All Hallows' Eve: Night Shift

The night shift at the old Charity Hospital was morbidly still. In New Orleans, Halloween was a noisy, boisterous time, but in Big Charity, an iceberg of concrete jutting above the crumbling storefronts of Tulane Avenue, even the noisiest of celebrations was reduced to the silence of a tomb. When we worked the night shift, if we wanted to know what the world was doing, we could open one of the metal sash windows and listen to the shouts coming from the dark neighborhoods of Mid-City in the distance like ghostly cries from the cemetery. And we would slam the window shut, preferring the suffocated silence.

We worked on 7 West, a general medical unit. I was charge nurse for the shift, and had just finished dividing up the patients among the four nurses on the unit when I heard the screech of the elevator door opening. A dark figure stepped out. It was a relatively warm night for October, so I was surprised to behold a man heavily dressed. If he had worn white I would have thought he was an attending doctor, as long his coat was, but it was all black. He seemed to know precisely where he was going, and came up the hall straight as an arrow, not a single step or motion wasted. He glided, almost as though he were used to the idea of flight. Perhaps he was a pilot, on a Halloween caper in the French Quarter? New Orleans would certainly be a preferred layover on Halloween for people in the airline business.

As he approached the nurses' station, the seam of his long cloak divided, which on closer examination proved to be a cape, and he produced from behind its curtains a manilla folder.

"For the charge nurse," he said. His voice was flat, cold, without inflection or accent. "I am a direct admission from Dr. Frankl."

Dr. Frankl. I turned my head to the other nurses and asked with my eyes. They all shook their heads.

"No one here knows a Dr. Frankl," I said at last. "Is he a staff physician here?"

"He most assuredly is," the man responded. His long hair was combed straight back, and neatly flowed over the collar. "He has admitted me here before."

He offered me the folder. Inside was a hospital order sheet with the words "Admit to Dr. V. Frankl" written on the first line. The rest of the order sheet consisted of routine admission orders, including an order to start an IV, medication for nausea, morphine, and an order to transfuse two units of blood. Whole blood, type A positive.

It was rare anymore to transfuse whole blood. In the modern era, blood was usually separated into plasma, platelets and red blood cells, so that one unit served at least three purposes, and could be used for three people instead of one. 

I looked up at the visitor. "In my time here I don't believe I have transfused whole blood more than once or twice. This is peculiar. I’ll have to check on this." 

“Please, be my guest. You are welcome to check, and you will see everything is in order. Dr. Frankl made arrangements with the blood bank for the blood in advance." 

Nodding, I picked up the phone and dialed down to the blood back. My friend Hank picked up. "Blood bank." 

"Hank? Laura here. I have a patient up here for admission who has a very strange order with him. From a Dr. Frankl." 

"Yes, and I have a very strange order down here. Someone called the bank a few days ago and requested that 2 units of whole blood be made ready for tonight. I had no idea about the order until I came on shift at 7. Very strange, whole blood.” 

“The patient is up here on the floor, and he wants his blood." 

"Near as I can tell, everything is in order. We can do the transfusion tonight." 

I hung up the phone and looked at my friend Jenny. “What should we do?” 

Jenny shrugged. “Put him in a room. I’ll put his chart together. We can check on this Dr. Frankl, see if he’s really an admitting physician here.” 

At the end of the hall there was an unused room. I had decided already I wouldn’t put him in the room with anyone else. Motioning towards it, I started down the hall. He turned and followed, moving so silently that I had to look back to see if he was still behind me. I told him to undress and get into the bed, laying a hospital gown on the clean white sheets. 

“We will work this out,” I said. “This is just unusual. Almost all of our admits come from the ER. And we never get direct admissions this late.” 

“My apologies, then. That was my request,” the man said. “Dr. Frankl was going to admit me first thing in the morning. I wished that the transfusion be done overnight. So as not to disturb my day. A transfusion will not keep me awake.” 

“I understand. We have a few details to work out before we can begin the transfusion.” 

“I am in no hurry.” He blinked when I turned on the fluorescent light, as if even this were too much brightness for his comfort. With a single motion, he swung the cape off his shoulders and onto the back of a wooden chair. Underneath he was dressed in black slacks and shoes, and a white loosely fitting button-down shirt. I kept looking, trying to decide if he was in a Halloween costume. His skin was very pale, accentuating his dark hair, and without blemish. As soon as I reached the door he had turned the light back off and stretched out on the bed. 

When I returned to the nurses’ station, Jenny had a physician’s directory on the desk and was looking through it. “Here it is. Frankl is indeed registered as an admission physician at this hospital. So it is all legit.” 

Somehow this did not quell my uneasiness. But at least I knew I would not get in trouble for admitting the patient. 

Other than the transfusion, the patient did not require anything, so I did not give him any medication or treatment while we waited for the blood to be sent to the floor. The man was patient. He lay in bed, the television in the corner of the room switched off. He had nothing to do and seemed uninterested in doing anything. After I had caught up with my paperwork and checked out the other patients I returned to his room. 

“It won’t be long,” I said. 

“You are probably wondering why I am here. I have a very rare blood disorder. It causes severe anemia, and abdominal pain. Every few months my blood count goes down, and if I do not receive a transfusion the abdominal pain returns. This transfusion will set me aright for the time being. And it may…keep me out of certain kinds of trouble.” 

“Trouble?” 

“I shall only say that my illness, when left unchecked, leads to certain atypical behaviors. I must say no more.” He licked his lips. I got out of there. 

A courier had arrived on the floor with the two bags of blood. After signing for them, I gave bedtime medications to two of my patients and went back into the room to start the transfusion. Hanging the bags on the IV pole, I looked around for a needle to start an IV. 

“I could have sworn I brought a 16 gauge needle in here,” I said. I looked over at the patient. The lights were very dim in the room, but his eyes shone in the gloom. 

“A mistake anyone can make,” he said. “As I said before, I am patient. Please, by all means, take your time and do the job right.” 

When I returned to the nurses’ station, Jenny was talking to one of the the other nurses. “Laura, you have to hear this! Cindy here says she remembers Dr. Frankl. Tell her, Cindy.” 

Cindy turned anxious eyes to me. “Yes, I remember Dr. Frankl. Never met him…he was in the news…last year, I think. He was an old man, practiced for 40 years in Gentilly, maybe more. He died. Well, they found his body by Bayou St. John on All Souls Day a year or two ago.” 

We all turned and looked down the hall. The door to the stranger’s room was open, but the room was dark, and the darkness seemed to be consuming all of the light at the end of the hall. It was as if black fog was spilling out of the room and filling the end of the corridor. 

Cindy’s voice was very quiet. “The coroner said someone had drained his body of all of its blood.” 

My heart pounded in my chest. Whole blood. What did it mean? Did this strange man collect blood? Could he be Frankl’s killer? Or were we crazy? 

“That’s ridiculous, isn’t it? Somebody stabbed him and he lost all his blood. Maybe a robbery. That can’t be right. You said, Cindy, you said Frankl was on the list of admitting doctors. That means he is still alive, we must have the two names mixed up. There are many doctors named Frank, Francis, Franco, maybe you remembered it wrong.” 

“I’m sure you’re right,” Cindy said. “I’m just telling what I remember, but I misremember a lot of things, you know?” 

“Yes,” I said, reaching for the IV tray on the station desk. “Why don’t you two girls come with me when I go to put in the IV.” 

“Do we have to?” Cindy said.  

Jen poked Cindy in the side with an elbow. “Yes, of course we will come with you,” Jenny said. 

We walked down the hall, three abreast. It was only a hundred feet or so, but it seemed much farther. With each step the air felt more and more damp, and the lights seemed to dim. It wasn’t that the fluorescent lights weren’t working, or even that they were putting out less light, it was as if the light was somehow scattered, or absorbed, as it passed through the air, the intensity absorbed like sunlight cast into the ocean deep.

We arrived at the room. It was dark, as before, lit up only by the pale light shed by a footlight near the window. Nothing moved. We paused, frozen in the doorway. I looked hard, and in the gray shadows I could make out the bedsheets, which were rolled back as if the occupant had gotten out of bed and pushed the covers back. The window was open, and a breeze passed through the room, rustling papers I had left at the bedside only a few minutes before. Something else was moving above the bed, two fluttering surfaces, like an animal flailing in the darkness. 

At last I whispered to my companions, “This is crazy. It’s just a patient. We’ve all had a million of those.” Walking into the room, I switched on the light.  

The darkness disappeared, and the room was empty. We could now see that the fluttering above the bed was two empty blood bags.   

“I thought you said you brought two units of blood in here,” Jenny said. “These bags are empty.” 

“There was blood in them. Two units. The bags were full, I swear they were.” 

Jen examined the bags. “Name’s right on the bag. But there isn’t a drop of blood in them. Clean as if they had never been used. And look at this.” She showed me the base of the bag, and her fingers touched two puncture marks in almost the same place in both of the bags. 

At the bedside table, there was a piece of paper folded once over into a little tent. The word “Laura” was written on one side. I picked it up. It read: “I thank you for your assistance, and regret that I was unable to wait until you properly placed the IV and infused the blood the proper way. I regret that I lied to you — I am not a patient man — I could not wait. 

“You are an attractive young lady and I hope perhaps we shall meet again. In my younger days I might have considered asking you out for a drink, but my doctor informs me that I have a drinking problem, and I am trying to abstain from consuming my favorite beverage in its fresh form. That is why I came by tonight, to keep from going out drinking. 

I wish you a pleasant night shift. 

Your most obedient servant, 

V.”

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