Sally pushed the roving cart full of medicines, IVs, the works.

"You are doing better, Lola. We'll have the doctor check on you again in a little while," Sally said, smilingly as she adjusted the IV drip of an elderly diabetic.

The old lady managed a tired nod. "Thank you, Nurse."

"Sally!"

She turned towards the voice. Ronald Avenilla, the new Intern, waved a clipboard over his head.

"Room Seven's asking for you. The patient says he'll only let the pretty nurse insert another IV.

Sally rolled her eyes. "Doc, tell him the pretty nurse is busy."

"I have said that already," Ronald grinned. "He asked for the prettier one."

A nearby resident doctor, nurses, and even the cleaning staff mopping the floor burst into laughter. Sally chuckled as she accepted the chart. The exchange lasted just thirty seconds, but it helped ease the tension inside the ER that the medical team and patients needed. Humor was a survival skill in the hospital.

As Sally walked towards Room Seven, her phone vibrated and rang very low inside the pocket. She smiled before answering.

"Mama, I'm still on duty."

"I know. This is just short, anak. The creek is getting higher. If the weather gets really terrible, you can postpone coming home this weekend, OK?"

"Ok. We will continue talking later, Ma. Regards to Tatay and Junior. I have to go now." Sally slipped the phone back into her pocket, left the cart outside the Ward, and pushed aside the division curtain to Room Seven.

The patient, a middle-aged delivery rider, looked up awkwardly. "I was only joking earlier, Nurse Sally." He said, looking at her name badge.

"I know. I've heard worse jokes from a patient."

He smiled. "I'm not joking, actually, when I asked for the prettiest nurse. Are you really the pretty nurse?" trying to look at her face behind the mask.

Sally raised the fresh IV catheter. "I am the nurse who's about to poke your arm with the biggest catheter if you keep talking."

The whole ward erupted in laughter. Outside, thunder rolled.

***

The ambulance driver climbed out without waiting for the guards to assist. He was shouting in panic. Inside the ambulance, a patient slammed repeatedly against the rear doors. The impact echoed through the rain not just once, but three times. No one inside the hospital knew that the ordinary Monday had just come to an end.

Silence followed that Sally immediately noticed. For seconds, the emergency bay outside the glass door stood motionless, with two red lights from the ambulance reflected in the glass wall. The driver could be seen outside, back and forth, speaking frantically into the cellphone. Two EMTs were standing near the closed rear door of the ambulance.

This was not normal in emergencies. EMTs do not hesitate, especially when a patient's life is at stake. Nurses exchanged glances.

"What are they waiting for?" Ronald muttered.

The intercom crackled overhead, "Incoming patient. Possible seizure. Male, 38 years old. Patient, extremely aggressive."

Minutes later, the ER door slid open. Rain gusted inside. Four paramedics rushed in, wrestling a wheeled stretcher through the entrance. The patient was strapped to it against thick canvas restraints, as if every muscle in his body had become a constraint. His wrists were raw as they rubbed against the restraints. His fingers curled into rigid claws, and veins stood out beneath his pale skin. His eyes were wide open, unblinking, looking at people, watching the people. The eyes lingered on every nurse, every doctor who came into view. His gaze was not confused but calculating.

Sally felt a little anxious with that gaze. The lead paramedic, sweating, handed her the chart and said, "Male, thirty-eight. Found wandering near Cubao. Witnesses said he attacked two pedestrians."

"Drugs?" She asked.

"We assumed d**g-induced psychosis, but we are not sure, really."

Sally scanned the chart and could not believe that his temperature was 41.3 Degrees Celsius. She checked the temperature; it indicated 41.3. Even severe infections rarely reached that high without leaving the patient barely conscious. Sally checked all the vitals. Blood pressure was normal, but the pulse was just 82. A fever of 41 degrees should have driven his pulse rate to the roof. Almost all vitals were realistic except for the pulse. Sally looked at the patient. His chest rose and fell in slow, controlled breaths.

The patient looked at her, following her movement without blinking.

"Sally? Are you OK?" Ronald came near.

"His vitals don't match," Sally answered, almost whispering. "If that temperature is accurate, he shouldn't be this aggressive."

"Equipment malfunction?" Ronald glanced at the monitor.

"Maybe? But the paramedics' equipment and ours got the same results, so I'm not convinced."

The patient spoke, almost a whisper.

"Water…"

Sally leaned closer. "What did you say?"

"I'm so thirsty." Barely louder than a whisper.

Sally reached for a cup. The lead paramedic grabbed her wrist.

"Don't. He almost bit me."

"Bit?" Ronald asked.

The paramedic nodded slowly. "We were loading him into the ambulance. He suddenly lunged at my arm. I was just fast enough to move it away," he explained.

"What did he say?" Sally asked.

"Nothing. I think," he hesitated, "In my 14 years in the EMT services, I have never seen eyes like that. Just watching, not blinking, and not once did he show fear."

The cardiac monitor seemed to become louder. Beep, beep, beep, too steady, almost tranquil. The patient's mouth moved. Sally thought he was about to smile, then she realized that he was sniffing the air like an animal catching a scent. The hair on the back of Sally's neck stood up. Her gut told her a warning. Leave now. She ignored it because nurses do not walk away from patients. She put on a new pair of gloves and reached for the thermometer to get another patient's temperature. The patient's eyes looked at her hand, then his lips parted like a smile. Just then, a violent crash echoed from somewhere inside the ER. A girl screamed. Everyone turned toward the sound.

Sally looked back after a few seconds; the patient's right arm was right in front of her eyes.

"Restraint's loose!" Ronald shouted.

The room moved all at once. The lead paramedic lunged for the patient's freed arm, while another tightened his grip on the shoulder straps. Ronald also helped hold the arm down. The stretcher rocked violently. Then the patient's free hand sprang upward and gripped the wrist of the holding paramedic. The EMT felt the crushing pain right away. His face was so red with effort to move away, but the patient's hand never loosened.

"Sir," Sally said, keeping her voice calm. "You're in the hospital; you are safe here. Please let go."

The patient's eyes shifted toward her. For the first time since he arrived at the hospital, he blinked. His mouth opened, and he said something inaudible. The paramedic had taken advantage of the very abrupt moment that the patient was distracted; he was able to free his hand.

"What, Sir?" Sally asked.

"So hungry…." The patient said.