The floor at St. Catherine’s smelled like a mix of industrial bleach and canned chicken broth, a heavy, dead sort of smell that settles into your clothes even when you have only been there two days. I was in bed 318B on the third floor, stitched right down the middle from a bowel resection I did not want and could not talk my way out of. My daughter, Melissa, had dropped me off on a Monday morning with three canvas bags of oversized nightgowns and a fruit basket nobody touched, then kissed my forehead like she was dropping me off at a matinee she didn’t plan to stay for.

By Wednesday, my ribs felt like someone had driven a dry pine stake straight through my diaphragm. Every time I coughed, the staples pulled. The room was divided by a heavy green plastic curtain that had a coffee stain near the middle hem shaped roughly like the state of Florida. I stared at that stain for hours because the television bolted to the wall only got three channels through some ancient cable box that hummed like a refrigerator with a dying compressor.

On the other side of that Florida stain was Rosa Alvarez.

Rosa was eighty-one, maybe eighty-two, though in a hospital gown everyone looks about the same age, which is roughly the age of wet cardboard. Her hair was cut into a sharp, gray bob that never seemed to get mussed no matter how much she tossed around. Every evening at precisely 6:15, her daughter called. The phone would ring twice before Rosa reached out with a hand that shook like an engine idling low and pressed the speaker button.

They spoke in Spanish, fast and musical, and even though I didn’t know the words, I knew the cadence. I knew the way a daughter sounds when she is trying to convince her mother that everything is fine back at the house, and I knew the way a mother sounds when she is trying to sound stronger than her lungs.

Rosa would smile at that little black speaker box like the voice itself was a woolen blanket pulled up to her chin. Then she would say, “Mañana,” and the screen would go dark, and the room would drop back down into that heavy, wet-cardboard silence.

That was the Rosa of the daylight hours. At night, the room shifted.

It wasn’t that she got confused, exactly. It was more like the light left her eyes and left behind a very thin, very sharp kind of terror. The second the night cart wheels started their rhythmic clicking down the linoleum hallway outside our door, Rosa would stiffen under her sheets.

She wouldn’t call out for a nurse. She wouldn’t press her call button. She would just turn her face toward my side of the curtain and whisper into the gap.

She said the same thing every night. “No blue one. Watch the blue one.”

The nurses told me she had hospital delirium. They weren’t mean about it, not really. They were just young and tired, running on double shifts with clipboards tucked under their arms like shields. One of them, a blonde girl with a permanent grease smudge on her white tennis shoes named Mallory, told me while she was changing my IV bag that Rosa had suffered a small stroke six months back and her brain just sort of stuttered after dark.

“Sundowning,” Mallory called it, like it was a weather pattern you could track on the evening news. “She thinks her house is on fire half the time. Just ignore her, honey. You need your rest.”

I tried to ignore her. I really did. I was sixty-nine years old, and I have always been the sort of woman who minds her own teacup. I don’t make scenes in grocery stores when the clerk overcharges fifty cents. I don’t send cold eggs back at diners. If the soup is lukewarm, I eat it and leave a decent tip anyway because I know what it is to stand on your feet for ten hours straight.

So I lay there in 318B and stared at my Florida stain and tried to sleep through the clicking of the medication carts.

Then Jenna Polk started her shifts.

Jenna wasn’t a registered nurse. She was a night aide, the kind of person who emptied bedpans, brought fresh pitchers of ice water, and occasionally handed out the little paper medicine cups after Mallory scanned the barcodes on our wristbands. She had a high, tight ponytail that swung against her neck like a metronome and wore hot pink sneakers that squeaked on the wax even when she tried to tiptoe.

She also wore her plastic identification badge flipped backward so the metal clip was all you saw from the bed. When I asked her about it on her first night on duty, she just laughed a short, dry sound that didn’t reach her eyes and said, “It keeps swinging into the basins, honey. Easier this way.”

That first night, Jenna brought in the little paper cups on a plastic tray. Rosa took one look at her tray, pulled her blanket up to her chin, and pressed herself hard against the metal rail of her bed until the springs groaned.

Rosa said, “No.”

Jenna didn’t blink. She just set the cup down on Rosa’s rolling table and let out a long breath through her nose. “Here we go again. You take your little green pill or I’m calling Dr. Vance to tell him you’re acting up.”

Rosa didn’t take the pill. She kept her mouth clamped shut like a turtle pulled into its shell. Jenna muttered something under her breath about stubborn old goats and picked the cup back up, dumping the contents into her palm before walking out into the hall. I told myself she was just taking them back to the station to crush them in applesauce. That’s what they do for people who won’t swallow. I told myself that three times before I managed to turn over onto my side without screaming at my stitches.

By the second night, the pattern had settled into something that made the hair on the back of my neck stand up like wire.

Jenna came in at midnight with Mallory. Mallory scanned my wrist, then scanned Rosa’s wrist, dropped the little paper cups, and hurried out because her pager was buzzing for a room down at the end of the hall where a man with pneumonia kept trying to climb out the window.

Jenna stayed behind. She stood between our beds with her pink shoes planted wide apart on the mustard-colored linoleum.

Rosa spit one tiny white pill straight out onto her chin. It rolled down her hospital gown and landed in the fold of her sheet.

Jenna leaned over the bed. Her voice dropped into that low, flat hiss that people use when they think nobody else is listening. “You want them to think you’re crazy? You want to go down to the secure ward? Because I can make one call and you’ll never see that Spanish-speaking daughter of yours again.”

Rosa looked right through the gap in the curtain at me. Her eyes were wide and milky with cataracts, and they were wet, but no tears fell. It was the look of an animal that had stopped trying to bite long ago because its teeth were too soft.

Jenna reached out, picked up the white pill from the sheet, and dropped it into her scrub pocket with a little flick of her wrist. Then she picked up the second pill, the blue one, and shoved it toward Rosa’s mouth. “Swallow. Now.”

Rosa swallowed. Her throat gave a hard, dry jerk.

Then Jenna turned her head toward my side of the curtain. Her smile came back on like an electric sign in a diner window after the power flickers. “You’re due for your second pain dose too, honey. Let’s get you squared away.”

I looked down at my tray.

My chart on the whiteboard by the door said three pills every six hours after the surgery. That was the rule Dr. Vance had written in black marker himself. Two white ones for inflammation and one little blue oval for the deep stitching pain.

My tray had two pills. Just the white ones. The blue oval was missing.

My mouth felt like someone had rubbed it down with coarse sandpaper. I didn’t reach for the cup. I pulled my hands back under the sheet where she couldn’t see my fingers shaking.

I said I felt a little sick to my stomach and didn’t want the medication right now.

Jenna’s smile didn’t drop, but the corners of her mouth tightened until they looked like sewn thread. “Doctor’s orders, honey. You skip this, you’re going to be crying by four in the morning when the wear-off hits.”

“I’ll take the risk,” I said. My voice sounded thin, like paper tearing in another room.

Rosa made a tiny, wet clicking sound from behind the Florida stain. Just one word, barely louder than the hum of the cable box.

“See.”

Jenna didn’t say anything more. She took my cup, dumped the two white pills back into her palm, and dropped them into her left pocket right alongside the ones she’d taken from Rosa. Then she picked up her tray, gave me a little pat on my knee through the blanket that felt like a cold fish sliding across my skin, and walked out. The pink sneakers didn’t squeak once on the way to the door.

That was when I reached under my pillow and pulled out the cheap pink plastic hairbrush Melissa had bought me from the dollar store. I didn’t use it for my hair. I used the handle to pry open the back of my phone where I kept a little pad of yellow sticky notes I’d brought from home to keep track of my crossword puzzles.

I didn’t sleep for the rest of that night.

Every time the cart wheels clicked down the hall, I wrote. My handwriting looked like a spider that had crawled through an inkwell and died on the page.

At 2:19, Jenna went into Room 316 down the hall. I heard her voice through the transom, bright and cheerful. “Time for your little blue helper, dear.”

At 2:42, I heard the faint, metallic clink of a pill bottle cap being unscrewed in the supply closet across from our door, followed by a soft, rhythmic rattling. Like someone shaking dice in a leather cup.

By sunrise, my yellow sticky note was covered front and back.

I had written down three names: Jenna Polk, Mallory Hayes, and Dr. Vance, because I didn’t know yet who was just careless and who was part of whatever game was being played in the dark. I had written down two times: 2:26 and 4:11. And I had written down the four-digit number I managed to catch when Jenna leaned over my tray and her backward badge swung out from beneath her pocket for half a second.

4419.

At 5:40, the day shift came on with a clatter of metal charts and bright, sharp overhead fluorescent lights that made my eyeballs ache behind my lids. A nurse with short red hair and a mouth that looked like she’d sucked on a lemon all the way from Bangor came in to check my vitals.

I asked her for the patient advocate.

She stopped with the blood pressure cuff half-wrapped around my arm. “The advocate’s office doesn’t open until eight-thirty, Mrs. Bennett. Is your incision draining?”

“I want the advocate,” I said. I didn’t blink. “And I want my chart from the night shift brought into this room before I let anyone else touch my IV.”

She looked at me like I was just another old woman losing her grip on the linoleum. “I’ll see what I can do after I finish my med pass.”

She didn’t come back with the chart. At 6:12, Rosa’s daughter called on the wall screen. Rosa sat up straight in her bed, her hair sticking out in gray tufts on one side, and stared at the little black camera lens. She didn’t smile this time. She just kept saying three words over and over to the screen, her voice rising until it cracked like dry pine.

“Pastilla azul. Pastilla azul. Pastilla azul.”

Blue pill. Blue pill. Blue pill.

The daughter on the other end started crying. I could hear her through the tiny speaker, a high, thin wail like a gull over a parking lot. Then the screen went black because someone at the nurse’s station had hit the disconnect button.

At 7:03, Dr. Vance walked into my room with his white coat flapping and his stethoscope dangling from his pocket like a dead snake. He looked tired, the kind of tired where the skin under the eyes turns the color of an old bruise.

“I hear you’re giving the morning crew a hard time, Martha,” he said, reaching out to pull back the curtain between us.

I reached out and grabbed his wrist with both hands. My fingers weren’t strong, they were like dry twigs, but I dug my nails into the cuff of his white coat until he stopped moving.

“Don’t touch that curtain,” I told him. “And don’t you dare give me another pill until someone from risk management looks at the yellow pad I’ve got sitting right here under my pillow.”

He blinked down at me. For a second, the doctor face slipped off, and I saw a middle-aged man who had sixteen more surgeries scheduled before dark and didn’t want to deal with a stubborn woman from the paper-mill towns.

“Martha, what is this about?”

“It’s about the blue ones,” I said. “The ones that aren’t making it into our mouths. Rosa’s been trying to tell you for three days, but everyone on this floor thinks she’s just got water on the brain.”

He stared at me. Then he looked at the closed curtain, where Rosa was sitting completely silent now, her breathing sounding like a saw hitting a knot in a pine board.

He didn’t pull the curtain back. He dropped his hand from my wrist and pulled his little penlight out of his pocket, clicking it on and off twice against his thumb.

“Stay right here,” he said.

At 9:18, the hospital room phone on the wall next to my bed let out a sharp, electronic ring that made me jump so hard my staples burned like fire.

I reached over and hit the speaker button with my thumb.

A woman’s voice came through, crisp and cold as river ice in November. “Mrs. Bennett? This is Sarah Lin from hospital risk management. Dr. Vance gave me your notes. I need you to tell me everything you saw before Jenna Polk comes back on shift at midnight.”

I looked over at the Florida stain on the green plastic curtain. On the other side, Rosa’s bed was empty; they had wheeled her down to physical therapy ten minutes ago, or maybe somewhere else where the lights stayed on all day.

“I saw her take them,” I told the phone. “And I’ve got the badge number right here.”

The line was quiet for a long second, just the sound of papers shuffling on the other end, like someone turning the pages of a very thick, very ugly ledger.

“Mrs. Bennett,” the risk officer said, her voice dropping an octave until it sounded like iron hitting iron. “Jenna’s shift logs show she dispensed thirty-two milligrams of oxycodone to your room and Mrs. Alvarez’s room over the last three nights. The pharmacy inventory says those doses are entirely unaccounted for in the waste bin.”

I didn’t say anything. I just reached down and pulled the yellow sticky note out from under my pillow, smoothing out the crumpled corner with my thumb.

“I know,” I said. “And she’s got pink shoes that don’t make a sound.”

The risk officer didn’t laugh. She didn’t tell me it was hospital delirium. She just asked me to read her every single name I had written down, starting with the ones Rosa tried to say before the carts even reached the door.