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and interlacing issues with their organs or chemistry, and each responded uniquely. It was a busy spring, and Charlie was less interested in names than in causes and effects.
    Michael Strenko was young for the unit, their only patient with hair gel, and his illness was particularly upsetting to the nurses. The twenty-one-year-old Seton Hall computer sciences student had a genetic autoimmune disease that cascaded into complicated symptoms and system failures. Amy, back on the unit from a pacemaker surgery and bed rest, was deeply worried that young Michael wouldn’t survive. Charlie was sure of it.
    In the end, it had been digoxin, or epinephrine, or some combination which had put Strenko over the edge—the sick were so precariously balanced, it only took a little push, a sigh that floats a feather, a nudge so subtle and dispersed that nobody noticed the cause, only marveled at the effect. The codes that night were multiple, and not pretty. After the second, Charlie shuffled out to the waiting room to find Michael’s terrified mother, giving her a graphic and technically accurate word picture of what was happening, at that very moment, inside her son’s dying body. He explained how the EKG indicated the failing pulses in his heart, and how you could affect those pulses with drugs, norepinephrine or digoxin, up or down, depending. He told Mrs. Strenko that Michael was sick, and that sick people, like it or not, eventually died.
    Michael’s parents were horrified by this rendering, and they asked Charlie to leave. But Charlie was right. And at approximately 2 a.m. on May 15, when Mrs. Strenko finally waved off the last shock paddle from her son’s exhausted body, the flatline proved it.

    S he didn’t set out to make a stink, but Amy questioned everything. Amy figured, if that made her a pain in the ass, if sometimes she went too far and wasn’t nice about it, then fine, at least she wasn’t cattle. That was her, she always said so, a hotheaded, reactionary bigmouthed girl with a temper, but not cattle. She wouldn’t just go along. They heard about her all the way down in Oncology: Amy, the ICU nurse who refused the exasperating new safety protocol, the one who wouldn’t put her name on their new insulin sign-out sheet. That told her what a big deal she was making—you practically needed a shuttle bus to get from the ICU to Oncology.
    They were calling the new drug protocol an “insulin adjustment form.” Her manager, Val, had explained it, trying to convince Amy to sign. Previously, the insulin had always just been there in the little fridge. But now for some reason they were changing the protocol, making the nurses moreaccountable by forcing them to put their electronic signature on their guess as to how much was left in the vial. Amy thought it was inaccurate and stupid. How could she eyeball exactly how much was left? They were asking her to bet her nursing license on a jellybean counting contest. Clearly, something had happened, on her unit, possibly to her patients. Amy demanded to know what was going on, but her supervisor wasn’t about to tell her. Why treat insulin like a narcotic? Amy demanded. What was so dangerous about insulin?
    When her manager wouldn’t answer, Amy refused to cooperate. Val said “Sign,” and Amy said no. “Just do it,” Val said. Amy wouldn’t.
    Now Val was angry, too. Amy didn’t understand the reaction. Why the hell get so worked up over a simple piece of protocol—what, did somebody die?
    Val was practically screaming as she finally told Amy, “Look, just sign it—this whole thing isn’t about you, anyway!”
    What did that mean? Who was this about?
    At the time, Amy did not connect the new protocol requirements with the sudden frequency of codes. All she knew was she was wrapping so many bodies now, probably more in the past half year than during her entire career. She had no idea there was a problem, much less did she imagine that Charlie, or anyone, was the cause.