System failure (Cage Dunn version)

Passengers rocked with the movement of the train. Most were on the phone, immersed. A chubby black woman looked neither left nor right, stared out the window opposite her seat, and a drunk in the back yelled verses of a song I didn’t recognize.

Someone coughed.

Everybody glared at the homeless man asleep over four seats. The drunk lurched forward, grabbed every handle until he stood a few feet from the group of people crowded into the doorway. He snickered, stretched his arms toward us, leering like a mad monkey.

Then the drunk turned his attention to the grey-bearded homeless man tucked under the morning papers. The front page was all the reports about the infected. I saw it clearly, couldn’t miss the huge type. It was everywhere, on the radio, on people’s whispers, in their movements away from contact.

The drunk kicked the seat, once, twice, until he was rewarded by the old man’s open eyes.

“Cover your goddamn mouth! You wanna kill us all?” He punched the newsprint-covered lumpish body.

The old man squealed and curled his legs up to his stomach.

More passengers moved closer to the exit, and I hugged my suitcase, anxious to get out. The drunk pushed the old man, punched him to the floor, kicked him in the head, in the chest, in the stomach.

“Oh, God,” someone whispered.

The train entered the station. The door hissed open, passengers emptied onto the platform. I sped up to stay ahead of them, stay out of trouble. Getting involved was dangerous. I checked my phone.

“Where are you?”

I leaped two steps at a time on the way to the open-air above. A lone taxi prowled the streets between skyscrapers. No people. The office buildings unlit, empty, silent. I scuttled the next few blocks, reached the overpass, looked around before I entered the old house where I ran the clinic. I ran up the stairs to the fifth floor and knocked. Tap, tap, pause. Tap-tap-tap.

The door cracked open. A slit of Clayton’s face slid into view.

“You’re late.” He clacked the door-chain off and opened the door until light filled the darkness of the unlit hall.


I tilted my head. Clayton pointed me to the short corridor almost blocked from view by the high stack of cardboard boxes. I walked around them, entered the hallway. Five men in masks and hoodies lined the hall.

A barely-muffled scream leaked out of the main room. I said nothing, nodded and squeezed the suitcase. Clayton lit up a joint and followed me into the room next to the screamer.

“No gangs,” I said and placed the suitcase on the table.

“You can make the rules when you invest your own money. Just stitch him up and forget everything you see and hear.”

Smoke puffed from his mouth into the already thick air in the room.

“Why don’t you do it? I’m taking the risks, I’m the one going to jail if the feds come to the clinic.”

Clayton turned his back, and I clambered into the protective gear.

“There are more medics out there doc. Got a few on speed-dial. You wanna work or not?” He puffed a large breath of sweet-smelling smoke toward me. “Paramedics and private clinics always need more scrubs.”

“It’s a fucking game to you. You hustle the desperate, the uninsured. You’re greedy, want more and more, and now what?” The five men – who were they? I could guess. “You need a gang now – what’s that about? Validation, is that it?” I sealed the waist to the plastic over-pants. “My qualifications don’t mean anything.” I shook my head. How had it come to this? “Hospitals run by gangs worse than the mafia.”

“Stop bitching. It doesn’t matter, man. Nobody gives a fuck. Your country is in bigger shit.”

“And they have the cure – a bullet to the head.” I groaned. Was it worth talking to him? “I took an oath to help the sick, but this is far beyond what we agreed.” I stared at him through the face-mask, waited for the usual unfunny remark he always had ready.

He stared back, eyebrows raised.

“It’s one thing to help people who don’t have options. Completely different when the gang takes you into its fold. If that gang claims this clinic, they’ll cut the middle-man – that’d be you – and I’ll become the designated paramedic.”

Clayton leaned against the wall. I washed my hands, put on the gloves, the plastic wraps, and sealed them. The instruments in the suitcase were sterilized, and I opened the packaging and laid them out on the sterile linen, checked each one for damage before I rolled them up.

With my hands lifted into the air and the instruments cradled in my elbows, I shouldered past Clayton and pushed the door open with my foot. He wouldn’t stop me. It was his honor at stake. Not like the life of the person in the next room mattered.

The smell hit me first. Blood. Perfume. Dope. Sour sweat.

The young black guy lay spread out on the dirty table in the center of the room. He twitched, screamed like a big kid, and squeezed the hand of the girl who stood next to him.

After a preliminary check of the bleeding, and a quick roll to check for the exit wound, I pinched his legs, to test the responses. The angle of the bullet wound, the clean exit – anyone would think the shooter wanted him alive, but the kid put on a good act. Or he was scared shitless.

Infection was the greatest risk. Bacteria. I cleaned up the wounds with antiseptic, put a few stitches in to make it look good and leave him with a battle scar. The screamer would live.

That was the worst of his problems, what else was there. I pulled his vest up and found another wound on the second rib on the left side. More needle and thread work. Quick and easy, but the kid screamed. Why was he overreacting? However, it was beyond my role to ask.

The last stitch was heralded by the door swinging open, a blast of street stink overpowering the stench of congealing blood and sickly disinfectant.

“Close the door,” I said without turning around.

“Who called you in?” The leader wore the thickest gold chain around his neck, partially hidden by the unkempt black bear with a few strands of grey. His bunch of thugs sauntered up to the table and stood behind him. “What is this?”

“You’re not clean. This is surgery. Out.”

“Doctor, right?” The leader leaned over the patient.

“A doctor, yes, not a surgeon. He’ll live.”

“Clayton’s brother supplies medical supplies. He’s a legit cannabis salesman.  Taxpayer.” He smiled broadly. “A businessman with ties. A corporate man, while we smuggle guns, meds, everything else.” He raised his eyes to stare at me. “The sick pay you, what? Thousands of dollars, rather than spend more than double what you charge in a regular hospital. Very interesting.” He took a slow breath and winked. “What if you worked for us? How much for that service?”

“Can you put a price on freedom?” I focussed on tidying up the row of stitches.

“Would you prefer a price on your head?” The leader grinned a thin, black line.

“I help families to treat their children. I give them insulin, vaccines and basic treatment.” I was tired of the shit from the gangs. “What do I have? A clinic,” I indicated the walls around us, “not to shake their last dime, but to help them. Who else do they have?” I wiped antiseptic over the wounds and applied the gauze and tape. “I know how this goes. You want to control everything, and when you can’t, you shut them down. Do that and these families are doomed. What then? They come begging to you.” I took another breath. “And you give them something they can’t refuse.”

Black eyes stare at my facemask. I try not to look directly at him. He placed both hands on the table and lowered his eyes to the bandages, lifted one hand and ran it over the outside, slowed at every ridge of a stitch. The patient remained quiet, but the eyes widened, the pupils enlarged.

Fear. The same fear as the people who’d suffered the pandemic. One more victim of the failed system.

“Your oath says to help everybody who needs medical assistance, right? If I keep putting holes in people, and they keep coming to this clinic, your medical supplies run out. What then?” He turned his gaze to the boxes piled in the corner, to the half-filled trays in the storage rack, and down to the full trash bin. “Work for me, doc. You get a clean operating room, well-equipped. Bigger. Professional staff. Good pay. You get to treat people properly.” He rolled his shoulders. “Why insist on working in these inhuman conditions?”

The boys behind him squared their chests and he puffed himself up like a toad-fish. As tempting as the offer was, the bullying steeled my spine. I cleaned up the last of the blood from the patient’s body, gave him a final swipe of disinfectant and pulled his vest back over the evidence of his activities.

“You need to rest and drink – water, fluid, not alcohol. Try not to move too much. If you tear the stitches, you could bleed to death in a few minutes. Avoid any heavy physical activity.”

“No basketball?” the patient asked.

“No physical activity.” I looked at his girl and waited until she nodded. It probably wouldn’t do harm, but a bit of care from a loved one healed better than false hope. “Come back in ten days for the final check and removal.” Did I have to say it again? “No heavy objects, no heavy activity, nothing that causes stretching or pain. Okay?” I can only do so much. Advice, consolation, hope. Not much to offer, not nearly enough, but it was all I had.

The syringe I held up made the black man go grey around the eyes.

“What for?” he asked.

“Painkiller. You’ll like it.” Unauthorized, unmarked. The patient could buy it for under ten bucks on the street. It cost me double, but I couldn’t ask for money. I held up the box with three more vials. “Do you want it?”

The answer wasn’t direct. The patient looked to the leader first, and only after he nodded did he hold out his hand for it.

“Don’t abuse it,” I said. Surreal as it was, if I wanted to help the people who needed it, I had to carry on with the charade and let the gang access my services. Free. Option A – ask politely, treat me like a real person. Option B was their preferred option. A bit of fun, burn houses or the known warehouses, shoot up walls, leave bodies leading to me. I don’t need to feds to stop me working.

If they dug up the backyard, I’d be out of business and deregistered. Medical waste, gloves, bloody linens, syringes – all the stuff would land me a long stretch in a cold hole, whether prison or a ditch. Whether police or rivals.

Two of the henchmen tossed a few boxes to the floor as they left, frowned and wagged their fingers at me like I was a bad dog. Not like I’d just saved the life of one of their comrades. Clayton smoked a joint in the corner near the window, didn’t look at anyone. I snapped my gloves off and tossed them into the bin next to his feet. He didn’t move his eyes or his body.

“Logistics, Clayton. Your job, remember. Get more stock, better prices. I can’t keep giving it away.” I know he walked the edge of legal and criminal, closer to criminal more often. Sharks and crocodiles in all the waters. Life is a dangerous metaphor.

“Come on, Clayton. Let’s eat.” I threw him the sterile cloths and cleaned the desk, the door, anywhere they might have touched and gently rattled the boxes as I set them back in place.

No more patients came that day. None the next. None for the week.

Apart from the addicts who made up broken arms to get a fix, there were no patients.

A hooded man followed me from the clinic on Friday night. I took a different route home, ducked into alleys that were dark and close and lost him easily. The easiest to lose were cops, the hardest were the politicians’ lackeys. The government can pay better, have stronger motives.

A few days into the following week and I ran out of messages. No visitors, no calls. The clinic was as quiet as a morgue. At least there were no spontaneous and unexplained fires, the place didn’t get burgled, no taps left on while I wasn’t there. The old house remained standing and open for business.

On Wednesday, I dressed and checked my suitcase. I took the train to the city as always and walked to the clinic. Parked on the footpath in front was a black SUV with heavily tinted windows. I stopped with my foot halfway to the curb, held the suitcase to my chest.

Who would step out? An urban soldier, fed, gang soldier? Any one of them would riddle me with bullets for not following their rules. They’d leave me to bleed out as a message, a warning. I took a breath, lowered the case and lifted my chin. I walked toward the clinic. I’d seen worse. It wouldn’t be the worst death to wish for.

The passenger door opened. The leader who visited while I treated his soldier stepped out. Alone, hands folded across his chest. His blank gaze bored into me. Emotionless, cold. Well, two could play that game. I’d seen more death than this thug could imagine.

“Your friend hasn’t come about his stitches. I need to check if they’re healed or infected.” It wasn’t a thought that brought the words, just a reflex. I suppose doctors are like soldiers, it’s not a job that fits only into working hours.

“He used another doc.”

“He’s my patient.”

“Does that mean you’ll work for us?”

“No. I work with my patients. I like to check up that they’re okay. That’s all.”

He stood in front of the door to the clinic. I couldn’t get past him. We stood there, the stare not breaking for a full two minutes. Then he lifted his hand and knocked on the window of the car.

Two men got out. Reinforcements?

One went around the back and opened the trunk. Not a good sign. He took out a box and handed it to his comrade. I recognized the sign on the boxes. Cuban manufactured medical supplies. First-class goods.

The two men nodded at the door. I unlocked it and they carried the boxes upstairs.

“The pay for saving your man?” I asked.

“A gift, doc.” The leader waved his men out. “No more embargo. This is my area now. Secure. Although you don’t work for me, you can keep helping the locals, my people.”

“I’ll do my best.” Those supplies would certainly help a lot of them. “Why?” I had to know. The Devil was in the details, and if I didn’t ask, the Devil would make more of it than I cared to give. I smiled, but my throat was tight. I might not like the answer.

“Your accent, doc. I know where you come from, what you saw, what you did. No more problems with your clinic in my territory. Just talk to Clayton when you need more.” He waved as he walked out the door.

I pushed the door closed behind him, sank to the floor with a mix of relief and shock. The phone rang, and I jumped up to get it. A patient.

A dozen patients came that day. A dozen the next. Life returned to normal, an emotionally shattered doctor trying to patch the lives of the broken where possible.

Sometimes, I think about that day. It was an odd encounter, one I will remember. There were no more problems with the underground Medicaid system. No more delivery supply problems. Drugs became legal, even if the moral code was upside down. Life was Picasso’s Guernica, a broken image of a system failure.

System Failure cover

Cage Dunn was kind enough to play with my story and really bring it to shine. I just love what she did with it and I do aspire to be this good one day.

So, what do you think? Isn’t she a doll for giving this story a better spin?

4 thoughts on “System failure (Cage Dunn version)

  1. I think: black bear should be black beard. There are still a few minor niggles, but the final proofread is done after all the edit stages during review, revise, rewrite.

    I really enjoyed this story.

    Liked by 1 person

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