After lunch—a bland sandwich and a coffee that barely got me through the afternoon—I walk to the procedure room. The hallway is lit by the slanting light of the broken hour; voices bounce off the walls with a faint, disciplined echo. I push the door open with my knuckles so as not to leave marks. Inside, Verónica Olmos is waiting for me, sitting in her impeccable uniform, her hair pulled back without a strand out of place. There is no tiredness on her face, nor annoyance. There is that defensive calm that one learns to recognize when someone knows they are going to be evaluated and decides to show their best side.
"Thank you for coming in early," I say, closing the door carefully. "I won't take up much of your time."
"No problem, doctor," she replies with functional courtesy. Not a molecule more.
I take a seat across from her. On the table is a hand sanitizer dispenser and a notepad with the hospital logo. I take out my notebook. The click of my pen sounds like a metronome.
"I want to go over some details of the care provided to patient Arturo Figueroa Sanz," I say. "Friday the 29th in the morning. Did you have the shift that day?"
"Yes. Tomás handed it over to me," she replies without hesitation. "Patient under pharmacological and physical restraint, stable, no nighttime incidents. The usual."
I nod. It matches the paper. But the paper doesn't always match reality.
"In your progress note, you refer to 'incoherent verbalizations, no significant changes.' Was there anything that caught your attention outside of that description?"
Verónica thinks for a second. She doesn't look down; she looks at a point behind me, as if reading an invisible cue.
"Not particularly," she says. "He was calm under the effect of the medication. He didn't try to harm himself or anyone else. He talked a lot, without any clear meaning, but without any escalation in behavior."
"Did you request a psychiatric reevaluation?"
The pause is minimal, but it's there.
"Not directly. The resident had indicated a subsequent reevaluation." I assumed it would be coordinated by the medical unit.
"And if it didn't happen?" I ask, neutrally.
The air in the room changes density. It's not a threat; it's precision.
"It's not my place to decide whether or not to maintain the medical schedule," he replies, keeping the conversation going.
"No," I say. "But it is your place to document if it's not followed. Or to insist through formal channels."
Silence. The wall clock marks the second with a dull thud. Someone pushes a stretcher down the hallway; the wheels add a brief laugh to the echo. Veronica moistens her lips with a small gesture.
"Did you receive any instructions, formal or informal, not to intervene beyond the initial plan?" I ask.
"No," she replies.
Her voice is firm. It's a statement, not an answer.
"Were there any repeated calls to the service pager (locator)?" I insist, with a phrase that has become a ritual for me. "I mean repeated attempts with the time, name, and result."
"It was left 'pending availability,'" she says. "Two repeated calls were noted in the log."
"With the exact time?"
"Approximate," he admits.
I make a note. The pencil scratches the paper as if sanding a surface.
"Anything else that's not in the notes?" I ask, my expression open. "Smell, visitors, a change of bed, a failed transfer, any detail."
"Nothing I remember as significant," she replies. "The patient slept in fits and starts. He ate little. There was noise in the hallway early in the morning, but nothing out of the ordinary."
"What kind of noise?"
"Technicians," she says, then immediately corrects herself. "Or maintenance. I couldn't say for sure."
"Thank you, Nurse Olmos."
I close my notebook. I'm not dismissing her; I give myself a second to see if she fills the silence with something. She doesn't. Her economy is precise. She gets up and, before leaving, looks at me as if she were sizing me up.
"May I ask if there is a particular problem?" she asks, formally.
"If there isn't," I reply, "I want to make sure there isn't."
She nods once, without emotion, and closes the door behind her. I write down two words in smaller letters than usual: "pending economy."
For the first time in this case, I feel someone else's fear. Not for me, nor for a summary. Fear of the ecosystem: of that hospital mechanism that crushes biographies by force of protocol. I can smell it in the room, mixed with chlorine.
I go out into the hallway. I walk towards the elevator, but decide to take the stairs. I need my body to make noise in order to clear my head. On the landing of the first flight, an orderly pushes an empty chair; the wheel squeaks a little. The image reminds me of the essential: in the hospital, what has no body usually goes unnoticed. And what is not written down sometimes did not exist.
In Quality, I open the preliminary report I left half-finished. I reread: "Total adherence to protocol observed. Verify absences (not done) and consistency of circuits (not recorded)." I think about the black camera footage. I think about the temporary pass for technicians. I think that two approximate insistences are not a clock; they are an intention without a time.
My phone vibrates. Processes proposes moving up the meeting to "align expectations." I close it. I take a deep breath.
Before the impulse dissolves, I call the front desk. I ask for confirmation of extraordinary income for that day: suppliers, technicians, maintenance. "Official letter by mail, please." "Sent," I say ten minutes later.
I go upstairs to get a coffee, not out of necessity but for continuity. The cafeteria smells of something toasted that isn't quite bread. The line moves forward. I take a cup, pour hot water into it, drop in the coffee packet with the gesture of someone repeating a spell. When I look up, I see him.
He is sitting on a concrete bench by the window, at the edge of the rest area that overlooks the internal parking lot, where at this hour almost nothing moves. His elbows are on his knees, his hands are clasped, his gaze is lost in an area that no one else can see. If it weren't for his clinical uniform, anyone would say he was posing for a calendar: broad shoulders, straight back, that stillness that is not that of a statue but of an attentive animal.
He doesn't seem to have noticed me, but when I approach him—because I do approach him—he speaks without looking up.
"Are you going to ask me the same thing you asked her?" he says. His voice is even, without defiance.
"Veronica?" I ask, in case he wants to correct the name he didn't mention.
"She's not very good at lying," he says, now looking at me.
"And you are?" I reply, more to stir the air than to gain anything.
There is no guilt on his face. Nor innocence. There is compact weariness, like a stone in his pocket.
"Sometimes you get tired of no one listening," he says.
"Did you try to talk to someone?"
"It doesn't matter anymore. Not in this place."
The phrase doesn't come from the Tomás I saw in the cubicle, precise and cold; it comes from somewhere else. I sit down next to him, leaving a prudent space between us. The bench is cold; the cold helps. The silence lasts less than I think it will.
"Why are you still here, Varela?" I ask.
He turns his face just enough for me to see his entire profile.
"Because in this hospital there are two kinds of people," he says, "those who watch without doing anything, and those who do something even if no one is watching."
"And you?"
"It depends on who's watching," he replies, and it doesn't sound like a joke.
He stares at a stain on the pavement for a while. The light cuts through the dust diagonally. A thrush perches on the railing and flies away.
"I didn't come here to get information out of you," I say finally. "I came because the detailed version is useless to me if the stitching doesn't hold."
"The seams always give way," he says. "The question is where."
"And where does this one give way?" I probe.
He doesn't answer. He smiles with the corner of his mouth, but it's not quite a smile.
"Doctor," he says, "be careful what questions you choose."
I get up. I don't say goodbye. He doesn't turn to watch me leave. Even so, I feel—like an invisible current—something in his posture change, and something in me that I no longer want to ignore.
Back at my desk, the afternoon rolls by like a train without passengers. I make calls that go unanswered. I write emails that only return empty acknowledgments. I surprise myself writing "I would appreciate delivery with Audit present" with the serenity of someone asking for bread. I write "blackout 7:12–7:34" three times in three different documents as if repeating it would make it more real. There is no magic, but repetition brings order.
I open the patient's file. Arturo Figueroa Sanz. I return to the resident's first note, at 11:17 p.m. on the 28th. I force myself to read as if I didn't know the story. Midazolam en route, haloperidol SOS, secure restraint. I close my eyes and see the scene. The chair, the hands that hold him down, the breathing that quiets. I wonder where attention really breaks down: whether in a misprescribed medication or a visit that doesn't happen. There are restraints that are not visible on the skin.
I think about calling Claudia, but not now. Her "I'm listening" always comes with a clarity that I don't want today. Today I want the noise that allows me to discover where the silence fails.
The afternoon falls. At the window, the sky takes on that unmetaphorical blue that only exists when things are over for today and all that remains is to wait. I decide to stop by the front desk before I leave.
The guard at the entrance—the usual one—has the knowing look of those who work watching. He prints out the extraordinary income form for the 29th. I search with my finger: camera technicians, external supplier, 7:10–7:25 a.m.; internal operator accompanying. I write in the margin: "confirm company name with Maintenance; request temporary pass; check with IT office about spooler restart." The guard looks at me over the paper.
"Everything okay, doctor?"
"Everything's fine," I reply.
I go upstairs. Roxana isn't in Maintenance, but her colleague lets me see the screen with the OTs for the block. I jot down numbers, take a mental photo. Then the elevator takes me back to the Quality floor with its mirror that always reflects two of me. I decide to turn it off.
Before I go through the turnstile, my phone vibrates. A short message from Veronica: "If you need exact times, tomorrow I can check with the intern who covered the station." I put my phone away. I don't reply. Not today.
At home, Wilson comes out to greet me with that abstract joy that taught me not to give explanations. I give him water, serve him food, pour myself a glass as if giving myself a break. I sit down without turning on the TV. The chair knows my weight. I let my mind review the day like someone running their tongue over a tooth: pain that doesn't hurt, but persists.
I think of Veronica and her precise economy. I think of Tomás and that comment I didn't know who he was referring to. I think of the phrase "it depends on who's watching" and wonder if I also avoid acting when no one is watching.
I write a paragraph without bullet points in my notebook:
"Friday 29th: the circuit was supposed to call in a starter who didn't show up. Nursing assumes that someone else will insist. The system trusts that what someone said would happen will happen. And when it doesn't happen, the record is limited to stating what was written last night. Nothing fails, because there is no record of the failure. But a man dies on Monday. I don't know if that's why. I do know that the edges don't match."
Wilson rests his snout on my knee as if signing. I pet him. I get up. I wash the old coffee cup that the morning left in the kitchen like a domestic crime scene. In the hallway mirror, I see the dark circles under my eyes, I see my loose hair that I promised myself I would tie back, I see a woman who, without meaning to, is telling a story to the hospital and to herself.
I go to bed early and sleep poorly. Sleep comes in fits and starts, like Sunday's records. I dream of a camera that doesn't record but casts shadows. I dream of a nurse who writes with invisible ink. I dream of a cold bench and a voice that says, "Be careful which question you choose." I wake up at 4:17 a.m. I give Wilson water. I go back to sleep.
I arrive at the hospital before my shift. The hallway smells of fresh chlorine and bread that never appears. In Quality, the mail brings what I requested: Reception attaches the complete spreadsheet of extraordinary income from the 29th to the 31st, Systems sends me a line that reads "spooler restart 7:12–7:19," Maintenance schedules me to review OT in the presence of Audit. Three pieces that rub against each other without fitting together.
I go down to Psychiatry. Veronica is at the station, already with the papers lined up. She greets me with a minimal gesture.
"The times," I say.
"7:55, 8:20," she replies. "The incumbent was covering a liaison. I put it as 'pending availability.'"
"Thank you."
"Doctor," she adds, before I leave. Sometimes what is not written down is also a decision.
"I know."
I turn around. I feel the pulse in my fingertips. I decide not to respond with something clever. I go down to Monitoring with Audit. The technician replays the video. The black section is an animal that does not move. I make a note in the presence of a witness; it is less poetic, more useful.
The morning slips away in formalities. Tasks that in another language would mean "take charge." In ours, they mean "pretend to take charge." I remember Tomás without meaning to. I look for him a couple more times in the cafeteria and in a hallway. He doesn't show up.
At noon, he walks past my door. He doesn't stop. He raises a hand briefly. That's enough.
At the end of the day, I take my notebook and write in no particular order, on purpose:
— Veronica: two reminders, headline in link, "pending availability." Sentence: "What is not written is also a decision." — Reception: temporary pass for camera supplier 7:10–7:25 a.m. — Systems: spooler restart 7:12–7:19. — Monitoring: blackout 7:12–7:34, no incident report. — Maintenance: appointment with Audit for OT in block 29–31. — Tomás: "be careful with the question you choose."
I could organize all this in a spreadsheet. I could put together a Gantt chart. Instead, I draw a thread that goes in and out of a rectangle with the word "Arturo." Next to it, I write: "don't forget he was a person." I repeat it quietly so it doesn't become a formality.
I turn off the computer. I go outside as night begins to cling to the windows. On the concrete bench, now empty, the space left by someone's body is almost like a mold. I sit down for a second. The cold heals. The noise of the hospital is like a tide. I let it wash over my ankles. Then I get up.
I walk toward the turnstile. The guard gives me his usual look. "See you tomorrow," he says. "See you tomorrow," I reply. I don't promise anything; I say what I know.
I cross the street with the distinct feeling of pulling on a thread that is finally offering resistance. I don't know where it will break. I know that if it breaks, it will tell us where it was sewn.
At home, before going to sleep, I open the notebook again. I write a single line: "Tomorrow, ask the same question again, to someone else, from another angle." I close it. I turn it off. And for the first time in days, sleep comes without having to negotiate it.