Chapter 3: The Open Door

Chapter 3: The Open Door

The whispers followed Elara down the corridors like a trail of breadcrumbs leading to her own execution. They were soft, clinical, and all the more damning for it. Holloway, sixty-eight, laparoscopic cholecystectomy… anoxia of unknown origin… Cohen’s record is spotless… Vance was in the room…

The Morbidity and Mortality conference was scheduled for Friday. A neat, formal inquest into how a man could walk into a hospital for a routine procedure and end up on a slab in the morgue. Elara spent the next two days in a state of hyper-vigilance, her professionalism a brittle shield against a rising tide of panic. She triple-checked every chart, every medication, every piece of equipment. She was trying to prove, mostly to herself, that the fortress of her hospital was still secure, that Mr. Holloway’s death was a one-in-a-million tragedy. A fluke.

It wasn't.

Wednesday brought a knee arthroscopy. The patient was a fifty-four-year-old woman named Carol Gable, a cheerful librarian with a kind, wrinkled smile. Dr. Cohen was the anesthetist. When Elara saw his name on the board next to hers, a knot of ice formed in her stomach.

“Just a coincidence,” Cohen murmured to her as they prepped, his voice low. He wouldn't meet her eyes. The easy-going man from a few days ago was gone, replaced by someone tense and guarded. The entire OR team was on edge, the usual pre-op banter replaced by a taut, professional silence.

Elara wanted to believe him. She needed to. She focused on Mrs. Gable, on her reassuring chatter about her grandchildren. Normal. Everything was normal.

The surgery was even more routine than Holloway’s. A simple clean-up of some frayed cartilage. Dr. Evans, the same surgeon, worked quickly and efficiently. The monitors beeped their steady, reassuring rhythm. Elara moved through her tasks with the seamless precision of a machine, her mind a blank slate where she refused to allow the shadows to creep in. For ninety-three minutes, everything was perfect.

“Alright, bringing her out,” Cohen announced, his voice tight.

Elara watched the patient, her heart hammering against her ribs. This was the moment. She watched for the flutter of eyelashes, the first cough against the intubation tube, the small signs of a mind returning to its body.

Mrs. Gable’s eyes snapped open.

There was no groggy transition, no sleepy confusion. One second she was under, the next she was awake, her eyes wide and fixed on the ceiling with an expression of pure, animalistic terror.

A sound started in her throat, a low, guttural moan that escalated into a full-throated, blood-curdling scream.

“Easy now, Carol,” Cohen said, his voice strained. “The surgery’s over. You’re in the recovery room.” He was lying; they hadn’t even moved her yet.

Her head thrashed against the pillow. “No! Get it away! Get it away!” she shrieked, her voice raw.

“Get what away, Mrs. Gable?” Elara asked, moving to her side, trying to keep her voice level and calm.

The woman’s terrified eyes locked onto Elara’s, and for a heart-stopping second, she saw a flicker of the same deranged recognition she’d seen in Mr. Holloway.

“The smiling thing!” Mrs. Gable clawed at her own face, her nails leaving red tracks on her cheeks. “It was in the dark! It looked out through your eyes! It looked at me!”

The room went cold. Elara felt the blood drain from her face. It looked out through your eyes. The accusation was so specific, so impossible, it felt like a physical blow. The surgical team froze, their faces a mixture of confusion and alarm.

“She’s having a severe psychotic break,” Evans snapped. “Post-anesthetic delirium. Cohen, sedate her. Now!”

Cohen fumbled for a syringe of lorazepam, his hands shaking slightly. As he injected it into her IV, Mrs. Gable’s screams softened to hysterical sobs, her words dissolving into a horrifying, nonsensical babble.

“…the carver… he’s making a new mouth… a happy mouth…” she whimpered, before the drugs finally pulled her back under into a twitching, uneasy silence.

The aftermath was a quiet, bureaucratic storm. Mrs. Gable was transferred to the ICU, and then to the psych ward. A full neurological workup was ordered. But the damage was done. Twice, in less than a week, a routine procedure involving Dr. Cohen and Nurse Vance had gone catastrophically wrong. Coincidence was no longer a plausible explanation.

The Head of Nursing, a stern, impeccably dressed woman named Eleanor Albright, called Elara into her office that afternoon. Dr. Cohen was already there, sitting ramrod straight in a chair, his face pale and clammy.

“Close the door, Elara,” Ms. Albright said, her voice devoid of warmth. She gestured to the empty chair beside Cohen. The blinds were drawn, casting the room in dim, oppressive stripes of light.

“I’ve just come from a meeting with the Chief of Surgery and hospital administration,” she began, her fingers steepled on the polished surface of her desk. “Two major adverse events in three days. One fatality, one acute psychotic episode. The only common denominators are this operating room, the anesthetic, and the two of you.”

“Eleanor, my record is flawless,” Cohen protested, his voice thin. “I followed protocol to the letter on both patients.”

“And yours, Ms. Vance?” Albright’s sharp eyes pinned Elara to her seat. “Was everything by the book?”

“Yes,” Elara said, her voice barely a whisper. “Everything.”

“Mrs. Gable’s husband is threatening to sue. He says she has no history of mental illness. She went in for a knee scope and came out… like this.” Albright let the words hang in the air. “Until the internal review is complete, you will both be assigned to administrative duties. No patient contact. We can’t risk a third incident.”

It was a suspension in all but name. A professional quarantine. Elara felt a wave of dizziness, the walls of her fortress crumbling around her. She was being treated like a contamination. A virus.

She left the office in a daze, ignoring Cohen’s attempt to speak to her. She needed to be alone. She found an empty supply closet on a deserted floor, the air thick with the smell of disinfectant and cardboard. Leaning her back against the cool metal shelves, she finally let the tremors take over.

It looked out through your eyes.

Mrs. Gable’s words were a brand on her mind. Was it possible? Could this thing… use her? Was she the vector? The carrier? The open door through which it crawled to get to them?

She squeezed her eyes shut, pressing the heels of her hands against them until colors exploded behind her lids. She was exhausted, a deep, cellular exhaustion that sleep couldn’t touch. Her reflection in the polished steel of a supply cabinet door was a warped, distorted parody of her face—pale, hollow-eyed, on the verge of shattering.

She stared at it, at the pathetic, frightened woman looking back at her. Get a grip, Elara. You’re just exhausted. You’re projecting.

Then, for a single, heart-stopping beat, the reflection changed.

It wasn't a trick of the light. The haggard face in the steel wavered, and for a fraction of a second, the mouth was wrong. Her own lips were gone, replaced by a thin, pale, waxy crescent that was pulled taut in a grotesque, unmoving smile. It was his smile. Carved onto her face.

She gasped, stumbling back, her hand flying to her mouth. She blinked, and the reflection was normal again. Just her. Just tired, terrified Elara Vance staring back from the warped metal.

But she had seen it.

It wasn't just a nightmare. It wasn't just a patient’s delusion. It was real. The man in the hallway, the smiler, the carver—it wasn’t just following her anymore. It wasn't waiting at the threshold.

It was inside. Looking out through her eyes.

The door wasn’t in her bedroom. It was her. She was the open door.