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5 am. We are down to zero. You heard me right. Zero. I cannot believe it.

I hit the side of the computer monitor with the palm of my hand. Harder. The system sucks. I assume that the screen has frozen again, that this is some cruel computer mediated joke at my expense. I consider shutting it down, starting it up again. But no. It really is zero.

And it is not just in the department, either. I actually get up from my chair, walk out to the waiting room, look for the people who haven’t been registered yet but are still there all the same, the people who are always there, with their dental pain or insomnia or orthopedic complaints, the people who live at the margins of my daily work all the time, these people almost a comfort to me to know they will always be there, that I will always have a job because they will always be there. They are not there. No one is there. The waiting room is cavernous in its emptiness, the giant plasma TV louder than I have ever heard it without the bodies to absorb the sound, the echo of my footsteps across the floor. I open the bathroom doors “Hello, is anybody there?” No one is there.

I feel elated. This has never happened to me. I have heard others talk about this moment happening to them, and I always assumed it was tinged with the same hyperbole that colors stories of great trauma saves, that it was at the very least an exaggeration, that there was always a patient already admitted that they were not counting, or some intoxicated individual sleeping it off in the hall. But there isn’t a soul. I half expect some kind of sign to light up, like when I used to play Space Invaders as a child and cleared a screen, Congratulations, you have just completed Level 1! A change in the soundtrack music, a high score listing. Something. But no.

My elation fades almost immediately into something uncomfortable. Beyond uncomfortable. It is eerie. It is like the aftermath of some actual alien invasion in a movie (which are the only actual alien invasions I know about) when almost the whole population has been wiped out, except for a couple small hold-out communities which will get driven underground to unite forces, eventually fighting back. I expect that at any second a giant monster created from unadulterated intergalactic irradiation will attempt to break in through the ambulance bay doors. It will be followed by another, another, we will huddle under our counters and try to remember where the panic button is, knowing it does not matter really because no one will know what to do with this kind of panic, how to stave off this kind of disaster. We will be so tired after having worked all night, we will feel our intellects fuzz with the problem of it, trying to find a solution.

But we will rally. We will invent weapons out of our paracentesis kits, we will make clubs with casting material, poke needles out to make maces, superheat the saline to make burning water balloons. Oh, we are fighters. Make no mistake. You chose the wrong hospital. Not on my watch.

Half-seriously, I peek quickly out the door to look up at the sky. Still dark.

Sufficiently creeped out, I go back in to the safe haven of the emergency department. The residents are playing catch with a rolled up ACE bandage and the nurses are shopping on-line, unaware of the impending disaster.

And then it happens. Of course it does. The radio starts to beep, there are three traumas coming in 10 minutes, and an entire family has just registered for cold symptoms.

If I recall correctly, Level 2 is even harder.