PROLOGUE
The clear glass ampoules sat in the locked cabinet alongside disposable syringes and sharps containers—morphine and OxyContin for strong pain, Propafenone for atrial fibrillation, and the blood thinner Pradaxa, safely sealed in little boxes and wrapped in clear plastic: standard medications in the cardiology department at Copenhagen’s National Hospital, paths to relief and a better quality of life, sometimes even a cure.
The nurse cast a quick glance over the medications and did the calculations in her head. How heavy could he be? The patient’s weight was on the whiteboard at the head of his bed, but she was too exhausted to go check.
The night had dragged on forever. Just before her shift ended the day before, someone had called in sick and she had ended up pulling a double shift. Instead of spending an evening home with her family, she had worked for almost sixteen hours. Her brain was echoing with beeping alarms, requests, and questions from anxious patients. Her feet ached in the ergonomic shoes, and her neck felt stiff.
She yawned, rubbed her eyes, and caught her reflection in the shiny metal door of the medication cabinet. No thirty-two-year-old should have chronic bags under their eyes. This job was wearing her out. Just one hour left, then her shift would end, and she could go home and sleep while the kids got up and ate Coco Pops in front of the TV.
She selected three ampoules, put them in the pocket of her scrubs, and locked the cabinet behind her. Three 10 ml ampoules of 50 mg/ml ajmaline, that would be plenty. The patient couldn’t weigh more than 150 pounds or so, which meant that 30 ml of the anti-arrhythmia drug would be twice the recommended maximum dose. Enough to cause immediate cardiac arrest and release him from his suffering. And all the rest of us, she thought, setting off down the empty morning hallway toward room eight. The old man was demanding. He was foul-mouthed and rude, and complained about most things, from the weak hospital coffee to the doctors’ arrogance. The whole ward was tired of his cranky personality.
She had always been one to speak up and do something about a situation, not a role that makes one popular, but what else could she do? Stand idly by and complain about poor staffing ratios and the shortage of beds like her colleagues? No way! She had not become a nurse just to fetch coffee and bandage abrasions. She wanted to make a difference.
A cleaning lady, sporting a head scarf and a downcast expression, pushed her mopping cart down the hall without looking up from the linoleum floor. The nurse strode past her with the ampoules hidden in her pocket. Her heart rate sped up. Soon she would perform, live up to her full potential, and try to save a life. The anticipation started throbbing through her, as if it had a pulse of its own, a life to counterbalance the emptiness that normally filled her. In this moment, she would be indispensable. The stakes were high, so much rested on her shoulders. In this moment, she would be God.
She locked the door to the staff bathroom, quickly cleaned her hands and the countertop by the sink with alcohol, and laid out the ajmaline ampoules neatly side by side. With experienced fingers, she removed the disposable syringe from its packaging and drew the medicine up, flicking it per instinct to make sure it held no air bubbles. She crumpled the packaging up into a little ball and stuffed it down to the bottom of the trash can, then, with the syringe hidden in the pocket of her scrubs, she opened the door.
In front of room eight she cast a discreet glance down the hallway; no sign of colleagues or patients headed for the restroom. She pushed the door open and stepped into the darkness. A quiet snore from the bed told her the patient was asleep. She could work in peace.
She approached the bed, looking at the old man, who was lying on his back with his mouth open slightly. Gray, bony, and dried up with a little bubble of saliva at the corner of his mouth, his eyelids twitching ever so slightly. Is there anything, she thought, more superfluous in this world than grumpy old men?
She opened the cap of the venous catheter that adorned the thin-skinned back of his hand, and drew the syringe from her pocket. Direct access to the blood that flows to the heart, an open gateway for God’s outstretched fingertip.
The good thing about ajmaline is that it is fast acting; the cardiac arrest would occur almost instantaneously. She connected the syringe to the catheter, knowing she would just have time to hide the syringe before the monitor alarm was activated.
The patient moved a little in his sleep. She gently stroked his hand. Then she pushed the plunger all the way down.
MONDAY, OCTOBER 9
FIVE DAYS EARLIER
CHAPTER 1
“Ugh, this sucks!”
Frederik wiped the water off his forehead and put the cap back on his head. He pulled up the hood of his rain poncho, made sure his under-seat bag was closed, and set off on his bike. Getting out of bed was always tough when the alarm went off at five fifteen, but some mornings were worse than others. This morning the driving rain made it hard to remember why he had ever said yes to this newspaper route. Six days a week, fifteen buildings in downtown Copenhagen, 620 flights of stairs up and down. Unfortunately it was the only way to make the money for his sophomore-class trip. And he wasn’t going to miss out on that.
The distribution point vanished into the dimness behind him as he rode along over the cobblestones. The phone in his pocket pumped music into his ears and reenergized him: “I got my black shirt on, I got my black gloves on.” Even in the rain there was something cool about having the city’s busiest pedestrian shopping street to himself. He stood up on the pedals and rode along Strøget until the old market square, Gammeltorv, and the new market square, Nytorv, opened up on either side of him. The neighborhood was full of neat stucco apartment buildings with muntin windows and copper gutters currently overflowing with autumn rain, grafted trees, and iconic Copenhagen benches with trash stuffed between their dark-green slats. The city’s municipal court’s sand-colored columns seemed to glow in the early-morning darkness, a moral juxtaposition to the age-old basement pubs across the square. During the daytime the two squares served as a hub for bicycle messengers, tourists, and people selling cheap nickel-alloy jewelry. At this hour it was completely deserted.
Frederik hopped off his bike and leaned it against the fountain in the middle of the square. He pulled out his earbuds and felt his jacket pocket to make sure he had enough coins for a warm cinnamon roll. Passing the fountain, he cast a quick glance at the surface of the water, which was rippling from the raindrops in the dark.
There was something in the water.
There was often something in the water. Every day city workers fished out beer cans, plastic bags, and curiously solitary shoes.
But this was no shoe.
Frederik reeled. Three yards away from him, in Copenhagen’s oldest fountain, a person floated facedown with their arms out to the side. The raindrops hit the person’s naked back with innocent plops, splashing up into the air like hundreds of tiny, individual fountains.
For a second, Frederik couldn’t move. He was paralyzed, like in those nightmares he sometimes woke up from, sad that he had grown too big to be comforted by his mother.
“Help! Hello?” he yelled hoarsely and incoherently. “There’s someone in the water.”
He knew he should jump into the fountain and turn the body, administer first aid, do something, but the warm urine running down his leg emphasized how unable he was to help anyone at all. Frederik looked back at the body in the water. This time really understanding what he was looking at. He had never seen a dead person before.