Chapter 1 — Awake
It was nine o’clock at night. The exercise room had the odor of antiseptic cleaners mixed with hopeful ambitions and glum disappointment. It was empty except for a dark-haired woman running slowly on the treadmill in a t-shirt and sweatpants. She had buzz-cut hair and her t-shirt was stained with sweat. As she ran, she repeatedly visualized the steps needed to strip, clean, and reassemble a Sig Sauer P239 pistol. Her memory had been playing tricks on her lately and there were some skills that she thought were just too important to forget.
Her breathing started to get ragged and the color drained from her face. She needed to keep running so she began to play a mental game: she would run four more strides and then decide if she could continue, and then another four strides, and then another four strides. She played variants on this game before, in life-and-death situations, and it had proven its effectiveness. She considered getting back in shape to be a life-and-death proposition for her now.
But even the game had limits. Waves of nausea began to wash over her. If she were outdoors, she would have just puked and kept running, but she didn’t want to get stuck cleaning the hospital treadmill. Instead, she hopped off, doubled over, and grabbed her side. “Shit, shit, shit! I hate this.”
As she was bent over a tall, balding man wearing a doctor’s coat came into the room, paused by the door, and then walked slowly towards her. “Samantha, what are you doing? You already had your P.T. for the day. You should be in bed now.”
Samantha looked up at the middle-aged man with a pained expression on her face. “Do you know what an Iron Man competition is, Doc? In a single day, you have to swim two and a half miles, then bike for over a hundred miles, and finally, run a full marathon. Last year I could have competed in an Iron Man and been one of the top finishers. Look at me now. I can’t even run four minutes on a fucking treadmill. I’m pathetic.”
The doctor shook his head. “That was before your injury. Considering you have only been in the rehab wing for three weeks, I am surprised that you have the strength to walk to the exercise room, much less run on a treadmill for five minutes.”
Just then Samantha’s heartbeat started to roar in her ears, the doctor’s voice faded into the distance, and the room began to shrink. She knew that she was close to fainting, so she quickly lay down on the floor and propped her bare feet up on the side of the treadmill. “How much longer will I have these fainting spells, Doc?”
“Let’s see if it’s the same as last time,” the doctor said as he came over to examine Samantha. He peered into her eyes, took her pulse, and then repeatedly pressed a finger against the top of her foot. “Are you still feeling faint when you’re just walking around, or is it only when you’ve been exercising?”
Samantha tried to remember the last couple of days. “It can happen anytime. I think that eating may trigger it sometimes. The last two days I had an attack right after lunch. The food here is lousy, but not bad enough to do that.”
“Well, it’s most likely another problem caused by the blood loss from your injury. According to your chart, when you first arrived at the emergency room there was so much blood loss that you had some hypoxic brain injury, your heart was in distress, and your kidneys were shutting down. Based on your medical history and the symptoms you’re presenting, I think you may have Postural Orthostatic Tachycardia Syndrome.”
Samantha stared at him uncomprehendingly. “Just for a moment, pretend you’re talking to an ordinary human being, Doc.”
“Oh, sorry. I’m afraid that right now your body isn’t regulating your blood pressure properly. Sometimes it gets confused and can’t tell if you’re standing up or laying down. Your B.P. drops for no apparent reason and your heart has to kick into high gear to compensate.”
“Okay, so how long before I’m well?”
The doctor shook his head. “Samantha, you are going to have to accept that things aren’t going back to the way they were. All of your major organs suffered at least some damage from the blood loss, and even with the electro-stim while you were in a coma you lost a lot of muscle mass. I doubt you’ll be able to compete in an Iron Man for a very long time.”
“Or ever?” she asked.
“Or ever,” he said, nodding his head.
Samantha started visualizing the various ways she could kill this man, this bearer of ill tidings. She wasn’t really going to hurt him, at least not now, but running through death scenarios was a good mental exercise that kept her sharp. She decided that a quick chop to his throat would probably be best under these circumstances. It would be quick, quiet, and she could do it even though she was still a little dizzy.
“Are there some pills or something you can give me to at least cut down on the symptoms?” she asked.
“At this point I think the best thing is to up your salt intake, keep you well hydrated, and get some compression stockings for you to wear. If we can increase your blood volume and prevent it from pooling in your legs and feet, you should do better.”
She was fine with wearing compression stockings. Her knees were so badly scarred that she always tried to keep her legs covered, anyway.
“Well, I think I’ll take your advice and head for bed now,” she said. “If you’ll give me a hand up, I’ll be on my way.”
Samantha steadied herself by putting a hand on the doctor’s shoulder as they walked. “What about my memory problems? Do you think they are ever going to clear up?”
“We hope they will, over time. Right now, you have some holes in your long-term memory, and your limbic system is struggling a little bit when it’s making new memories. But what you need to do now is concentrate on good things. Positive thoughts really will help you recover. You are quite lucky, actually. You had a horrific injury and were close to bleeding out. And yet here you are, still able to speak, still able to see, and seizure-free.”
“Wonderful,” she grumbled, removing her hand from his shoulder. “Positive thoughts are fine, Doc, but I have to make plans for the future. Are there any surprises you haven’t told me about yet, or do I have the whole story?”
“Well, now that you’re up and interacting with people again, we do need to start monitoring you for minor personality changes and problems with executive functioning.”
“Executive functioning? What the hell is that?”
“The type of brain injury you have can lead to poor decision-making.”
Samantha turned to him and smiled. “Like running unsupervised on a treadmill when I’m supposed to be in bed?”
“Exactly,” he replied, smiling back at her.
“You know, you had visitors again today,” the doctor continued resignedly, as they reached the door to Samantha’s room. “I’m afraid I’ve run out of excuses to keep them away. I’m getting leaned on by people in high places to grant access to you. I’m afraid that you’ll have to start meeting with them tomorrow.”
“Well, that will certainly increase my blood pressure if nothing else works,” Samantha muttered.
“Just one more thing,” she called out as the doctor turned to walk away. “What about my memory problems? Do you think they are ever going to clear up?”
She enjoyed watching the doctor’s face struggle with how to respond but eventually couldn’t help herself and began to laugh. “That felt good," she thought. “I haven’t laughed in a very long time.”