executioner’s song
Half a sheet of blizzard white paper protrudes from the lifeless mauve binder from which it is trying to escape. I am meant to free this paper. I will casually release the binding as though I have been releasing bindings and temporarily freeing papers such as this one for ages. I will make it seem perfunctory. Once removed I will survey the black freckles spotting the body of the paper. They are acquired traits formed from incestuous and careless copying done with total disregard for what once was. These freckles will require me to write boldly, to be decisive, to do what must be done in a manner that cannot be taken back. My eyes will scan the paper from top to bottom comparing it with the previous day’s paper of the same nature. I will see empty boxes to be checked which denote continuous or cyclic infusion, central or peripheral access, standard or custom solutions. I will see blank spaces for indications for use, for volume, for amounts of electrolytes and lipids, for insulin and pepcid. Most of these boxes and blank spaces I will quickly check and fill in, but I will carefully decide what I think to be the proper amounts of electrolytes because they can do funny things such as the following:
Increased extracellular potassium levels result in depolarization of the membrane potentials of cells. This depolarization opens some voltage-gated sodium channels, but not enough to generate an action potential. After a short while, the open sodium channels inactivate and become refractory, increasing the threshold to generate an action potential. This leads to the impairment of neuromuscular, cardiac, and gastrointestinal organ systems. Of most concern is the impairment of cardiac conduction which can result in ventricular fibrillation, asystole, and death.
Potassium Chloride is the last of three injections which are used to execute those who we have said deserve executing. Potassium Chloride sits next to a blank space on the freckled sheet I will fill in today.
But today will be different than other days because I will see the physician’s scrawl across the blank line that preceeds “M.D.” It is a blank check and I am a man who cannot be blamed. I am not yet credentialed and thus I will not face the consequences that could be wrought from this bag of could-be chaos. My name will never touch this sheet and any note I will write will be the responsibility of the credentialed person who has co-signed it.
My will is all that separates many from misery and one from nothingness and I am a man who cannot be blamed. Today I will choose whether to write my own executioner’s song. Imagine that.
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This piece was a work of fiction.
