Medical Fiction: Bosco the Body Packer - Physician's Weekly

This is one of a collection of stories that are like "Final Destination" meets "The Monkey's Paw" (W. W. Jacobs, 1902). As such, they are tragedies more than either mysteries or horror, and would appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. In each story, a protagonist makes a wish that comes true with fatal results for someone, often the person making the wish. Nothing supernatural, but just how things work out. (Or is it?) The technical details surrounding the fatal (or near-fatal) event are drawn from real cases in the US OSHA incident report database or similar sources and are therefore entirely realistic, even if seemingly outlandish. The plots draw lightly from cultural beliefs around actions such as pointing at someone with a stick or knife, wishing in front of a mirror, or stepping on a crack.

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Rose was a hot mess. She was witty, pretty, and bright, but she made choices and friends that would try the patience of the most abiding guardian angel.  Rose had terrible luck with three things: men, cars, and jobs. Her latest in a long line of loser boyfriends had pocketed money from the tip bowl when Rose was working as a hair stylist. The job had not been the best she had ever had, but the hours were flexible, the rest of the staff were friendly, and the tips were great. Rose had accumulated two warnings, both related to her latest boyfriend. She had missed a shift because he got her drunk, and she had come to work one Monday smelling of his weed. Nobody there really hated Rose's new squeeze, but he was just too smooth for comfort, and they were all waiting for something nasty to emerge from his past and blow up in Rose's face. The gossips had three leading contenders for what it might be: a wife and kids; an arrest warrant; or the favorite: he was on the run from the mob.

It turned out to be much simpler than any of those, though. He was a common, sneaky thief. When one of the other stylists caught him emptying out the tip jar, things got very ugly very fast. Rose tried to stand up for him, words were said, things were thrown, and Rose stormed out no longer in possession of either a job or a boyfriend.

Claude ran a grimy pawnshop in a seedy part of town. He was very careful to keep scrupulous books and a clean inventory. Nothing that passed through the shop was stolen or even slightly doubted. His back-alley side hustles, though, were almost never legal. Although it would be hard to pin it on him, Claude had a very lucrative business running drug mules across the Canadian border. Most of the mules ran one trip only before vanishing, and none had any prior record with law enforcement on either side of the border. His gift was spotting people who desperately needed cash, didn't want to do any repeat work, and would just melt into the population on either side of the border.

Dr. Opal Otter was taking Bosco, the Great Pyrenees Mountain dog, for a visit to the groomer and then to see the kids at the pediatric oncology clinic. He loved the attention, and the kids and families were just thrilled to see the big floofy white pile of fun. The clinic was situated on level three of the St. Camillus de Lellis hospital. It was an aging building with some modern additions, a stylistic smorgasbord that derived from the influences of nearly a century of patrons, each eager to leave a mark. While the original front was a tasteful, if Gothic, mix of wrought-iron fencing, carved statues, and classic columns, the black, glass, concrete west wing was a sheer obsidian monolith that housed a five-level parking garage, Mental Health, Urgent Care, ED, General Surgery, and Orthopedics. After visiting colleagues in Toxicology at the far end of level three of the new wing to show Bosco off, Opal cut through Urgent Care on her way to ped/onc in the old building.

Rose's week was just not getting any better. She had not even applied for unemployment yet when the water pump on her old Ford truck seized. The squealing belt had meant nothing to her, and the red dashboard light gave her about a block's warning before the head gasket blew. The sputtering truck coasted to a stop with a plume of steam billowing from under the hood. A friend towed it for her as a favor, but the cost of skimming the head, replacing the gasket, and fitting a new pump would be at least three times more than what she had in the bank. The agonizing irony was that the same afternoon, her theatrical agent had left a message for her about a new gig, if she could get there on her own steam. Rose had pawned the last of her small inheritance of her grandmothers' jewelry, but it wouldn't even cover half. She sat in the pawnshop amongst the tatty remnants of people's lives and sobbed in bitter self-reproaching dismay.

It didn't take much nudging for Rose to find herself in a cheap motel bathroom with a wad of cash in her pocket, being coached and coaxed to swallow a heap of little rubber sausages. She soon got the hang of it when the antiemetic kicked in and her swallowing technique improved. Once she had swallowed every last little rubber cocktail sausage and memorized her destination address, they pressed an envelope with her boarding pass, spending money, and tickets to a Broadway show into her hand, and stuffed her and four others into an airport shuttle. She was just a day-tripper going to a show. Although Rose was terrified throughout the flight, the blur of activity through arrivals quickly resolved into the shape of the curbside pickup point, where she relaxed. Like a dozen others, she was just standing around bored, waiting for the motel shuttle.

The shuttle trip quickly ratcheted up that sense of frenetic panic, though, and Rose was terrified again. The driver was being paid by the trip, so after rushing everyone in, he squealed away from the curb and hurtled towards the freeway. Snow was falling, and the driver was simultaneously swerving through the traffic and talking to three motels. Rose clutched her backpack to her chest and pinched her eyes shut as the van swerved around an 18-wheeler, then barreled down the offramp. She didn't see him oversteer, but she felt the sickening lurch as the van slid out, and then the stomach-wrenching vertigo as it tipped over and rolled when he overcorrected. The van came to an abrupt and grinding stop against a barrier, and her eyes were still shut when her forehead hit the seatback in front of her with enough force to knock her out.

Rose was barely aware of being dragged, lifted, and rolled into an ambulance, but by the time she arrived in the ED bay, she was plenty awake. She calmly watched as they wheeled her into the ED and counted the rows of neon lights flicking by above her until she was slid onto an ED bed. She was unperturbed as the flurry of faces and hands scoured her body, and she amiably answered that she felt fine, her pain was maybe a one or a two, that she knew who she was and why she was here. She was transferred to Urgent Care on level three, where she waited for someone to check her black eye, the cut on her forehead, and X-ray her ribs and belly just to be sure about the bruising that had developed where her bag had been trapped between her body and the rigid seatback.

Bosco stopped abruptly in front of a dark-haired young woman in a wheelchair, who was hunched over a smartphone. The leash jerked taught and brought Opal to a sudden and unexpected halt. Bosco gave a low howl, barked loudly, and placed a paw on the woman's knee. Opal apologized profusely, but the woman didn't stir, even as her smartphone slipped from her limp hand and fell to the floor. Bosco was adamant and sat solidly in front of the woman like a stone statue, a barking statue that kept a paw on her knee.

Opal switched gears. Kneeling in front of the woman, she peered more closely at her hands and then her face. "Shit!" Opal muttered to herself, reaching into her pocket for Narcan. After checking the woman's eyes, and unable to detect breathing, Opal administered a dose. She wheeled round from the pretty woman with the pinpoint eyes and dusky lips and waved to the triage nurse. The team that had swiftly materialized around them administered oxygen, and the young woman was soon in a world of pain from her bruised ribs and abdomen as her opioid overdose was counteracted. Opal watched her being wheeled off to radiology to look at the "rubber sausages" she had started talking about. Opal looked down at Bosco to praise him. "Did Joshula Trebaux teach you that?"

She was interrupted by a commotion in the hallway. The transporter was lying in a heap, the wheelchair was tipped over, and someone was dragging the screaming woman toward the level three parking entrance. Before Opal could yell for security, a blur of growling white fur leapt over the chairs and sped toward the scene.

Rose struggled, trying to free herself even though pain was tearing through her guts like fire. She recognized the guy from the pawnshop and was pretty sure that if she let him drag her off, things were not going to be good. He was too strong, though, and people just gaped as he dragged her screaming and fighting toward the exit. Then, he just let go, and she fell backward. There was something above her, big, white, and attached to his butt. It was a giant dog! She shook her head, not sure if she was tripping.

Clyde had almost got her to the exit and had just 20 feet to get her into the waiting van. Almost there, but then there was pain, and there was a large white dog with its fangs buried deep into the fleshy part of his ample buttocks. He let go of the girl, and broke free of the dog, swinging at the head with his fist. Clyde sprinted through the exit and disappeared into the parking lot.

Bosco's head ached from the blow, but he was now focused again, and in full gallop, gained fast on the man. He leapt, launching hard with back legs, using his back muscles to uncoil and leap. His large front paws landed in the middle of the man's back. Bosco watched as Clyde was propelled over the railing of the parking lot wall and sailed, almost gracefully, down three stories, coming to an abrupt halt on the sturdy wrought iron fence where the two buildings met. When he came to rest, his fingers were barely touching the concrete, and steel spikes bloomed from his back and thighs like exotic iron flowers, a final metallic salute to body packing.