Jason P. Burnham
Dr. Stefan Hoverstadt looked over his computer at the gray double doors. On the other side, ambulance sirens extinguished and he waited for the emergency room entrance to burst open. He wondered which of the Top Three the gurney would bring.
The doors surged open with a bang; through them rushed two exhausted EMTs, a man on a stretcher, and, struggling to keep up, a white woman with matted brown hair framing a tear-stained face. The group paused at the triage nurse and Stefan observed the patient—sunken eyes, only the whites showing, scraggly beard, sallow skin, and, cinching Stefan’s suspicion, duct tape over his mouth.
Furiously taking notes on a clipboard, the triage nurse in blue scrubs followed the EMTs into Bay 1. On the count of three, the EMTs and nurse transferred the newcomer into bed, a curtain separating him from another of Dr. Hoverstadt’s patients. Stefan trailed them for report, the EMT’s rapid, well-practiced staccato giving only important details.
“This is Jack Scott, fifty-seven-year-old cisgender white male, past medical history includes hypertension and hyperlipidemia. Currently, he takes no medications, though anti-hypertensive and cholesterol-lowering medications have been prescribed by his primary care physician. He takes no over-the-counter vitamins or supplements. Mrs. Scott here,” the EMT nodded toward the bleary-eyed woman standing at the foot of the stretcher with damp, ragged tissues in her hands, “called 911 because of the patient’s unresponsiveness. Mr. Scott had locked himself in the shed at their residence.”
Stefan nodded. “I’ll take it from here.” The EMTs nodded to Stefan as they exited with their stretcher, empty only until they could retrieve another patient with a Top Three diagnosis. Stefan knew they would not be gone long.
The triage nurse cocked her head. Should I start working him up? Stefan knew she was asking. He waved her away politely until he could talk to the wife. The triage nurse retreated quietly from Emergency Bay 1.
Stefan turned to Mrs. Scott, his green medical scrubs swishing as he lifted his arm to her shoulder and clasped it with his warm hand. He could feel the clamminess of her skin through her thin cotton t-shirt.
“What would you like us to do for him, ma’am?”
She looked Stefan in the face, her mascara running, eyes brimming with tears. She opened her mouth, but no words came out.
“How long ago did he stop drinking water?” Stefan asked.
A croak emanated from her throat. She held up a hand, thumb folded across her palm.
“Four days?”
She nodded.
Stefan sucked his teeth reflexively—after four days without water, Mr. Scott wouldn’t have much time left. “Would he want hydration to save his life?”
Mrs. Scott dabbed her eyes with a red-and-white spotted handkerchief and cleared her throat. “Jack just… he can never admit when he’s wrong. He refuses to…” She stopped herself and changed the subject. “Do you have any kind of alternative water? Some that won’t…” she tapped on her head, “ya know?”
Stefan shook his head. “I’m afraid not.”
From behind the curtain, Mr. Scott’s emergency bay roommate shouted. “Oh God! Who gave me water?” The patient sobbed.
Stefan raised his eyebrows at Mrs. Scott, tacitly asking leave to attend his other patient, the one whose wife had agreed to hydration over the phone.
Mrs. Scott didn’t get the message. Stefan squeezed her shoulder gently. “Would it be okay if I checked on my other patient for just a moment?”
Before Mrs. Scott could respond, there was a frantic rustling on the other side of the curtain and then the sound of a zipper opening.
Stefan’s eyes went wide. Mrs. Scott didn’t connect the dots.
Not until the newly and unwillingly-enlightened patient’s gun went off.
Mrs. Scott screamed.
Stefan threw back the curtain and Mrs. Scott screamed again. Stefan’s other patient lay dead on the gurney, blood dripping from the gaping, self-inflicted bullet wound to the head. The gun clattered to the floor.
Mrs. Scott sobbed. Stefan pulled the curtain and guided her to the nurse’s station, where the staff was huddled behind desks.
“Dr. Hoverstadt, are you okay?” one nurse called.
“Self-inflicted,” Stefan said. “No risk to us. Can someone get Mrs. Scott here some water and maybe some crackers?”
The normal din of the ER returned quickly as Stefan and Mrs. Scott sat on a bench outside her husband’s bay.
After a time, Mrs. Scott finished her drink and crackers and found the strength to speak.
“That other patient, he…” Stefan gave her space to process. “He stopped drinking water too?”
Stefan nodded.
“Did you hydrate him?”
He raised his hands, palms up. “Mrs. Scott, it might be a HIPAA violation to tell you any further information about another patient; I may have already said too much.”
“But you did, didn’t you? He hydrated and when he woke up and the water showed him the truth, he… he…”
She was right, but he couldn’t confirm it. Mr. Scott’s roommate wasn’t even the first person that week whose hydration had directly led to their suicide. Not the first person Stefan had treated who took their life rather than having the world revealed as it truly was.
Mrs. Scott cleared her throat. “Jack wouldn’t… I can’t watch him awaken just to…” She wrung her hands and cried.
Stefan rested a sympathetic hand on her shoulder.
“How long if we don’t hydrate him?” she asked finally.
“Most likely a few hours,” he said.
“Can I say goodbye?” she asked, sniffling.
He nodded and left Mrs. Scott to tell her dying husband goodbye.
Stefan walked to his computer to begin documenting causes of death for the two patients in Emergency Bay 1, one deceased already by suicide, the second an impending death by dehydration and kidney failure.
Outside the gray double doors, another ambulance pulled into the queue. Stefan wondered if it brought the other of the Top Three causes of death for truth-water-avoidant persons—poisoning from alternative water. It was going to be another long shift.
August 9th, 2024
Jason P. Burnham loves to spend time with his wife, children, and dog.
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