The Patient with an Empty Diagnosis

By Chef Manen_Lyset


Last week, when I was taking a break in the middle of the graveyard shift at the hospital, one of the other nurses ran in looking rattled.

“Claire, I need you in room B,” he said, his face as white as the walls surrounding us.

I closed my book and craned my neck to peek into the ER. Being dragged off mid-break was nothing new, but it usually happened during an emergency, when all hands were needed on deck. This time, however, the ER was empty. There was one drunk sleeping it off across a row of benches, but aside from the sounds of his snores, everything was quiet. No one was prepping for the arrival of multiple casualties, either: if we’d gotten a call, there would already have been people lined up with gurneys by the door. Still, despite all appearances, Chris wouldn’t have come for me if it wasn’t important. I got up and headed out of the break room.

“What’s up, Chris?” I asked, as I followed him swiftly. If there was an emergency, every second counted.

Chris replied, “There’s a 40-something Caucasian male that came in. Seems in distress, but won’t let anyone near him.”

I raised a brow. “All right. Let’s have a look. Did the EMTs say anything about his condition?”

Chris shook his head. “He’s a walk-in. Came alone. Looked panicked, but wouldn’t say why,” he hesitated for a moment, “and there was something weird about the way he walked.”

I nodded. We didn’t always get great work-ups on patients, especially the walk-ins. With what little information Chris gave me, I could only assume the patient had hurt his leg or something like that. If I wanted to know what was going on, I’d have to examine him myself.

I entered Emergency Room B, and found the patient standing in the corner. He was tall –but not unnaturally so–, wore a fancy suit, polished black shoes, and white silk gloves. Every single button on his dress shirt had been done up. In fact, it looked uncomfortably tight. His collar pressed against his Adam’s apple so snugly I could only imagine it’d leave a mark. I could hear his strained, panicked breaths as he struggled to inhale through the constriction. Like many balding middle-aged men, his hair had gravitated to his chin, but I could still read the worry and terror through the bush hiding his tense facial features. His eyes darted side to side, like an antique cat clock.

If I had to guess based on his attire, my money would have been on a limo driver of some sort, but even then, the quality of his tailored suit seemed a few notches above their usual uniform.

“Hi sir. My name’s Claire, and this is Chris. We’re here to help you,” I said softly.

He twitched, but didn’t reply.

Chris whispered, “Hasn’t said a single word since he got here. Not one.”

I took a step forward, and saw the man’s jaw clenching in response. I lifted my hands non-threateningly and took another cautiously slow step.

“Listen, I’m here to help you, all right?”

My hand slowly slid down to my stethoscope. He watched me with almost impossibly dilated eyes, showing barely a sliver of his green irises. He must have been on some heavy drugs, I figured.

“Sir, I need to take your vitals. It won’t hurt, I promise.”

He continued to stare, but made no effort to escape as I bridged the distance between us. I pressed the chest piece against him, and slipped the earpieces on. I closed my eyes and listened, expecting to hear a thrashing heartbeat, but no heartbeat came. Instead, there was a constant, shallow, droning sound like the depths of the ocean, or the cosmic hum of solar radiation. I pulled my stethoscope back and touched it to my own chest to test it. It was working fine: I could hear the pitter-patter of my heart. Now almost as unnerved as Chris, I put the stethoscope back on our speechless patient. Still, all I heard was that same otherworldly noise.

Chris picked up the empty chart and looked at me. “Pulse?” he asked nervously.

I was torn between not scaring my patient, and giving Chris an honest reply. I hoped Chris would understand the subtle head shake I gave him. There was no reason for my patient not to have a heartbeat, though. He had to be alive: he was breathing, moving, and responding to what was happening around him. He was quiet, sure, but looked otherwise normal. Maybe the stethoscope couldn’t capture his heartbeat through the thick layers of his suit. I took a calming breath and reached my arm around back to try and slide it up his shirt. The man, however, stopped me. His arm swatted at mine, and though the impact was light and painless, the movement itself was enough to stop me in my tracks. I pulled away, sweat dripping from the sides of my face as I lifted my hands up again to show him I meant no harm. The way his arm had moved…it wasn’t normal. It was, in fact, distinctively abnormal.

I’m not sure how to describe it without making it sound stupid. But, you know those long, colorful, inflatable decorations outside of car dealerships? Those cylindrical men with goofy faces that flap around? As silly as this sounds, his arm movement reminded me of them. The way it bent, the ripple it sent through his clothes as he unravelled it, as though it were hollow inside…that’s the only imagery it evoked.

I wiped my brow and looked at the man. “All right. I’m sorry if I scared you. I just wanted to check your pulse.”

He shuddered. I could see that odd effect now again, this time, across his entire body. The way it moved wasn’t right. It was as though there was nothing but wind holding his suit in place.

I took a step back and grabbed Chris’ arm, pulling him out of the room for a one-on-one conversation.

“You said he was walking funny. What did you mean by that?” I asked, in a hushed and stressed tone.

Chris looked down. He didn’t seem to want to answer – he probably thought I wouldn’t believe him. “A flag on stilts.”


“His legs,” he furrowed his brows, “they looked like flags on stilts. Or like those orange cone things at the airport. Look, I know it sounds crazy, but-”

“I believe you,” I replied.

I could feel his relief as he let out a sigh. “Should I call a doctor?”


Chris stumbled down the hall. I’m not sure whether his rush was to get help as quickly as possible, or to distance himself from the man inside Examination Room B. I couldn’t blame him if it was the latter. Even I wanted to get away, and I’d seen all manner of horrors come through my ER over the years.

I peered into the room, but when I did, the stranger’s face was inches from my own. I yelled and jumped back. He recoiled in terror, inching back to his place in the corner of the room, his body not so much moving as it was flapping. He fell into the fetal position and held his head between his trembling hands.

“I’m sorry! You just startled me,” I said, regaining my composure.

His head slowly lifted and his eyes focussed on mine. Though no sound came out, his lips moved, and I could have sworn they were wording out a plea for help. But, just as I was about to answer, the doctor stormed in.

“I hear we’ve got a problem case on our hands,” she said, with the lack of a bedside manner typical of veterans of the ER.

“Doctor Ulmar, there’s something wro-”

“Well, come now. Stand up,” she barked at the patient.

If waves could turn broken pieces of a beer bottle into smooth rocks, then the ER could do the opposite to the empathy of their staff. Especially when the doctor in question had been on duty for almost 48 hours.

The man stayed in place, clamming up now more than ever.

“I can’t examine you on the floor, sir,” Doctor Ulmar said dryly. “If you want treatment, you’re going to have to cooperate.”

I chewed at the insides of my cheeks. It wasn’t typically a nurse’s place to speak up against a doctor, but I had years of seniority under my belt. Still, I used my authority sparingly. It was imperative to maintain a ‘pleasant’ working environment.

“Doctor Ulmar, you’re scaring him.”

She let out an insulted huff. “Get him on the bed.”

I nodded and knelt down in front of the suited stranger. “We need to move you. I promise, we’ll make you all better, okay?”

He shook his head, lips quivering and eyes showing both desperation and nearly tangible fear.

“We won’t hurt you,” I whispered.

I could feel the doctor’s patience waning.

I held out my hand. “Come on, let’s get you up.”

He moved. Just barely, but I could tell he was about to reach for my hand and get up. It seemed, however, that doctor Ulmar had waited long enough. Without warning, she stomped over to us, grabbed his arm, and pulled.

I can’t tell you for sure how it went down. It all happened so fast. I know one of the buttons on his dress shirt came off: I found it later under the bed as I was clearing the room. I think doctor Ulmar tugged so hard it popped off, and his shirt opened just a crack. I heard the sound of a deflating balloon as I felt a rush of scorching hot air fizzle out of my patient. Then, his figure seemed to shrivel, and I heard something hit the floor. Doctor Ulmar let out an uncharacteristic scream as she stumbled back and looked at the scene. I, on the other hand, stared in shock at the pile of clothes laying in front of me.

There was a bulge in the middle of it. I reached for the suit and gently pulled it up like a used tablecloth. There, under the soft fabric, was his head, a length of spine dangling from it.

I don’t know if I screamed, or if the shock was so great that I went emotionally numb. I just remember looking at the now blank, lifeless head as it rocked back and forth to a stop. There was no blood, no smell, and no groans of agony. Just a perfectly –almost surgically– decapitated head, and an empty suit.

No ID was found on the man, no one showed up looking for him, and, without hands, it was impossible to run his prints. As far as I know, his head was sent to the coroner for an autopsy, where it has since either been preserved or disposed of. I’ll probably never know what happened to him, but based on the fear I saw in his eyes, I have a feeling whatever it was, it wasn’t intentional.


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