The Graceview Patient By Caitlin Starling - 37

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“Meg?”

I stared down at Isobel’s body in the bed. I couldn’t remember walking there; my brain was on fire, the roar drowned out by my own screaming thoughts. Isobel had known, all along, what was going to happen to me. I’d tried to absolve her of all the guilt she bore, and for what? She’d said she was just burned out, that she felt responsible in some nebulous way, and I’d—I’d reassured her. I’d assumed she was wrong.

But she had been telling me, in her own way. Every time she’d tried to get me to leave. Every time she’d warned me.

It hadn’t been enough. And she’d worked here, stayed on this ward, until it had put her in this bed.

Did she deserve it?

(She had told me to run. She didn’t want me in that room. Was that pragmatism or self-loathing?)

“Meg, please look at me,” the thing behind me said.

I forced myself to straighten. I turned to the abomination wearing my nurse’s face. “Did you get me sick? Intentionally?” I asked. I needed to know; it was the only answer that mattered now.

“No,” the nurse said. “No, we were just ready when you did get sick. Meg, nothing was withheld from you. You have to understand that. There’s nothing we could have done.”

“Except warn me,” I said.

She looked away.

“Usually,” the pathogen mouth said, speaking with a glacial, halting cadence, just learning how to use words, “growth is slow. But not there.” It gestured to me. “Delivered, in force.”

“Infected, deliberately,” the nurse said, and she sounded—surprised. “Are you sure?”

Infected, deliberately.

I couldn’t breathe. A performance. This was a pantomime, for my benefit. An attempt to soothe. But even as I had the thought, I registered the horror crossing both the nurse’s face and the suffering patient’s.

No, Isobel hadn’t known. But somebody must have.

With Veronica’s voice, the pathogen mouth said, “He brings you flowers, too?” And then its face frowned. “No. Not that. Something else.”

The faint stench of rot was replaced, for just a moment, with the blooming scent of mango.

All of those meals, with their color-coded containers.

I finally vomited.

Isobel the nurse was there in an instant, but I recoiled, staggering away, colliding with the bed rail. Isobel’s body jerked from the force of it. No, not the body, Isobel . The real, barely breathing Isobel. She was displaced from her bed, or at least transported, transformed, right behind me—but it wasn’t her. I couldn’t see it as her, not split as it was. I clung to the railing, staring down at her wan face. I felt blood, my blood, fresh and hot once more. My heaving must have torn open the closures on my chest, or maybe my nose was bleeding again.

Plit plit plit , in time with the pump.

My toes touched something warm and viscous.

I looked down.

Beneath her bed, splattered with my vomit, was the pink-peach biofilm. Compared to my skin, compared to Isobel’s, it looked oversaturated. Vivid and vivacious. Alive in a way we weren’t. It slicked the floor and was beginning to climb the caster wheels of the bed. But where my blood had fallen, it had retreated, as if burned. I stared at the bare linoleum beneath.

The voices beyond the door were quieting, but the roar rose up to replace them. I struggled to think through it.

“Meg,” the tripartite Isobel called. “Meg, come back to me.”

Isobel shouldn’t have been in that bed. For all her sins, she should have been safe. “Why are you this sick?” I asked. The ground was pulling away beneath me. The world was closing in. But this was important. I could feel it, some missing detail, just beyond my grasp.

“Changing, learning. New patterns, new approaches, new hosts,” said the pathogen mouth. And yes, that made sense, pathogens evolve, don’t they? And maybe that was how it had jumped to her. Maybe it was the burnout, her own immune system crumpling under the stress heaped upon it. Or maybe—maybe that one dinner, shared with Isobel, maybe that had been the last vector needed.

But it couldn’t be why she was dying so much faster than I was. By all rights, I should have been the one in the bed, not her. They’d all but destroyed me.

Except … maybe that was it. Maybe that was the difference. Not SWAIL, even if it had left me vulnerable, but why I was being put through it in the first place.

I had Fayette-Gehret syndrome.

She didn’t.

In her own words, something about Fayette-Gehret made me vulnerable, but only after SWAIL. And while SWAIL had all but hollowed me out, it wasn’t finished yet. Isobel had said the next treatment would kill me. Lauren had said there was almost nothing left for my body to fix. Louise had called this my last chance.

There was something still in my blood. Something left over, something SWAIL hadn’t gotten rid of, not quite. Something that fought back the biofilm.

Something that, without it, I’d die just like Isobel was dying.

Which meant that with it?

Maybe she could live.

I pushed away from the bed, going to the supply cabinet. I needed—tubing. Some kind of tubing. Maybe a syringe? I didn’t know, I didn’t have the training. And I didn’t have the code I needed to open the drawers, either. I looked over my shoulder, the strain on my neck making the world grow dim for a moment, the floor pitch and yaw. I stood my ground.

I would only have one chance at this. The voices outside the room had quieted, which meant they were preparing some new tactic. Some way in. I met the eyes of the patient aspect of the grotesque amalgamation.

“Give me the code,” I said. “I’m going to give you my blood.”

“No,” said the nurse mouth. “Absolutely not, we’re not compatible.”

“I don’t care,” I said, and pointed to the film on the floor. “Look. Look, my blood kills it, something in it, my rogue white blood cells, whatever the fuck it is. It’s the only useful thing I have left. And I am going to give it to you before it’s gone.”

I know what I sounded like.

The mind seeks to create a narrative. It keeps trying to exert control over an environment. The only alternative is a damaged passivity, learned helplessness keeping you stuck while the shock comes, again and again.

“Five-seven-two-three,” the patient mouth said, and the nurse aspect swore.

The pathogen side, strangely, was quiet.

Of all three of them, I expected it to fight the most. And its lack of reaction made me falter. But what else could it have done? It spoke with Isobel’s mouth, but didn’t think with her brain. This wasn’t battle, not in the way I could understand it. It simply was . It lived, it reproduced, it consumed. But it didn’t plan or fear.

I punched in the code, then opened the cabinet and drawers. I stared, unsure of what came next.

“Tell me how to do it,” I said. “Tell me what I need.”

“You’ll kill me,” the nurse mouth said. She was reaching out, as if to stop me, but the patient’s hands grabbed those wrists, held them fast.

“No, no, let her,” the patient mouth begged. “I can’t do this anymore. I’m going to die.”

She sounded so much like me, just then.

But while the nurse in her wavered, it also wasn’t enough. She’d seen so many people sick, so many people die. My throat was so dry, but I managed one last plea.

“ Other people could die. If you’re sick, other people could get sick, too.” I gestured to the bed. “And if this works—if I can save you—”

Maybe it could end with us.

That was enough. She came to my side, the whole misshapen bulk of her, and she pointed to each thing I would need. Tubing, gloves, Vacutainer needle, scalpel, tape, a prepackaged saline flush, antiseptic wipes, a tourniquet.

“Thank you,” I said. I don’t know why; I was saving her , not the other way around, and she had done so much to me, put me at such risk. But I needed her, even in this. We needed each other.

I took everything to the bedside. I stepped onto the film and shuddered, but I kept going, dumping everything onto the sheets and then undoing Isobel’s restraints. Her skin was so damaged. It was like I could feel it, all that raw, sore skin. “What next?”

The creature loomed over the bed, gazing down at Isobel’s shivering, sweating body. She had another IV port in her far arm, not connected to the pump, but even from where I stood, I could see discoloration. Not available.

“Gloves first,” she said. When I’d complied, she continued, “Wipe everything down. Remove the hub at the end of your IV tubing—yes, that. Now attach the Vacutainer needle.” The plastic cylinder had a bright blue lock on one end, and it screwed on seamlessly. “Now cut off the spike on the new tubing, that’s right. Careful. Insert it into the Vacutainer … add tape. Should be a good enough seal.”

Isobel was so steady, so patient. And that, in turn, made me steady enough to manage the fiddly work despite my numb fingertips and the strange interference of the gloves.

With the tape in place, I looked up and met her eyes. I could see the panic in them, just below the surface. I looked away.

“Now: you’ll need to turn off everything in the pump except for the saline.”

Isobel’s pump wasn’t locked down.

My hands shook as I followed the nurse’s instructions. The machine was as slow and unresponsive as I remembered, but it was simple to pause everything aside from the one she pointed out. We waited for the line to run a little longer, the air quiet, hushed, impossible.

Then something hit the door.

I flinched but didn’t look. “Hurry,” I said. “Hurry, they’re coming.”

“Move me to the floor,” the thing said. “Quickly.”

“Help me?” I asked, breathless, but the tripartite creature shook her head.

I reached into the bed. Isobel’s body was so light, but my muscles were far weaker than they needed to be, and she slipped from my arms. I heard the thunk of her head hitting the ground, but I didn’t have time. I left her there. Her hand was in the slime. I could feel myself starting to hyperventilate.

Another slam against the door, then another. I clambered back onto the gurney. The nurse hands reached for mine but didn’t touch. She mimed for me how to massage the tubing until my blood oozed through the four-foot length of it. I fumbled through it, struggling to manage everything on my own, but she never stabilized a thing. Unable or unwilling? I could still see in that central set of eyes a banked anger, mistrust, fear.

When the blood ran through, she pointed to the stopcock in the line below the pump. “You shouldn’t do this,” she warned.

“Please,” the patient mouth begged.

The pathogen side just observed.

It would have been—not easier, but more understandable, if it had fought.

I connected my blood to Isobel’s IV and watched it flow into the pulses of saline. Down, down, into her vein. The first bloom of red disappeared beneath her skin.

I held my breath. It burned in my ravaged lungs, but I held it, and watched, and waited. More slams echoed from the antechamber, and I could hear the cart squeaking against the floor. They were close. It wouldn’t hold much longer. Was it working? How would I know? Would there be any sign?

The roar exploded inside my skull.

Louder than I’d ever heard it, it obliterated all other thought. My eyes were open, and there was light to see by, but the onslaught was so terrible, so all-consuming, that I couldn’t tell you what was happening around me. If the pathogen aspect fought, finally, I couldn’t see it. Couldn’t understand it. There was just me, in the bed, once more a patient; Isobel, on the floor, relegated to nothing. It wasn’t supposed to be like that.

And I felt nothing. No mystical connection, no flash of triumph. I could barely feel the blood leaving me at all and had no way of knowing what it felt like as it entered Isobel’s veins. Not cold, like my transfusions had been, I suppose, but beyond that—nothing. Nothing but the roar, and the burn of withheld oxygen.

I felt like I was falling. The world began to fade. The roar softened. And, as sight returned, as I watched, the pathogen limbs stopped moving. It didn’t go limp, but stiff, as if frozen in place. As if a connection had been cut.

I began to breathe again.

And then the first alarm went off. I couldn’t see the screen from where I was, didn’t know what had gone wrong, but the sound pierced my brain, ramified down my spine. I wanted to cover my ears but couldn’t, not without pulling too hard on the tubing.

“Stop!” the nurse mouth yelled. Her arms, still capable of movement, grabbed for the IV pole. I realized too late that she had half a chance of moving it; nonliving objects had been fair game in the past. The scalpel, the cart.

Before she could get hold of it, Isobel’s patient aspect had tangled herself around the nurse’s arms once more.

But the patient face was shifting, receding, as if the bone beneath her skull was beginning to fall away. I tore my gaze from her and looked at the real Isobel, sprawled helpless on the floor. Her skin was breaking out in red patches, welts and hives, and as I stared, she began to twitch. Her breathing sounded—wrong.

Then she began to scream.

It hit her and the creature behind me simultaneously, a great wave breaking. Louder than the alarm, louder than the renewed pounding on the door and the motion of the cart. They were breaking in. I had minutes left, seconds. And all I could do was stare down at what I had done.

Her eyes opened, sightless, as she thrashed. The creature construct collapsed into itself, disappeared into nothingness. There was just me, in the bed, blood running into Isobel, on the floor, and we were so sick, so sick, and she was dying.

I was killing her.

I scratched at my arm, desperate to tear the tubing away, but I was so clumsy. Click click click went the pump, and my blood kept inching down the line, dumping into her veins again, again, again. I sobbed, wishing her skin would balloon with blood, the IV shot, the vein ruptured. Anything to keep it from moving, anything to stop it.

The cart spun away from the door. I gave up on my own IV and heaved myself to the edge of the bed. I hit the ground beside her, a new blur of pain added to the rest. I couldn’t understand the voices behind me, above me, and I reached for her IV.

I never got it free.

They pulled me away from her. I didn’t see their faces, still don’t know who was there to witness everything, who knows exactly what I did. They disconnected us, moved Isobel back into her bed, took her out of the room. There was so much shouting. Adam stood above me, staring down in horror, and I stared back up at him. His eyes were the only thing keeping me there, keeping me in my body, as I sobbed and fought and begged.

“Please,” I whispered, my throat so hoarse, my lungs so tired. “Please, please. I only wanted to save her. Tell me she’s going to be okay. She’s going to be okay. Is she going to be okay?” I babbled: about the blood, about the roar, about how I’d just wanted to give her a weapon.

They brought a gurney for me. They moved me into it. I never felt the push of drugs, but I felt their effect. Absences, spots in my mind, there and gone, there and gone.

I never saw Isobel again.