Soulless Deception

Warning: contains attempted suicide, rape, drug use, profanity

“Oh no... Something isn’t right,” Crystal McGuinn thought to herself while attempting to find her bearings.  

“What’s going on? I definitely took more than enough. Or did I?” she continued to question before making a most unsettling discovery. 

“Wait a second... Oh crap, I can’t move my arms or legs... Why can’t I move my arms and legs? What the hell’s going on? What have I done?” 

Though unable to blink her eyes or manipulate her mouth to call for help, Crystal’s eyes happened to be wide open, and she was able to see two nurses in maroon scrubs enter the room and approach her bed. 

“Ms. McGuinn,” shouted the shorter Filipino nurse. “My name is Lawrence Ramos. I will be taking care of you today.”  

“Come on Larry, I don’t know why you even bother. She can’t hear you! The ER sign-out says she took an entire bottle of Xanax. Her tox screen was also positive for opiates, marijuana, and cocaine,” explained his heavier set partner. 

Yet Nurse Ramos simply rolled his eyes and continued with his preliminary assessment of the new patient. 

“Crystal, can you stick out your tongue or squeeze my hand?” he asked and then waited a short period before moving on to the next task. 

“I told you, you’re wasting your time,” interrupted the cynical nurse who finished checking the ventilator and intravenous settings. 

Nurse Ramos shook his head while continuing with his evaluation.  

“Hey Maureen, when did you become so jaded?” 

She laughed. “Not jaded. Just realistic and efficient. Ever since they introduced this new buddy system, we have to know twice as many patients. They also used it as an excuse to add an extra patient for every two nurses. The result is an ICU with the same number of patients but one less RN. ‘Making a better, safer, Downtown Memorial,’ my ass! I simply choose to focus my time on the people who have a chance of surviving.” 

Lawrence Ramos was still inspecting his patient’s body and had just found multiple healed cuts on her wrists and forearms when Maureen Keller completed her rant. Crystal McGuinn was beside herself after hearing the nurse's words. She attempted any method she could think of to attract their attention but found herself trapped inside her shell of a body. Crystal wasn’t even sure she could cry until Lawrence noted a few tears run down her cheek, however Maureen Keller was quick to dismiss these. 

After Nurse Ramos concluded his examination, including her genital region and backside, he checked her urinary catheter, and followed his partner to their next patient. Crystal found the entire ordeal invasive and humiliating, and with each of her diatribes, hated Nurse Keller more and more. But now, with the nurses having vacated the room, she was left alone with her thoughts. 

Crystal’s initial considerations continued to focus on her paralysis, and she began to panic. Her goal had been to end her suffering; yet, it appears she only made her situation exponentially worse.  

“What if I stay like this forever and no one knows I’m alive?” 

She questioned whether she possibly had a stroke or had fallen and suffered severe trauma, but knew these answers would likely have to wait for now. Crystal then shifted her deliberation to the equally important matter of how and why she survived. Having taken what she believed was enough Xanax, alcohol, and cocaine to end her life, Crystal now wished she’d chosen a more definite method of suicide. 

“If only I had the nerve to shoot myself or jump, I wouldn’t be alive in this predicament. I couldn’t even kill myself correctly.” 

But then again, her anxiety since the rape had dictated every aspect of her life. It had been ten years to the day since her attack, yet she continued to feel ashamed as if it had occurred yesterday. And to top it off, on the anniversary she was now lying paralyzed in an intensive care unit while that asshole lived with his gorgeous wife and two kids in a massive home on Long Island. This Crystal knew for a fact having physically and virtually stalked his every movement since their one and only date, including on the night of her most recent overdose. 

“That bitch doesn’t even know she’s married to a rapist,” she recalled thinking while obsessing over social media pics from the Jenson family vacation to Cabo. By that time, she had already drunk a half dozen shots of vodka and taken a few of her prescribed pills. And while she’d thought of ending her misery on many occasions, reading the caption from beneath Carly Jenson’s post pushed her over the edge. 

“Family time with the greatest hubby in the world and my angels!” 

That was more than she could take. At that moment, Crystal decided this had gone on long enough. Then again, what was the point of living as she had for the past decade? Despite countless therapists and psychiatrists, she still couldn’t hold onto a job or even fathom thoughts of a healthy relationship; physical or emotional. And while her parents cared immensely, having her admitted to numerous inpatient psychiatric hospitals and rehabs, even they were at the end of their rope. 

And so, Crystal held up and gently shook a half-filled bottle of Xanax. 

“This should be enough she thought to herself.” 

But looking back, there was no second guessing her decision to take her life; only the means with which she chose to take it. More than ever, Crystal wished she’d never woken up.  

With her limited view of the room, Crystal was unable to locate a clock and had no sense of time. Every so often, one of the nurses or covering ICU staff would stroll in to check her vital signs, or administer fluids and medication, and then immediately exit. But apart from Nurse Ramos’ occasional few words, everyone assumed Crystal was unconscious, near death, vegetative, or brain dead, and she was largely ignored.  

Over the next few hours, she found herself fluctuating between sleep and wakefulness. Crystal wasn’t sure if it was the prescribed medication or the drugs and alcohol she’d self-administered. And while she preferred sleep which provided a break from her dismal reality, Crystal desperately sought important answers regarding her condition and didn’t want to miss a visit from the doctors. 

After hearing Maureen Keller comment about the leftover burrito she ate for lunch, Crystal assumed it was early afternoon when the medical team made its way to her room. From her vantage point, she could see at least four doctors who were joined by Nurses Ramos and Keller. 

“Dr. Klein, is this your patient?” asked the more senior doctor of the group, all who were dressed in light blue scrubs, long white coats, and surgical masks. 

“Yes, Dr. Menkins. This is Crystal McGuinn. She is thirty-two-years-old and was found unconscious late last night by her parents after overdosing on a large quantity of Xanax. UTOX was also positive for opiates, alcohol, and cocaine. She was intubated in the field and then reintubated in the ER when it was found the ET tube was poorly placed. Initial O2 sats were in the sixties but then quickly corrected. Hypotension responded to fluid and pressors. Initial labs showed a significant acidosis, elevated creatinine, and LFTs however these have slowly improved over night. Exam is significant for some coarse breath sounds at the bases, but she remains completely unresponsive. Her neuro exam also shows depressed brainstem reflexes.” 

“Thank you, Dr. Klein. Does anyone have any questions about her history or exam?” questioned Dr. Menkes. 

Another member of the team inquired, “Sandra, do we know if it was a suicide attempt or accidental OD?” 

Dr. Klein replied, “No notes were found at the scene; however, I spoke with mom who provided a history of intractable depression, anxiety, and prior passive attempts. She also has scars on her wrists from prior cutting.” 

“What’s your plan and prognosis, Dr. Klein,” the senior doctor probed. 

“Continued supportive care, daily chest x-ray, follow up labs, and a Neurology consult. Sadly, I fear she’s suffered significant hypoxic brain injury and her prognosis is grave.” 

“Thank you, Dr. Klein. Well done. I agree with your prognosis. We’ll give her a few days, but it doesn’t look like this one’s gonna wake up. Unfortunately, it looks like she was successful in her attempt this time... Let’s move on everybody,” instructed Dr. Menkes while escorting the team out of Crystal’s room. 

When the last doctor had cleared the curtain, Crystal was again alone in her own head. “Grave prognosis... Not gonna wake up... But I am awake. I hear everything. I just can’t fucking move!” 

She again began to panic at the prospects of a prolonged existence imprisoned within her own body. Tears again flowed from her orbits and the machines and monitors in her room began to loudly chime. In response to these alarms, Nurse Keller casually walked in. 

“Honey, what’s going on here?” she questioned. “Suctioning these secretions should shut up these damn machines!” 

The nurse grabbed hold of a suction catheter, curtly and painfully jamming it back and forth inside of Crystal’s mouth. Although she felt the urge to gag, she was unable, but the sudden discomfort disrupted her panic attack and Nurse Keller achieved her goal. After a minute, the machine fell silent and she exited the room. 

 “How did that women ever become a nurse,” Crystal considered before returning to more pressing matters.  

“So, no one mentioned a stroke or trauma, yet I’m still completely paralyzed. And I couldn’t have suffered significant brain damage because I can understand everyone and think clearly... right?”  

After a few more minutes contemplating questions to which she knew the answers were presently unavailable, Crystal again drifted off. Since her attack, she typically had variations of the same dream in which she was being restrained in some manner. At times she was held in a prison cell for crimes she didn’t commit, or stuck in a narrow cave while hiking, or more commonly, trapped in a locked car under perilous circumstances. Yet here she slept peacefully for the next two hours until she was awoken by an overzealous Neurology resident deeply rubbing her chest. 

“Ms. McGuinn... Ms. McGuinn, do you hear me?” he shouted inches from her face. He continued to press sharply on Crystal’s sternum and barked further directions which she understood but was unable to follow.  

Over the next five minutes, the resident, who Crystal questioned was even old enough to be a doctor, performed a thorough examination. He shined a light in Crystal’s eyes, turned her head side to side, moved her limbs in search of any response, and finally tapped her knees and elbows with a tiny hammer. When he concluded, a more senior doctor entered. 

“So, Dr. Wexler, what’d you find,” she asked. 

“Not much... Not much at all.” 

The attending neurologist repeated a few aspects of the exam before agreeing with her student. “I see what you mean... And what’s your diagnosis and prognosis?” 

The resident paused and formulated his response. “Given the circumstances, you know, the overdose and the faulty intubation, my diagnosis is hypoxic encephalopathy, and her prognosis is poor.” 

“Dr. Wexler, typically neurologists should wait at least twenty-four to seventy-two hours before providing such a prognosis, just in case the ingested toxins are impacting your exam. However, in this case, regrettably, I ultimately believe that you will be proven correct. Either way, watching her for another day or two won’t hurt anybody and is the right move. Why don’t you put her in for a CT scan and an EEG, and we’ll see her when these are completed.” 

The resident agreed with the plan before adding, “It’s very sad. She’s so young. I wonder what could’ve been done to intervene before she finally succeeded in killing herself.”  

The two doctors then vacated the room and Crystal McGuinn was left to understand the power of their words. Despite hearing another opinion regarding her prognosis, it was the resident’s last statement which struck a chord. What could’ve been done to have changed her destiny? Crystal found it ironic that she was only considering this question while lying paralyzed, on death’s door in an ICU, and not during the previous decade when the answer might’ve made a difference. 

At first, she again presumed that the only meaningful action would’ve been to have never gone back to Andrew Jensen’ dorm room, but this conclusion was neither innovative nor productive. And although she placed the blame primarily on Andrew, Crystal knew had she listened to her girlfriends' warning that night, her life would’ve followed a very different path.  

The more she processed her attack and the years which followed, Crystal realized that her deliberations always followed the same pattern, marked by regret, shame, and ultimately anger. Regret for her prior decisions both leading up to the rape and following. Shame that because of her inaction many other women had likely been victimized. And lastly, anger that Andrew Jensen suffered no consequence and was allowed to live a normal life while hers was destroyed. 

For the next few hours, Crystal was largely left to her own devices. Except for a brief, silent visit and intravenous injection from a physician in a dark suit, there were no other interruptions by doctors, nurses, or associated hospital staff. When she had finally concluded her rumination over the cause and effect of her rape, she then returned to the ultimate questions surrounding her present condition. 

“I can’t be dead, yet for some reason none of the doctors believe I’m going to survive. So, where does that leave me now?” she pondered. 

   Crystal then hypothesized whether she could be in some form of transition state between life and death; her paralysis signifying her soul's slow departure from her physical body. And while Crystal found this thought scary, part of her believed it might be for the best.  

“But if this is the case and I’m still conscious, that means a new existence might await me on the other side. I cannot enter a new life making the same mistakes which plagued me in this one.” 

Crystal took her time as she processed the significance of her own words. Then again, what other options could explain her current metaphysical state. She imagined inhaling a breath and began to speak with purpose, aloud in her head. 

“Andrew Jensen, you will always be a piece of shit, rapist, but I now release you from my life. You were responsible for violating my body and mind, but no longer. While I should’ve done this a long time ago, I take full responsibility for my existence moving forward and no longer give any consideration to how you chose to live yours.” 

Crystal then fell silent and focused on the sound of her heart beating in her head. Having said her peace, she wanted to refocus on her new transitional theory, but found the experience to be very different than minutes earlier. Strangely enough, the anxiety, regret, shame, and anger which had weighed her down for so long had lifted. And while Crystal felt remorse for the pain she’d cause her family, she was ready to accept whatever fate awaited upon her death. 

Resting comfortably following an eventful few hours, which included a tear-filled visit from her parents, Crystal was awoken by an odd sensation. Out of the blue, she found herself gagging on the endotracheal tube strapped inside her mouth. She immediately came to and realized that her eyes were closed and that she had regained volitional control over her eye lids and even more astounding, her fingers and toes. Crystal didn’t know what to think.  

Was it a miraculous recovery or was she finally free? By this point, she wasn’t even sure which she favored. Crystal began to cough which again triggered the alarms on the ventilator. For a change she couldn’t wait to see the look on Maureen Kelly’s face when she’d enter the room and see her patient’s unexpected recovery. But sadly, this encounter would never take place. For instead of Nurse Kelly or Ramos, Crystal was greeted by the man in the dark suit from earlier who quickly silenced the machine. 

Now slightly able to move her neck, Crystal read the name on the man’s identification badge, “Kenneth Tepper, M.D.”  

“Ms. McGuinn, it looks like I under-dosed you last time. Well, that can be easily remedied,” explained the man who reached into his suit pocket and removed a full syringe. 

Confused by the turn of events, Crystal began to struggle, however this quickly abated when Dr. Tepper injected her with the high potency paralytic agent. Within thirty-seconds, once again she was returned to a state of complete paralysis and panic. 

“There. Isn’t that better?” patronized Dr. Tepper. “Don’t worry dear. This will be all over soon. I’ve read your file. I know all about your suffering and I believe we can help each other. After all, the monster downstairs needs fresh souls, and yours is too damaged to be of any further use to you in this world. I am very sorry Ms. McGuinn, but there is no other way. I do hope you’ve taken advantage of the time which I have provided. ” 

Dr. Tepper left Crystal’s room and headed out into the hallway. There he met one of the hospital’s maintenance workers whose work ethic and loyalty were never in question. 

“Mr. Laguerre, so nice to see you.” 

“Yes, Dr. Tepper. How can I assist you?” inquired Louis Laguerre. 

“So, unfortunately it looks like I may need you to transport another unfortunate soul to the back of lower level three this evening. Is that ok?” 

“Of course, Doctor. Just let me know when they're ready.”