The clear glass ampoules sat in the locked cabinet alongside disposable syringes and sharps containers—morphine and OxyContin for strong pain, Propafenone for atrial fibrillation, and the blood thinner Pradaxa, safely sealed in little boxes and wrapped in clear plastic: standard medications in the cardiology department at Copenhagen’s National Hospital, paths to relief and a better quality of life, sometimes even a cure.
The nurse cast a quick glance over the medications and did the calculations in her head. How heavy could he be? The patient’s weight was on the whiteboard at the head of his bed, but she was too exhausted to go check.
The night had dragged on forever. Just before her shift ended the day before, someone had called in sick and she had ended up pulling a double shift. Instead of spending an evening home with her family, she had worked for almost sixteen hours. Her brain was echoing with beeping alarms, requests, and questions from anxious patients. Her feet ached in the ergonomic shoes, and her neck felt stiff.
She yawned, rubbed her eyes, and caught her reflection in the shiny metal door of the medication cabinet. No thirty-two-year-old should have chronic bags under their eyes. This job was wearing her out. Just one hour left, then her shift would end, and she could go home and sleep while the kids got up and ate Coco Pops in front of the TV.
She selected three ampoules, put them in the pocket of her scrubs, and locked the cabinet behind her. Three 10 ml ampoules of 50 mg/ml ajmaline, that would be plenty. The patient couldn’t weigh more than 150 pounds or so, which meant that 30 ml of the anti-arrhythmia drug would be twice the recommended maximum dose. Enough to cause immediate cardiac arrest and release him from his suffering. And all the rest of us, she thought, setting off down the empty morning hallway toward room eight. The old man was demanding. He was foul-mouthed and rude, and complained about most things, from the weak hospital coffee to the doctors’ arrogance. The whole ward was tired of his cranky personality.
She had always been one to speak up and do something about a situation, not a role that makes one popular, but what else could she do? Stand idly by and complain about poor staffing ratios and the shortage of beds like her colleagues? No way! She had not become a nurse just to fetch coffee and bandage abrasions. She wanted to make a difference.
A cleaning lady, sporting a head scarf and a downcast expression, pushed her mopping cart down the hall without looking up from the linoleum floor. The nurse strode past her with the ampoules hidden in her pocket. Her heart rate sped up. Soon she would perform, live up to her full potential, and try to save a life. The anticipation started throbbing through her, as if it had a pulse of its own, a life to counterbalance the emptiness that normally filled her. In this moment, she would be indispensable. The stakes were high, so much rested on her shoulders. In this moment, she would be God.
She locked the door to the staff bathroom, quickly cleaned her hands and the countertop by the sink with alcohol, and laid out the ajmaline ampoules neatly side by side. With experienced fingers, she removed the disposable syringe from its packaging and drew the medicine up, flicking it per instinct to make sure it held no air bubbles. She crumpled the packaging up into a little ball and stuffed it down to the bottom of the trash can, then, with the syringe hidden in the pocket of her scrubs, she opened the door.
In front of room eight she cast a discreet glance down the hallway; no sign of colleagues or patients headed for the restroom. She pushed the door open and stepped into the darkness. A quiet snore from the bed told her the patient was asleep. She could work in peace.
She approached the bed, looking at the old man, who was lying on his back with his mouth open slightly. Gray, bony, and dried up with a little bubble of saliva at the corner of his mouth, his eyelids twitching ever so slightly. Is there anything, she thought, more superfluous in this world than grumpy old men?
She opened the cap of the venous catheter that adorned the thin-skinned back of his hand, and drew the syringe from her pocket. Direct access to the blood that flows to the heart, an open gateway for God’s outstretched fingertip.
The good thing about ajmaline is that it is fast acting; the cardiac arrest would occur almost instantaneously. She connected the syringe to the catheter, knowing she would just have time to hide the syringe before the monitor alarm was activated.
The patient moved a little in his sleep. She gently stroked his hand. Then she pushed the plunger all the way down.