It began on a Tuesday night just about three months after he had been assigned to the rehab unit. One of the patients came to the counter at the nurse’s station while Erico was seated updating a pile of patient charts. “Excuse me? Erico?”
Erico looked up and he could feel the blood drain from his face as he stared at a death’s head. It was a face, not unusually thin, but there was the image of a death’s head within the features, almost as though Erico could see through the tissues that covered the skull.
“Erico?” asked the patient. “Are you all right?”
Erico Ramos blinked his eyes, rubbed them, and willed the death’s head image from the patient’s face. The patient was a boy in his late teens, Pat Nelson. Tall, olive skinned, trimmed black hair and liquid brown eyes. His eyes reminded Erico of the little girl, Alicia. The image of the death’s head would not go away.
“What is it, Pat?”
“Are you all right, man? You look like you seen a ghost.”
“I’m all right. What is it?”
The kid shrugged and raised his eyebrows. “If you say so. What I want to know is what to do with my bedding and book issue. I’m going home today.”
Erico leaned back in his chair and frowned at the boy, death’s head and all. “What the hell do you mean you’re going home? You’ve only been here a week.”
Pat looked sheepish and turned his head so that he no longer was making eye contact with Erico. “I’m not going to do the whole month. This place isn’t for me.” It was a death’s head talking. It was saying, “I’m terrified. I’m so frightened of death, I’m going right out there and make certain I die.”
Death’s head. Erico couldn’t shake the image. Pat Nelson had bent things to the point where anything would be better than facing life, and eventual death was one piece of life those who lived in the real world all had to face. Pat Nelson was going to die. It was written, literally, all over his face.
“Pat, you know what your odds of recovering are even if you go all the way through treatment and complete it? Maybe one out of three. If you quit, your chances are maybe a hundred — a thousand to one. I wish you’d reconsider.”
The boy’s face reddened slightly and he still refused any kind of eye contact. “I’ve heard the sales pitch from my counselor, and from about half a dozen members of my group. I really don’t think I have a problem. All I really need to do is learn to control my using better.”
“Don’t try to snow me, Pat. Don’t you remember back there in detox? I was there when they pumped your guts out and fought all night to quiet down your heart before it ripped loose from its supports.”
“I overdid it one time,” answered Pat Nelson. “One time. Okay, I’ve learned my lesson, and that’s it. I’ll never do that again, so don’t worry about it. All I need to know is what to do with my bedding and my book issue. The N.A. text and the A.A. Big Book are brand new; hardly been opened.”
“I wonder why I already knew that,” cracked Erico. Like the rehab nurses kept telling him, if a person wants to recover, you can’t say anything wrong. If he wants to die, you can’t say anything right. Recovery isn’t for those who need it; it’s only available for those who want it. “Stuff your sheets and blanket in your pillow case and leave it on the floor in your room. The books are yours. I suggest you take them home with you and read them.”
Later that day housekeeping found Pat Nelson’s bedding stuffed in a pillow case on the floor where he had been told to leave it. Housekeeping also found Pat’s book issue in the room’s trash can. Nine days later the assistant manager of the Seventh Street McDonald’s found Pat Nelson himself dead in the toilet stall in the men’s room at the aforementioned establishment, a few granules of blow still adhering to his upper lip.
The autopsy showed his heart had torn itself to pieces. Erico read the notice of Pat Nelson’s death that made it to the rehab unit. It upset him because, since then, he had seen the death’s head in the faces of four more of the rehab patients and one of the nurses.
Erico Ramos went to a psychiatrist and paid a total of one hundred and twenty dollars to be told that he had a fear of death. A little on the extreme side, but perfectly normal. The death’s heads were a manifestation of his fear in combination with twelve hour shifts, too much caffeine, and the life style of a lone wolf; he was too isolated; too much into his own head. Pat Nelson’s death had been simple coincidence, as were the deaths of the nurse and the four other patients in whose faces he had imagined seeing death’s heads. After all, how many had died without such advance advertising? Less caffeine, fewer hours, a little meditation, and a lot of medication.
Erico had spent long enough on the rehab unit to appreciate the risks of treating problems with Valium and other chemical wonders. He destroyed the prescription. Meditation seemed like nothing but a way to play with his nightmares. He didn’t bother with meditation. He did manage to arrange for fewer hours and he cut out caffeine.
He didn’t have any idea what to do about his isolation; his lone wolf life style. He wasn’t dating and he had no close friends or family. He didn’t know what good it would do anyway. Friends seemed to be more obligation than comfort. That went doubly so for romantic attachments. It was redoubled for family. For a brief moment he considered splitting the difference and purchasing a kitten, but his landlord didn’t allow pets any riskier than a goldfish. Hard to cuddle a goldfish.
He did note that several persons he had known had died recently, none of whom had sported death’s heads in advance. One was a suicide; Mrs. Baum who worked for the cleaners next door to the apartment house. She had inoperable cancer and had taken an overdose of sleeping pills. Erico had seen no death’s head in her face. Roger Stokes, a police officer who lived in the apartment building, had died in his sleep from a massive coronary. There had been no death’s head in his face.
Perhaps the wigpicker was right. Imagination, lack of sleep, a preoccupation with the fear of death. Erico decided to take it easy, take care of himself, and ignore the death’s heads that he continued to see. After all, anyone who had a head had a skull inside of it. A little outline here, a jutting chin, a cheekbone, the ridge of an eye socket. The suggestions were all about him. It was his imagination that was turning them into death’s heads. He forced himself to relax.
One snowy night in late December Erico was driving back to his apartment on the interstate after shopping at the supermarket. In the oncoming lane was a BMW full of merrymakers wending their way from one party to another. Young, modern, and politically correct, they had designated a driver, one of their friends who could not tolerate alcohol. It was he who, after four joints and a line of coke, plowed the vehicle and his mates head on into the front end of Erico’s Mazda. When the fire department, paramedics, and coroner showed up to sort out the pieces, the merrymakers were on their way to the county morgue while Erico Ramos was unconscious, bleeding internally, and on a fast chopper heading toward Northvale General.
Dread.
Before he opened his eyes, Erico was filled with horror. He remembered the accident, the car’s dashboard and steering post folding into his abdomen, the shower of glass, the stunning blow through the back of the seat into his spine that caused him to lose consciousness. He knew he was in an ICU. The heart monitor was on audio, he could feel the automatic cuff on his upper left arm, the IV taped to the back of his left hand, the blood oxy clip on the tip of his index finger, the catheter inserted into his bladder.