By J. L. Thurston

Abigale Walters had been found in the morning by her young nieces and nephews on the couch. They couldn’t wake her, so they called their mother who called 911. When responders arrived, they couldn’t find a pulse. CPR was performed for over two minutes before bringing her back. They did not know how long she had gone without breathing.

Once she was mostly stabilized in the ER, the doc decided to order a head CT.

When I arrived to take her for her scan, Abigale was not what I was expecting. She was in her late twenties, covered in tattoos, and weighed over 400 pounds. She had been stuffed into the bed with a ventilator shoved down her throat. A blood pressure cuff was barely secured around her wrist because they don’t make them big enough for her bicep.

Three phlebotomists were attempting to find a vein to draw blood. Four nurses were examining her arms to place an IV. In the ambulance, they had to drill a hole into her shin in order to administer meds and fluids. They call it an IO, I dare you to Google that.

Despite having been in the hospital for a few hours, this woman had received almost no care besides her CPR and her IO and her vent. Because they couldn’t find a vein. Probably because she was enormous, but also because she was a heroin addict.

I was made to wait before I could take her downstairs. While waiting, I received a front-row seat to the circus act performed by her family.

The couple that was in her room when I arrived were young. Around her age. Her sister and brother-in-law. They were explaining that yesterday they had been at a funeral. Abigale’s brother had accidentally overdosed on heroin and died in our hospital just last week. They had Abigale sleep over at their house afterwards, because they knew she wasn’t taking it too well.

Before the couple left the room, the brother-in-law planted a ten-second cringe-worthy kiss right next to Abigale’s intubated mouth before crying his way out the door.

Enter stage right, two aunts. Now, look, most of the time big people run in the family. It’s a lifestyle, sometimes self-taught, sometimes passed down. The sister and brother in law were huge. So big they almost didn’t fit in the ER room with all of us. But the aunts, they were barely one-hundred pounds each. One was dressed like a soccer mom, the other had smoked so many cigarettes in her life she started to assume the form of dried tobacco, all wrinkle-skinned and brownish yellow.

These aunts cried at her bedside. One began explaining in broken, sob-choked words, how Abigale was all broken up about her uncle dying. We asked to clarify. Uncle? We thought it was her brother. The aunts explained that her uncle killed himself by downing a bottle of pills five years ago.

Not to seem heartless, but I’m sensing a pattern here.

The aunts take their leave and make way for two more aunts. These women are even bonier than the last two. One was covered in tattoos, the other was a frail little butterfly who looked as though she’d feint if she saw a needle.

The tattooed aunt spoke enough for the entire family.

“She just comes from a good family,” she spat. “I know this wasn’t suicide. She’s on a lot of medications. She has a lot of medical problems. But she doesn’t take the pills, she sells them. She doesn’t work. She sells her medications for money. That’s why I took her purse when she arrived. Her fucking sister wanted to take it but that’s because her and that worthless husband are big fat drug addicts. They’re addicted to heroin. I don’t trust them. But Abby, she’s a sweetheart. I know she’s had her problems in the past. She was a heroin addict, too, years ago, but now she’s just trying to get by. She’s a good person, comes from a good family. She’s just really stupid, sometimes. Pardon my language, but she knows how to really fuck up. She’s in that weird relationship with her brother-in-law, and the brother that died last week was in on it, too. Yesterday, she called me, all fucked up on pills, didn’t know where she was or how she’d got there.”

We stared at the aunt, waiting for her mile-a-minute story to continue. She just glared at Abigale.

“Did you think she needed help?” a nurse was brave enough to ask.

The aunt shrugged. She was angry.

“I told her to go to McDonalds and get something to eat. She said okay, and that was the last I heard from her. Until her shitty sister called me to tell me the ambulance was coming to get her. I think she just couldn’t remember what she’d taken and just accidentally took too much. That’s all.”

I wondered if the aunt knew about Narcan, the drug given to reverse the effects of medications. It’s used in overdose situations. Abigale had received as much Narcan as possible, and still was on the brink of death. It’s hard to imagine that, the day after her brother’s funeral, she just accidentally doubled-up on meds. She’d have to empty bottles. And the bottles weren’t empty, hence the fight over who got to hold Abigale’s purse full of pills.

Whether her situation was intentional or not, we’ll never truly know, because Abigale expired an hour later. That’s the terminology we use in the hospital. The patient doesn’t die, or pass on, they expire. The nature of the death is more or less irrelevant.

I think about that family a lot. They had some major problems to work out. They had some deep wounds that weren’t healing. And where were Abigale’s parents? There was not a word about a mom or dad. We met sister, brother-in-law, four aunts, and learned about a brother’s funeral.

Did Abigale kill herself? She would have had many reasons to feel suicidal, one would assume. Drug addiction, morbid obesity, pill pushing, terrible family, unhealthy romantic life. She needed help. Badly.

Did Abigale kill herself? Well, even if it was accident, I suppose she did. And her rotten family had to manage another funeral. I wonder, every day at work, if soon I will see another one of them brought in.

God, I hope not.