The first sip of coffee brings me back to the edge of the world. At this hour, before the morning unfolds into emails and hallways, the ritual is all that matters. The French newspaper stayed in my kitchen; I make this coffee in the break room with the hospital coffee maker: water at the right temperature, filter, and four minutes. If there's one thing I can control today, let it be this.
I open the record system, the warm bitterness still on my tongue. I type in the room number, then the patient's number. Room 419. Name: Arturo. Age: forty-six. Admitted: Thursday night, March 28, brought in by SAMU with severe agitation, paranoid verbalizations, and a history of suicidal ideation. The first medical evaluation appears on the screen, signed by resident Cristian Gajardo at 11:17 p.m. I read it twice, not out of mistrust, but out of professional habit: a concise note, in line with the manual—"Patient calm; due to severe agitation, midazolam was administered by SAMU personnel prior to admission. Disoriented. Haloperidol IM SOS indicated, temporary physical restraint measures, vital signs monitoring, and subsequent reevaluation by senior psychiatrist."
So far, nothing out of the ordinary. Gajardo acted within his competence and according to protocol. The strange part comes later, as is often the case with things that no one signs.
I review Friday the 29th. There is no evaluation note from the attending psychiatrist during the workday. That shouldn't happen: if a resident leaves instructions to reevaluate, someone from the specialist team should have gone down to see him. If this was not done, the least that could be expected is that the nursing staff would record the omission or reiterate the request. But there is nothing: only mechanical compliance with the initial instructions, clean obedience.
I open the nursing records. Shifts:
— Night of the 28th: Tomás Varela.
— Day of the 29th: Verónica.
— Night of the 29th: Tomás again.
— Saturday the 30th: Tomás covers part of the morning; then Verónica takes over in the afternoon.
— Sunday the 31st: minimal records, only basic checks.
The notes repeat what is to be expected. Tomás reports uncomplicated drug administration, patient with intermittent agitation, monitoring as medically indicated. Verónica describes episodes of verbosity, hallucinations, fluctuating confusion, "no significant changes." At no point do they record that a specialist reevaluation was requested or that it was insisted upon.
I close my eyes for a second to listen to the echo of that absence. In an emergency, it is normal for a single person to record a section; I learned this years ago and confirmed it yesterday with the record sheet: continuity of handwriting does not surprise me. But continuity of omission does. I mark a timeline with the cursor and write in my notebook:
— Check whether a formal request for reassessment was issued (folio, time, who entered it).
— Check the schedule of psychiatrists on duty on Friday 29.
— Cross-check with the nursing roster (did Varela and Verónica share more than one shift that month?).
— Request log of technical incidents from Ala C cameras (29–31).
A pop-up window distracts me: Processes invites me to "align expectations" for next week. I close it without reading any further. Today I'm not going to waste words on euphemisms.
I take a breath and return to the file. On Saturday the 30th, Tomás appears covering part of the shift. There is a note of secure containment at 5:10 a.m. The handwriting reveals a weariness that does not come through in the abbreviations. In the afternoon, Verónica resumes: "no relevant developments." On Sunday the 31st, the record is minimal: signs, diuresis, sleep in fits and starts. Monday, April 1, early morning: the world narrows. The patient dies before the psychiatry team arrives to reevaluate him. The screen does not flicker, but sometimes I wish it would.
I close and reopen it, as if the second reading will reveal what is missing. Nothing changes. I write down another list, so as not to lose track:
— Check hallway cameras and access to 419, 03/29 to 03/31.
— Confirm unregistered visits (front desk, extraordinary income spreadsheet).
— Talk to Veronica after the shift change on the 29th.
— Check with Systems about retention policy (copies, overwrites).
I turn off the screen. I get up. I need different eyes: glass ones.
The Monitoring Room is two floors below, behind a door that always smells of air conditioning and reheated coffee. The technician on duty recognizes me and nods; in these matters, my badge opens doors more easily than my voice. He offers me a chair without saying a word, as if he understands that silence is part of the procedure. I ask him for the range, dictate dates and sections. He loads it.
I start on Thursday the 28th, almost midnight. I advance at x4 speed; my eye gets used to reading in jumps. Arturo enters in a wheelchair, accompanied by two SAMU paramedics. Tomás receives him. The camera has no audio, but I can hear the scene: signatures, brief exchange, transfer to the box. Arturo's body moves slowly, not calmly but in pause. Tomás's hands are a sure map: they apply, correct, hold without haste.
I jump to the early morning of Saturday the 30th. At 3:00 a.m., Varela enters the box. He leaves fifteen minutes later, returns to the station. He repeats the routine at 6:00 a.m. Nothing out of the ordinary. The eye gets bored and disciplined at the same time.
Between 7:12 and 7:34, the camera goes black. Not white. Black. A flat void, without interference or snow. The rest of the recordings work perfectly. Only that segment is cut. Right after the last night entry, right before the shift change. I don't move. It's the kind of silence that has shape.
"Backup copy?" I ask.
"Overwritten," replies the technician. "Retention five days, without a formal request for backup, it is not preserved."
"Incident log?"
"Nothing reported in that section," he says, typing. "Neither on cameras nor on the network. If it was black, no one here wrote it down."
I take note. I bite my lip out of habit, not out of embarrassment. I ask him to export the rest of the footage; it's not worth much on its own, but it adds up. The technician looks at me with that neutrality you see when you've seen the same pattern too many times. I thank him. I leave as cold as when I came in, but more awake.
The cafeteria always smells of something toasted that isn't quite bread. I go in because my body demands it. There is the sound of glasses, a blender, laughter that doesn't correspond to any joke. I see him in the line. Clinical uniform, blue sweatshirt open. He walks with firm steps, as if telling everyone that he is sure of himself. I recognize him before my mind decides to say his name. He looks at me first. He doesn't smile. He nods as if the greeting were a word that doesn't need a mouth. That brief gesture is like a scan: it goes through me from head to toe and leaves me standing the same, but with a different breath.
I could avoid it. I don't. I approach the hot water machine. He doesn't move. The steam between us serves as a border and, at the same time, a bridge.
"Doctor," he says, without emphasis.
"Varela," I reply.
We take paper cups. His trembles slightly when the machine spits out the water; it's not nerves, it's exhaustion. I don't look at his hands. I look at the rim of the cup as if looking at the edge of a precipice.
"Resting?" I ask. A wild card.
"I try," he says, "but you know... Some days are harder than others."
I nod. In the phrase "you know," there is an invitation and a judgment. I don't take it. I change my angle.
"Was that shift heavy?"
He doesn't answer right away. The pause isn't defensiveness, it's calculation.
"They all are when they end like that."
He doesn't specify what he's referring to. He doesn't need to. We both know what case he's talking about. It takes me two heartbeats to decide whether to push or not.
"Do you think anyone else saw it that day?" I shoot, deliberately choosing ambiguity.
Silence. The cafeteria continues, oblivious: someone drops a spoon, the blow against the porcelain makes a clean clink.
"The patient?" he clarifies, putting the arrow back in its box.
I nod. It's a minimal movement, but we were going to get there anyway.
"I don't know," he says. "But if it did happen, it doesn't necessarily mean that someone took action."
There is no irony or defense. It might sound cynical, but there is no acid in his voice. I want to say something clinical, something correct that will give me back control. I don't. Control, today, doesn't get good press.
"Have a good rest, Varela," I say at last.
"Same to you, Doctor."
I don't wish him a "good shift." Here, science coexists with useful superstitions: whoever says it invokes disaster. And I'm not here to invoke anything. I walk away with the glass still too hot for my hand.
Back at the computer, I open the psychiatry agenda. The names for Friday the 29th are scattered like cards: head of the morning ward, liaison resident, internal consulting team, extension staff. I don't need to know who's who to know that the circuit worked differently than it was written. I add another line to the notebook:
— Confirm if the head was off duty; if so, who is covering plan B and at what time.
I call the front desk. I ask for a list of extraordinary admissions for the end of March: technicians, suppliers, maintenance. The voice on the other end asks me for a letter. "I'll do it," I say, and I put the paper together in two paragraphs: purpose, period, support. As I send it, I remind myself that breathing is also a way to move forward.
In Quality, I put together the chronology like someone sorting buttons by size. Friday 29: resident indicates reevaluation by head physician. Nursing does not insist in writing. Saturday 30: partial replacement, secure containment, "no news." Sunday 31: minimums. Monday 1: death before reevaluation. Between 7:12 and 7:34, blackout on camera. No incident report. Retention five days; copy overwritten. The puzzle does not come with a picture on the box, but one learns to intuit the drawing from the edges.
I write a preliminary report. First line: "Full adherence to protocol observed." Second line: "Verify absences (not done) and consistency of circuits (not recorded)." Third: "Request log of restarts in critical range from Systems." Fourth: "Request work orders for blocks 29–31 (03/29–31) from Maintenance." Fifth: "Gatehouse: external admissions with temporary passes."
I force myself to eat something other than coffee for lunch. The body doesn't negotiate forever. On the tray, the rice tastes like nothing, but it represents something: eating is also a way of sustaining a case.
In the afternoon, I go up to Psychiatry. Veronica is at the station with her pond-like composure. I ask her for the bare minimum: if she remembers any insistence on the pager on the morning of the 29th and if the request for reassessment was recorded in the guidelines. I don't ask why there is no headline note; not today. She checks without haste. "It was pending due to availability," she says; "there were two requests," she adds, and slides her finger down the wrong column as if she doesn't want anyone else to read it. I note the approximate time. She doesn't sign it for me. I don't need it signed to know it exists.
I return to Maintenance, not to the workshop but to the office where orders are printed in letters that know nothing of patients. I ask for any OTs for cameras or adjustments in the area by date. The system spits out numbers. One looks back at me as if it had seen me before. I write it down. I don't need to resolve it today; I need to remember it tomorrow.
In the middle of the afternoon, the hospital takes on that siesta tone that only exists in buildings that never sleep: less noise, more echo. I take the opportunity to open Archives again. I look for print stamps on the nursing report, in case there are previous versions. One, two, three print marks. They don't reveal duplicates, they just tell me that someone printed the same order several times. It's not proof. It's texture. Sometimes texture counts more than ink.
Claudia writes to me: "Coffee tomorrow. You talk, I'll listen." I smile at the screen as if no one can see me. In fact, no one can see me. It's a relief and a curse.
I leave the office when the building's shadow stretches across the street. At the exit, the guard raises his eyebrow as if greeting those who leave late by choice, not by punishment. When I get home, Wilson greets me with the unspecific joy of dogs who carry no baggage. I tell him quietly enough to hear myself think: that the system has a black spot where there should be noise, that sometimes the most perfect thing is the most suspicious, that a name—Arturo—is enough to make the page more than just paper.
I don't play music. I leave the silence. I force myself to write down three things before the day turns into a dream:
— What was said: "No relevant news," "pending availability," "every day weighs heavily when it ends like this."
— What was not said: "we insisted three times," "the headline went up," "there was technical intervention."
— What was seen: a black section, a continuity of letters, a tray without used bandages, Varela's intact gesture as he held the inmate when she stumbled.
I could try to sleep with a series playing in the background. I don't. I prefer to stay with the discomfort for a while. Discomfort is a compass. I wash my face. I turn off the light.
Before sleep takes me, the thought persists: when everything is too perfect, it's because it was too imperfect. Someone decided not to move, and others, perhaps, arranged the scene to make it look like any other night when nothing could be done. I don't know yet who those "someones" are. Tomorrow I'll go back to the hospital with a simpler and more fierce question: who was there when no one was looking?
I fall asleep with that phrase and with the image of a black screen like a curtain deliberately lowered. It's not proof. It's direction. Sometimes that's enough to start pushing. And every time I push, I breathe better.
I arrive early. Not as early as yesterday, but early enough for the hallway to have the slanting light that encourages attention. The guard offers me the same gesture as always; I appreciate what doesn't change. In Quality, the mail brings me confirmation from the front desk: "Attached is the extraordinary income spreadsheet for 3/29-3/31." I open it. I look at the names as if I were looking at a word search puzzle. I look for technicians, suppliers. A camera supplier with a temporary pass, a time that matches the shadow that was already looming in Monitoring. I don't get excited. I make a note and ask Audit to be present when we request the log. I learned, through fear, that there is no worse loneliness than opening a door without a witness.
I walk toward Psychiatry deliberately slowly. Veronica sees me coming and puts away the chart without fuss. I tell her that tomorrow I will make the formal request and that I need the exact times, not approximations. She nods. There is a kind of economy in her nodding that has always intrigued me: she gives the bare minimum. I still don't know if it's a virtue or a strategy.
In the cafeteria, I run into Tomás again. We don't talk. There's no need. We pass each other like two people who have already had the conversation that matters, the one that won't be recorded in any minutes. I wonder what he sees when he looks at me: an insistent evaluator, a threat, a woman who takes her job too seriously, an opportunity. I wonder what I see when I look at him. I don't answer myself. Some questions are better left unanswered.
Back at my desk, I end the day with a clear plan: compile the exact hours for Friday, demand traceability of the reevaluation request, cross-check with spreadsheets and gatekeepers, ask Audit to hand over the camera log. I'm not going to accuse anyone. I'm going to shine a light where there is order and silence. Sometimes light helps. Sometimes it doesn't. I turn it on anyway.
I turn off the computer. I look for a moment at the hand I use to take notes. I think of Arturo. Of his name spoken aloud in a hallway that smelled of chlorine. Of an inmate who stumbled and was held up by an arm that didn't sweat. Of a video clip that doesn't exist and yet weighs heavily. I go out into the street with the feeling that today the thread has become a little tighter. Better. That way we know it's not imagination.
Tomorrow, more coffee. More hallways. More questions. And, if I'm lucky, some answers that aren't dressed up in protocol.