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  “Mrs. Samson, if you can hear me, please stay calm. You are just waking up after a series of strokes. I need to get a doctor.” Sarah was surprised how articulate she was able to be, given that she could feel the blood surging in her forearms, hear its hum in her ears. She was flying higher than any roller coaster or close call on the highway had ever taken her. Some healthcare professionals thrived in high-pressure situations, even craved the rush, but they were in emergency rooms. Sarah Campbell craved control, order, professionalism, and she could feel all three of those things ebbing away as Mrs. Sampson spoke again.

  “Where are my things?” she repeated. Mrs. Samson ignored Sarah’s pleas to stay still and with a frustrated and flailing gesture, knocked over a stack of cards and toys, the domino effect further blocking the framed photos from her view.

  “They’re right there, Mrs. Samson, no one has moved them,” Sarah said, chastising herself for trying to reason with someone who was clearly impaired and who needed more medical attention than she was qualified to give.

  Mrs. Samson didn’t respond, just closed a hand around one of the cards and squeezed. The cardstock gave way under her grip, Snoopy’s face crumpling inward.

  The patient was getting stronger by the second and Sarah began to fear a pulled IV line, the flesh around the needle tearing like tissue paper and then requiring stitches. She took a step forward and grabbed ahold of Mrs. Samson’s wrist. The woman’s hand twisted at a sharp angle to lash out at Sarah’s flesh with long fingernails, a snake wriggling around to strike.

  Sarah screamed, more from surprise than pain, but there would be pain, she could see the white divots that Mrs. Samson’s fingers had left, ready to well up with blood in a moment. She hadn’t thought to trim Mrs. Samson’s nails because there had been zero risk of the woman cutting herself, since even her most violent episodes were the equivalent of turning over in bed.

  “Mrs. Samson, you’re hurting me, please let my hand go and lay back.”

  The woman wasn’t listening though, she was too busy growling. It was a deep, animalistic sound that may have had its roots in words but was indecipherable by the time it reached Mrs. Samson’s lips.

  Sarah tried to shake herself free, gently at first but then with a violence that rose proportionately to her pain and panic. Mrs. Samson was digging deeper now, the nonwords coming out of her mouth faster. Apparently, Mrs. Samson had said something funny enough to make herself smile.

  Cursing herself as she did it, assured that the motion was as good as tendering her resignation, Sarah slammed Mrs. Samson’s arm down on the metal guardrail next to her mattress. The blow, which should have gotten the old woman to let go and was probably strong enough to cause a fracture, did nothing to stop the nails from digging into the meat of her palm.

  The woman’s nails were hitting bone, and Sarah brought her other hand up to pry off the fingers, but that was a mistake. Quicker than she could react, despite having half a century on the woman, Sarah’s other wrist was now in Mrs. Samson’s free hand. It was a bad dream too painful, with too much bloodshed, to be Sarah’s imagination at work.

  Although Mrs. Samson’s fingers were vise-strong, her arms and wrists were offering Sarah little resistance as she pumped her own biceps, trying to shake the woman free. It was a reverse puppet show, Mrs. Samson’s ineffectual silly-string arms controlling Sarah’s youthful and powerful ones.

  Sarah took two steps back, passed the edge of the bedside table, and dragged Mrs. Samson nearly off the bed by her ropy arms. One hand gave up its grip and landed on Sarah’s breast, the fingers scrambling for purchase and finding it as they balled up around the neck of her scrub top.

  For the first time since their scuffle began in earnest, Sarah took her gaze off her shredded hand and looked into Mrs. Samson’s eyes. They still moved in soft, clumsy loops, but now there was a fire to the whites, red with rage, and the pupils were dilated to black.

  A new set of growls brought the first recognizable words with them. “Kill you…,” Mrs. Samson said.

  With her left hand, Sarah reached over the woman’s skinny outstretched body to grab one of the picture frames off the table. “Your things are right here, you need to calm down! Greta!” It was the first time in forever she could remember calling a resident by their first name, which was not done even with the ones that asked to be ignored. She pressed the picture frame to Mrs. Samson’s face, hoping the reappearance of the item would calm her.

  Greta didn’t care.

  The hand at her breast was crawling up now, using the material of her scrubs to inch along until it was at the flesh of her throat. Greta Samson ran a sharp thumb along Sarah’s neck, too little pressure to draw blood, as if she was drawing a “cut-here” line.

  Sarah backed farther away, pulling the woman along with her, the blade at her throat not going anywhere. It was far enough that Mrs. Samson’s body was over the tipping point and spilling off the side of the bed, her IV line pulling taut and the needle plucked from her arm as the woman dropped to the floor.

  They both hit the ground, Sarah’s butt doing little to cushion her fall, and Mrs. Samson’s uncovered legs smacking against the tile. Sarah imagined the woman’s bird bones pounding into splinters and paste, but the woman gave no sign that she was in pain.

  The hand still around her neck, Sarah screamed for help.

  Either their fall or her screams was funny to Mrs. Samson, so she started smiling anew as she pressed the thumbnail into Sarah’s throat, the blood warming and cooling as it poured over the thin skin above her collarbone.

  “No,” Sarah said, and swung the picture frame without thinking about anything else but her own life force eking out of her.

  The first blow did nothing to stop the press of the nail as it dug deep, an inch from her carotid, so Sarah raised her weapon again. Before she hit Mrs. Samson, angling the corner of the heavy frame into the old woman’s temple, Sarah caught a glimpse of the picture. The photo was of Mr. and Mrs. Sampson on their wedding day, old enough to be black and white, faded around the edges. The man and woman looked happy. Mrs. Samson’s dress glowed so white that it looked almost religious. It could have been a painting titled the “Transfiguration of Greta Samson.”

  There was the crack of glass as Sarah lowered the frame a third time, a shard slipping through the paper backing of the frame an slicing a gash into Mrs. Samson’s ear. The hands at her throat and wrist relaxed as Sarah crawled out from under the seventy-pound old woman.

  What have I done?

  Standing, Sarah grabbed the bedside remote unit and depressed the red button before checking for a pulse that wasn’t there.

  After a minute, when nobody replied to the emergency call, she flung open the door and ducked out of the room that was now hot with blood and exertion.

  There was no doctor or other nurse running down the third-floor hallway to help her; there were only residents.

  Chapter 9

  “And you, Nikki, what do you do?” Gail asked. They weren’t yet done with their appetizers and they had already burned through most of the usual small talk.

  Harriet sat at the head of the table, a guest of honor position that left only one open seat at the opposite end of the long dinner table. It wasn’t a first-class affair; there were no silver dining trays, but the air of the room was stiff.

  Awkward, as her kids at the center would say, misappropriating the word most of the times they chose to use it.

  “I work with kids,” Nikki said. Gail’s eyes lit up and she cut in before Nikki could elaborate.

  “A teacher! So wonderful. What grade? What subject?”

  Gail sat in the middle of the table, flanked on either side by two residents, and next to them two Mercy House employees, the pattern of no resident being too far from professional help continuing around the table.

  “Not kids, little monsters,” Harriet said. “She’s not a teacher.” Her mother-in-law didn’t have to speak up to be heard, there was no chatter around the table. Everyon
e was taking turns when they spoke, one at a time like they were onstage, a by-product of this forced interaction. Don, seated in a corner in between his mother and Nikki, shushed her.

  “I work at a youth center as a counselor for the Department of Human Services. I see troubled teens and talk to them about making better choices.” It was the two-sentence pitch she had prepared for social situations. Anything beyond that and she’d likely end up using words like drugs or gun violence or prostitution, and that always seemed to take some of the officious sheen off the job description, true as it was.

  Gail reached a hand across the large table, but since Nikki was too far away, her free hand in her lap, the woman had to settle for patting the oak between them instead of squeezing Nikki’s hand. “Well, bless you for your service anyway. A valuable institution,” she said.

  Nikki said thanks and stuffed her mouth with Caesar salad, signaling that it was time for the conversation to bounce back to either Don or Harriet, that she’d answered the question posed and it was no longer her turn.

  “A contractor and a social worker, such an odd pairing. How did you two meet?” Gail said. She must have sensed Nikki’s reluctance because the question was directed toward Don.

  Nikki allowed herself to relax and listen to Don’s version of the story. She was usually the one telling it at parties, had allotted for all the appropriate pauses and had a few jokes to go along with it, but she’d let Don take it this time.

  Long story short: Once upon a time there was construction in her building and Don had been the one to kick her out of her office. He was nice about it, though, and not in a way that told her he was being nice because she was young and attractive. He offered to buy her coffee for the inconvenience of disrupting her workspace, and then went to the staff lounge and the communal coffeepot to get it.

  It had been cute, even though he was the shortest man she had ever dated, and one of only two white guys. And he was still cute, with the smile of a boy but the grit and scars and sadness of a man.

  She looked at the faces around her. The staffers, five of them including Gail, were all looking politely engaged in Don’s story, boredom still seeping through the holes in some of their masks, with only the doctor looking openly hostile to conversation.

  The doctor had introduced himself, but Nikki had already forgotten his name. He had a pencil mustache and looked ready to fall asleep. Across from him was a warm nurse with a Spanish name. Flores. That meant flower, right? Nikki had asked, and the woman had nodded Yes, before returning to helping the old woman and man on either side of her, rearranging one’s grip on her fork after she’d tried to pick up her salad with a steak knife.

  Don reached the punch line of the story and most of the table, those who had heard him and been following along, laughed. The big man across from Flores laughed the loudest, but that was to be expected, he was a giant. His name had been something equally big-sounding, a strong syllable that required you to fill your cheeks with air and that sounded like a Samoan or Mauri war cry when he said it. Even though his ancestry probably wasn’t nearly as exotic. It was just Nikki making a story to go along with his face, not something she was supposed to do in sessions, but she was off the clock. On the clock, if she made assumptions based on a kid’s angelic face, she might forget that that same kid had seen more carnage than most active military and end up saying something that hurt the patient, or herself.

  Nikki was bad with the names of the staff. And remembering the Mercy House residents she’d met? Forget it. They were a blur of gray eyebrows and wrinkles. This was one of the reasons why Nikki liked working with teens. With tattoos and wild hair, kids took great pains to distinguish themselves from their peers, something that helped Nikki remember them if time passed between meetings.

  There was a pause after Don finished, and Gail was caught with her mouth full so she couldn’t jump in with a reply. The salads and soups around the table were nearly depleted and the lunch lady—now in a conservative dress—was clearing plates.

  —

  Harriet wanted to claw Nikki’s eyes out. The evil bitch kept her smile pressed tight, not wanting to look too happy, too pleased with herself and her dark magic manipulations.

  She broke her stare away from the girl long enough to look at her son. There was a smile on his face, too, as he gesticulated, telling the story of how he met his darling wife. You try to raise them as best you can, and at a certain point you may have even fooled yourself into thinking you’d succeeded, but sooner or later they find a way to disappoint you. Then—at the end—they lock you away to add insult to mortal injury.

  Harriet could feel the anger surging through her. It came in waves lately, and part of her rational mind knew that it wasn’t just an emotion but a symptom. Her frontal lobe was destroying itself, the damage headed backward toward the rest of her brain. It was part of the reason she felt angry all the time, at least more angry than she used to feel, and also the reason that her lips were cracked and bloody no matter how hard she tried to stop licking them.

  Pick’s hadn’t ever manifested itself like this before, as a dark cloud at the end of the room that felt so real she could almost see it, did see it, flickering in and out of existence like a kind of static. But maybe the cloud was a combination of her disease and the fact that it was her Abandonment Day.

  There was a lull and Harriet decided to speak. It was her party and she would ruin it if she wanted to.

  “What’s your deal? How do you like it here?” she asked the redhead next to her. The woman’s makeup made her look like a Dickensian hooker. She smelled like a slut, too. She stank of too much makeup and some kind of ointment and wasn’t fooling any man with that wig. Sniffing the woman reminded Harriet to ask, “Does the stink get any better?”

  —

  “The smell. Do you get used to it?” Harriet asked again, the flesh around her lips red and cracked, even though Nikki hadn’t caught her licking once since they’d been inside Mercy House.

  The redhead looked at Harriet, her hands becoming fists on her silverware, her eyes looking red, close to tears. She didn’t speak.

  “Come on now, Beatrice. You’re usually such a chatterbox. Tell her how you like it here, all the friends you’ve made.” It could have been Nikki’s imagination, but the emphasis on friends seemed suggestive, an inside joke that Gail was sharing with the rest of the staffers, or maybe just herself.

  Beatrice brought her head around slowly to regard Gail. It was the motion of an old dog, cloudy in the eyes and gray in the face, turning because it heard its name called.

  “Well, I’m not quite sure what it is you’re smelling, Harriet. You may just be adjusting to new surroundings; you’ll get used to it. Rest assured that it’s very clean here. We know what an adjustment it must be,” Gail said, turning to the big man, who wasn’t standing on ceremony for the rest of their entrées to be delivered before digging in. “Do you smell anything new, Paulo?” Ah, that was his name; he’d just put special emphasis on the Pao sound when he’d introduced himself.

  The big man swallowed, the sound a cartoon gulp as he forced down a lump of steak he didn’t have a chance to properly chew.

  Before he could speak, Beatrice did.

  “No. She’s right. It stinks. Rot. Fucking moldy cum loads left on shit-stained sheets,” she said.

  Gail dropped her fork; her makeup unable to conceal the blush of her embarrassment.

  There was a beat, and then Chairwoman Gail Donner gave her best public relations laugh. Nikki felt herself leaning forward in her seat, desperate to hear how the woman was going to attempt to spin this outburst from Beatrice.

  “Probably not the worst thing you’ve ever heard, with one of you working construction and the other one spending her day around teenagers, eh?” She nodded at both of them separately as she spoke. “We have a colorful environment here and encourage our residents to express themselves. It sometimes manifests itself in, uh, interesting ways.” She laughed again and this time the
staff around the table joined her. The sound was loud enough for Nikki to notice the contrast as the residents weren’t sharing in the moment.

  The entrées were set down in front of them now, steak for the staffers, Don, and Nikki, and what looked like baked cod for the elderly residents. Their dish was a softer food but looked no less highbrow.

  “What’s this?” the woman to the left of Gail said.

  “It’s Chilean sea bass with lemon, Marta,” the lunch lady said, leaning over the old woman and readjusting the plate, as if the issue was with the old woman’s vision, not the dish.

  “I want meat,” Marta replied.

  “Well, you know how tough steak can be,” Gail said in response, nodding the lunch lady away. The chubby woman exited the dining room with an overly formal combination of a bow and a curtsy.

  “I want meat in my mouth, too,” Beatrice said from the other side of Gail. This particular biddy seemed incapable of saying anything that didn’t carry a sexual suggestion. Nikki fought down a rising giggle.

  There was something wrong with these women. If these were the residents that Gail had chosen to introduce as pillars of the Mercy House community, Nikki tried to imagine what the rest of the population must be like.

  Don gave her thigh a squeeze under the table and the playful touch reminded Nikki of better days, when the world and the people in it were a sitcom performed only for the couple’s entertainment. Those were the days when there would have been no suppressing their laughter at two randy old women fighting over meat.

  “If your speech therapist clears you for steak, if she says that you can handle it, then you can have steak. But not until then,” Gail said, a flash of what she must be like, without a family watching her, slipping through. In one quick statement the woman demonstrated that she was more than capable of sternness, maybe even cruelty, when it came to dealing with the residents.