“Let’s push epinephrine…what’s his blood pressure?”

“Eighty over fifty and dropping.”

“Medications?”

“Paramedics say the family didn’t speak English, and he has no file on record anywhere we could find, so medications unknown.” I check the chart again, but there’s nothing there that can help us.

The patient is a male, forties—Luis Hermano—admitted to the ER earlier in the week for a heart attack, from which he was recovering in the ICU where I work…and is now suffering an unexpected anaphylactic shock. Non-English speaker, uninsured, no medical history available…unconscious and unresponsive.

The attending physician, Dr. Wilson, and two other nurses—Lydia and Sally—are in the room, and we go through the process of keeping the patient alive. He stabilizes somewhat, and now we just have to figure what caused it—we go through medications used during surgery, during recovery, try to determine if he could be on any medication that would cause the anaphylaxis…and by the time that’s done Dr. Wilson is being paged to another room, and my watch is going off because it’s time to check on Mr. Renfro in 213, who’s supposed to be up and walking every hour or two, and then Mrs. Lasseter in 215 will need another dose of painkillers to keep her comfortable…and by the time I’ve made my rounds and administered medication and turned patients and checked vitals and crossed items off my checklists, I’m supposed to have been off duty for an hour and I still have another hour’s worth of wrap-up to do and I’ve been on since six this morning, never ate dinner because of Mr. Hermano going anaphylactic and then the John Doe with the coma in 219 woke up screaming while I was with Renfro…

Finally I clock out, shrug into my hoodie, shoulder my purse, wave goodbye to Dr. Wilson and Sally and the others, and head for the elevator. I’m waiting for the elevator when I hear Dr. Wilson’s shoes behind me.

“Nadia.”

The elevator arrives, but I hear the news in Dr. Wilson’s voice before I even turn around. I don’t want to turn around. I just don’t. But I do. Wilson’s face is tight, hard, pinched.

“Mr. Hermano?”

He nods, and I wonder if his goatee is whiter right now than it was this morning. “He coded while you were with Mrs. Lasseter.”

“You didn’t page me?”

“There wasn’t time. I don’t think the stent took. I dunno. He was gone by the time I got there myself. I just thought you should know.”

“Thanks.”

“Good work today, Nadia.” He hesitates.

“What?” I ask.

“You worked a double today.”

“Yeah.”

“And yesterday.”

“Yeah.”

“And you’re on the schedule for another one tomorrow.”

“Adrian is out of town.” I shrug. “I’d rather be working than at home alone.”