Major Tom

         Leaning heavily against the sink he peers into the mirror, his nose only an inch from the glass. "Shit, my pupils are blown, I must've hit a vein," he muses to himself. "Wouldn't be the first time, won't be the last." The shakiness is nearly gone, though his legs still felt like rubber. John sticks a hand into the running water and combs his fingers roughly through his hair, then scrubs his face with both hands, hoping to dislodge some of the brain fog. He checks his watch to determine how long he's been out, but can't remember what time he slipped into the bathroom. He takes a deep breath and stretches, which brings on a coughing fit that ends with him hocking a lugie into the sink. He hears footsteps approach then someone trying the doorknob. He answers in a loud voice, "Be out in a minute," waits several seconds to flush the toilet for effect. With a quick scan of the floor he finds the syringe, snaps shut the protective needle cover and shoves it into a pocket of his scrubs. A tiny drop of blood on his thigh is the only evidence of what he's done. That can be easily explained away, nurses are always getting blood splatters and shit and vomit on their uniforms during a shift. No one will even notice the needle hole.
         Rejoining the turmoil in the busy emergency room, John scans the board for any new patients or information. Luckily nothing much has transpired in his absence. The charge nurse spots him and makes her way over with a chart in her hands. "Your patient in 3 is still complaining of pain," handing him the chart, "you know, the Migraine." John rolls his eyes and says, "She's just another drug seeker. I can ask the doctor for more Demerol." Distracted for an instant by another nurse with a question, the charge nurse turns back to him and considered the options, " No, give her another 30 minutes and then offer her some Vicoden. If she's developing a tolerance for Demerol, more probably won't make much difference. A script of Vicoden is probably what she's here for, anyway." John agrees and ducks away, feigning interest in something happening near the ambulance entrance. The nurses, doctors, and even unit clerks in ER have developed an exceptional ability to not look up when someone approaches, giving John easy access to retreating outside without being noticed. He slips out and lights up under a no smoking sign. Even the security guards smoke out here.
         The cigarette hits him hard, improving his buzz. A song is running through his head, but he can't quite place it. Somewhat familiar, he first noticed it when he woke up on the floor in the bathroom. He hums it to himself as he returns to his duties. He checks in on the 'Migraine', trying to walk in quietly but manages to kick a wheel on the gurney. She jerks awake and automatically grabs her head in a defensive move. John smiles at her, more of a sneer than a smile, but she wouldn't be able to tell the difference in the darkened room. Whether she actually has a headache is relative. Only the patient can feel their pain. And in response to the query of how severe the pain is on a scale of 1 to 10, they always answer 10. If not more. An elevated heart rate and high blood pressure may indicate pain, but that's not always accurate. John asks her if the pain has eased any, knowing the answer since she didn't actually get any of the Demerol, only Phenergan, which is often ordered with Demerol to increase the efficacy and reduce nausea. It also has the pleasant side effect of causing the patient to fall asleep, and it burns as it is being administered, giving the patient an indication that something besides normal saline is being given. She carefully shakes her head no. He considers telling her that he feels great, but only smirks at his own cleverness and reassures her he will bring her more medicine soon. Giving her two Vicoden now while the Phenergan is still in her system will do the trick.
         John feels absolutely no remorse for stealing her Demerol. He isn't one of the dozens of lazy, drug seeking, frequent fliers that pack the ER waiting room night after night in search of a cheap, easy high. They come in with no insurance, many of them are illegal aliens who make no attempt to speak the language, and most have no intention of paying their bills. This, he feels, justifies his occasional misdirection of medication. After all, it isn't for recreational use, John needs the anagesics to keep on working. With the nursing shortage everywhere he could work 7 days a week, 12 hours a day if his body would allow. And because he is a man, he is always being called to help other nurses lift or restrain patients. His back is in worse shape than many of the patients he cares for.
         Humming the same song, John checks on his other patients. A two year old girl with asthma is getting a nebulizer treatment. Her mother fidgets by her side, holding a pack of cigarettes and a lighter in her hand, knowing she cannot go out for a quick smoke. John could stay with the child for a few minutes to relieve the mom, but he figures that the asthma was probably caused by second hand smoke. "No sense in enabling her," he decides, as he gathers up some smoking cessation materials to give her.
         He tries to sit down and chart, but the words run together and his eyes won't focus. It may be another hour or so before the effects of the Demerol wear off enough to chart, so John decides to have another smoke. Just as he gets to the ambulance bay doors, paramedics rush in with an MVA. John directs them to the nearest open critical room and follows, catching bits and pieces of report as it is being shouted to the doctor over the patient's cries. Several other nurses rush in to assess the situation and the doctor starts barking orders. With an impressive display of teamwork, the crowd of nurses speak very few words as they each anticipate and then fill every need as it arises. Within minutes the patient is stabilized and being wheeled to surgery. The adrenoline rush is heady, adding to John's drug induced euphoria. The excitement ends and John remembers his 'Migraine'. He quickly grabs two Vicoden and gives them to his patient with some fresh juice, remembering to ask again what her level of pain is but not paying attention to the answer. It falls somewhere between the place where he doesn't care and the hole in his memory created by drugs.
         Finally, he is able to step outside for another smoke. He notices the paramedics still there, cleaning the ambulance and restocking with supplies stolen from the ER. The radio is playing in the cab of the truck, an old song that John finally recognizes, the one that has been spinning around his head all night. "this is ground control to Major Tom....." He smiles, thumping his cigarette into some bushes and turns back toward the gaping jaws of the ER, thinking 'once more, into the'....crap, I don't remember.