Sharp Scratch

Trigger warning: this story contains themes of mental health and physical violence.

There are six of them on the floor before I kneel.

The alarm is still screaming — not the flat wail of a fire drill but the sharp, pulsing shriek of a personal alarm held too long. It vibrates in my teeth. Someone hasn’t reconnected their pin. The sound drills through the room, through bone, through thought.

“FUCK YOU!”

He is face down on the linoleum, five nurses holding him in a practised constellation. One on each limb. One at the head.

“GET OFF ME! LET ME GO!”

His voice fractures on the last word. There is fury in it, yes. But there is something else too — something breathless and animal.

The head nurse isn’t restraining. Not really. She is crouched near his ear, watching his breathing, one hand hovering near his shoulder in case his head turns. Her voice is low, measured, almost tender.

“We know you’re struggling. We just need you to stay safe. You were throwing chairs. You were swinging punches.”

Her tone is the only soft thing in the room.

“FUCK YOU! YOU’RE TRYING TO KILL ME.” Is the breathy, angry and frightened reply.

The two nurses on his arms are leaning their weight through his shoulders and wrists. One adjusts his grip and mutters something that makes the other snort. A joke, quick and private. It lands wrong in the air. The head nurse taps one of them without looking up.

“Quiet.”

They fall silent. One of them smiles, brief and boyish, before lowering his head again.

At the legs, the other two stare in opposite directions. One looks at the ceiling tiles as if they hold instructions. The other fixes his eyes on the far wall, jaw tight, breathing hard through his nose. Their trainers squeak in small, relentless rhythms as the patient thrashes.

Squeak. Squeak. Squeak.

The alarm is still shrieking.

Another nurse circles the perimeter, scanning faces.

“Anyone need a swap?”

No one answers at first.

“Left arm?”

A pause. “I’m fine.”

He’s been in longest. Sweat darkens his collar. There’s something bright in his eyes — adrenaline or anger or something harder to name. Is he enjoying this?

“Right leg?”

“Yeah. I’ll swap.”

The handover is careful, deliberate. Weight shifts in increments. Fingers release and replace. The choreography is practised. No sudden gaps.

The nurse who taps out stands slowly. Her knees crack. She rolls her shoulders once, wincing, then looks at me.

“You about ready?”

I’m standing just outside the circle, holding the tray. Two syringes lie in the hollow. Two small cotton wool balls. Two round plasters already peeled at the edge so they’ll lift quickly. The sharps bin rests against my hip.

My hands are steady because I am gripping the tray too tightly for them to shake.

“Yeah,” I say. “Can we kill that alarm?”

She nods and moves toward the noise, unclipping the small black box from someone’s waistband. The silence when it stops is immediate and enormous. In its absence, everything else swells — breath, fabric, the scrape of rubber soles.

The room seems smaller without the sound.

The staff look at me now.

It’s my turn.

I step forward and they adjust automatically, rolling him a fraction onto his side. His cheek presses against the floor. One eye is visible. It is wide and furious and wet. There’s saliva on the floor.

“Please,” he says, sudden and clear. “Please don’t.”

I don’t know if he’s speaking to me or to all of us.

I kneel.

The linoleum is cool through my trousers. I set the tray down within reach and pull the sheaths from the needles. The sound is small — plastic sliding from metal.

Every time, there is a flicker. A question that never fully forms.

Is this really the least restrictive option? Or is this monstrous?

That’s the phrase: “least restrictive”. I play it over and over in my head, what a sad state of play when this is the least restrictive.

We don’t restrain with pain. We use leverage, body weight, pressure above joints. It is taught carefully. It is audited. It is documented. It is, on paper, humane.

Five people holding one person on a hospital floor.

I reach for the waistband of his trousers.

“Hold him steady.”

They tighten, not cruelly, but completely. The fabric lowers only as much as it must. The top right quadrant of his glute, pale under fluorescent light. Exposed skin in a room full of colleagues.

His body jerks once, hard. He’s stopped with swearing and insults now, his behaviour is almost resigned to this inevitability. I don’t judge him for fighting, I don’t judge him for swearing, in fact I almost commend it, I like to think I would be exactly the same.

I clean the site with one swift circle. The alcohol smell rises sharp and clinical.

“Sharp scratch,” I hear myself say.

The words sound misplaced. Something you say in a GP surgery to a child bracing for a vaccination. My voice is even. I do not recognise it.

The first needle goes in cleanly. Skin yields. Muscle receives. I depress the plunger steadily — one, two, three, four, five. The liquid empties. I withdraw.

He gasps, more in rage than pain.

“Second scratch.”

The second syringe follows the first path. In. Down. Out.

It takes seconds.

I press cotton briefly, more out of habit than hope, and smooth the small plasters into place. There is almost no blood.

“Done,” I say.

The word feels insufficient.

I stand. Peel off my gloves. Drop them onto the tray. The sharps bin opens with a practised thumb. One syringe falls in. Then the other.

Click.

Behind me, he is still fighting.

Nothing has changed.

The medication will not work for at least ten minutes. Maybe fifteen. There is no cinematic slackening, no sudden surrender. Chemistry moves at its own pace.

The head nurse is still talking to him.

“Slow your breathing. In through your nose.”

He swears at her. His voice cracks again.

I pick up the tray and step out of the circle. No one looks at me now. They are focused on their holds, their footing, their breath.

In the corridor, the air is cooler.

I walk to the treatment room and set the tray down beside the sink. My reflection in the metal cabinet is faint and warped. My face looks ordinary.

From down the hall, through two sets of doors, I can still hear him shouting.

Someone laughs — not loudly, not unkindly, just the sharp exhale of adrenaline leaving the body.

“Good job,” a voice says somewhere behind me.

I don’t know if it’s meant for me.

I turn on the tap and watch the water run over my hands. Clear. Warm. Unremarkable.

Less than five minutes have passed.

In the room at the end of the corridor, five nurses are still on the floor, holding a man who did not want to be held. The medication is moving invisibly through muscle, toward blood, toward brain. It will soften the edges. It will quiet him. It will make the paperwork easier.

For now, he is still shouting.

I dry my hands carefully and reach for the notes.