The snow fell everywhere.

It’d been falling since well before dawn. By the time Alex found the flat brick building, the sign for Treeline Surgical Care was half buried. Alex did his best to navigate the maze of snowdrifts and find a parking space between the partially covered cars that had arrived before him.

He found a space, but it wasn’t close to the building. Alex opened his door to a rush of cold. He stepped out and hurried towards the entrance. He bent forward against a gust of wind, hunching down into his coat as best he could. Even with his jacket’s lapels up, the blowing snow found plenty of gaps; sliding down his collar, into his dress shoes, up his pant legs, down into his socks. Snow crusted his eyebrows and hair. By the time he reached the double doors to the lobby, he was chilled and soaking.

The double doors slid open onto the lobby, and Alex quickly stepped inside, almost stumbling but grateful to find shelter from the storm. He stood for a moment, dripping onto scuffed linoleum. The lobby was unremarkable; faded green walls that once might have been chosen to seem professional or medicinal but not repainted for decades. One of the bare fluorescent tubes overhead was buzzing and flickering wildly, an obvious annoyance nobody had fixed. But it wasn’t snowing inside, so it was an improvement. The doors sighed closed behind him.

The lobby was not calm. Two phones at the reception desk were ringing constantly, but not being answered by either of the women who sat there. They ignored the noise, frantically moving papers from one pile to another. Two other women in scrubs hurried by the desk, their arms full of paperwork and folders, arguing in loud fragments about charts and a whiteboard. A man in a puffy coat was sitting in a chair, talking loudly into a cell phone, dripping melting slow onto the seat.

One of the receptionists looked up at Alex as he approached, glancing at his coat and tie, and the snow that had accumulated on him. “I’m Alex Mitchell, starting as a new admin…”

Without waiting for him to finish, the receptionist looked back down at her papers and pointed down the hallway to her right.

“HR,” she said, and didn’t react at all when Alex thanked her. The two phones kept ringing.

Alex went where she pointed, leaving the incessant ringing behind. The hallway smelled faintly of bleach. The green walls bore small signs printed in some industrial font: Billing, Records, two bathrooms, Staff Break Room. Alex passed a door labeled “IT”, and heard angry voices inside. Finally, at the end of the hall, HR. The door was propped half open.

“Mr. Mitchell?” The voice came before Alex saw the speaker. “You’re late.”

Linda Hartwell stepped into the hallway, a clipboard tucked under her arm, and extended her hand for a brisk handshake. She was in her late 40s, her brown hair pulled back in a bun, a neat blouse, and reading glasses pushed up on her nose. Alex could feel her look him up and down, and felt like she was judging his posture.

“The storm,” Alex began.

“Yes, I see that.” Linda said. “Come in. Don’t worry about the floor.”

She turned crisply and disappeared back into her office, leaving Alex to follow. The office was small and crowded; beige metal cabinets along one wall, chairs scattered near the door and the desk, a single small window in back with a view of overcast sky and blowing snow. Linda’s desk itself, though, was obsessively clean, a pen, a stapler and the clipboard she placed squarely in the center. Alex could see the cover sheet was labeled “Mitchell, A.”.

Snow slid off Alex’s coat onto the floor as Alex sat down in the chair that looked appropriate. He could feel melted snow trickling down his back. Linda didn’t comment and began to turn pages of the clipboard.

“I-9, good. W-4 for withholding, Confidentiality agreement, looks fine…” she flipped through the paperwork methodically, going down a mental checklist she’d obviously used a hundred times. “HIPAA training acknowledgement, Computer use policy…” she looked up “We’re having some computer problems today, so we’ll have to get you onboarded to the system when we get it back up.” Alex nodded as Linda went back to her checklist.

“Emergency contact… you didn’t complete the second page.” She slid the form across to him. “Signature here, initial here,” handing him a pen. Alex fumbled for a moment then signed and slid it back.

“Everything looks in order, except for your medical form. I’ll need your physical results before I can issue you a badge.”

“Oh,” Alex said. “I couldn’t get to see my doctor in time. I can bring the form back before the end of the week.”

Linda set her pen down. “Company policy requires a pre-employment physical and basic blood work before allowing access to patient areas. You’ll obviously need access to patient areas to run files.”

She sighed loudly, and Alex got the sense the frustration was with him and not with the policy. “I’ll need you cleared before you can do your job.”

“Luckily… because of the storm, I think we can do this.” Linda said. She pushed her glasses up her nose with a knuckle. “Half of our scheduled procedures cancelled this morning. Patients aren’t coming in, and more than a few staff aren’t either. The storm has left us short-handed. But I think with the gaps, a physical and a blood draw a well within our capabilities.”

“I don’t want to be any trouble.”

“It’s not any trouble, it’s efficient. There’s no sense sending you away for something we can handle.” Linda slid the clipboard to the side, a gesture of closure. “One of our nurse practitioners can see you between other patients. You’ll be in and out, and we can get you working before lunch. We need the hands today of all days, with the computers out.”

Alex opened his mouth, probably to argue. He’d prefer his own doctor, and the impression he’d gotten of this office so far wasn’t a good one. He’d expected to have an easy first day, learning the computer and file system and basics of billing and so forth. That was not what he’d gotten. But Linda was already rising from her chair, and Alex closed his mouth without objecting further.

“You’ve started on not our best day. The storm has made everything worse,” she said, roughly echoing his thoughts. “But we can get back on track. Follow me.” Alex wasn’t happy with this situation, but it was clear the decision had been made.

Linda led him back into the corridor, walking quickly, assuming he’d keep up.

They walked back towards the ringing phones, and then took a sharp turn, through a set of doors that swung on stiff hinges. Behind the doors was another pale green corridor. This one was wider, and more chaos was immediately visible. A janitor mopped melted snow off the floor. A cart of folded linens had been abandoned in the middle of the hallway, and a technician hunched nearby tapping on a laptop that didn’t seem to be working, muttering to himself. An intercom crackled overhead; a woman’s voice, compressed and barely intelligible, calling a name Alex couldn’t understand.

The hallway took a bend, and Linda pressed on through another pair of swinging doors, which only opened when Linda scanned her ID badge. This door was marked “Staff And Patients Only”. Alex figured that he was staff already.

The doors opened into a long, rectangular room filled with the sound of voices and beeps of machines. A nurse’s station sat directly in front of them, along with a large, rolling whiteboard. The whiteboard was enormous, nearly floor to ceiling, and had been divided into rows and columns with black electrical tape. What sounded like room names or locations ran down the leftmost column; Bays and ORs organized by number. 30 minute timeslots ran along the top. Patient names and medical abbreviations filled less than half the slots in four different colors. Many had been poorly erased or crossed out, leaving multicolored smudges. A nurse in pale blue scrubs was working with an eraser in one hand and a marker in the other, and Alex watched as she wrote a name in a space, OR 2 at 11:30.

“See?” Linda said, pausing in front of the board. “Half the schedule gone today. Some patients calling but most just not showing up, maybe stuck on the highway. But it’s a mercy because more than half of the staff didn’t make it, too.”

The nurse at the whiteboard glanced at them without interest, and turned back to her task.

Linda turned away from the board and the nurse’s station. The room had been divided along both long walls into narrow bays, each one curtained off with a heavy mint-green fabric hanging from a track along the ceiling. Some of the curtains were pulled shut; filled with patients waiting or being examined. But others were open and obviously empty, with white gurneys made up waiting for patients that hadn’t shown. Nurses in matching sky-blue scrubs moved between the bays, disappearing behind the curtains with clipboards or plastic basins in their hands. None of them looked at him or Linda; there were not a lot of nurses relative to the number of bays and they all seemed busy.

Linda led Alex down the long axis of the room, scanning the numbers stenciled on little signs above each curtain. She stopped at one marked 14. She drew the fabric back on its track with a rattle.

“Here we are, Bay 14.” The bay was small; barely big enough for the furniture inside. A narrow gurney was pushed up against the wall with a folded hospital gown laid crisply on the white pillow. A plastic chair sat nearby, near a small metal tray-table and a small electronic scale. A rolling cart with an apparently inoperative computer monitor was crammed into the corner.

“Coat on the hook,” Linda pointed to a hook on the wall. “Gown on, the ties go in the back. The NP will be along.”

Alex looked skeptically at the gown. It was a pale off-white, like every other medical gown he’d ever seen. It was patterned faintly with tiny blue diamonds. ”Is the gown really… ?” He trailed off.

“It’s nothing we all haven’t seen,” Linda gave him a smile that somehow seemed condescending. “And you’re soaked through, Mr. Mitchell. Take off those wet clothes.” She was already turning, half out of the bay. “I’ll track down one of the NPs and get her over here. Sit tight.”

The curtain swept closed behind her with a rattle.

Alex stood for a long moment in front of the gurney. But Linda was right; he was soaked. And there was no point in being demure here, even in the unexpected situation he found himself. He didn’t really want to do this, but better to get through it and get to work properly.

Shrugging out of his coat, Alex hung the heavy, damp garment on the hook as he’d been instructed. He methodically removed his layers; he peeled off his shirt and tie, his undershirt, and his pants. He took out his phone and his wallet and left them on the chair, then folded everything and made a small pile. He wanted to give his new coworkers a good impression in this odd situation, and made sure the pile of his wet clothes looked neat and orderly. He pulled off both his socks and shoes, leaving damp footprints on the green floor. After a minute’s hesitation, he removed his underwear, too. He was already feeling fairly vulnerable, and he wasn’t sure if he was supposed to, but they were soaked through.

Taking the gown from the gurney, he shook it open, sliding his arms into it. The short-sleeved gown hung down to his knees. Reaching behind himself, he fumbled with the ties and was relived when he managed to secure two of them. Only a small gap was still open down his back, a far better result than he’d feared.

Alex turned and sat down on the side of the gurney to wait.

And waited. He spent a few minutes listening to the sounds beyond the curtain. It still sounded busy out there, with plenty of footsteps going by every few seconds. Somewhere an alarm pinged. A woman’s voice was reassuring someone in a neighboring bay, too faint to fully make out the worlds. Nurses loudly discussing time slots with a shorthand he could hear clearly, but didn’t understand. More footsteps and a rolling cart went past.

Minutes passed. Five, ten, more.

Finally, the curtain twitched aside. A woman in wrinkled scrubs peered in. She was stocky and solid, maybe in her forties, and carried a noticeably large pile of folders. She had the tired eyes of someone who had been on her feet since the early morning.

“Oh, hon,” she said, surveying him. “Been waiting long?”

“A little while,” Alex said.

She frowned. She glanced at the files she was holding, frowned harder, and stepped over to the dark computer cart beside the gurney. She tapped a key. Tapped it again. The screen stayed dark and unhelpful.

“System’s still down,” she explained, as if this wasn’t obvious. “Lord give me strength.”

“Bay 14, Bay 14. Okay. We’ll get you.” She glanced up at him and smiled a small, tired, reassuring smile. “Sorry for the delay. Storm’s got us all sideways. Someone’s coming.”

Alex opened his mouth, to ask how much longer until the NP was available, but she was already stepping back out of the bay. He heard her raise her voice, yelling down to the nurse's station.

“Ashley! Honey! You got a minute? I got Bay 14 still sitting here. Can you get him handled?”

Somewhere beyond the curtain, a cheerful voice answered. “Sure, I’m free now!”

More footsteps and then the curtain swept back on its track again. A woman came through, holding a clipboard and a plastic tub of supplies. She was wearing the same light blue scrubs that Alex had seen on other nurses. Around her neck was a black stethoscope, and on her head she wore a bright orange scrub cap, patterned in cartoon cats. Her skin was a warm brown and her face was round and encouraging. Alex smiled to match the smile the new nurse had on her face. Alex found the cheerful cap and her smile reassuring.

“Oh, I’m so sorry for the wait,” she said, a slight southern accent, more noticeable than the other people Alex had interacted with today. She pulled the curtain closed behind her in a practiced, one-handed motion. “It is absolutely wild out there today. The storm, the computers, the schedule, don’t even get me started. But I’m here now and we’re gonna get you squared away, all right?”

“Are you a nurse practitioner?” Alex started. “I think I was supposed to…”

“I’m Ashley,” she said, already moving about her tasks. She set the tub and clipboard down on the tray-table and flipped through the top two pages with one quick thumb. “All of the nurses who made it in are running flat-out this morning. We’ll have you taken care of in no time.”

“Let me see,” Ashley said, glancing up from her form at him for a moment, then back down. “Can you tell me your name and date of birth, please?”

He gave them. Rather than check his information against the dark, nonfunctional computer, Ashley wrote them down in small tidy block letters across the top of the first page.

“All right,” she said, brisk but warm. “Let’s do the boring stuff first. You mind hopping on that scale for me, sweetie?”

At the side of the bay was a small, electronic scale, not unlike the cheap one in Alex’s apartment. Alex stood up and stepped onto it, conscious of the gap at the back of his gown, the cool air on his spine. In a minute, the LCD flashed out the number. Ashley wrote a number down.

“Thank you. Back on the bed for me.” She patted the gurney. “You’re gonna feel a little squeeze here.” Alex saw that she’d pulled on a pair of violet-colored gloves as he’d been on the scale, moving quickly.

She produced a blood pressure cuff from where it had been coiled in a stand on the bed’s headboard, opening its Velcro with a scraping rip, and wrapped it around his upper arm. Ashley took the stethoscope from her neck, and carefully positioned it in her ears and then on his arm. The cuff tightened around his biceps in slow increments until his pulse drummed loudly in her ears. Her eyes were on the analog gauge, and she let the cuff hiss back down.

“A little high,” she said, making a note, “but that’s to be expected, hon. Weather like this, new place, unusual situation, normal to be a little high. Nothing to worry about.”

She slid a plastic probe cover onto a digital thermometer and slipped the tip under his tongue. It beeped a few moments later with a quick chirp. She read it, wrote it down. She produced a pulse oximeter and clipped it onto the tip of his index finger, and watched the glowing red numbers settle. She wrote them down too. Each gesture was unhurried but quick, the result of having done this many times. It was more or less the same things that Alex had expected from his own doctor, and this reassured him.

“Open wide for me, sweetie, and tilt your head back.” She produced a small penlight from a pocket of her scrub top and clicked it on. “Just going to take a look in your mouth. There we go.”

He opened his mouth. She leaned in, pointing the light. Alex wasn’t sure what she was looking for, but this was easy enough, and he was eager to get this over with. Her gloved fingers pressed gently along the sides of his neck, palpating beneath his jaw.

“Beautiful,” she said, clicking the penlight off. “Nice and clear. All right, I’m gonna go ahead and get you an IV started. Just a little needle. You all right with needles? Some folks aren’t.”

“I’m fine with needles,” Alex said. He watched her lay out more supplies from her plastic container. “Is that… I mean, blood work, right?”

“Just like that, “ Ashley said, cheerfully, laying out a small clear adhesive square and setting it aside. Alex watched as she opened and staged a needle and a small plastic catheter. An alcohol prep pad came out of its packet, and she began swabbing the back of his left hand in slow concentric spirals.

“Make a fist for me, Alex?” Alex obeyed as the nurse picked up her small blue tourniquet.

The curtain scraped open before she could tie the tourniquet, and a younger nurse stepped half into the bay. She was slight, early twenties, with dark hair scraped back into a tight low ponytail and no makeup to speak of. Her scrubs were a slightly different color; a flat navy blue. The new nurse’s eyes seemed to slide over Alex, she focused entirely on Ashley.

“Ash,” the younger nurse said. “Dr. Moreno’s stuck in that thing over in OR 1, the GI. Gonna be at least thirty minutes. OR 2’s done, though. They’re turning it over now.”

“Good,” Ashley said without looking up. “Gives us a minute to breathe, at least.” She tightened the tourniquet around Alex’s forearm with a small snap.

The new nurse produced a syringe from a scrub pocket and held the syringe out. Something Ashley had forgotten, Alex assumed. Ashley took it without ceremony and set it on the edge of the tray beside the open, readied catheter.

“Hi,” Alex said, uncertainly, drawing the new nurse’s attention for the first time.

“Hi,” the young nurse said, and flashed him a quick, professional smile. “I‘m Nicole. I’ll see you in a bit.”

Alex agreed; it was an odd way to meet his new coworkers but what first day isn’t awkward? Nicole was already leaving. The curtain moved again behind her.

“Oh, what a day,” Ashley said, clearly just to herself, and then, louder, to Alex: “Little stick now. Deep breath.”

He breathed in. Ashley, with her purple-gloved fingers, pulled the skin taut with her thumb. The needle slid in with a small pinch. She advanced the plastic catheter, withdrew the needle, and with movements almost too quick for him to follow, she had an extension tube with a port pressed onto the hub and the transparent dressing pressed smooth over the site, holding it all in place. The blue elastic tourniquet came off with another small snap.

“Almost done,” Ashley said. “You’re doing great, hon.”

She picked up the small syringe that Nicole had left. She uncapped it and fitted it into the port on the IV and pressed the plunger down. Alex felt a faint coolness as the clear liquid flowed through the line. It took only two seconds, by all appearances a normal part of getting an IV working. She withdrew the empty syringe and dropped it into a red plastic sharps container on the wall.

“All right, hon,” she said. She patted his knee through the gown. “You go ahead and lie back. Nicole’s gonna come get you in just a bit. Okay?”

For the first time, this seemed odd to Alex. Ashley hadn’t taken any blood yet. Alex began to ask the nurse if she was forgetting to do it, but again Nurse Ashley was moving quick. Too quick. Ashley tucked the clipboard back under her arm, and hustled out of the bay, leaving him alone before he could finish the thought.

Alex sat on the edge of the gurney, the IV now taped into the back of his hand under the dressing. Ashley had done the whole exam but no vial had been drawn. Why was he not done? Was that why she’d said Nicole was coming back?

The last few seconds didn’t make any sense. Alex was starting to feel something was wrong. It occurred to him that he’d never actually explained why he was here. But Ashley’s clipboard had his employment form on it, right?

But… he should just make sure they knew what he needed done, get the forms signed, and go find Linda again. He decided to follow Ashley; he could get up and go after his new coworker; even wearing the gown, he could just walk out and ask. He didn’t really want to walk around in his half-dressed state, but he could swallow his embarrassment. That’d be the wisest thing to do.

He leaned forward on the gurney, making to stand up. But as he did, a wave of dizziness hit him. The green fabric around the bay seemed to rotate, as if he’d stood up too fast. He felt lightheaded. Alex paused, waiting for the feeling to pass. But it didn’t pass. Instead, the room began to sway. The room tipped sideways a few inches, then tipped back the other way. Then the rotating got more intense.

And he couldn’t remember what he’d been doing. Why had he wanted to go anywhere? The confusion brought with it a moment of fear; what was happening to him? But a second later, the fear and confusion seemed… softer. Everything seemed softer.

Next thing he knew the thin pillow was pressed against the back of his head, and he looked up at the ceiling. He had no memory of lying down, as if he’d fallen or teleported slightly backwards. This didn’t concern him much, either. Someone had told him to lie down, hadn’t they? He pulled his legs up onto the gurney. He had a deep sense that everything was alright. He’d just take a little rest and then everything would start to make sense.

The green curtains rotating slowly around him started to look slightly gray. No, it was more than that; the whole world was starting to feel gray. The color reminded him of an overcast sky.

For a little bit, Alex didn’t think of anything else. The gray world vibrated slightly, the room rotated, and his eyelids drooped. Everything was soft. Everything seemed alright.

Everything was not alright.

Outside the curtain, down the length of the room, Ashley paused at the large whiteboard. The name that had been written in Bay 14 was half-erased, a smudge, a smear. But luckily for her, the procedure abbreviation was still there. Ashley diligently copied it down onto Alex’s file on her clipboard. She picked up a blue marker and wrote, in her neat script, MITCHELL, A. He’d already waited a long time, so she wrote his name in the very next time slot for OR 2.