After Hours (InterMix)

Chapter One


I heard the sign before I saw it, bent metal rattling in the breeze as my car rounded a curve.

DO NOT PICK UP HITCHHIKERS!

The directive was bisected by a ribbon of red rust, as though the sign were bleeding out from its bolt.

Duh-duh-dunnn . . . Cue the requisite horror-movie music.

But ominous sign notwithstanding, the road was quiet and pretty. Elms and oaks and firs rose up on either side, watery dawn sunshine winking between green leaves to the east. There were no pop bottles or old fast-food bags littering the roadside, those scraps of urban apathy I’d grown so used to, living in southeast Michigan my entire life.

Too quiet and pretty, my paranoid inner narrator whispered.

My eyes narrowed at an elderly man shuffling along the shoulder with a walking stick. Though he looked harmless, I knew better than to trust such a thought. But he didn’t acknowledge my approach let alone try to thumb a lift, so I decided he probably was just an old man, out for an early stroll on a June morning.

Then again, I was heading in the wrong direction. If he’d just escaped from a mental institution, hitching a ride from me would land him right back where he’d come from. My heart slowed when a bend in the road took him out of my rearview.

I spotted the gate first—a tall, stately gate, its wrought iron glossy with a fresh coat of black paint, and the name Larkhaven glowering from fifteen feet up, flanked by security cameras. I could feel them blinking at me, curious as crows. I edged my cranky sedan forward to a brick pedestal, and leaned out to press a button below a panel labeled Intercom. A vision of a hand grasping my wrist flashed across my brain and I yanked my arm back inside, bonking my elbow.

“Mother—”

A speaker crackled, followed by a bored female voice. “Good morning. What brings you to Larkhaven today?” This was the guest entrance, I knew, and employees, deliveries, drop-offs, and pick-ups usually came the back way. But I didn’t have security clearance yet.

“I’m Erin Coffey,” I told the panel, rubbing my elbow. “I’m starting today, with Dennis Frank?” Was I? It came out as a question, like I didn’t really believe it myself.

“Hang on.” Silence, then another crackle. “Okay, come on in. Employee lot is all the way around to the left. Follow the signs to the Starling building and the staff entrance, and hit zero on the intercom.”

The gates glided in, divorcing the Lark and haven. I cranked up my window on the sweet spring air and punched down the door lock.

I drove slowly, taking in the grounds as I passed a stand of pines. If it weren’t for the imposing black fence, it would’ve passed for a small private college—five or six three-story yellow brick buildings connected by paved walking paths, green lawns dotted with benches. Nicely maintained, if a bit worn around the edges. A bit eerie as well, with no one to be seen save for a tall woman in blue scrubs, speed-walking across the grass.

The main hospital that governed Larkhaven was a quarter mile away, this campus dedicated to outpatient programs serving those with developmental issues, mental illness, substance abuse problems and the like, along with several short-term residences, plus an eldercare facility with a focus on Alzheimer’s and dementia.

Skylark, one building’s prominent placard proclaimed. Warbler, said another, and Waxwing. The employee lot was just behind the building labeled Starling, Limited Access. My building. Made sense, that the locked ward would be closest to the drop-off zone.

I eyed the windows as I pulled into a free space, searching for signs of violence and chaos, confirmation that I’d made a Big Mistake, but I saw only slim metal bars. They were a grim comfort, at least while I was outside. They kept the scary people in. But once I was inside, I might not find them so reassuring.

And I didn’t mean it, about them being scary people. The mentally ill had enough stigmas to bear without a psych professional casting aspersions.

But I was scared. It felt like someone had drawn my ribs together with corset laces, tugging them tight, tight, tight until I couldn’t get a deep breath, lungs and heart bound.

I’d been immersed in my slow-motion nursing education for four years, now certified as an LPN, and had spent six years as my grandmother’s live-in caregiver. She’d passed in the winter, peacefully. A mercy, by the end. But she’d been the center of my life, and losing her had left me adrift. My certification felt like the only anchor I had, the only arrow pointing me toward anything.

My grandma’s dementia may have disturbed its fair share of people, but she’d been a gentle soul, generally. She’d only ever shouted out of fear and confusion, never anger, whereas this was a high-security ward designed specifically for men who suffered from persistent, disruptive psychotic episodes. A dozen unpredictable, occasionally violent men. And little old me, the LPN who’d had exactly one real patient in her entire so-called nursing career.

And I was little. An inch or two shorter than average, plus after a few years on what I called the Social Security Diet—a lot of beans and toast and soup to stretch the pathetic amount of money the government deemed adequate to keep me and my grandma warm and fed and clothed—I didn’t cut a very authoritative figure. I had a baby face and round blue eyes to match, too-soft light brown hair that defied all promises made by thickening shampoos. Once on the ward, the most intimidating thing about me would surely be the syringe in my hand.

All my worries gathered in a scrum and elbowed for attention. You’ll get stabbed with a plastic fork. You’ll f*ck up some poor man’s medication and give him a seizure. Your coworkers will treat the patients cruelly and you’ll be too chickenshit to report them. Amber’s stupid redneck boyfriend will pick today to show up and cause drama, and you won’t be there to rescue her.

F*cking Amber. My f*cking sister whom I f*cking loved.

I’d loved her from the moment I first held her as a baby, when I was five, but I wouldn’t be here—taking a job that frightened me in this nowhere corner of the state—if it weren’t for her. Her and my nephew Jack in that grubby little house on that grubby little block, thirty minutes’ drive from Larkhaven. If I wasn’t around to check in on them, nobody else would be doing the job. Nobody except Amber’s awful boyfriend or ex-boyfriend or ex-fiancé or whatever she was calling him this week. Jack’s father, she was seventy percent sure. When she was mad at him it dropped to ten percent, soared to ninety-nine whenever they reconciled. She’d turned into our mom. Same temper, same lousy taste in men; a too-young mother prone to impulsive, dramatic mistakes. Our mom had worked two jobs and treated dating like the night shift. Treated dating like playing the lottery, always imagining, This guy will be the one to lift me out of this shithole. She’d never been a lucky one, but you couldn’t fault her determination, putting in the hours at the singles’ bars, upping her odds.

I’d basically raised Amber from when I was ten or so, been the one who got her up for school, fed her, cracked the whip on homework. Not that I did such a great job, considering she’d dropped out at sixteen. I only prayed she wouldn’t take yet another leaf out of our mom’s book and ask me to raise her kid . . . Though mainly because I knew, given how much I adored Jack, there was no question I’d choose to turn my life inside out and accept.

After I shut off the engine, I held the steering wheel and counted my breaths, waiting for my heart to slow, for those corset laces to go slack. They never did. I pocketed my keys and stepped into the cool, damp morning air. There was birdsong all around and the grounds smelled of spring, like the final weeks of school before the freedom of summer. I sucked it in, knowing my first day would be busy, and that I might not get outside again until the end of my twelve-hour shift.

My flats crunched across the gravel lot, to the door labeled Staff Entrance. I pushed the zero key on a bank of buttons.

“Yes?”

“This is Erin Coffey, for Dennis Frank.”

“Hang on.”

I waited in silence for a full minute or more, then the metal door swung in, and a man was smiling at me.

“Come on in,” he said. “Welcome to Larkhaven.”

I stood aside in the little windowless foyer, and the man I assumed was Dennis let the heavy door hiss shut before swiping another open with a keycard. He led me down a short hall and into a cramped break room with a kitchenette, tidy but cast in a sickly glow by the fluorescent bulbs.

Dennis looked about fifty, with gold-rimmed glasses and a professorial goatee, and overgrown salt-and-pepper hair. He wore scrubs, pale blue, and boat shoes. He seemed at once kind and exhausted, defeated and determined, with one of those expressive, guileless faces that told you everything he was feeling.

“Coffey?” he asked.

“Yes,” I said. “Erin Coffey.”

“Oh, sorry, I meant, would you like some coffee?” To demonstrate, he filled a paper cup from a carafe on the counter. When I waved it away he added a packet of sugar and took a sip. He smiled. “Six thirty in the morning on your first day and no caffeine? We’d been hoping to find somebody superhuman for the day shift.”

“I had a cup on the drive over.” Plus, being here had me so jittery, more coffee would surely plunge me headlong into my own psychotic break, landing me in Larkhaven as a patient.

“Well, Erin Coffey, I’m Dennis Frank.” We shook. He paused to check a roster of names listed on a large whiteboard beside the door. “I’ll be showing you the ropes this morning, before I hand you off to one of the senior nursing staff. The nurses run this ward. You’ll see doctors around, of course, for groups and one-on-ones. But their offices are all here on Starling One. S1. Up on the secure floors, S2 and 3, where you’ll spend most of your time, it’s the nurses’ show.” He said it with a little air of false haughtiness.

Dennis and I had spoken a few times already. I’d gone through the interview process at an affiliated hospital back home, recruited via a job fair. Dennis had been present, if only as a kind voice coming through a conference line. He was a veteran nurse himself, turned shift manager and administrator, and he’d been working at Larkhaven for fifteen years, most of them on the locked ward, the unit reserved for the most dangerous patients. What shocking things had he seen in all that time? What shocks were in store for me? My invisible corset gave a mean squeeze.

“So we’re standing in the most important room in the building,” Dennis said, swiveling, gesturing with outstretched arms. “The coffee room. Some argue the smoking patio is more important, but to be fair, it’s not technically a room. Do you smoke?”

I shook my head.

“Give it a week,” he teased, but the joke was playful, not cynical. “Actually where we are now is called the sign-in room. Everyone comes in, writes their name in the appropriate slot so we know what their duty is for the day. You’ll be signing in as a general LPN, so easy-peasy, everyone will know to find you in the usual places throughout your shift. But our orderlies, for example, might sign in for general duties or be assigned for close obs on a difficult patient, so everyone will see they’re busy with a specific resident.”

He grabbed a dry-erase marker for me, and tapped the whiteboard. I printed my first name carefully in a free slot in the nurses’ section, and my in and out times, the same number for both columns—seven to seven. Dennis told me to write nurse shadow in the duties column, so I did, picturing myself as a mysterious Batman-like figure in a dark gray catsuit, black cape, stethoscope glinting in the moonlight. Nurse Shadow. A useful vision, lending me the illusion of unflagging competence until the day I’d feel it for real.

Dennis led me next to a storage room, eyeballed me and said, “Definitely a small.” He slid a bin from a shelf and handed me a set of butter yellow scrubs.

“The women’s lockers are through there,” he said, pointing to a door. “There’s a hamper for the dirties, and you can grab a fresh set from in here each morning. Yellow for the nurses and techs, green for the orderlies, blue for senior staff and managerial scum like me. Plus the classic white coats for the doctors and therapists. The residents in this ward wear gray. The residents in other programs are allowed to wear their own clothes, but at Starling we keep a dress code. Some say it’s depressing, makes it feel like a prison. But our patients do best when things are predictable—egalitarian, if you will—and we’ve found the uniforms help.”

“Right.”

“Bring your own lock if you’ve got valuables, but don’t worry if you don’t have one today. We’re all too tired to steal much of anything.”

I didn’t own anything of value. My cell phone was six years old, practically a brick, and I hadn’t worn any jewelry. If anyone swiped my car keys, they’d wind up driving off in a ’93 Ford Tempo, more orange than teal these days from the rust. The thing had been cranky since I’d inherited it from my uncle in my junior year of high school, and the only force holding it together now was a kind of willful, joyless, made-in-Michigan pride. The thief was welcome to it.

I changed quickly and met Dennis back in the hall.

“Every morning at ten to seven we have a hand-off meeting in the lounge,” Dennis said as he led me into a stairwell with another swipe of his keycard. We hiked up two flights, then banged a left down an echoing corridor. “The overnight staff catch the day crew up with anything that’s gone on. Ditto in the evenings. Bit old-school, but that’s kind of the Larkhaven way, you’ll find. Usually takes five minutes or less. Then at seven we start waking the residents.”

With a combination of a swipe and deft punching at a keypad, Dennis preceded me into a more welcoming hallway, lined on one side with tall windows, weak morning sun glinting off its clean linoleum floor. Another swipe and code and we were inside a nurses’ station, with a counter and a wired glass window for handing out meds, lots of shelves arranged tidily with boxes and equipment, a scrub sink, and a half-dozen filing cabinets.

The station looked onto a plain room with beige couches and chairs, two big windows; a high-ceilinged space lit equally with overhead bulbs and sunshine, as square and adequate and inoffensive as a Saltine.

There was a patient dressed in the requisite gray in the lounge, leaning a hip on the deep windowsill with his large arms crossed over his equally large chest. He stared over his shoulder into the yard beyond the glass, a placid expression suggesting he hadn’t noticed the cage of white bars marring his view. His head was shaved to brown stubble, and even from twenty feet away I could make out the scar running from beneath his ear down his neck. More an inmate than a patient, he seemed to me, fresh from a brawl in the exercise yard. I eyed the glass of the nurses’ station window, suddenly doubting its un-shatterability. Jesus, what on earth have I signed up for?

Salary, I reminded myself. Insurance. And cheap rent, for as long as I could stand living in the drab little apartment I’d been offered, in the transitional residence just across the road. It primarily housed adults who were enrolled in or had completed programs at Larkhaven, a stepping-stone toward truly independent living. I’d been sent photos. Its walls were painted cinderblock, the space tiny, and I’d be sharing a communal bathroom and kitchen. In all likelihood it would feel far too much as though I were going home to another ward, after I’d clocked out of this one.

“Shouldn’t he be supervised?” I murmured to Dennis, staring at the lone resident and trying to guess his diagnosis.

Dennis laughed, freeing a clipboard from a hook on the wall. “That’s not a resident. That’s Kelly.”

A frown tugged at my lips as I processed the nested facts: he wasn’t a patient, and he had a girl’s name.

“Kelly Robak. We call him ‘the Disorderly,’” Dennis went on, gaze skimming his clipboard. “He can wrestle down a psychotic like nobody else. Of course we like to have three men on hand for the job, but he’ll do on his own in a pinch.”

“For sedation?”

He nodded. “De-escalation’s always best, but failing that, we’ve got Kelly. You two’ll be working together plenty.”

I eyed my new colleague with guarded curiosity, realizing that at some point in the indeterminate future, Kelly Robak and his beefy arms and shaved head might be the only thing that stood between me and a grown man in the throes of a violent psychotic episode.

“I hope he’s good. Why isn’t he wearing scrubs?”

“He’s the best. So good we let him wear what he likes. And he likes gray, to keep himself on par with the patients. I wish he’d just get psych tech certification already, but he seems to prefer to keep his role as minimalist as possible. I’ll introduce you.”

Dennis set his clipboard on the desk and unlocked the metal door that separated the nurses’ station from the lounge with a tap of his keycard. It locked behind us, the sound heavy and hard and confident. Kelly Robak’s body looked much the same.

“Kelly.”

He turned at his name and stood, meeting us halfway across the room.

Up close I saw the gray he wore wasn’t a uniform, after all, or rather one of Kelly’s own making—thick canvas pants and a tee shirt, the latter snug not for stylishness, I suspected, but to give his charges as little fabric as possible to grab hold of. Same strategy with the hair. I saw scars on his head, small streaks of white skin where his brown hair hadn’t grown back so densely. From fingernails? I wondered. Or from broken bottles in rowdy bars, off the clock? He looked the type, though looks occasionally deceived.

“Kelly Robak, this is Erin . . . sorry, Erin. I’m hopeless with names.”

“Erin Coffey,” I supplied, and Dennis slapped his forehead to say, duh.

I accepted Kelly’s shake. His arm was a huge python, massive hand swallowing my tiny, mousy one whole. He gave it two firm, businesslike pumps, and his warmth lingered long after he let me go. I rubbed idly at my knuckles, noting the bruises decorating Kelly’s arms, like smudges of paint, yellow and olive and dark purple.

“Our new LPN,” Dennis added.

Kelly nodded. “Welcome aboard.” His voice befitted a man of his size, the words dark and deep from tumbling around his broad chest. He made me feel small and vulnerable, dependent. Not sensations I liked, but given our relationship they seemed somehow essential. After all, this was a man who’d keep me from bodily harm—if not emotional damage—if this job did indeed seek to break me. I didn’t like feeling reliant on men, but concessions could be made, considering the context.

“Nice to meet you,” I said.

A nurse arrived, then a pair of orderlies in mint green scrubs, toting paper cups of coffee.

Everything looked like a weapon to me—pens to stab, hot drinks to scald, drawstrings to choke, just about anything a ready projectile. But they seemed bored, if anything. I was introduced and their names and titles immediately fell out of the back of my head, so preoccupied was I with the immense mistake I must be making.

No. Not a mistake, merely a challenge. With training and patience, I could do this.

Another nurse arrived, somehow managing to look harried and tired at once; a doctor in a white coat, and then another; then two fresher faces who must be just coming on duty, both orderlies. I forgot all their names as well.

The senior of the two doctors led the brief meeting, which took place standing, most people balancing clipboards and coffees. I noted the bolted brackets pinning the armchairs and sofas in place, precluding the assembly of a cozy circle. The docs ran down their notes on the patients from the latest one-on-one and group sessions, then the senior nurses put in their two cents, then the LPNs and techs and orderlies were allowed to ask for clarification or share their own thoughts on the residents.

Kelly Robak didn’t have a clipboard and didn’t take notes—his role seemed less reliant on dosages and exact times than most people’s. The overnight staff walked me and Kelly and the other day-shifters through any “incidents.” The patients’ names meant nothing to me, and my skittish brain eagerly filtered out the words that validated my fears. Outburst, belligerent, episode, agitated. And these were the men I’d be jabbing full of sedatives. Not a function that seemed likely to endear me to them.

“How was Don?” Kelly asked the overnighters.

A meaty female tech with eyebrows plucked into slashes of permanent annoyance shrugged. “Quiet. But he got a dose at nine. Before that he was his usual effervescent self. I’m sure he’s saving up his energy just for you, Kel.”

Kelly nodded, expression perfectly neutral. I stole glances at him as the meeting went on.

His irises were pale with a dark ring, gray like his self-designed uniform—almost as though he were withholding color on purpose, lest he paint this place as anything other than the stark fortress it was. Clear eyes, pretty and cold as ice. Pretty eyes, pretty name, those ugly scars and bruises along the arms he recrossed.

And a gold wedding band on his left hand.

I wondered idly what Mrs. Robak was like, and whether she occasionally enjoyed getting wrestled into submission by her gigantic husband.

The meeting broke up, and suddenly my workday was starting. Dennis reintroduced me to a nurse practitioner named Jenny—a sturdy gal of early middle age, with tight blond braids like a milkmaid and cheeks stained by rosacea into a look of constant mortification. She spoke briskly. I could sense her patience had bounds, and I didn’t care to ever mess up enough to discover them. She was my supervisor, and I was going to shadow her closely for the first few days as I got accustomed to the ward’s routines. Routines were everything, I’d learned over and over in school.

“Routines are a promise that must be kept,” Jenny echoed, prepping dosage cups at the nurses’ station counter. And with doctors, nurses, techs, and orderlies all on staggered shifts, falling out of sync with the ward’s rhythm was a ready invitation for chaos. “The second we break the promises the ward rules make to our residents, we’re back to square one. Especially with the paranoid cases.”

The patients had to bathe—or be bathed, depending on how lucid they were on a given morning—shave with single-blade safety razors under exceedingly close supervision by the Kelly Robaks on duty, dress, then be led to the dining area.

There were fifteen male residents in the S3 locked unit, plus a handful of women on the Starling building’s second floor. Most arrived in the midst of major psychotic or substance abuse crises—or often a combination of the two—and weren’t expected to stay long before being cleared to move to more lenient programs, other facilities, or back home to their families.

Of the fifteen men in my ward, nine had potentially dangerous disorders and were prone to lashing out, verbally and physically. Contrary to pervasive popular belief, most people suffering from serious psychological disorders, if a threat to anyone, are only a danger to themselves. But our unit specialized in the minority of patients who were subject to fits of deep paranoia and resulting rage. If they acted out, they did so with the fervor of men whose very lives were in danger. Because in their minds, that was exactly the case.

The morning was quiet, which Jenny told me was typical. Patients had a half hour to eat breakfast and come up to the nurses’ booth to accept their little plastic cups of pills. Some were sullen, a few friendly, a couple completely blank. At least five demanded in tones of varying suspicion to know who I was, and somehow I retained their names far more ably than I had my colleagues’.

Carl. Thirty-six, paranoid schizophrenic, said the clipboard I glanced at as I helped Jenny with the meds. He was cheerful, with sharp eyes and a too-eager smile.

John B. Forty-three but looked to be pushing sixty, with a gravelly chain smoker’s voice. He had PTSD coupled with bipolar disorder, and after he left, Jenny told me he often woke thrashing, screaming his brother’s name.

Lonnie. Sixty-one, another schizophrenic. Lonnie was chatty, moving with quick, birdlike twitches accenting each gesture, an effect that didn’t match his doughy frame. He wore thick glasses strapped to his head with an athletic band, dividing his frizzy, graying hair into two lobes.

The resident Kelly had asked about in the morning meeting, Don, was plump and pale, as chipper as one could expect of a middle-aged man at seven thirty. I asked Jenny why Kelly had inquired about him, of all the patients.

“Don and Kelly have a . . . special relationship. When Don goes into a psychotic episode, Kelly’s the only one who can ever seem to settle him down, short of a jab.”

“What does he do?”

She shrugged. “Nothing extraordinary. Nothing any other orderly wouldn’t. But Kelly’s got a certain calm about him. Like a wall. You can fight a man and maybe win, but you can’t fight a wall.”

“How often do Don’s episodes happen?”

“He’ll have a violent one twice, maybe three times a week, nearly always in the early afternoon. Kelly shadows him between lunch and about four, and just knowing he’s there seems to keep Don under control. I think Kelly’s a comfort to him. Some people like having a wall near them, especially paranoid people. Something to lean against. Some sense of security at their backs.”

Junior nurses’, techs’, and orderlies’ shifts were long and irregular. Mine were all 7:00 a.m. to 7:00 p.m., two days on, then one or two days off in between. One week I’d work Monday, Tuesday, Friday, Saturday; the next just Tuesday, Wednesday, and Saturday. Plus Sundays on a rotating, monthly schedule. After six years with an exceedingly rigid daily routine, I found it all at once confusing and luxurious. Weekends? What were those? And some weeks I got four entire days to myself? I might need to cultivate some kind of social life. Whatever that was.

“How does Don do on Kelly’s days off?”

“Worse,” Jenny said, melancholy in her voice. “But what can you do?”

Some of the patients lingered in the lounge after receiving their medication, gossiping in small groups or staring out the windows, but most eventually disappeared down a hall, to the recreation room, I was told.

The rec room had a television, mounted below the ceiling in one corner. It was tuned to a game show when Jenny took me there after post-meds paperwork. Beneath it stood a shelf stacked with books and a small selection of board games. No Monopoly, no cribbage board. Nothing with sharp metal bits, basically, nothing that required a pen to record scores. It didn’t leave much.

“But a lack of variety beats a tiny metal knife in the eye,” Jenny told me, surely dooming me to tear up every time I thought of playing Clue again.

Kelly had been off doing his orderly rounds in the patients’ residential wing, but he appeared in the dining room toward the end of the breakfast period, accompanying a slow-moving older man I hadn’t met during morning meds. Once again, I mistook Kelly for a patient at first, in his light gray shirt and pants.

They could have been a father and son having a friendly talk, except for the way the man’s hands and elbows jabbed the air as he spoke . . . just a bit off. Just a bit manic, if you knew how to spot it. Kelly led him to a table, then commenced patrolling the room’s periphery, strolling silently with his hands clasped behind his back. It’d take more than that show of deference to make a bruiser like him pass for nonthreatening, I thought, but he looked as calm as he did alert.

We were in a sliver of downtime before the various morning therapy sessions and support groups began, one of a limited number of unstructured “social” periods that peppered a given day. Kelly circled like a prowling animal—fluid and silent, watchful. His sharp eyes scanned everything, but they didn’t dart. Nothing about him promised sudden movement, and I could understand what Jenny had meant. He was an impenetrable, unscalable presence, gray and huge and immovable. Comforting to everyone in the room. Me in particular.

There were lots of boring lulls between intermittent administration and meds prep, and I passed much of it—too much of it—watching Kelly Robak. He was on general duty, playing UNO with two patients during the pre-lunch break, until one became agitated. Such a normal scene suddenly launched into crisis.

“Here we go,” Jenny said, getting to her feet beside me. I followed her into the rec room’s little nurses’ booth, where she prepped a Haldol dose with shocking speed—those shots were a bitch to draw, but she snapped the vial open and switched out the needles, smooth as a close-up magician.

“We’ll wait and see if he calms first,” she said, discarding the sharps, “but knowing this one, he won’t.”

Beyond the booth’s glass, the angry patient was on his feet, as was Kelly. Kelly listened patiently to the vitriol suddenly streaming from the older man, nodding with his thick arms locked benignly across his chest. While my body vibrated with adrenaline, his looked positively serene.

“Red cards!” the man was shouting. “Six reds cards in a row! Six six six! Red like the Devil! He’s leading me into sin!” He pointed at the other patient who’d been playing. The accused was so stuporous, he looked close to dropping off to sleep, which seemed to enrage his fellow resident more. He made to lunge, but Kelly had his arms behind his back in a blink, holding him in place as two more orderlies ran over. The man kicked, the table jumping and a stack of cards fanning across the wood. In seconds they had him belly-down on the ground, a man securing each arm and one his legs. I hurried out of the booth behind Jenny, heart thumping.

Often a physical restraint was enough to calm this type of episode, but Jenny had called it—this guy was not soothed. Quite the opposite. Normally the shot would go in the patient’s shoulder, but with a table and two orderlies in the way, we had to go to Plan B.

“Pants,” Jenny ordered me, and in a robotic, unthinking daze, I knelt to pull the elastic waistbands of the patient’s pants and underwear down. Jenny scouted the injection site in a fraction of the time I’d have needed, and gave him the dose.

And just like that, I’d taken part in my first restraint and sedation.

It happened so fast, I hadn’t had time to register my fear as much more than a chemical rush. In its wake I felt high, but knowing maybe I did possess some modicum of instinct was a relief beyond measure. I got to my feet, shaky but proud, feeling like a part of a team.

“Well done,” Jenny said, once the patient was calm and settled once more and his doctor had been paged.

“Thanks.”

Back in the booth, she jotted a note on a clipboard. “Dennis said this is your first psych gig.”

“Kind of. I was my grandma’s live-in caregiver for six years. She had dementia. My psych hours for school were at an outpatient substance abuse facility. So no hands-on experience with . . . you know. Nothing this intense.” Nothing this dangerous.

“Ambitious,” she said, scribbling.

Ambitious wasn’t quite the word. This position was the only one I’d found within an hour’s drive of Amber. I’d have far preferred to get work in a nursing home, but I didn’t think it’d curry me much favor to tell Jenny I was only here as a matter of complete desperation.

“I saw on the roster you’ll be doing restraint training the next three days,” she said.

“Yeah.” And I couldn’t for the life of me decide if I was pleased about it. This was restraint as in wrestling a patient into submission in order to calm him or administer a sedative, not restraints like you’d use to strap him to a bed. Mastering the drill in the event of an outburst was essential, of course, but I worried that after I’d completed the training, the danger would feel all the more acute. The training would also take a bite out of my days off, Wednesday and Thursday, which I could have used to process all these changes, get my things unpacked, and explore my new town.

“It usually takes place in the gym in the Warbler building,” Jenny said. “You’re the only new hire from our ward who’ll be taking part, but Kelly helps teach, so there’ll be one familiar face, at least.”

As if I could call anyone’s face familiar yet. And as if I’d be able to relax, counting down the hours to when six-feet-several-inches of Kelly Robak would likely be pretending to assault me. The thought of his massive arm locked around my neck made my southerly lady region flutter to sudden life.

Oh dear. That wasn’t right.

Kelly Robak was not my type. He was too big, too covered in bruises, and far too married—just too much. Most worrisome of all, he looked an awful lot like Amber’s type, which meant I’d already spent years fostering a grudge against him.

Still, he drew my eyes from across the rec room, some obscene muscle or other flexing in his forearm as he reached up to change the channel on the television. Knowing my luck, I’d seize up and faint in his demonstrative choke hold, outing myself as the neophyte I was. Though perhaps I’d ought to be more worried that some sexual monkey wrench would jam my good sense during a drill and my body would refuse to fight him off. In any case, all the logical, northerly regions of my being decided restraint training was something to dread.

* * *

Things got busy after the morning lull. Lunch meant more meds to organize and distribute, then Jenny took me through the exhaustive inventory rigmarole in the various nurses’ stations. There weren’t any more incidents after the UNO debacle, and by late afternoon I’d gotten most of the patients and their diagnoses and treatment plans copied onto a mental crib sheet, having spent a couple of hours studying their files.

Rattling off their histories and dosages couldn’t hold a candle to actually having relationships with them, though, and when dinner was getting underway, Jenny suggested I join her, eating with the residents in the dining room. I’d scarfed a banana for lunch, feeling pokey with my paperwork, so the promise of a sit-down meal was enough to steel my resolve.

Since breakfast I’d been hearing mutterings of “pizza day,” and now I could smell it. Ambrosia. I followed Jenny and we got in line alongside patients and staff at the S3 cafeteria counter. I grabbed two cheese slices and a root beer, and tailed Jenny to one of several large, round tables. I caught sight of Kelly not far away, eating with a group of residents, a circle of gray. He’d taken a seat with a view of the entire room, and I bet it wasn’t an accident.

“Has everyone met our new LPN, Erin?” Jenny asked brightly, glancing around our table.

There were three patients, and I tested myself on their names and conditions. Lonnie and Carl, both schizophrenic, and Les, a deceptively cheerful sociopathic type who’d served three separate prison sentences for arson. I remembered him easiest, as I’d employed the thoroughly un-PC mnemonic device of “Les be sure to not give that one any matches!” while quizzing myself earlier.

The three men murmured greetings, and Jenny nodded to a seat between Lonnie and Les, taking her tray to the other side of the table.

Conversations resumed, which meant Lonnie and Carl went back to arguing. Paranoid schizophrenics can be prone to that, and both of the men were clearly feeling a touch self-righteous. As best I could gather, Lonnie was insisting that the military had planted him here on the ward, and that they’d be coming any day to collect his findings. Jenny had told me he was what the Starling staff called a popper, meaning his illness was particularly potent and frequently “popped through” the bubble of civility created by his meds. Carl seemed simultaneously unnerved by the notion of a government operative in his midst and annoyed by Lonnie’s self-importance. He’d been distractedly cutting his pizza slice with a plastic knife for some time, so long he now seemed to be trying to saw through the tray. I stole a glance in Kelly’s direction, suddenly wishing he were at my table.

Jenny attempted to shift the topic. “I wonder what movie they’ll show in the rec room tonight.”

Carl dropped his knife, shooting her a patronizing look. “It’s Monday. On Mondays we watch the singing show. We always watch the singing show on Mondays.”

Lonnie wasn’t listening. He was studying me as I stripped the wrapper from my straw, hazel eyes squinting magnified skepticism through his thick lenses at my hands and face and the shiny new picture-ID badge clipped to my scrubs.

“Do you like the singing show?” Carl asked me earnestly.

“I don’t think I’ve seen it. Maybe I’ll check it out, later.” There was a TV in my apartment. I could watch whatever program it was, and have something to talk to him about tomorrow.

“I know what she likes,” Lonnie said, in a slow, snide, creepy murmur, loud enough for most of the table to hear.

I took a bite of my pizza, ignoring his attempt to affect me. He was only testing the new girl. Don’t take the bait. “Do you like the singing show, too?” I asked him politely.

Lonnie stood, fast enough to topple his chair. He grabbed a pizza crust, and jabbed it toward my face and shouted, “You’ll like this when I jam it up your cunt!”

The room went flat, panic reducing everything to soundless slow motion. Like being underwater. I lunged to the side, a second’s scrambling that felt like an hour’s swim. Smooth, cold tile found my palms, and legs rustled past from above—orderlies rushing to restrain Lonnie.

Sound returned. Someone was helping me to my feet. Lonnie was on the ground, face pressed in my direction, wild eyes locked on mine. One orderly held his ankles while Kelly Robak knelt straddling his waist, pinning his arms.

“She’s an agent!” Lonnie was shouting. “Don’t trust her!”

Jenny must have dashed for the nearest nurses’ station and prepped a syringe. She reappeared, offering Lonnie a seeming eternity to settle before deciding to give him a jab in the deltoid. “That’ll calm you down, Lon.”

“Agent!” he shrieked, eyes blazing hatred up at me through his skewed glasses. “Bitch agent! Sent by the council!”

The shot took effect in a matter of moments, and Lonnie’s fiery eyes went dim under heavy lids. I watched him blinking groggily, everything seeming to me as if it were happening on a TV screen, two-dimensional and glassy and unreal.

A tech was rubbing my back, saying something soothing. She may as well have been speaking to a coatrack.

The numbness slowly lifted, uncovering a crisis in my body. My heart had never beat this hard—my head pulsed, my eyes, my bones. I knew my chest was heaving so violently it must’ve looked as if someone were thumping me with invisible defibrillator paddles, but it was theoretical. The entire room was a theory, as all I could do was stare at the floor, blood and breath crashing through me in waves.

Jenny’s hand on my arm. She was saying something. I was being led to the nurses’ station and steered to sit, my hand wrapped around a white paper bag and coaxed to my mouth. I huffed into it. Soon I could control my eyes enough to blink and scan the room. I felt my fingers and toes, my prickling cheeks, the padded chair under my butt.

“There we go,” Jenny said. “Keep that up.”

After another minute my wheezing quieted and my head cleared, the fog lifting to reveal a massive headache. “Sorry,” I gasped. It came out thin and high.

“Hyperventilation’s a joy to treat, compared to what I’m used to.” She stood and gave me a soft, casual clap on the back. “Sit tight for a few. Actually . . .” She consulted her watch. “Your shift’s done in twenty minutes. Why don’t you take your paperwork down to the sign-in room, have a Coke, take your time with the forms? Don’t worry about evening hand-off. I think you’ve had enough excitement for your first day.”

As much of a relief as the offer was, I felt like a failure and a coward as I gathered my clipboard. I thought I could feel everyone’s eyes on my back as I headed for the stairs, hear them thinking, Well, she’s done. Another one bites the dust. Tears stung my eyes and I could feel my face going pink . . . if it wasn’t already from the anxiety attack.

I bought a pop from the vending machine and sat at the table, pressing the cold aluminum to my burning cheeks before I cracked it open.

I hadn’t felt this defeated and useless in ages, not since the early challenges of caring for my grandma. Not even physically touched by a patient and I’d fallen to pieces. I shook my head and a lone tear made a break for it. I wiped it away with my wrist and sighed.

My whole life, I’d been the one who kept it together. Grace under fire. I felt more lost than I could remember, naked with my veneer of capability stripped away.

Paperwork helped. It required me to recount what had happened in clinical detail, to label Lonnie’s outburst in impersonal terms and remove myself from it. Though it seemed callous to draw the analogy, I told myself it was no more personal than an angry dog snapping at me. I’d been nothing more than the least trusted face in the room. Or maybe he’d smelled my fear.

I’d do best to quit thinking of the patients like they were some other species. I never, ever would have let myself think about my grandma that way, and those men were all somebody’s family—somebody’s son or father or brother or lover. The thought left me more exhausted than ever.

Though I’d stopped shaking, my handwriting was barely legible and stringing coherent words together was a struggle. A sob of frustration rose in me. I tamped it down, knowing other staffers could appear at any time to sign in or out. I sat up straight and tried to look studious. Well, she had a scare, but she bounced right back. Worth a shot.

I finished my incident forms, three pages that left me as spent as a triathlon. I stood to toss my can in the recycling bin, then yelped when I turned around, finding a huge body materialized in the threshold. But it wasn’t the shiv-wielding maniac my brain expected, only Kelly Robak. Just as scary in his size and general ominousness, but unarmed, and placid as always.

My hand had flown to my chest, like an old lady set upon by ne’er-do-wells. I dropped it hastily. So much for looking cool and collected.

“Hey,” Kelly said. He wiped his name from the whiteboard with his improbably big thumb.

It was useless to pretend I wasn’t upset, so I let him see as I combed my hair with shaky fingers. “Hey.”

He leaned against the door frame. “Lonnie gave you a scare, huh?”

“Yeah. I’m okay. Just, you know. My first day.” I rubbed at my sternum, trying to soothe my panicky heart. “It’s my first clinical job. My first real psych job.”

One of his brows rose a fraction. “You picked a real deep end to jump into.”

I nodded. True, it would’ve been nice to start at an end with steps, not a high dive. “It was the only end with a job opening.”

“Get changed and I’ll take you out for a drink.”

“Oh jeez. I better not. I’m really tired, and I have to be up at six again tomorrow.” I hadn’t even unloaded my car or set foot in my new apartment. I wanted to change into my familiar pajamas and reread a few nursing textbooks’ chapters on paranoid schizophrenia, try to figure out how I could have handled myself better with Lonnie.

Kelly shook his head. “Get changed and meet me in the lot. You can follow me in. You living in town now?”

“I’m staying here. In the transitional housing.”

He gave me skeptical look, the most judgment I’d seen from him.

“Just temporarily,” I added.

“I’ll drive you, then. You can leave your car.” And then he disappeared, giving me the distinct impression that his invitation was as negotiable as a hostage taking.

I was pooped. I obliterated my name from the duties board, dropped off my paperwork, and changed, tossing my scrubs in the hamper. The day had done the same to me—wiped me clean out and wadded me into a rumpled heap.

Though Kelly was surely only trying to be helpful in his bossy way, I resented being ordered around, especially by a man. Like I needed rescuing. I didn’t want to be rescued—in my family, I did the rescuing.

If I suddenly needed assistance, who in the hell was I?

But it was good, I decided as I buttoned my sweater—an invitation to grab a quick drink with Kelly. I was in over my head, and he’d have advice to help me stay afloat. He’d had a first day once, too. We’d talk and it’d push the incident a bit further back in my head, so it wouldn’t be the only thing running through my mind as I tried to fall asleep in a strange room. That voice, those words; that accusing pizza crust pointed like a switchblade at my face.

As I left the locker room and headed down the hall, I felt that corset sensation again. Only it wasn’t from the scare. Every step I took toward the exit, closer to Kelly, tighter, tighter. Funny how my body reacted to him the same way it did to the thought of getting assaulted by a patient.

Punching the keycode to the foyer, I wondered idly what Kelly’s wife looked like. And what she’d make of some underfed, round-faced urchin of a hapless trainee LPN going out for a drink with her oversized husband.

She probably wouldn’t think anything of it, I reminded myself, since it doesn’t mean shit. It’s a pity drink with your married coworker.

Still, as my fingers punched the final code, those laces yanked tight, tight, tight. At least if I passed out, Kelly was strong enough to carry my sorry ass home.