“All death is suffocation,” Travis Gott overheard an ER nurse say as she strode briskly past his bed. He felt his heart rate rise. He’d been brought into this Lake Arrowhead hospital on an ambulance gurney not half an hour earlier. It was nearly midnight. A white plastic ID bracelet now encircled his left wrist like a small pale snake that’s swallowed its own tail. He wore on his right ring finger a black onyx class ring.

“Choking, strangulation, drowning,” Travis heard another unseen nurse say, “those work. What others?”

“Kidney failure, heart disease, they all ultimately result in pulmonary collapse,” answered the first nurse. “That’s how we die.” Travis’ breathing, already thready, quickened as he imagined his lungs – those pinkish-gray bellows – locking up forever. What pain that would be!

All he’d done in the ER so far is produce his Kaiser card, remove his loafers, partly undress, lie back in his powder blue hospital gown on the alarmingly flat hard bed, and wait. In the hospital there was a strong scent of disinfectant and a noticeable trace of something less pleasant. He compulsively twisted his ring.

He knew from personal experience that his case wouldn’t warrant immediate urgent attention. And although he felt himself in extremis, he knew by now that a panic attack – no matter how frightening, no matter how long lasting – wouldn’t kill him. He craved a sedative. It’s why he was here – again.

His things – wallet, keys, cell phone – had been taken from him and stored temporarily in a metal drawer behind his bed, and the fact that he couldn’t see them only further fueled his blistering anxiety. Lying flat on his back, he looked up at the fluorescent light panels on the ceiling. Overlaid upon them, strangely, was a pattern of scudding cumulus clouds. Travis imagined that this illusion was supposed to be calming. He thought instead about how he rarely looked up at the sky when he was outdoors. He’d once been an avid hiker. He’d once been many things. He removed with some difficulty his class ring, holding it tightly like a talisman, and ruminated on his lost youthful ambitions – to find true love, to travel the world, to be a writer.

Another nurse came in time to Travis’ bedside and brusquely raised him to a sitting position. “Mr. Gott, because you’ve been drinking tonight, we can’t give you a sedative until we know your blood alcohol level. It may not be safe. It may be contraindicated. An so,” she said as if with some distaste, “someone will be here shortly.”

“It was just some beer,” Travis said.

“Frankly, you reek, sir.” And then she was gone. Travis now regretted buying that case of Pacifico, which he’d done, as always, only to try to soothe his wrecked nerves. He’d been left to his own devices when some six weeks prior his doctor had cut off his Xanax prescription because Travis had been abusing the drug. The doctor had recommended as an alternative aromatherapy, journaling and yoga. He was a criminal fool, felt Travis. His panic attacks had spiked in frequency and intensity since then.

He was coming out of his skin, Travis felt. This was intolerable! On the ambulance ride to the ER, the EMTs had measured Travis’ heart rate with an index finger monitor. It had been 172, which they indifferently informed him was dangerously nearing stroke levels. Similarly, his blood pressure was unhealthily elevated: 160 over 105. And so at the ER, straightaway he’d been hooked up to an IV. He was profoundly dehydrated.

And now on his raised hospital bed he waited some more. Turning his black ring in his hands, he reflected on his second wife, Cheryl, whom he’d met at a sorry frat party at Cal State L.A. That marriage lasted nearly three years. After a while a trim young Hispanic man with immaculate manners appeared, holding what looked like a narrow red tackle box. He was a phlebotomist. He asked Travis to state his name, then his date of birth.

“June 5th, 1983,” Travis answered. He was 42 years old now. Was he having a midlife crisis – an acute, debilitating one? So much over the years had gone wrong. Three marriages and three divorces. Two daughters whom he couldn’t see because of an unfortunate and unpleasant blackout episode in which he’d permanently lost his visitation rights. But Travis was sure that he had never struck Kimberly, his third wife, or their kids. He had never struck anyone. His sins were sins of omission. Was that sufficient explanation the chronic nightmares and the sleepwalking fits that plagued him? Jesus, the police had once found him, in February, out walking in his boxers in his sleep in the snow.

And then the phlebotomist finished up his leech-like task, drawing four vials of plum-colored blood. He told Travis that he’d be bringing the blood to the hospital lab for analysis and that he could expect results in about an hour. Then the young man left. He had been uncommonly handsome, Travis thought. No one knew, he reflected, that, though he’d but once acted on his proclivities, he was in his heart bisexual. Was this, too, why he drank?

Travis Gott was literally white-knuckling it now, his reddened slim hands clamped onto the hospital bed’s stainless steel safety bars as he waited. His ring hurt him. he could hear his pulse thrumming madly in his ears. He wanted to get up and run; he wanted to curl up tightly in a fetal ball. He wanted relief.

He tried not to listen to the other patients’ complaints here, but in such a confined and intimate space this proved impossible. This, after all, was a dinky rural hospital in the mountains. And so he overheard the muted wails of car crash victims, the ponderous sighs of an elderly man with chest pain, the grotesque laughter of a woman who’d put her hand down into a whirring garbage disposal. Altogether in the ER there were eight beds. Already he had been here three times earlier this year. It was early November and a late autumn snowstorm swirled outside. It was half past one in the morning.

Travis abruptly palmed his smallish square head with both hands in excruciating impatience. He fingered his full beard speckled with silver-gray, then ran a trembling hand through his curly dirty blonde hair with its receding hairline. There was no evading the truth: His youth was gone. And still he waited.

He wondered with some agitation whether he belonged in a mental ward. He knew that he suffered from a number of psychological ailments: Panic attacks, mood disorders, phobias. He was afraid. He had never been institutionalized. He imagined a bedlam replete with drooling lunatics and straitjackets, ice water baths and barbarous shock treatments. Travis wanted no part of that. All the same, though, he longed for that dreamy, pillowy, enraptured feeling that only a strong sedative can beget.

*

Finally, shortly after three-thirty, an irritated, yawning, olive-hued woman wearing rumpled scrubs stopped by Travis’ bed. He was nearly out of his mind with anxiety now. The woman held a clipboard and did not smile.

“I’m Dr. Bugatti, Mr. Gott. I imagine you’re feeling quite unwell. I have something that might help. The lab results are in – your blood alcohol level is in the tolerable range.” She gave him a long hard look as if deliberating what to do next. Travis held his breath. “So,” Dr. Bugatti went on, “I can give you that sedative now: Ativan, 2 milligrams. This should help.”

Travis took the tiny white pill gratefully, greedily, and washed it down with a Dixie cup full of water.

“But there’s one matter that I must discuss with you, Mr. Gott. I believe I’ve seen you here before with the same complaint, haven’t I?” Dr. Bugatti studied the clipboard a moment, scowling a bit. “It says on your chart that you’ve been to the ER five times in the past twelve months.” She fixed him with a scolding expression. “This simply won’t do.”

“I’m sorry,” Travis said meekly. All he wanted was to feel better.

“You need desperately to find help – psychiatric help – outside the emergency room. Do you understand?” The doctor took a breath, then said: “I don’t want to see you here again.” And with that unequivocal admonition , she turned and left.

*

Feeling ebullient now, his whole being light as gossamer, Travis happily watched horrors unfold on The Weather Channel on the hospital waiting room’s flatscreen TV. It was five in the morning. The Ativan, blessedly, had taken full effect. Travis waited contentedly for his early morning ride home.

Also in the waiting room was a monstrously obese man who sported a Fu Manchu and a shaved head. He was swaddled in ink. Gangland graffiti decorated his meaty skull. To Travis, who sat two seats away, he looked like Ray Bradbury’s Illustrated Man.

Then the fat man, who’d been watching the weather report too, turned to Travis and said, “A Chicago blizzard in November. Who’d have thunk that!”

“It looks bad,” agreed Travis good-naturedly.

“The name’s Frank Guzman,” the man said, extending a hog’s shank hand. “I’m with High Serenity. Waiting on a client now.” High Serenity, the man explained, was a mountain rehab and he was a flunky there. The client whom he was waiting on, he added, was a silly teenage girl who had tried to thwart a mandatory morning drug test.

“Really?” Travis said.

“She drank bleach.”

Guzman asked Travis what he did for a living.

“Freelance writer. I’ve got deadlines and assignments waiting for me at home.” Feeling sociable, he further added that home was a 1920s, rust-red, A-frame cabin that his grandfather had bequeathed to him.

“Must be nice to be a writer,” Guzman ventured. “Be your own boss, and all. Nobody to answer to.”

“I’ve written a novel,” Travis said, surprising himself with this revelation. It must have been the sedative talking. “It’s an Agatha Christie-type murder mystery set here in the mountains.” Travis neglected to mention that the novel was unpublished. Still his words had awakened in him a sad recognition that his writing was strictly utilitarian and that his creative endeavors had gone nowhere. He had wanted to be a bestselling author ever since his college days. Suddenly glum, Travis knew now that this would never be. He was a failure. And so he resolved that when he finally got back to his little cabin he would build a robust fire in the wood-burning stove, and toss into it his unpublished manuscript. It was time to face facts.

The hours passed thus in melancholy ease. Outside, the snowstorm had abated and now only a few light delicate flakes fell spiraling to earth. Soon it was dawn, and then past dawn. Travis shrugged on his gray parka and readied himself to go. The shuttle bus that would bring him back to his Crestline neighborhood would be making its first stop at the hospital at eight.

Travis Gott exited the two-story beige building and meandered across the slushy gravel lot until he reached the bus stop at a rocky hillock in a stand of blighted pines. In his breast pocket he had his onyx class ring. He thought about what it represented – innocence, dreams, hope. All gone now. And so he took out the ring, looked dolefully at it once and then flung it into a nearby snow bank. It was time to go home.

– JM Hollwig