The Lottery

“And the winner is….”

Hannah turned up the volume in the waiting room. She was part of the evening shift, so they could pretty much do whatever they wanted in the ER after six pm. The TV announcer rolled the cage of balls to reveal the winning lottery numbers. Hannah held her ticket tightly in her hands. She’d picked her daughter's birthday. She was behind on rent and student loans, and she really wanted to get her daughter, Emma, a new bike. But above all else, she just wanted a fruity drink on a beach somewhere far away where no one could page her.

The announcer called each number as it popped from the wheel and rolled down to its designated spot. “101621”

Hannah crinkled the card. She was one digit off. One of the older nurses rubbed her shoulder, empathically.

Hannah faked a smile. Her voice pitched at the end. “Whoever wins these things anyway, no one I know!” Her pager buzzed; she was needed in room 112.

A loud shout came from room 102. “Wooh!”

The nurses at the station rushed over to the room just as the pharmacist wheeled out, nearly running him over.

“I won, I won! I can’t believe I won!” shouted the patient inside.

Hannah joined the others, curious about this self-proclaimed winner. A man strapped to oxygen with catheters protruding from his neck sat straight up in his hospital gown. The last time Hannah saw him, he could barely open his eyes for PT.

He wrung his hands together. “This must be a sign!”

He was on the heart transplant list but was recently hospitalized for sepsis. Hannah bit her lip; she wanted to feel excited for him but secretly felt like she could use the money in better ways.

The crowd of scrubs chanted around him, “Congrats!” Nurses and doctors high-fived him as he made a stiff little dance in the bed while machines chimed next to him. Her pager buzzed again, room 112.

Hannah hurried over to 112. “Mr. Edwards, how are you?”

He opened his toothless mouth to give her a Jack-o-lantern smile. “Living the dream!” Tubes sprouted from every limb. Hannah lifted his swollen feet.

“Heard we got a winner?” He winced as she bent his knees. They cracked with every movement.

Hannah chuckled. “Word travels fast.”

“What else is going on?” Mr. Edwards groaned as he sat up. “Don’t know what he’s going to do with all that cash.”

Hannah could think of hundreds of things she could do with that cash, and paying off her student loans wasn’t even first. “Sky dive. I don’t know what you would do with it?”

“Give it to you, sweetie.” He winked. She playfully rolled her eyes. He wrapped one arm around her shoulder to help him to his feet. He moaned, “He’s 87!”

Hannah guided him to the door, pulling a pool of sloshing IVs with them. “So his kids or something will get it.”

He grabbed the pole to stabilize. “Don’t got any, or at least no one visits.” He paused to suck in air. “Never seen any when I walk by.”

Hannah returned to a mountain of charting as the waiting chairs filled behind the nurses' station. She clicked into the ‘winners’ chart. His list of comorbidities was dire: heart failure, a collapsed lung last month, and recovering from sepsis. She clicked through his emergency contact. A stepsister in Oklahoma; otherwise, no one else was listed. Mr. Edwards was right. A red flag blinked at the top. She hovered over it to see what the electronic record wanted from her now, but no hover instructions appeared. Usually everything in the EMR demanded something from her, but this flag sat idle, giving her an eerie feeling. Despite the patient’s condition, the pharmacy cleared all recurring prescriptions. Maybe that’s why it was flagged. Hannah sent a message to the pharmacy to re-enter the meds. It annoyed her that she had to micromanage every other department with everything on her plate.

The next day, a News crew tried to enter the quarantined area of the transplant floor.

The head nurse barricaded the floor doors. “This is a no-visitor area; we’ve got some of our most sensitive patients!”

The News crew reporter huffed. “He won; he deserves to be on camera!” They squabbled in the hall when the call came over the loudspeaker.

“Code blue, attention, attention Code blue 201.”

Staff rushed by. The reporter froze. “Wait, isn’t that our guy?”

Within minutes, more clinicians rushed through. Hannah waited, holding her breath. With that much staff, it was never good. She counted down from ten three times, hoping someone would come back through the doors. Finally, one of the nurses she recognized from ICU pushed through. His scrubs scrunched around his waist where blood stained the side.

“Hey, all okay?”

He frowned, and he gave her a slow shake, no.

Hannah sagged into her chair with mixed emotions. On one side, it was horrible. On the other side, did that mean the money was up for grabs?

She didn’t find out for a month. Then the announcement came. Because he’d never formally accepted the money, it would go back into the lottery for a fresh round. She rushed out to buy a ticket, this time picking her mom’s birthday. The waiting room was busier than usual, filled with many people whom Hannah suspected didn’t need urgent care. Several people asked for the TV volume to be turned up while holding their lottery tickets.

“121589.” The numbers scrolled across her eyes. She picked the right numbers but in the wrong order. Her forehead pancaked on the counter in realization. A resounding aww filled the room. Many trailed out, leaving only the actual sick ones keeled over in their seats.

“Oh my god!” A female voice cried out from 126. Pills scattered to the floor like a bag of Skittles. The pharmacist trailed out of the room, this time pinned against the wall so as not to get run over by the curious group of clinicians clipping down the hall.

Hannah paused, puzzled.

It felt odd that a man in transplant won; it felt suspicious that a woman on the same floor won a month later. As clinicians ran by to congratulate the winner, Hannah typed in her name into the hospital electronic health record. She too was on the transplant list but for a liver. She scrolled through her medical history. The prognosis was dire, and her likelihood for transplant was very low, given she was 82. Her hip buzzed. Again, a page from room 112.

“Bling.”

A little red flag popped up on the winner’s chart. No other direction provided. A sinking feeling filled Hannah’s chest. As the pharmacist passed by, she asked for Mr. Edwards' pills. As he handed them over, his new watch glinted under the fluorescent light. Hannah didn’t know much about watches, but that one looked very expensive. "Do you know why the meds are missing?" She pointed to the chart. He hardly looked over, "No idea, I'll check later."

She busied herself with her loyal, forever-hospitalized favorite patient. “Mr. Edwards, do you have a crush on me?” She joked as she sauntered in with his pills.

He squawked from his bed. “I like who I like, don’t square me up with some new know-nothing!”

She poured his Lacroix into his cup for his pills, knowing he wouldn’t take the tap water.

His face brightened. “It’s the small things you know!”

Two days later, the woman in 126 was dead, unable to collect her money, and the lottery would need to be redrawn.

That evening, Hannah searched through every chart of her sickest patients, trying to find a pattern. She filtered by age, demographics, race, ZIP code, diagnosis, and gender, but nothing stood out. She compared the two transplant patients, trying to see if there was anything in the chart that would draw a link. When she couldn’t find it there, she turned to Facebook, LinkedIn, and Twitter. She thought she’d found something, focusing on the three main similarities: age, transplant status, and no next of kin.

When the announcement came out one month later that they would pick a new winner, Hannah debated if it was even worth getting a card. She bought one anyway, picking her good-for-nothing brother’s birthday. She waited on pins and needles all week. On the day of the announcement, the waiting room was so packed that Hannah couldn’t make it through the crowd.

She shoved a man wearing a beer cap with two straws in it. “Why are you all here?”

He belched before responding, “This place has some luck; everyone who wins, wins here!”

Someone shouted, “Maybe the luck only works if you’re admitted!”

This thought made Hannah shudder as hoards of people clamored to the desk with “self-diagnosed” urgent needs. Staff hurried to her aid, demanding that only legitimate issues be addressed and that any false ones would incur a hefty fine. Security started dragging able-bodied people out who tried jumping off furniture to self-inflict an injury.

Hannah jumped onto the nursing station desk. “All of you out!” Her feet flailed in front of her as if keeping a stampede of zombies away. She got one man in the eye and regretted that she just increased his odds of getting in.

Someone shouted from down the hall, “Oh my!” The crowd booed.

Scared of the rowdy crowd, she scurried down to the winning person’s room. A man strapped to a ventilator lay still. His chest moved mechanically as every machine around him kept him alive. His grieving wife curled in a chair holding the winning card. This threw Hannah’s theory right out the window. She scoured his record. In the last ten years, he’d come in for a broken arm from skateboarding. Otherwise, he was young, not on a transplant list, and married. It didn’t make sense.

She opened his chart. Sure enough, it was already red-flagged. Hannah’s vision tunneled. She searched for other flags in other accounts. They seemed to be hard-coded to these specific patients. The wife walked past the nurse station, dabbing her eyes. Hannah typed in her name. It was flagged red. Her heart raced as the woman walked out the front door.

Her pager buzzed for room 112.

Hannah started in on him before she reached his room. “Mr. Edwards, what now!”

He looked pale in his bed and thinner than before. She wondered if it were even cruel to have him here waiting for a lung transplant, she believed would never come.

He croaked. “Water.”

She reached for the sink, then thought better and fetched him a fresh can from the vending machine. Curse the rule against carbonation; let him have the small perks he can still enjoy.

She focused the conversation on the recent events. “Too bad about that guy who won and then got in an accident.”

Mr. Edwards nodded as his throat bobbed. “His mom’s here too.”

Hannah paused; she wasn’t sure she heard him right. “His mom?”

Mr. Edwards searched for air like a fish trapped in a net breaching the surface. “Waiting for a lung like me! Doubt she’ll get it.” He sucked in. “I’m younger!” It took everything out of him to laugh.

One day later, the wife of the brain-dead winner died. Her fridge fell over. Hannah tested her fridge at home several times, perplexed how the whole thing tipped over suddenly. His mom passed almost immediately after. They were dropping like flies.

Three days later, the announcement came out; the money was back on the table. Hannah had a theory now. Lines filled convenience stores. People from all walks of life stood together, from businesspeople to stay-at-home moms with toddlers clinging to their legs, waiting to buy the now-very-inflated lottery ticket.

She rushed to Mr. Edwards' room before he could page her. “Would you be willing to put me in your will?” Mr. Edwards, like the others, didn’t have any next of kin, older and on the transplant list with a low chance of survival.

She dragged Jerry from Legal. Before Jerry could even protest, Mr. Edwards shrugged, “Sure.”

Jerry stammered, annoyed Hannah had a grip on him. “Mr. Edwards, this is unethical; you can’t simply.”

Mr. Edwards cut him off. “I got thirty dollars in my account, I doubt I’m getting a lung, and ya’ll know I’m not paying this hospital bill from Hell.”

Hannah handed over the papers she forced Jerry to print. Mr. Edwards needed her to help hold the pen as he signed. She signed, then she glared down at Jerry until he signed as a witness.

“I can’t believe you’re making me do this.”

“Shut up, Jerry, you have bigger fish to fry.” She wasn’t going to let Mr. Edwards get screwed. Either way, she’d take care of him and make sure he didn’t get scammed by this rigged lottery.

The pharmacist's cart wheeled into the room. “Oh, Hannah didn’t expect you?”

Hannah side-eyed the pharmacist. “I usually give Mr. Edwards his pills.”

The pharmacist grinned. “I know, I’ll leave them on the counter for you.” He placed the pills down along with a lottery scratch card.

“What’s this?” Hannah picked it up. “Oh, a little luck for our bravest patients.” He winked.

She fought to keep her face in check. The pharmacist wheeled his cart out. Hannah trailed behind. She whispered to his back. “I know what you did.”

He stopped. “What?”

“Whatever you got going on, I know.” Her foot stopped his cart. “Is that how you do it, drop off winning cards with their pills then clear their prescription records and mess everything up?”

“You know nothing.” He tried to maneuver the cart around her.

“Do you get some kickback or something?” She pointed to the new watch now noticing he’d recently upgraded his shoes and glasses.

“It's crazy, isn’t it, how many people will buy a ticket despite every winner dying. But the stakes are so high now, and so is the pot of money.” He pinched lint off his shoulder. His puffed out his chest in arrogance. “It’s called cognitive dissonance.”

She kicked his shin. “Just shut up!”

He crunched to the floor, grabbing his leg. His face scrunched with pain.

Hannah raised her foot again, ready to kick him in the jaw. “I’m stopping your game.”

He cackled. “Good luck!”

The day they announced the winner, Hannah held Mr. Edwards hand and the lottery ticket as they watched in his room.

His voice came out raspy, his breathing haggard. “You seem to think I’ll win!”

The announcer called out the winning numbers. “547891.” Resounding boos flooded from the waiting room and adjacent rooms.

Hannah looked down at the winning card just as Mr. Edwards machine started beeping. Clinicians rushed in to revive him. Hannah curled into the corner, tears running down her face.

A voice hissed in her ear. “That’s not your winning card.” The pharmacist reached for the card. Hannah swung. She didn’t realize her own strength when she hit him in the face, breaking his glasses.

Everyone froze for a moment as blood gushed from the pharmacist's nose.

She held up the card. “I won!”