Sixteen Minutes

Irene Holcomb had been dying for twenty-two days when Philip Chambers walked into bay four and told me I was out of time.

I was adjusting her morphine drip — slow work, two-handed, nothing to rush — when he appeared in the doorway with his tablet and his lanyard and his expression that was trying hard to be neutral. He looked at Irene before he looked at me. That was the part I wished he hadn’t done. It meant he knew exactly what he was asking. I'd had the unsigned consent form in my scrubs pocket since the previous Friday. Irene was asleep, or close to it.

"End of shift," he said. "I need your signature on the supplement form."

I didn't answer him. I finished what I was doing, checked the flow rate, noted it. He waited, which I will give him credit for.

"The accommodation expires today," he said. "Hospital policy is clear. All clinical staff in palliative are required to be compliant by May 15th. That's today."

The supplement was an affective modulator, a chip about the size of a nickel worn against the neck. I knew what it did — I'd read every paper. I'd been filing hardship extensions for most of a year, citing incomplete long-term data on vagus nerve interface effects, which was true. That wasn't the real reason.

"I'll review it," I said.

"Audrey." He looked at Irene's chart, not at me. "We've had this conversation."

We had. More than once. He wasn't wrong.

He left. I pulled the chair up next to Irene's bed and sat for a while listening to her breathe. She had COPD and late-stage cardiac failure and a general exhaustion with her body that she'd described, on a good day, as a fight she'd decided wasn't worth finishing. She was seventy-eight. She had two daughters and a son, all of whom had been here yesterday and would be back today. She had, on her intake form, checked the box for unaugmented staff.

She opened her eyes.

"Was that Chambers again?" she asked.

"Yes."

"He has very squeaky shoes."

I smiled. She did too.

"Today's the day," I said.

"I know." She'd known since last week, when I told her about the deadline. She hadn't asked me to refuse. She wasn't the type. "What are you going to do?"

I said I didn't know, and I meant it. The real reason I'd been refusing was my father, who'd died in 2038, in a room a lot like this one, and who'd asked me during one of his lucid stretches whether the nurses here felt anything. I'd said yes. He'd said it didn't seem like it. He died in November. I submitted my first extension request in December.

I'd told myself I was protecting something: that if I refused the mod, the emotional weight of these rooms would reach me the way it was supposed to. I wasn't sure that was true. I wasn't sure it wasn't.

Irene shifted against her pillow. I poured her water, held the cup while she drank, set it back.

"My second husband wore a hearing aid," she said. "He hated it. Four years he refused it. Thought it made him less himself."

"Did he adjust?"

"He said it was the best decision he'd ever made." She closed her eyes. "Also said he wished he'd done it sooner."

She was quiet for a moment. Then: "My older daughter cried the whole drive here yesterday. I could tell when she walked in, even though she'd washed her face." She turned her head toward the window. "I don't know what to say to her. I keep thinking I should know by now."

I told her I didn't think there was a right thing.

"I know," she said. "I'm just talking."

Her daughters came at eleven. I stepped out, charted, went through the rest of the ward. At twelve-thirty I went to the break room and sat with the unsigned consent form on my tablet and the supplement in a small envelope from supply where it had been sitting for six weeks. The envelope was still sealed.

I sat there without touching it for a while. Compliance meant the signed form, not just wearing the supplement — you could put the chip on and take it off, it wasn't monitored. What mattered to Chambers was the paperwork. I'd known that distinction for months and never done anything with it.

I thought about my father asking if the nurses felt anything. I thought about the answer I'd given him. I thought about four years of extensions that kept proving I didn't need the supplement, and whether I'd spent those years actually being more present in these rooms, or just more uncomfortable in them. Those probably weren't the same thing.

I opened the envelope. The chip was about the size of a coin and lighter than I expected. I pressed it against my neck where the diagram showed and it adhered, and for a few seconds nothing changed.

Then the tightness in my chest — the thing that rose whenever I walked into a room where someone was close to the end — eased off. It didn't go away. It just stopped pulling at me. I was still there, still aware of what the afternoon would ask. I just wasn't bracing against it.

I sat with that for a while.

I went back to bay four at two. Irene's daughters were on either side of the bed. Her breathing had changed — longer gaps between, shorter draws. Her son arrived at 2:40. He stood by the window with his phone face-down in his hand.

I didn't leave the room.

What the supplement took away wasn't the feeling. It took away the part where I kept looking at the door. I stayed because I could stay — without rationing myself against it. She'd asked for an unaugmented nurse. I wasn't that anymore. I stayed anyway.

She died at 4:07. Her son held one hand and her older daughter held the other. I was near the door in case anyone needed anything, and nobody did.

In the hallway afterward, I filed the signed consent form. The system logged it at 4:23. Sixteen minutes after Irene died. I had waited until after, though I couldn’t have said exactly what I thought that proved.

I went back in for post-care documentation and to make sure the family had what they needed. Her older daughter thanked me. I said I was glad I'd been there.

Her hand had been warm when I'd checked her pulse, earlier. I remembered that. I'd been present for it.