The Second Stage

A hiss followed the clattering equipment as fog blasted out of the anesthetic machine. The thick gas sank to the floor then rose like flood waters. This was wrong; sevoflurane shouldn't behave this way.

Meredith batted it away as she scanned the room and ducked upon seeing the operating table. Jacob was gone. Only the blood-encrusted oxygen mask remained, his silver chain swinging from a sprinkler on the ceiling.

The surgery light glared as Meredith sank further into the gray smoke. She lay there, pain electrifying her ankle as she pondered whether to hide or make a run for the door.

Upon hearing a crash from the OR stockroom and the crinkle of sterile packs tearing open, she decided. Meredith hobbled to her feet, but the fog was now higher than she could see. She dug through the air, thrashing the gas away to allow a better view. The mist thickened further as she turned to the surgical lamp, the only beacon in the smog. Her heels clopped and echoed through the surrounding opaqueness. With each step forward she winced.

The operating light came no closer. In fact, it drifted off, shrinking from the size of a dinner plate to a quarter. She scrambled after it, now no larger than a pinhead, until it trailed out of sight. It vanished and, Meredith realized, so had every sound of the OR.

The beeping electronics disappeared, the rustling in the stockroom disappeared, only her own footsteps remained. The polished concrete stretched to infinity into the smoke. Most notable, though, was the stench: not putrid but sterile. It reminded her of her colleagues' descriptions of bleach or mothballs; a scent so strong and so clean it could cover up horrible things: the blood, the urine, and the death swept under it. But until now, Meredith hadn't been able to smell anything at all.

She tried to calm herself. This would be fine. She knew the hospital well. A landmark—that's what she needed.

With a limp, she worked her way to the OR table with outstretched arms. She took five paces, ten paces, twenty paces, and still nothing, so she took twenty more—but the cold metal surface never greeted her—so she bounded another fifty, stumbling onward, flailing and finding not a single solid object. Her footsteps echoed back at haphazard intervals as if the walls were at once a mile and then ten feet away. She ran now, her ankle burdened by no discomfort relative to the pressure in her veins threatening to blow her entire body into a bloody supernova. A sob rose in her chest but she forged on, unsure how she hadn't crashed into a table, or a person, or even a fucking wall by this point.

Meredith muffled the scream rising from her throat with a hand to her mouth; she collapsed, her knees slamming against the concrete floor, eyes darting in every direction, finding fog, fog, and only more fog. She dug her fingers into her face and was startled from her own breakdown by a sound: a distant metallic scraping interspersed with three oddly spaced thuds. Her whimpering ceased as she cupped hands around her ears to track the source of the noise. There was nothing.

"Stop. Reassess." She told herself. "This can't be real. Something happened. Just find an exit... or... or pinch yourself." She expelled a nervous chuckle and dug her fingernails into her pale ring finger. A crimson drop leaked to the floor, steaming and sizzling as if boiling. Meredith watched in horror as smoke rose while the blood bubbled and screeched. Far in the distance came the intermittent thudding and odd clattering again but she lost it again as the droplet hissed like an insect in a frying pan. Within its snapping and crackling, called screams of agony, hauntingly familiar.

Meredith backpedaled from the screaming blood. As she did so, her finger dripped red ink to the gray canvas below, each drop wailing upon landfall until the empty expanse filled with a choir of horrific screeching. She stumbled away, the shouts and pleas and sobs following her as the drops continued to ooze. Finally, gathering the mindfulness to stop the leak, she wrapped her hand in her navy scrub top and applied so much pressure she lost sensation in her digits. The remaining droplets wailed as tears cascaded from her cheeks and landed on the floor, erupting into their own hysterical laughing. She sank to her knees again as the cackling and screams roared to the point of quaking the entire world. The fog sifted without ever offering a glimpse farther than ten feet and the voices amplified until Meredith dreaded that her heart might shake from the attachments in her chest. She opened her mouth and screamed back, but if any sound emerged, she didn't hear it. The laughter and shrieking collided together, twisting into a roar as Meredith gasped, unable to even draw oxygen from such noise-saturated air.

Then, everything returned to silence; only her breath hissed in and out of her constricted throat.

A soft metallic scratching called. With each gasp stretching into a low moan, Meredith gave what little attention she had remaining to track the commotion. This time, the scraping continued, followed by a familiar clattering. The thudding joined in a strange but discernible pattern of threes. She waited, her breath rattling in and out, trying with every pause between rasping inhalations to understand the encroaching presence.

The thumps then arrived in twos, capping each third beat with metallic scratching. As the sound amplified, Meredith found an uneasy understanding and backed away. A figure appeared in the fog, first amorphous then humanoid, limping but determined to make forward progress. Then she heard the giggling.

Jacob charged through the smoke. His leg, the one to be corrected today, bent at a 45-degree angle with his tibia and fibula protruding at opposite angles. His right arm pulled back, still attached to fluid line and dragging the IV pole. In his white-knuckled left hand quivered a set of long tenotomy scissors. Most disturbing to her, Jacob's smile hadn't stopped at the skin: his lower jaw detached on one side and swayed with each step, blood pooling and spilling from his mandible.

Meredith dashed away, not screaming, not shouting, saving her adrenaline for the old, but not yet retired, legs carrying her. As she stumbled off, Jacob roared, red foam spewing from his mouth as his figure disappeared in the mist. Meredith ran until it felt that the lactic acid might melt her bones; that her heart might burst from her chest. But she kept running. Between gasps, she found no other sounds, even her footsteps muffled as if she outran those too.

If anything caught up, it would be the agony in her left ankle, and sure enough, it did. She couldn't keep this pace; she needed a permanent solution. So, she slowed to a jog. Meredith took one last look back and confirmed Jacob wasn't lurking still.

A grinding squeal followed by an echoing metallic groan resounded in every direction as her hips collided into something unyielding. Meredith moaned and set her hands on the surface: rough, jagged, solid. She looked downward. It was the operating table.

Yet, it was not. It had the same height but rust gnawed away its entire face, leaving holes the color of dried blood and human waste. Instead of the adjustment knobs, four hooks curved menacingly from its corners and thick belt straps dangled to the ground. Under its dilapidated top, there wasn't a base holding it aloft. It hung, suspended by black chains that ended three feet above the table. From the drainage hole at the center, tubes coiled into a rusted green utility box. She recognized the box at least; she remembered what lay inside. However, her downward gaze came to another astonishing finding. Beneath Meredith's bare soles was manicured—albeit rotting—grass. In the distance, a new faint sound reached her ears: music. The Beach Boys.

Footsteps tore her attention away from the distant song as she whirled around and shrieked at the sight of a child standing still at the edge of the mist. He waited—watching her—only his shadow visible through the swirling fog.

"Jacob or whatever the fuck you are, leave me alone!" she screamed, throwing her hands out. The boy didn't respond or even move—he stared at her. She opened her mouth to shout again but cut her words short. It wasn't Jacob.

He was too tall, too skinny... too familiar. She edged closer. Meredith recognized the clothes he wore: a gray tee shirt, far too bulky for the child's body. The boy's khaki shorts conjured memories as well.

He gazed at her, no judgment or expression in his posture, the smoke curling in front of his face. She recognized his light up shoes, flickering in the fog. She should have noticed those first. After all, she bought them. Tears welled in Meredith's eyes and her breath quivered as she accepted her realization and let it strike the air from her lungs.

It was her son, Kyle.

It couldn't be him, he was gone: taken far earlier than a child should ever be taken from a mother. But he was there and if such a thing could be so certain she had yet to see it. The smoke blew away from his face as her heart swelled and her chest ached. Kyle's blond hair draped to just above his pale blue eyes as his scrawny frame took a step forward. And with him, the mist encroached. Meredith mirrored the motion. The fog followed her.

A cry and gasp jammed together in her throat. She stumbled, then sprinted for him, tears streaming through the canyons in her face cut by years of similar rivers. And as she approached, the smog congealed and the gray sky sank. Their fingertips extended to each other, and everything darkened. Meredith pushed through, stretching her hand as far as possible. So close, mere inches now, arms expecting embrace.

And when their fingers touched, it all went black.