Today’s story came from an earworm and a dictionary search. When I saw that “membrane” was the prompt, I immediately couldn’t get “insane in the brain/ insane in the membrane” from cycling through my head on repeat. So I went ahead and looked up “membrane” in the dictionary to see if anything popped up. In Merriam-Webster, one of the example sentences referenced the use of an extracorporeal membrane oxygenation machine, which pumps and oxygenates blood by pumping it out of the patient’s body, through a membrane, and back in, bypassing the heart and lungs. It’s used to give them a rest when they have been overtaxed. That then led me down a rabbit hole and I ended up looking up hospital evacuation procedures and that led me to… well, this story. I even kept in a nod to the original earworm. Hope you enjoy it, and Happy Halloween 3rd!

Day 3: Membrane

The empty hospital was a horror movie cliché, but the sirens had sounded sixteen hours ago, and now the corridors resembled the paper-and-medical-debris strewn halls of Hollywood’s finest set design.

The evacuation plan sat in its pristine binder in the Director’s office. The pages, crisp and unwrinkled, hadn’t been disturbed since they slid smoothly off the printer, three-hole punched by a clerk, stuck in the binder with its distinctive “Cypress Heights General” stamped on the cover, and deposited to the shelf after the annual tabletop exercise.

From their vantage point under the Director’s large, solid-wood desk, Mel could see the white spine of the binder, lined up in a row with other spotless binders full of protocol and standard operating procedures.

Nothing in there had been remotely useful. Nobody had even tried to open them.

Mel was—had been—a week or so into a student nursing internship at Cypress Heights, barely long enough to learn where the good bathrooms were, and which residents to avoid.

They hadn’t been there last year when the hospital staff had earned high marks in the chosen scenario—a pre-evacuation in the face of peaceful protests turned into violent riots and looting. It didn’t matter than the staff had written its own test scenario, one that included an overwhelmed ER and blocked streets with emergency vehicles unable to navigate. The hospital doctors and nurses and internists and actors dressed in moulage all performed at the highest of levels, and the Director got a plaque and a binder of lessons learned that sat, collecting dust, on the shelf.

The desk was a good place to hide. A good place to stay. Mel swallowed back a cough and wiped their cheek with the back of their hand, the stubble on their jaw rough against their skin. They’d been under the desk longer than they thought. Long enough for the lights to flicker and fade, and the daylight to take their place. Long enough for the alarms to run out of battery and die, for their cell phone to lose signal, for the screams and the feet pounding in the corridors to fade into dead silence.

Mel had been assigned to the respiratory ward, with a resident who kept referring to them as “dude,” and who was supposed to show them the finer parts of working with a patient currently undergoing extracorporeal membrane oxygenation. They didn’t expect to ever work with ECMO patients; as the resident explained, it required a specially trained nurse to administer the anticoagulants and monitor for infections and correct sedation levels. But again, they were new, and the senior nurse did not have much time or patience for explaining things, so Mel had been told to observe, and they interpreted as: “Stay quiet and out of trouble until we find a good place for you.”

The first wave of evacuation had been everyone who could walk or run or hurry, led by a group of nurses who shepherded them through the halls and down the stairs. There were supposed to be more groups after that, orderly rows of triaged patients, but after the first wave, when the panic hit and people started shoving and pushing, everything had gotten muddled.

Mel had been left in the chaos, handed a chart and forgotten, sweating under their layers of mask and gloves and face shield and sterile clothing cover. That resident had stared at them, told them: “Keep an eye on the patient,” and left them there when the sirens went off and the announcements started blaring through the loudspeakers. The words had been completely indistinguishable, an unscripted emergency that no one could comprehend until the chaos was too complete.

In the hours that passed in the silence, Mel had waited. The waiting grew harder and harder. They’d stepped away from the patient only for a moment, to find a bathroom, in hallways that for once were full of people to watch which door they chose to use. The entire floor was quiet and empty, even when they came out.

Mel had tried the phone at the nurse’s station, but there was nothing on the other end when she picked it up, not even a busy signal. Their phone was in their locker on the ground floor, and they decided to go down quickly and come back up. No one was around to notice, and their patient was comatose.

They’d shuffled down a few floors, then stopped to look through the fireproof glass at one of the landings. Out in the hall of the oncology department, they’d finally spotted people. Or rather, bodies. Sprawled. In pieces. Painting the hall in macabre shadows.

There, in the middle of the hall, a figure. Short, thin, almost child-like, it stooped over a wheelchair, like a concerned child. At least that’s what Mel thought, until the figure straightened, and they saw the red smears, the matted hair, the way the arms of its victims flopped over the sides of the chair.

Mel had almost screamed. Instead, they pounded back up the stairs in their plain, white Asics and sprinted to their patient. They’d stood beside his bed in indecision, unsure, then had finally switched everything over to battery power, unhooking the various wires and tubes and rearranging them to prep the patient for transport.

They’d pushed the patient out of the room with it’s wide glass windows, meant for easy observation, the small ECMO device tucked into his side, beeping as it pumped blood from one side of the membrane to the other.

On this floor, the only room without those large windows was the Director’s office. It had a door with a small window, but she had papered it over. Mel had headed for it, pushing the patient bed in front of them, only to come up short against the doorjamb. There was no way they were going to fit the bed with its patient through the narrow entrance.

The silence had been deafening as Mel had stared at the conundrum. With the blood rushing in their ears, it seemed as if the empty halls echoed and clamored. It was only when an actual sound broke the silence that Mel realized how still it had become.

The sound was a thump somewhere, and Mel hadn’t stopped to see where it was coming from. They had abandoned their patient there in the hallway and, with a sob, thrown themselves into the room, closing the door and locking it behind them, then hunkering under the desk until their limbs cramped and numbed.

“Hello?” It came out as a croak, as Mel whispered around the saliva that had dried in their throat. They coughed and tried again. “Hello?”

They hadn’t been wrong. They had heard something, out in the hallway. Was it their patient? No. Their patient was… They had abandoned their patient, left him out there with that… thing.

Mel began to cry, deep, gulping, silent sobs. Shaking, they crawled forward, pulling themselves up, supporting themselves as they hunched over their desk, gritting their teeth against the pins and needles as blood flow returned to their lower limbs.

The thump came again. Not a knock, more like something stumbling against the door as it moved past.

Mel was a student nurse, on an internship. That wasn’t their patient out there. It was a patient. Probably a dead patient. Even the little ECMO couldn’t keep them going. The battery had to have run out. The anticoagulant failed. Something. He couldn’t be alive. They muttered that under their breath as they shuffled to the door, putting their ear to the heavy wood. Nothing. Wishing they had more fingernails, they pried at the paper covering the small window. They were still wearing their face shield, which now sat cockeyed on their head.

Finally, the paper, which was more like a thick sticker over the window, peeled away. Instead of giving them a view of the hallway, there was a film of red splatter that obscured their vision.

Was that another thump?

No. Just Mel once again hearing things in the silence.

They’d only seen one of those things. And it was small. Mel wasn’t that tall, but they could out-power a child, they thought. Or something the size of a child.

They placed their hand on the door handle, the other poised to flip the bolt.

From the other side of the door—only more silence.

* * *

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