In a hospital, quiet days are rare blessings. They really are.

What do you expect in a place where people are too sick to carry on with their lives as usual? Constant medical attention, that’s what. There’s usually someone in pain, or fear, sometimes both. I always anticipate tests that need to be done here and there, plus whatever treatments are needed to end the patient’s suffering. If a patient crashes, my day gets ruined. I’m on the move pretty much all the time. I’m so used to it that I don’t think about it anymore.

And yet, here I am: Ivory Memorial Hospital, seventh floor, East side, computer workroom behind the nurse’s station, so relaxed and carefree. It’s Tuesday morning and I have only four patients on my service. None are unstable or in serious condition. Three of them could possibly be discharged tomorrow. The last one will leave the hospital today, after I wrap up her paperwork.

Four days ago, 32-year-old Shannon Dixon came to the emergency department downstairs because of difficulty breathing. Right away, a CT scan of her chest nailed the diagnosis: pulmonary embolism, a blood clot stuck in a major lung artery. It formed initially in one of her leg veins before breaking off and traveling all the way to the right side of her heart and then into her lung circulation. As for how that happened, I’m thinking it’s her recent ten-hour flight from Tokyo to Los Angeles, where she barely moved her legs and never stood up once because she slept the entire flight. That means blood moving slower than usual. That means a higher chance for clotting factors in the blood to coalesce into clots. Thankfully, her treatments went just fine: injections of the blood thinner heparin, then transitioning to the blood-thinner pill warfarin. She’s now on the right dose of warfarin, which she will continue after leaving this place.

As great as that sounds, there’s still something else. One unexpected detail about Shannon’s case got thrown into the mix and has knotted my stomach since. Today will be my last chance to talk to her about it.

I submit the discharge orders through Icarus, the Integrated Clinical Record System, and leave the workroom. Shannon is in room 724, still in bed wearing a light-blue hospital gown. She adjusts her wavy blonde hair before getting a kiss from a muscular man, her husband Craig. The two spot me at the door, then smile.

“Well, it’s finally done,” I say, returning an equally friendly grin. “You’ll be going home in no time.”

“Woohoo,” Shannon responds, almost beaming like a little girl. “What time am I leaving?”

“Likely before noon. You can even stop by the cafeteria on your way out.”

“Is the food any good?” Craig asks.

“Oh, it’s five-star dining,” I answer with a small laugh. “But yeah, there are decent options. I would say they’ve got better in the past year.”

“Anything you recommend?”

“Not really. Just follow your gut.”

“I’m in the mood for ham sandwiches. What do you think, honey?”

“Sounds great,” Shannon says. “What about dinner?”

“I found a nice restaurant we could try out,” Craig says. “But it won’t be cheap.”

“I’m not worried. You’re the one paying.”

“Right. I lost to you in Trivial Pursuit.”

Shannon giggles slightly.

“So which restaurant did you pick?” she asks.

“I’ll surprise you.”

“Aw, come on, babe.”

“You’ll like it. Trust me.”

“Fine. I’m sure you won’t disappoint me, just like when you found that every bar on Super Bowl Sunday had no room for us.”

“For that, your football team beat mine.”

“Go Chiefs!”

The couple share a hearty laugh, face to face and eye to eye. Yeah, they are true lovebirds. Gotta love these two. Craig kisses his wife on the lips. Shannon smiles.

But all of a sudden, she freezes. Her expression does a 180. The happy face is gone. She also raises a finger, as if remembering something.

“Dr. Lin, about that thing we talked about yesterday,” she says.

I nod. This is the moment I’d been waiting for. I had expected that I would be the one to bring up the issue, but Shannon just beat me to it.

She and Craig had been trying to have a baby for some time. Two days ago, while she was hospitalized, Craig came here with a home pregnancy test kit. Shannon went into the restroom to do the test, and sure enough, the stick showed the wonderful plus sign they were hoping for. The next day, she asked me if her treatments for pulmonary embolism might harm her unborn child. I stopped in my tracks. I had no idea she was pregnant. All I could do was say that I would look into it.

I consulted Micromedex and other drug reference sources. They all confirmed it: warfarin is teratogenic. It causes bleeding in a developing fetus. Birth defects are sure to result, or worse, the baby might come out already dead sometime in the nine-month period. No wonder it’s contraindicated in pregnancy. Should I have considered the possibility of pregnancy beforehand? Yeah, sure. But when a blood clot gets stuck in a pulmonary artery and that problem is priority number one, it’s hard to think of anything else. Presumably, the emergency doc had that same problem, especially with the ED staff often overworked. Man, talk about falling through the cracks.

“I remember,” I say, trying to still sound friendly. “You caught me by surprise. Well, I hate to say it, but warfarin can harm a developing baby.”

“I’m so sorry,” Shannon says with a hint of guilt. “I should’ve asked you earlier.”

“No, don’t worry about it. What’s done is done.”

“But now our baby might be deformed.”

“When was your last menstrual period?”

Shannon stops to think.

“Like one-and-a-half months.”

“Early stage,” I respond. “That’s when the most critical development occurs in the womb, I believe.”

“Now I’m really concerned.”

“Dr. Lin, what are the chances that, if we wait eight more months, the baby will still come out normal?” Craig asks.

I pause, trying to recall any statistics about fetal warfarin syndrome. But I’m no obstetrician.

“Taking warfarin during pregnancy may not be one hundred percent guaranteed to result in birth defects, but I don’t want to say that the chance is small, either,” I comment slowly.

“Maybe we should assume the worst,” Shannon says, before pulling out a tissue from a box on the nightstand. Then she closes her eyes, sighs, and frowns. Craig leans over to hold her hand.

“It’s OK,” Craig says soothingly.

“But it’s gonna have problems,” Shannon says with a quiet sob.

Craig gives her a hug, letting his wife cry into his chest instead of her tissue. I hold still, not wanting to disturb what is already a difficult moment. So much for a happy patient discharge. I wait another minute before Shannon is calm once again.

“Do you want to wait and see if the baby turns out OK?” she asks her husband. “Or should I get an abortion?”

Craig slowly turns to me.

“Any advice, Dr. Lin?” he asks.

“It’s really up to the two of you,” I answer calmly. “I’m also not the best doctor to handle issues related to pregnancy, including the simultaneous use of warfarin. In fact, on the discharge paperwork, I included a referral to OB/GYN. Just wait for them to contact you. Then you can schedule an appointment.”

“How long until they call?” Shannon asks.

“I don’t know. I hope it’ll be soon.”

Shannon nods and looks at Craig. The couple talk to each other at a whisper level. I cannot hear them, which is fine by me. But I do see their faces. For a while, both husband and wife wear serious expressions. But soon, Shannon’s frown fades as Craig smiles a little. Then she smiles, too, while nodding her head slightly. Maybe Craig has suggested something to Shannon, who has arrived at some kind of acceptance or agreement.

They turn back to me.

“Is everything OK?” I ask politely.

“We’re fine,” Shannon answers. “This is the first time we ever had to deal with this.”

“You’re not alone.”

“Of course.”

“We can talk more about it over dinner,” Craig suggests. “You know what? Forget the surprise. I’ll tell you right now. We’ll eat at that Mediterranean restaurant you always wanted to try.”

“Ooooh, you read my mind.”

“Not really. You said you were in the mood for falafel.”

“Did I?”

“Yeah, just yesterday.”

“Oh, right. My mind has gotten fuzzy. Blame it on this hospital.”

The two laugh together. Now is the time to signal my exit.

“Do either of you have any questions?” I ask.

Shannon and Craig only shake their heads. I nod, wish them a wonderful rest of the day, and leave the room.

Today really is my lucky day. It’s a little after 4:15 PM and I have almost nothing to do. I still have only three patients in my list. All are doing well after I followed up on them this afternoon. I’m amazed that I haven’t been called down to the emergency department to pick up new admissions. After all, patients requiring hospitalization here in Ivory Memorial are assigned to hospitalists who currently have the fewest patients. So I can think of only two possibilities. One, no patients in the ED today need to be admitted. Two, the few who do are now assigned to hospitalists who happened to have zero to two patients. I could care less which is happening. This downtime is unbelievable.

In my corner cubicle, I sift through work emails and respond where needed. Nothing is terribly urgent, so I don’t bother rushing. Even then, I get it all done in no time. My next task is to compile summary notes on my three patients, in preparation for signing them out to the nocturnist covering from five o’clock PM to seven o’clock AM. That really doesn’t take long either. Now there’s still half an hour to kill before I can finally go home, if things remain quiet.

I stand up and stretch my arms above my head. Then I step away from my desk, out to the big empty space in the middle of the room. My stomach soon growls. I grab a granola bar from the nearby lounge and devour it in two bites. That’s when I hear a door open. A fellow doc has entered this office area from the hallway. I recognize the black man with the big smile and upbeat demeanor: one of my friends, Thomas Chandler.

“Hey, Mark. Aren’t you getting any work done?”

“I’m all finished,” I clap back, almost laughing.

“Seriously? Man, I wish I had your workload.”

“How big is your list right now?”

“Eight patients.”

“Are they terribly sick?”

“None of them are, thank god.”

“So why are you complaining?”

“What are you talking about?”

“You said you wish you had my workload.”

“I did?”

I glare at Thomas.

“Come on, stop being in denial,” I say, stifling a laugh. “I have good short-term memory.”

“Not a short memory?”

“Oh, be quiet.”

Thomas chuckles out loud as he walks by and pats me on the back. He sits at his cubicle while I remain standing.

“So yeah, I did have a busy day,” Thomas says, logging into his computer. “When one focuses on work, everything else goes out the window. You know how it is.”

“Unlike today, I think I’ll be super busy tomorrow,” I say calmly.

“Because of new admissions?”

“Yeah. I only have three patients, all likely discharges.”

Thomas whistles.

“I think you’ve set a new record in this hospital: the shortest time to zero patients.”

“What’s the previous?” I ask.

“I don’t think there is one.”

“You mean nobody ever had an empty patient list?”

“Probably not.”

“OK, so I might become the first. Maybe the last as well.”

“Watch it, Mark. I’ll soon catch up with you.”

“When? The day you retire?”

Thomas and I share another good laugh before I let him get back to work. Still in the room’s open space, I slowly pace around. I don’t want this downtime to end. But I’m also a realist. I know it’s not going to last.

Soon, one of my mobile phones starts vibrating. Not the personal one in my right pants pocket. The work phone in my left. I pick it up and answer, noticing a phone number displayed instead of someone’s name. The caller is not in my contacts list.

“Hello. Dr. Mark Lin speaking.”

“Hi, it’s Shannon Dixon. Sorry if I’m interrupting anything.”

“Oh, not at all. But even if you were, I’d still be answering.”

She giggles a little.

“Well, don’t pick up if a patient is dying. So, I’m at Ivory Memorial Clinic right now. I got an OB/GYN appointment at four forty-five.”

“Really? In just a few minutes?”

“Yeah. Someone else had it before cancelling. When the clinic called to schedule an appointment and I asked about the earliest date and time, they told me about that slot and I requested it.”

“Wow. Lucky you.”

“I know, right? Anyway, I’m calling because I have two questions.”

“Sure. What’s up?”

“First off, should I worry about my Coumadin dose getting changed?” she asks, referring to a common brand name for warfarin.

“Any reason you’re concerned?”

“I remember you saying the medication must be taken at the dose and frequency you prescribed.”

“I don’t believe the obstetrician will adjust the Coumadin. Chances are that the doc will understand how important it is for you at this time.”

“OK.”

“In my experience, when there are multiple doctors of different specialties for the same patient, they try to keep current medications the way they are, unless it’s very clear that particular meds are causing a big problem or two. Does that make sense?”

“Yeah, sure.”

“Good. Hopefully, I won’t have to go over there and pester them about your Coumadin. Not that it’s even a possibility.”

Shannon laughs before continuing.

“That’s fine. Now, my second question. Since I survived a blood clot in my lung, should I worry about getting a clot somewhere else?”

I nod. I like it when patients take their health seriously.

“I don’t want to have another major crisis, you know,” Shannon says.

“It’s good to ask. In your case, I would say no.”

“Is it impossible for me to get another clot?”

“No, but I would say the probability is low, at least for now.”

“Why do you say that?”

“The most likely reason you developed a blood clot is that you kept your legs still for a very long time, during your flight from Tokyo. Combine that with your pregnancy, which made your blood more prone to clot formation because of all that estrogen. Now, if you were to avoid both down the line, or at least one of them, the risk won’t be as high.”

“So I should avoid flying while expecting.”

I pause as Shannon laughs.

“That’s one way,” I say, also chuckling a little.

“But seriously, do I need to worry about a clot in another part of my body?”

“Like where?”

“I don’t know. The brain, maybe?”

“Probably not. You don’t have atrial fibrillation, do you?”

“I don’t think so. But I don’t know what that is.”

“Your heart has four chambers: the two atria at the top and the two ventricles at the bottom. Atrial fibrillation is when the two atria beat chaotically, not strongly. That makes blood flow slower than normal there, making it easy for clots to form. The same way that a clot formed in your leg, dislodged, and traveled all the way to your lungs, a clot from the heart could make its way to the brain, causing a stroke.”

“Oh god. And you’re sure that won’t happen to me?”

“Very sure. Your EKG shows a normal heart rhythm, not a-fib.”

“OK.”

“Again, don’t worry. Remember, the factors underlying your clot were only temporary. You don’t have any chronic conditions that make you a constant clotting machine. You understand what I’m saying?”

“I do now, thank you. God, why am I such a coward?”

“Don’t feel bad. Caution can save your life.”

“Sure. But now I have the wait time to deal with. I’m supposedly the last appointment for the day, but there are still others in the waiting room.”

“Are you sure they’re waiting for appointments?”

“I don’t know. I just see—”

Her voice is cut off by a sound, probably a door knob turned forcefully. Followed by a pounding. I picture a door slamming open and hitting a wall. A different female voice speaks, in the distance.

“Ma’am, what are you doing?”

There is silence. I’m also holding my breath. All of a sudden, I hear footsteps, then a few high-pitched grunts before what sounds like a hand slapping someone’s face. The commotion gets louder.

“Oh my god,” Shannon whispers quickly.

“What?” I say.

“Some woman just barged into the waiting room with a gun. Others are restraining her.”

“Oh no. Can you hide somewhere?”

“I can’t.”

“OK, try to stay far away.”

Now I hear a big thud.

“She’s pinned to the ground,” Shannon says, voice quivering. “Now she’s clawing her hands at people. And… she’s pulling something from her jacket.”

“It’s some kind of button,” Shannon says softly. “With a wire going into her.”

I picture what she’s describing. Suddenly, the grunts reach an intense pitch, a mad struggle of women fighting for dear life. One voice shouts at the top of her lungs.

“Purity is mine!”

Followed by Shannon’s scream.

“Nnnnnoooooooo!”

A deafening boom instantly cuts her off. My whole body stiffens, especially my chest. I’m not breathing. I want to, I really do, but I can’t. The room is blurring now. I feel the phone slipping away from my hand. Its thumping along the floor barely registers. Everything is out of reach, out of sight. My body slumps. I’m sinking quickly with no strength left.

Darkness finally captures me. I welcome it with open arms.

I have no idea how long I blacked out. I just know it’s been a while. Right now, I don’t remember what happened, where I am, or even my own name. The only things I’m aware of are sensations: a distant voice, a dull pressure on my shoulder, and my face being squished. Soon, it makes sense. I’m face down on the floor and someone is trying to wake me up.

Next thing I know, my whole body is turned. I’m lying on my back. Something is gently hitting one of my cheeks. I slowly open my eyes. The source of the voice stares back.

“Mark,” Thomas says. “Wake up, buddy.”

I manage a slight nod.

“Say something,” he continues.

“I’m alive,” I respond slowly.

“That’s good. How many fingers am I holding up?”

I stop for visual confirmation, then answer.

“Four.”

“You need help getting up?”

“Let me see.”

I push my upper body off the floor using my forearms. That already drains me. I shake my head.

“All right, give me a hand,” I say weakly.

Thomas reaches down to slide his arm behind both of my shoulders. He counts to three before hoisting me onto my feet. But my legs are still wobbly. I wrap my left arm around his broad shoulder before I steady my steps. He leads me into the lounge, towards the couch. I quickly turn and drop onto the soft leather cushions. I lean back and close my eyes.

For about half a minute, I do nothing but breathe. Not long after that, another friend and colleague comes into the lounge: a young blonde lady, Dr. Jane Larsen. She looks as concerned as Thomas.

“Mark, are you all right?” she asks.

I nod slowly, then respond.

“You saw what happened?”

“Yeah. When I came through the door, you were standing while talking on the phone. Then you collapsed. Thomas rushed to you.”

“Did I hit my head?”

“I don’t think so. The rest of your body went down first.”

“How long ago was this?”

“A little over two minutes, maybe. By the way, here’s your phone.”

She hands it to me, the one I held while speaking with Shannon Dixon, up until that moment when…

Oh shit, I think I’m gonna puke.

I slide along the couch to my left, toward a waist-high garbage can sitting about a foot away. I stop, wondering if I should stand with my face over the stinking trash and risk gagging from the smell. Nah, I better stay put. The nausea is fading slightly. I start taking in as much fresh air as I can. If I still have to throw up, at least I can quickly cover the short distance to the can.

So far, nothing more happens with my gut. Good. I slowly lean back in the couch again. I turn to Thomas and Jane.

“One of my patients died,” I begin. “In a very unusual way.”

“You were on the phone with the family?” Jane asks.

“No, the patient herself.”

“What happened?”

“She died during the call.”

“Whoa, whoa,” Thomas cuts in. “What do you mean?”

“She was murdered,” I answer.

My colleagues look at each other, saying nothing. I use this opportunity to close my eyes and take a couple more deep breaths. I look at them again. They still don’t say a word. I think they’re expecting me to take the lead.

“Actually, I take that back,” I say. “She might be more of an innocent bystander, not a specific target.”

“I still don’t get what’s going on,” Thomas responds.

“My patient was in the clinic, talking to me on the phone. I heard a woman force her way into the waiting room in a threatening manner. Then a struggle took place, and…”

Thomas and Jane wait for me to finish my sentence. Instead, I start another one.

“Wait a minute. Did either of you hear a sound before I fainted?”

“Like what?” Jane asks.

“I don’t know. Some kind of boom?”

“Come to think of it, there was something,” Thomas says slowly. “A really faint rumble in the distance. Did you hear it too, Jane?”

Jane remains still, before slowly nodding and answering.

“You know what? I heard it, too, just as I was coming in here.”

The next thing I notice is the big-screen television at the opposite wall. I stand up to grab the remote control sitting nearby. I press the power button. At the moment, the TV is showing a commercial for laundry detergent. I check the wall clock and see that it’s exactly five o’clock. I sit back down.

“Mark, what’s going on?” Thomas asks.

I hold up one finger, staring at the TV. The local news is starting now.

After a quick program intro, there is a Breaking News alert. The accompanying live footage shows a white building with a big gaping hole from the ground to the fourth floor. Billows of thick smoke waft from inside, while firefighters aim two powerful hoses to put out the flames. The voices of a newsroom anchor and a field reporter are telling the public what they know so far.

There has been an explosion at Ivory Memorial Clinic.

The cause is not yet known, but Anaheim police are already on the scene. Currently, five survivors have been identified, all headed to the emergency department at Ivory Memorial Hospital. Authorities are looking for more victims of the blast, dead or alive.

All of us are glued to the broadcast. I notice that a thin, bearded man has already entered the lounge: Dr. Roger Garrison, our Chief of Internal Medicine. He has his mouth covered with one hand, just as Jane has one tear falling from one eye and Thomas wears a heavy frown on his face. Obviously, the proximity is just too much. The Ivory Memorial campus has its hospital and clinic lined up on the same side of the street, separated only by a parking garage for employees and patients.

The news anchor is now interviewing someone by phone: one of the police officers on site. The cop explains that an investigation will eventually reveal what happened. Given that the facility is a healthcare clinic rather than an industrial business storing high volumes of flammable materials, an accidental explosion seems less likely. However, when asked if a criminal act is responsible, the officer responds that there is no information right now to suggest that possibility. He emphasizes once again that a thorough investigation should uncover the answers soon.

Right away, I take out my work phone. On its web browser, I do a Google search to find a number for the Anaheim Police Department. I dial it and wait. By then, my colleagues and boss are whispering to each other, even as the broadcast continues its coverage of the clinic explosion.

“Anaheim police,” a woman answers.

“Hi, I have information about Ivory Memorial Clinic,” I utter rapidly.

“OK, OK, slow down. Take your time. Just relax and try to breathe.”

I do as she says. Thomas, Jane, and Garrison turn their attention to me. I mouth to them that I’m calling the police. They nod slowly.

“Are you OK now?” the policewoman asks.

“Yes, ma’am,” I answer.

“Tell me why you’re calling.”

“My name is Mark Lin. I’m a physician at Ivory Memorial Hospital, which is a short distance from Ivory Memorial Clinic where an explosion occurred. I want to pass along some info that might help.”

“OK.”

“I had a patient whom I discharged from the hospital today. I referred her to the OB/GYN department at that clinic, for a medical issue that is outside my expertise in internal medicine. She called me from an OB/GYN waiting room to ask a few medical questions. This was a few moments before the explosion.”

“I see. And you heard it on the phone?”

“Yes, plus a few other things.”

There is no immediate response. I hear what sounds like the policewoman getting a pen and paper ready. I also make sure I can remember the details clearly.

“Go on, Dr. Lin.”

“While talking to my patient, I heard a door slam open in the distance, over the phone. The patient told me that someone had barged into the waiting room with a gun. She didn’t describe what that person looked like. All she mentioned was that the intruder was a woman wearing a jacket.”

“So no other physical details?”

“I’m afraid not.”

“Did your patient mention what kind of jacket it was? What color it was? Anything like that?”

“No. Things happened so fast.”

“I understand.”

“Then there was some kind of struggle, with multiple people trying to restrain the intruder. My patient said so. She was near the chaos. Then she mentioned the woman pulling something out of her jacket, some kind of button with a wire attached. Then, right before a very loud boom, the intruder shouted a phrase: ‘Purity is mine.’”

The policewoman repeats that back to me, and I confirm she heard correctly. I stop for a moment. The sickness is coming back, though mildly. Thomas, Jane, and Garrison still look at me. At least they finally know the story.

“Basically,” I say to break the silence, “I think the clinic was attacked by a female suicide bomber.”

“Any idea who it might be?”

“No.”

“Do you know if the clinic received threats recently?”

“Not that I’m aware of.”

There is another pause. I hear pen scratches on paper.

“Dr. Lin, I am so sorry you overheard all of that,” the policewoman says solemnly. “My heart goes out to your patient and the other victims.”

“Thank you.”

“It really takes courage to come forward like this, after what you’ve gone through. If I were in your shoes, I’d be quite shocked, too.”

“Do you think this information will help?”

“It might. By the way, what floor of the clinic was the OB/GYN department on?”

“I don’t normally work there, so I can barely recall. But I think it’s the second floor.”

“And what was your patient’s name?”

“Shannon Dixon.”

“Do you know anything about her family?”

“Her husband is Craig Dixon. They were trying to have a baby. No other kids as far as I know. I last spoke to Craig this morning along with Shannon before I discharged her.”

“What time were you on the phone with Shannon before the explosion?”

“I can check my call log. Hang on.”

While still on the call, I access the list of recent calls on my phone. I review the details of the top entry.

“Shannon had an OB/GYN appointment scheduled at four forty-five,” I say. “She called me at four forty-two, and the log says the call lasted four minutes and nine seconds. That means the explosion occurred at or around four forty-six.”

I hear more pen scratches. I wonder if the policewoman is smiling at the level of detail I’m providing.

“Do I actually have to surrender my phone as evidence or anything like that?” I ask politely. “It’s a hospital work phone.”

“For now, don’t worry about it.”

I let out a sigh of relief. I also realize that the timing of the explosion could be pinpointed through multiple other sources, like eyewitness accounts from the clinic building itself and the surrounding area.

“Anything else you would like to pass along?” the policewoman asks.

“Not right now,” I respond. “Just make sure they look for a female suicide bomber. I can’t think of what else could explain all of this.”

“Well, if you do remember something later on, feel free to call back. Also, if the police need to contact you, can they reach you at the number you’re calling from?”

“Yes. It’s my work number.”

“Understood. OK, Dr. Lin. Thank you so much.”

I hang up and take a deep breath.

“No wonder you were stunned,” Thomas says softly, approaching me. “I’m sorry.”

“Me too,” Jane says.

“At least it’s finally off my chest,” I say, then turn to Garrison. “When did you first hear about the explosion?”

“Not too long ago,” the chief says. “I was down in the ED when I heard some kind of muffled boom. We all heard it and stopped. Moments later, a staff member ran into the ED and announced that there was an explosion at the clinic.”

“Wow,” Thomas says. “Just wow.”

Everyone remains silent.

“Mark,” Jane says. “If it makes you feel any better, I can remember two patients in my career who died within one day after discharge.”

“Were they murdered, though?”

“No. But it’s still sad when you go through all that work getting them back on their feet, only for them to expire so suddenly.”

I nod slowly. Unlike me, Jane did not have to overhear a patient’s final scream.

“Just rest a bit, wrap things up, and go home,” Jane says.

“I’ll try,” I respond.

“Then do something to unwind, like yoga. Or a bubble bath.”

“I don’t do either.”

“Not too late to start. But whatever you do, find some way to unwind. You really need it.”

For the first time since fainting, I smile. Jane reaches over to give me a hug before leaving the lounge. Thomas pats me on the back and heads out. Meanwhile, Garrison stays put. I fill a paper cup with water from a cooler nearby, then swallow it all in one gulp.

“Mark, I need to know how you’re handling this crisis,” the chief says, approaching me.

“What do you mean?”

“Emotionally. Are you just going to move on like it never happened?”

“I’m not ignoring it. How could I?”

“You think you can come in tomorrow and still stay focused?”

I don’t answer right away. It’s a rhetorical question. I know what he’s getting at.

“I’ve been through horrific moments before, at work and outside it,” I say. “Ultimately, this isn’t any different.”

“You think so?” Garrison asks skeptically.

“I know I’ve had plenty of bad luck. One bad thing after another hitting me. Yet, I’ve survived it all.”

“Still, don’t think you’re immune to the trauma. If it’s too much to handle, don’t try to fight through it.”

“I’ll admit that I’m not yet fully recovered. But I’m getting there. I’ll get some sleep tonight. I should be fine tomorrow morning.”

“Make sure to think it through. Remember, your patients’ lives are in your hands.”

I nod slowly.

“I was going to ask if you wanted to just take time off starting tomorrow,” Garrison says. “According to the hospitalist schedule, you’re still on service for another couple of days.”

“Right. For now, I’m still confident about coming in. The feeling will pass, I hope.”

“That doesn’t sound like a guarantee.”

“It’s more likely than not that I’ll be OK.”

“You’re no doubt a very hard worker, Mark. I always admire your dedication. But don’t think that you have no limits. Everyone is human. You’re no exception.”

I don’t say anything. He might be right. I could be messed up inside and not realize it at all.

“I’ll tell you what,” I say to the chief. “I’ll see how I feel tomorrow morning. If I really am in no shape to work, I’ll let you know then.”

“Very well,” Garrison answers. “In general, don’t ever be afraid to ask for help. I’m serious.”

“I know, sir.”

Garrison nods, though reluctantly. Ivory Memorial Hospital always has two hospitalists who are off for six-day periods but still placed on sick call, standing by to substitute for any inpatient physician who suddenly can’t work for the day. I’ll ask for one if I’m really not well. I won’t take unfair advantage of it.

Once Garrison leaves the lounge, I head back to my cubicle. I get ready to call the nocturnist who will cover my patients overnight. But I can’t just yet. The work phone is getting another incoming call. The screen displays a phone number. Unknown caller again.

“Hello. Dr. Mark Lin speaking.”

“This is Craig Dixon, Shannon’s husband. Have you heard from her?”

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