Sneak Peek of OVERDOSE

Medical intern Matt Robbins knew it was wrong, stupid—maybe even deadly—but in that moment, he wanted to feel the surge of fentanyl in his system as much as he had wanted anything in his life.

Sitting on the edge of the thin mattress in the cramped call room, he tried but couldn’t beat back this intense desire. It went against all the rules, against everything he had ever been taught. It’s not too late, just get rid of it. Flush it. But even as these thoughts were circling in his brain, he was cinching the tourniquet on his upper arm to raise a vein.

Would Julie really leave me for good? He couldn’t believe he’d managed to screw things up so completely. And so fast. A year ago, his life had been all mapped out: Finish med school and get his MD; match to a great anesthesia residency; eventually get married and raise a family. Now it was all falling apart.

With shaking hands, he cracked the glass ampule and drew up 5cc of the narcotic into the syringe.

The trouble began when Julie, at that time his girlfriend, had become pregnant, despite their taking every precaution. How the hell did they let that happen? We were both med students! They had been going out for more than a year, and had even moved in together, but getting pregnant wasn’t part of the plan. Not yet, anyway. The pregnancy was a surprise, but they figured their love for each other would be enough to see them through, so they got married. Matt wasn’t too worried—Julie was funny and sexy and they were good together. Really good.

The tourniquet was doing its job and several nice plump blood vessels stood up in his antecubital space. Is that the cephalic vein? Or basilic? Does it matter?

Amanda was born five months ago, and her arrival had rocked his world. He felt a depth of love for this adorable, helpless little person that shocked him. He vowed to be the best father ever. No more living for the moment or mindless pleasure-seeking. The concept of caring deeply for another, providing everything and expecting nothing in return, suddenly made perfect sense to him.

Swept up in this tidal wave of emotion was his love for Julie, who had been amused and delighted by his near-instantaneous conversion to loving parent. It was a journey she had started months earlier, when she had discovered she was pregnant. Things would be tough for a while, but Julie volunteered to put her education and career on hold to look after Amanda while Matt finished out his residency. The generosity of this gesture astonished him, and his feelings for her grew even stronger. Yes, their lives had detoured from the planned route, but life seemed good.

Matt cleansed the skin over the distended vein with an alcohol pad.

Not long after Amanda’s birth, the initial rush of love and dreamy notions of a life lived entirely for another person crashed headlong into the reality of Matt’s intern year. The crushing stress of it took them both by surprise. On top of being newlyweds and new parents, Matt routinely had to work grueling, thirty-hour shifts and Julie had to care for their colicky newborn alone, all day and frequently all night.

Matt’s month-long rotation through oncology proved to be the worst stretch. He routinely had twenty to thirty patients to keep track of, and when it was his turn to take call—every third night—he picked up all the patients from the two other interns on the service. These patients were all sicker than anyone he’d ever seen, and most would be lucky to leave the hospital alive. Matt was not equipped to manage the emotional toll of being surrounded by all that suffering, and he frequently brought that pain home with him.

 Another factor he and Julie couldn’t have foreseen was the debilitating effect sleep deprivation had on the mind. Those initial, sparkly thoughts of a blissful parenthood caring for a precious newborn were buried under an avalanche of raw survival instincts. The small fragments of time they spent together frequently devolved into bickering, often about things they couldn’t even recall a few hours later. Matt suddenly understood why the military used sleep deprivation to break down prisoners—he would have done almost anything in return for just three or four hours of uninterrupted slumber.

A month ago, as he was lying down in this same call room trying to snag an hour or two of sleep—a near impossible feat, knowing that the next beeper alert or phone call could be just moments away—he heard a knock on the door. Caught in the liminal twilight between exhaustion and sleep, he wondered if he was dreaming.

“Come in,” he said, clearing his throat. “It’s open.”

“Hi, sorry to bother you,” the nurse said. At first, he couldn’t recall her name. Sherry? Shelly? “I just wanted to bring you Mrs. Peabody’s blood gas result.”

This struck him as odd. He was waiting for this result, but wouldn’t a phone call have sufficed? His sluggish brain failed to make sense of this. “Uh, thanks.”

“Wow, you look so beat up. I just feel so-o bad for you. I wish I could comfort you in some way.”

“Well, it was nice of you to bring Mrs. Peabody’s test result . . . ”

He was moved by her kindness, even as he heard alarm bells ringing faintly in the back of his battered mind. He remembered her name now—Sharon. The two used to flirt shamelessly at med school parties. But then she had moved back to the main campus at State College, and he had met Julie.

As these fragments of memory slowly came together, Sharon sat down next to him on the cot and hugged him tightly. Instinctively he hugged her back, the dreamlike feeling from earlier reasserting itself. But instead of disengaging afterward, she leaned in and kissed him on the mouth. Within minutes, their clothes were off and any thoughts of Mrs. Peabody were forgotten as their bodies connected.

The following day, Matt straggled home after his shift, exhausted but also sick with guilt. He had cheated on Julie despite his resolution to be a better man, for her and for Amanda. When he got home, Julie asked how his call shift had gone and he instantly broke down in sobs and confessed what had happened. The look of pain and betrayal on Julie’s face would haunt him forever. After the shouting and the long, uncomfortable silence that followed, she said she was going to take Amanda to her mom’s place for a while.

“OK,” he muttered, at a loss to do anything but accept her terms.

That was a month ago and there was still no sign of her returning. Sharon had been eager to keep talking to him when they passed each other in the hospital hallways, but he immediately shut that down. Now she, too, seemed to want nothing to do with him. Which was mostly a relief.

He barely felt the needle pierce the skin. Withdrawing the plunger of the syringe a little, he advanced the needle. He saw a flash of his blood as it was sucked back into the syringe, swirling around, mixing with the fentanyl in the barrel. He hesitated, transfixed by the sight. He simultaneously did and did not want to push the plunger, and his fingers trembled, trapped between those two urges. Voices in his head were screaming at him not to do it, but the feelings of self-loathing and despair were too much to resist and he injected the full contents of the syringe. The medical part of his brain wondered if the dose would kill him.

The emotional part of his mind didn’t care.