The Graceview Patient By Caitlin Starling - 31

Have you ever been in an ocean cave? The kind on the shoreline that floods with the surf, then empties as the tide pulls back? So much stone, reflecting and amplifying the crash of the waves, the rush of water, breaking it apart and recombining it until it is deafening. Your skull turned into its own resonance chamber, a microcosm of the cave itself, the swell of breath, the sucking pull of an exhale.

If you’re lucky, there’s an upper exit, or somewhere safe to stand when the tide comes in.

The roar was everywhere. It was in every breath, every heartbeat. It was incomprehensibly loud, but it didn’t hurt. It just blotted out everything that wasn’t it.

On and on, it broke over me as I lay curled on my side in the hospital bed. My eyes were open to bare slits and no farther. My eyelids shivered with the thrum. I listened with every nerve in my body, vibrating along with it like a struck harp string. No variation on inhale, exhale. No change with the thump-thump-thump-thump of my heart, which I could only distantly feel and hear not at all.

And there, inside the roar, a distant note. The overlapping murmur of conversations. A brief fragment of Isobel’s voice, saying couldn’t shouldn’t couldn’t shouldn’t , until that, too, was part of the maelstrom.

It wasn’t the overwhelming crush of being sick. Of medication, of palliative care, of the dislodging of my consciousness from my meat. Medication was the method of action, yes, the pump dumping everything into me faster, faster, but this was something outside of me, too. Something I could feel. Something I could no longer ignore.

Listen , Veronica’s voice whispered.

My body twitched.

A door was opening. Inflow, outflow. I could hear the rattle of cart wheels. The cart would stay in the antechamber, too difficult to disinfect, too dangerous, but the creature pushing it would come in.

Another door. A shape, approaching the bed.

LISTEN , Veronica demanded. And the roar receded. It didn’t leave, no, but the tide went out, and I could hear what the technician was saying.

“Can you move onto your back, Ms. Culpepper?”

The name felt so strange against my skin. But I complied, spilling from my side onto the mattress. The room was still dark, the sun not yet risen. But he’d turned on one of the smaller lights in order to work, so I could see him. He wore a paper mask and a face shield on top of it, and he was double-gloved. I thought I saw his hands shake as he began to fill vials with my blood. He took it from my lower arm, not bothering with the port. Not a nurse, not my nurse. Somebody else.

Intruder.

He was a thief. A grasping, clawing little thief. The thought came from somewhere that wasn’t me, and it rang behind my eyes.

A thief, but did he know what he was stealing?

He knew enough to be afraid. Like Lauren. And there was Isobel’s voice again, Tuberculosis takes months to show symptoms. Everybody had to know that this wasn’t natural, whatever I had.

My head lolled to the side. “Do you run the tests?” I rasped. “Or do you just take the samples?”

It was so hard, keeping track of who did what here. So many faces I only saw once, maybe twice. Had I seen him before? Was he the same man who had told me about my decidual cast?

Pathology had told him all about that one. Gossip spread like mycelium.

He startled a little, but kept his hands moving. “Just take the samples,” he said.

“The nurses have been doing those lately.” Part of being in isolation, part of managing my instability. Minimize exposure for me. No— to me.

There had to be a reason he’d been sent in. He was studying me. Interpreting something he’d need special knowledge for. Maybe the pathologist hadn’t been gossiping.

Maybe he was lying about who he was. What his job was.

I thought of Adam, taking samples or medicating me without a trace. Not real , I’d thought, but maybe … maybe …

One of my hands flexed against the sheet, feeling out how much strength I had in me. I couldn’t remember the last time I’d eaten, and the roar had settled in beneath my skin, keeping me at a distance from the edges of my body.

This man knew what he was looking for.

This man would have answers.

“Did you hear about what they found growing on the floor?” I asked.

One vial left. He hesitated before twisting it onto the connection for it. “No,” he said. “No, nobody mentioned anything like that.”

His skin had gone white beneath all that PPE.

But the gowns were just paper. His tore easily even under my weak hands as I rose from the bed in one smooth surge. “Jesus fuck!” he gasped, not loud enough that anybody would be able to hear, as I wrapped myself around him, ripping, rending, and then my weight overbalanced him, and we crashed onto the floor. I felt the jerk beneath my skin of my port being tugged by the IV tubing, and the needle in my arm slipped sideways.

He could hurt me badly. But he didn’t, stunned and horrified. Trembling, I took hold of his face shield and peeled it off him. The whites of his eyes were so blinding.

“I know I don’t have tuberculosis,” I said. “Tell me what’s happening to me, and I’ll let you go.”

His eyes darted around, frantic, to the CALL button (out of reach) and the doorway (shut, he’d have to yell very loudly, and he seemed too frozen to do that). My bed alarm would summon somebody quickly, but how quickly?

I dropped my hand to his. He was warm through the nitrile.

“Please,” I said.

When I pulled his hand, he released the vial before it could do more damage to my arm. He let me have it. The needle slid free. Blood spattered onto him, and his heart beat so fast beneath my touch.

“It—it doesn’t have a name.”

Liar. But it didn’t matter. I didn’t need a name. “What is it?” I asked. “What does it do ?”

I pulled the vial of my blood out of the needle, discarding the little butterfly. The cap was stiff, unyielding, but he stared at it.

He shook his head.

“We don’t know. We—we can’t culture it. At first—at first we thought it wasn’t even pathogenic, thought it might be some chemical or procedural side effect. Like cancer from radium, before we knew what radiation does. But it spreads like an infection. And we—we keep seeing traces of it. Everywhere.”

“Everywhere?”

“Everywhere, it’s unavoidable. Like MRSA. You know what MRSA is?”

I nodded.

“But those traces, they don’t make people sick. People weren’t getting sick, we were just getting strange results on certain tests. Until … until they started these trials. Then people started dying.”

Above us both was a mostly empty bag of SWAIL. Drip-dripping away, too fast. I didn’t spare it a glance, even if he did.

“And now I have it.”

He nodded.

“And Veronica. The other trial patient.”

Another nod.

“It’s—it’s like a flip of a coin,” he said. “Either the infection kills you, or they fix you fast enough. Just like any opportunistic infection. You need to let them fix you, okay? You need to cooperate. We’re doing everything we can. I promise .”

Everything they could, including taking samples from me.

It clicked, then. They couldn’t culture it in a lab—but they could in my body. I was the petri dish. I was the experiment.

“Jesus, god,” he was babbling, “just—just put that down, let me go. Okay? Let me go. It’s okay, you’re scared, I get that, just…”

I sat back on my heels, grip loosening. The murmuring inside my bones had grown fractured, questioning, probing. Distracting. For just a moment, I wasn’t strong.

He saw that weakness and began to fight.

He tried to get up, snatching at my hand. The vial went skittering across the floor. But I didn’t need it. My mouth was raw, and the skin of my cheek split at the slightest pressure. Blood dripped from my mouth, onto him, and he sobbed as it soaked into his paper mask, as it oozed past to the skin beneath.

“Help! Nurse! Staff! ” he shouted, but shouting opened his mouth, and I saw the change in him the moment my blood touched his lips. His voice broke, and he retched. I didn’t care. I was rage and fury and strength, and I tore the mask from his face and bent down. I kissed him, smearing him with my blood, my saliva.

And then I sat up, triumphant, vicious and vindicated. There were no running footsteps, no doors slamming open this time. “Tell me,” I said, voice slurred from the little cuts. “Tell me what happens next.”

He said nothing.

But something was wrong with his face. The skin was swelling, turning puffy around his eyes, shiny across his cheeks. Too much fluid in him. It threatened to evert his eyelids, the rims growing wider, redder.

“Please don’t,” he whispered. “Please don’t do this to me.”

Beneath my hands, the skin of his arms grew loose. It separated from the muscle and fat. I felt it give way, and that, combined with his desperate plea, broke through to me. I let go. He collapsed, and I did, too, but away from him, in the shadow of my bed.

Nothing grew there but me.

Beneath me, the floor rose. Up, up by degrees, then down again, then shuddering with the force of a cough, a cough that ripped through my lungs, too. He jerked at the sharp crack of it, and where his skin was exposed, it was reddening, splitting, ulcerating. It moved so fast I could barely comprehend it, almost didn’t understand the golden sheen of plasma slicking his broken-down flesh.

But the shriek that filled the air was not from him.

It wasn’t mine, either. It was the roar, crashing down onto us both, the low dark weight of it, but through it came a piercing note. Screaming, inhuman screaming, and it reduced the world down to a bright and shining point.

I didn’t want this.

I didn’t want to be a part of this. Consumed by it. I was supposed to fight. To flee. But the shriek was everywhere, and then my voice was lifting, joining it, and the bright, shining point detonated and—

And I woke up to the technician packing up his things and leaving, blood vials sealed and ordered on his cart.

In the ringing silence, I leaned over the edge of my bed and vomited.