“You’ll be fine, new kid,” Charles said, but he wasn’t looking at me. I followed his gaze to see Mr. November making plucking gestures with his right hand. I thought Mr. November was reaching for his IV despite the pillow I’d placed in his way, until all but one of his fingers curled inward, leaving only his pointer out. He started to move it deliberately. Spelling things. I groaned.

“Stay out,” Charles advised. Mr. November didn’t stop.

“He’s trying to communicate,” I said.

“Just because he’s trying to doesn’t mean he can.”

Which was true. Most times patients would scribble off the page and onto themselves, if they had enough reach. But then again, a few could tell you if they were cold, or hot, if they wanted the lights on or the TV off. You’d be surprised what people can obsess on when they’re doped up and have nothing else to do. Once a guy told me in Spanish that he wasn’t getting enough aire. I did a blood gas to check, and he’d been right.

My patient, my call. I grabbed paper from the copier, a Sharpie, and a clipboard, and suited up to see.

Because working on Y4 is like being in a hybrid ward for biohazards, trauma, and psych, isolation gear carts sit outside each room. They’re equipped with gowns, face masks, hair nets, and gloves, just like every other isolation cart you’d find in County, until you get to the CO2-propelled tranquilizer rifles loaded with suxamethonium chloride darts in their top drawer. During training when I asked why we didn’t have garlic and crosses, I was told that garlic doesn’t work, and the Consortium doesn’t allow vampire-specific discrimination.

I pulled my gloves on and gave Charles what I hoped was a sorry-for-ignoring-you shrug before walking in.

The same badge that granted access to the elevator and locker rooms triggers the light set over Mr. November’s door, so Meaty will know where I am if there’s a lockdown. Charles knows where I am too, and is unimpressed, leaning on the doorway behind me.

“Okay, sir. Do me proud.” I removed both the restraints on Mr. November’s right hand, positioned the pen in it, then braced the clipboard upright for him against the pillow. “Are you in pain?”

I couldn’t imagine that he was, but he was still awake. He ignored my prompt, and began working on a laborious capital A.

“Do you need to have a bowel movement? Want the TV on? Lights off?” I ran through my routine, while he made three—no, four—n’s in a row. Typical intubated patient. I sighed. I glanced over my shoulder and saw Charles smirking.

I launched into my stock speech number three.

“It’s two A.M. in the morning on Sunday, November twenty-ninth.” And I’d been working straight through since Thanksgiving, courtesy of being the newest nurse and having a desperate need for holiday pay. “I know it’s frustrating when you can’t communicate, but you’re in the hospital. We’re taking good care of you.” I reached out and patted his arm. “Save your strength and rest.”

He finished another letter, a lowercase a. I took the clipboard from him.

“Annnna … Anna?” I sounded out aloud, and he nodded, tubes and all. A small triumph, potentially imaginary. “I’ll see if we can contact her for you.” The light of human connection—or whatever passed for it here—flashed in his eyes and his lips curved into a smile. If I didn’t know he had fangs and was getting a rhino-killing dose of narcotics, he’d look like any other elderly patient. I took the pen from his hand and his eyes closed.

Then the Versed pump started beeping. I hit the alarm silence button, and looked imploringly out to Charles.

He rolled his eyes at me. He would have never gowned up to come into a patient’s room and not brought in the medication they were almost sure to run out of next. “I’m on it.”

“Thanks,” I said, and gave him a winning smile hidden by my mask. I hit the alarm silence button a few more times and when Charles brought me the Versed, I hung it as quickly as possible before sneaking back out of the room.

* * *

“So, Meaty—” I held Mr. November’s clipboard out over the nursing station desk like it was proof of something. “This guy—no word on him yet?”

Meaty shook a large hand in an indeterminate fashion. “Sorry, Edie. We sent his photo out to all the Thrones.”

I looked at the clipboard and sighed. At least with patients at my last job I could make assumptions. I used to know that when someone had too high a drug tolerance, or too low a pain tolerance, that maybe they’d been a user back in the day. Here at Y4—maybe they’re a werewolf? Or weretiger. Or weremanatee. I snorted. Gina down the hall was a vet and an RN, in charge of the were-corrals in rooms one and two. I knew someone was in one now, because they were howling. Last night was the full moon. We kept track of that here.

Mr. November might be completely new to town, since the local vampire Thrones hadn’t jumped to claim him. It’d take longer to figure out which Throne he belonged to the farther he was afield. Maybe vampires only put out missing vampire bulletins at night.

“He doing okay?” Meaty asked. I didn’t know if Meaty thought I would hurt patients by my mere presence, or if I gave off a bad-nurse aura. It wasn’t that I didn’t appreciate the repeated check-ins, I just didn’t like feeling like I must need them all the time.

“He’s fine, I’m fine, everything’s fine,” I said, with just a touch of sarcasm. Meaty squinted at me, then went back to ordering morning labs on the computer.

The desk between Meaty and me had the telemetry monitor on it, a computer screen that showed all the vitals from all the occupied rooms, in coded colors. Heart rhythms were largest, in bright green, and when alarms sounded these were usually to blame. It was hard to keep lead stickers on squirming patients who were sometimes slick with sweat. So when an alarm sounded, I glanced over, wondering who’d flatlined momentarily while scratching themselves.

But none of the green waves changed, and the alarm went on. Mr. November’s corner of the screen lit up. I leaned in closer, actually reading numbers. After the obligatory oh-shit second, Meaty looked up, and I saw Mr. November’s oxygenation saturation go from an acceptable 92 percent, to a potentially emphysemic 85 percent, to an incompatible-with-life 40 percent.

“Wake him up!” Meaty yelled.

“On it!” I leaped and ran around the station to his room, racing inside without gear.

CHAPTER THREE

I stood there for a second, overwhelmed. I’d left his right hand unrestrained, and Mr. November’d pulled his ET tube out. Inadequate ventilation = certain death. The heart monitor over his bed warned of an atrial fib before its green line dove flat.

Charles blazed past me at a speed walk. He slammed the bed into CPR mode, and pointed at me. “Ambu bag, now!”

I swallowed and nodded and pulled it off the wall. It felt like it took me an hour to assemble the pieces, to shove the face mask and bag together, the one that was supposed to be breathing for Mr. November but wasn’t until I finished the fucking job. I managed it, and shoved the bag over Mr. November’s open mouth.

Which reflexively closed.

On my left thumb.

“Shit!”

I yanked my thumb out, catching it on his teeth, and put my fingers under his jaw for a better seal.

I hadn’t even seen Gina come in, but there she was, with epinephrine from the crash cart. Charles was already performing CPR. Meaty began counting cycles.

“Fifty-nine—switch!”

I vaulted onto the bed to straddle Mr. November, pumping with my injured hand, trying to pretend he hadn’t just bitten me, that a motherfucking daytimer had not just bitten me. What if the tests we had run were wrong? What if he was infected? What if it didn’t take repeated exposure? My thoughts flowed in time with my CPR, and just like his ribs, they resisted at first, then relented with a sickening crunch.

“Epi!” Meaty announced. I saw Gina push it.

Mr. November bucked beneath me, dislodging the ambu bag, sending the titanium-tipped ET tube by his head clattering to the floor. He stared at me, hard.

“Save her!” he commanded—but he was only mouthing the words. He’d shredded his vocal chords when he extubated himself. “Save her!” he mouthed again, before collapsing beneath me, expiring.

I sat there on his chest in shock. And then—the movies sometimes got this part right at least—he went from what’d once been a living, breathing thing, to a dough, then a dust. He crumpled in on himself, leaving a dark soot-colored stain on the insides of my thighs. All of the rest of his tubes and restraints fell and landed where they would have been were he an anatomically correct ash sculpture, something stolen from Pompeii. I wasn’t sure what to make of this, or what to do next—I sat there stunned, before dismounting with excessive care. Meaty, Charles, Gina—they were all staring at me, silent.

“Can’t the Shadow-things fix this?” I asked, my voice rising. The Shadows were some mystical protection for our floor, or so I’d been led to believe in training. I hadn’t seen them myself, but I’d write Santa Claus and clap my hands for fairies right now if I thought it would help.

“Nope,” Charles answered, and my shoulders slumped. He pointed at the remnants of Mr. November’s hand. “Wasn’t he supposed to be restrained?”

I nodded and Charles shook his head. “Awwww, new kid.”

“I’ll need an incident report,” Meaty said, dismissing the whole situation with a head shake. “Gina, stay here and show her what to do for the coroner.”

My mouth went dry. I’d killed a man. My mistake killed him. No—not a normal man, a daytimer, a vampire servant, and likely already alive way past his normal life span. But—he’d looked like a human, and he’d felt like a human, and he’d died, because of me.

A tall man I’d never seen before came up behind Meaty. His embroidered lab coat read DR. EMMANUEL TURNAS in red thread italics. “You rang?”