CHAPTER 1: THE WARNING  

Dr. Rajesh Nirula stopped chewing on his hamburger. All his attention zeroed in on a sheet of tan paper folded in two, the thickness and size of a birthday card. Nirula had seen and held such cards many times in his forty-three years of life. His first thought: My birthday came and went three months ago. His second thought: Why would the card show up in my hospital mail-slot without a return address or even my name on the envelope?  

But it was the card’s message that turned his face muscles limp, leaving him open-

mouthed: “YOUR HEART ATTACK WILL ARRIVE WITHIN 1 HOUR.”  

A heart attack? The leading cause of death in the world? A chill went through his spine. Just last week, to satisfy his curiosity, he ran his heart attack risk profile through an algorithm. The results: My chance of having a myocardial infarction any time soon are less than 1%. How could this stupid card be right? Then he remembered: Up to 25% of people who suffer heart attacks have no known risks beforehand. His heart paused and pounded as the possibility invaded his consciousness. 

His life flashed through his mind: India’s misery, America’s richness, the pizzas he had twirled through college, medical school, emergency medicine at the Washington D.C. Capitol Hospital, and the most beautiful American girl he had ever seen, now his wife. His life was perfect, at least up until the moment he opened this dreadful card. His eyes hadn’t blinked once since reading the card for the first time. The black words on the tan paper seemed to acquire a life of their own and shout a scornful threat to everything he had accomplished so far.  

Nirula reflected briefly on his two children. Despite his job as an emergency room physician facing deadly traumas and illnesses every day, he had never given much thought to leaving them behind at an early age. In fact, he had never felt mortal up to now. What would his family do without him?  

Something on the paper suddenly drew his attention. Just below the word “will” was a small gray disk. With one finger, he briefly touched it. Burning hot. 

“Shit,” he moaned as his fingertip turned red. He clenched the card and quickly surveyed the busy cafeteria crowd. Nobody seemed to have heard him. He ran his hand through his hair. Still thick. He took a deep breath, then began massaging his closed eyelids. Good genes, exercise, and avoidance of unhealthy substances had kept his body in shape. He was still in his prime. Or so he had assumed up until today. 

After a moment, Nirula opened his eyes and stared at the burger. The yellow cheese had solidified, droplets of fat spotting the dish below. His heart protested in his throat. Not the best cardiac-prudent food. The smell of fried grease drifted from the grill and hung in the air. A fleeting sense of nausea bloomed from his stomach. Was the card a joke? Who would send him something like this? Fear receded like a wave from the shore and crashed into anger. 

Suddenly, he had an idea. Those Congressional idiots had gone too far. First the ban on large sodas, then the trans-fats prohibition. Washington DC was becoming worse than New York 

City. Congressmen often asked the Capitol Hospital’s doctors for advice. Just because Nirula had expressed his support of legislation against fast foods didn’t mean they had to use him as a 

guinea pig for such scary advertisements. Who were those morons trying to convince with this crap? A message like the one on the card would only piss people off, push the public to hurriedly eat more junk food before the government made it disappear. Nirula sighed and glanced at his watch. His lunch break had taken longer than planned. January was a busy month in the ER. 

After the holidays’ intoxications, arrhythmias, heart attacks, and suicides, the flu season was in full swing.  

He flung the card onto the table with a two-fingered gesture underscoring relief and vindication, reassembled his hamburger, and finished it off in four giant bites. The Coke, in several long slurps, was next to disappear. Soon the remnants of his lunch hit the trash can, right along with the tan card.