“How can your liver be this good?” I stood outside Mr. November's room watching him stir restlessly. Normal people couldn't get twenty thousand micrograms of Fentanyl and eighty milligrams of Versed an hour and live, much less still be attempting another slow-motion escape from their hospital bed.

But I knew Mr. November wasn't normal. From my assessment, when I'd seen his chipped yellow fangs around his titanium-tipped endotracheal tube, from the way he was restrained in bed—six soft cuffs, two on each arm, one on each leg, a posey vest wrapped around his chest and tied beneath the bedframe—and from the fact that he was here on Floor Y4 to begin with. No one here was normal, except for me. I was human and looked it: average brown hair, average blue eyes, average hips. My patients here? Let's just say “average” was not the first adjective you'd pick for them if you saw them on the streets. Or the twentieth.

Mr. November continued to squirm. I wondered which cheerful member of our daytime staff I'd be giving report to come 7 a.m. with him crawling out of bed behind me. I could almost feel them judging me now.

His IV pump beeped empty, and his cuffed right hand made rabbit-punching jabs. Crap.

“Hey, you!” I shouted and leaned into his room to try to attract his glazed attention. “Stay still!” I commanded through the door.

Sometimes with agitated patients, the voice of nursing authority buys time. I dashed to the supply room, unlocked the narcotics drawer, grabbed a bag of Fentanyl, and made it back to his room as he started to thrash his head from side to side.

“Stop that!” I hauled on my isolation gear on as fast as I could. If he managed to knock his endotracheal—ET—tube loose, that'd be the end of his ventilator-assisted breathing, which'd be the end of him. I put my gloves on, snatched the bag, and rushed inside. When I silenced the pump alarm's beeping, he visibly calmed.

“You have to stay still, sir. You've got pneumonia and you're in the hospital.” I switched out the bags and reset the pump. I inhaled to say more, but I saw Meaty, my charge nurse, rise up like a moon behind the nursing station outside, holding one thick hand up in the shape of a phone. It was the international nursing gesture for, “Call the doctor?”

I nodded. “More sedation. Now. Please.”

Mr. November's hands spasmed again. I didn't know if he was reaching for me with a purpose, if he just wanted to be free, or didn't understand what was happening—not unlikely, with all the meds he was getting—but I grabbed his nearest hand in both my own. “You've got to rest now, okay?” His grip tensed and so did I—most of the training videos I'd watched before starting this job had emphasized the “minimal patient contact” rule, for vastly good reasons—but then he relaxed, letting me go.

I stepped back from the bed, took off my gown and gloves, washed my hands, and went outside.

“You okay there, Edie?” Meaty asked as I returned to sit behind my desk, just outside Mr. November's door. I grunted a response and flipped open Mr. November's flowsheet to hide behind. Meaty didn't check in on Gina or Charles unless they called for help. But I was new here. Just when I was starting to feel like I knew how to be a nurse at my last job, only a year out of nursing school, my brother overdosed. On heroin. For the third time.

An unknown “friend” (read: dealer) had been kind enough to leave Jake on a curb and call 911, which'd brought him here. By the time I got to the emergency department they were on his second dose of Narcan. Which ought to be called Nar-can't, seeing as it was supposed to counteract heroin's deleterious effects, like the making you not care if you ever breathed again. They'd put an IV line into his neck because he had too many tracks on his arms to find a vein. Only some cruel miracle had stopped him from getting infected from skin popping this far. If he kept it up, I knew his luck wouldn't hold.

I wanted to touch him and I didn't want to touch him, because it didn't take being a nurse to know all the diseases he might have. And so, as I was finding some gloves to wear to hold his fucking dumbass junkie hand, a man came by and said “Wouldn't you like to see your brother clean?”

I thought he was going to tell me about Jesus, and I was getting ready to tell him where to shove himself, when he offered me a job.