Kaiser permanente doctors notes

This document on the Kaiser Permanente website is short, but it says a lot about how the Kaiser system operates: https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/how-kaiser-permanente-providers-are-paid-ca-en.pdf
Keep in mind that this is a Kaiser-prepared document that is "sanitized." For example, it omits the key point that Kaiser Medical Groups are FOR-PROFIT.
This section drew my attention: "Every month, the Health Plan prepays the Medical Group a set dollar amount for each member enrolled. This payment method is called “capitation.” The Medical Group receives this payment for each enrolled member whether or not the member seeks or receives services during that month."
Those two sentences tell you most of what you need to know about Kaiser. Kaiser basically is a monthly premium collection business that happens to provide a few health care services on the side. Kaiser Primary Care Physicians do NOT want to hear from you, let alone address your medical concerns. The profit-maximizing action is to discourage Kaiser members from seeking ANY services whatsoever in any given month. The Kaiser system likes the six-week lag time between making appointments and seeing a physician because that is one more month that they can claim "capitation" payments without providing medical services.
None of this is surprising. There is the famous White House audio recording of a conversation between President Richard Nixon and advisor John Ehrlichman in 1971 concerning the Kaiser Permanente business model: "All the incentives are toward less medical care, because … the less care they give them, the more money they make.” https://en.wikisource.org/wiki/Transcript_of_taped_conversation_between_President_Richard_Nixon_and_John_D._Ehrlichman_%281971%29_that_led_to_the_HMO_act_of_1973:
That webpage about physician compensation apparently exists because it was a condition of lawsuit settlements in 2003. See: https://consumerwatchdog.org/uncategorized/kaiser-agrees-disclose-physician-guidelines-compensation-settle-suits/ (Thanks to CyclingRealtor for his/her post about the 2003 lawsuit settlements.)
After decades (a lifetime more-or-less) in the Kaiser system, I've concluded that too many Kaiser personnel today (especially physicians) really and truly do NOT want to see Kaiser members. They didn't know or care who you were before you set foot in their medical offices and they would be happy if they never saw you ever again in their lives. To too many Kaiser personnel, Kaiser members are just nameless, faceless sources of monthly "capitation" payments and are an unwelcome burden on the rare occasion when they request medical services.
A "good" Kaiser member pays his/her monthly premium bill and demands NOTHING from the Kaiser system ... until age 65 when Kaiser and its greedy for-profit Medical Groups and Hospitals can start "milking" the Medicare system.

Doctors found that eczema in young children is often the first sign of a potential allergy problem. The commonest form of eczema is atopic dermatitis, also called allergic eczema. If atopic dermatitis becomes established it is considered one part of the 'classic' allergy triangle of eczema, rhinitis and asthma, diseases that can appear independently or together. An allergy to house dust mites (HDM) can impact on all three diseases making symptoms worse. Below is a list of common causes of allergy in children. Please take note of the frequency of mites.
Common causes of allergy in children and the target organ
Gut: Egg White, Milk, Soy, Peanuts, Wheat, Fish, Nuts
Skin: (same as gut) Mites, Animal Skin, Pollens, Cockroaches, Fruits
Lungs: Mites, Moulds, Pets, Cockroaches, Pollens, Animal Skin
Nose: Mites, Pets, Moulds, Pollens
Eyes: Moulds, Pets, Mites, Pollen
In finding out a cause of allergy detective work is required. Doctors are best detectives!
Reference, The UCB institute of Allergy. European Allergy White Paper; Allergic disease as a public health problem. Braine-l' Alleud: UCB Pharma. Sector, 1997

32M
Complainants of note, AFib, GERD and hiatial Hernia
For any gastro doctors out there I’m just wondering is slightly elevated levels of bilirubin an thing to be over concerned about?
I had a blood test about 5 months ago and my doctor told me everything was perfect in it, while recently in hospital they looked up my last blood and told me I’d slightly raised bilirubin but everything else in my LFT was perfectly in range, when I asked what they meant they told me my bilirubin was 23umol and they like it to be from 0 to 21umol they didn’t see concerned at all
I have now convinced myself I have a liver condition or pancreatic cancer, I’m wondering would I of noticed anything if my bilirubin kept rising from then to now ?
Thanks for any help

20 Female
i have been experiencing blood when wiping after pee/poop but i am confused where is the blood coming from since there is no traces of blood in my urine or stool but only when wiping.
I suspected it from my vagina area because it feel sore once i touch/rub it in the middle so i thought maybe it is irritated, and also notice blood when wiping after peeing and once had bleeding during sexual intercourse
I also suspected it from my anus area because when i first notice this sympyom, it was after i poop then when i wipe there is blood in my wipes and I feel like there is fluid or watery feeling betwen my butt cheeks even after wiping them off
I had no pain with my abdominal area tho and no other green/white/yellow discharge aside from I can see the blood in my undergarments
I am confused if the blood is due to hemorrhoids or some vaginal issues since I could feel a flow sometimes
note: around this month i have a feeling of urging to pee whenever after pooping or usually in the morning after the very first pee like i would come back atleast 3-5 times to pee for very small amount but after that scenario the urge to pee will just go away and went back to normal. Could this be a sign of UTI?
ever since around 2021, i also experienced some odor whenever after peeing but i thought maybe just because of the wet underwear after washing the vagina since it will just go away whenever i wear new/dry underwear. Could this be also a sign of untreated BV that may lead to UTI now?
what type of doctor should i see first?

Hey there! Here is a little intro before going into the full story. My name is Kai, I am a 20 year old male, and Have been working this office job for 2 and a half years. My coworker, let's call her Sunny(27F), has been working the same job the same amount of time.
We got hired on at this job together and from the first few weeks of training I offered to give sunny a ride to work every once and awhile since her place was between the location and mine and she does not drive due to her high anxiety regarding being behind a wheel, and that causing her heart problems.
Sooner rather than later she began to rely on me getting her to work. And at first I didn't mind because of said reasons above. Even after I moved I was still willing to pick her up as we had arranged ways for her to pay for gas and have emergency rides should I not be able to take her.
Then she started asking for rides to other places like doctors, food, even groceries. At first I didn't mind as I have a pretty free schedual.
Things really only started to not sit right when she would constantly get annoyed if I could not take her to these outside-work activities even though she has a husband who could have taken her and other people willing to as well.
As of recently she has been having issues with her husband, which I will not go into severe detail for, that has caused her to believe they might be close to a divorce. Steam rolling from that she has also been on a lot of new medications due to her health problems.
Every day this week as she's gotten into my car all she does is complain about her situation. Which is fair and she has every right to vent. And as a friend I don't mind listening to her and giving advice when appropriate.
What I do mind though is that, the first time, she was yelling the whole time, screaming her problems even when we stopped to get gas for my car. And when I attempted to calm her, she snapped at me. I usually brush things like this off my shoulder but yelling and sharp tones have always been trauma triggers for me to recede into my emotional shell.
Things have steadily gotten worse. When making small talk about workplace drama with her I mentioned something she did not agree with and her response was "I DONT WANT TO AGRUE THIS WITH YOU KAI" Which was a common phrase I heard in my childhood that always translated to "Shut up your opinion doesn't matter!" Etc.
Once again this has triggered my own trauma various times. Over the course of the week I have attempted to communicate with her that I wish to take a step back from her personal problems. This is to shift my focus back to my own mental health and reduce the amount of stress that is severely impacting my work style. (Side note: I'm not meeting quotas because of the emotional stress this is causing me.)
Every time I have interacted with her as of late she's taken her frustrations out on me and hurt me in some way or form. And the worst part about it is that she had texted me and several of our friends on the weekend before saying she was going to "keep her head down so she doesn't accidently hurt any of us with her own issues."
I've talked to several of our fellow coworkers and friends about how I'm feeling and several have expressed that dispite the amount of drama it may cause I have every right to tell her that I need space and she needs to find another ride until she gets her problems sorted and/or apologizes and stops.
While their opinions about this situation matter I would also appreciate if any of you lovely readers have any advice to give. Or even critics if I am being an asshole.
Thank you for your time. -Kai

This post relates to doctors in the US.
Note: I’m not saying they’re overpaid, I’m saying they’re not underpaid (i.e. they’re fairly compensated).
So, how much do you think the average doctor gets paid a year? $200k? $250? $300k?
The answer is 3.5 times the average salary of a lawyer, four times that of a professor, four times that of a civil engineers and three times the salary of a software engineer. If you’re an accountant, you need to make partner at a Big 4 firm to make as much as an average doctor. The answer is $350k.
I know not all specialties earn that much but even at the lower end, pediatricians make $250k on average - a salary most people don’t even dream of earning. On the high end, orthopedic surgeons make on average $570k/yr, cardiology is at $510k and dermatology is at $440k.
Yes, most doctors spend a decade or more training but think about what your income will be after 10 or so years of education and experience combined. Will you be earning anything near those figures? More than 98% of Americans don’t.
To those still not convinced, what salary do you think doctors should earn? If $480k is not enough for a radiologist, what is?

I'm getting top surgery tomorrow and I'm so excited 😊 For reference, I'm located in Washington using Kaiser Permanente insurance for DI with nipple grafts, so if anyone has questions that I may be able to answer because of location or insurance then please ask! I've been soooo lucky...started the process in February, so it's been super quick. Thsnkfully my grandma offered to help me while I recover for as long as I need someone to help me with things. I may be brave enough to post progress pictures, but I'm not sure yet.

26 y/o Persian-American male - I sometimes feel like my brain is a lvl. 45 Pokémon in my party (of other organs? IDK), and because I don't have any 'gym badges' under my belt (aka a college degree that I've shamed myself for ever since, in a familial structure founded upon my Father immigrating here from Iran at 17 due to an ongoing war, learning English, and earning his Doctorate degree at UT Austin in Mathematics by 24/25 y/o + Mother whom also immigrated here from the same area & around the same time which has been working as a laboratory scientist within a highly established Hospital in TX), I wake up each day with ~75-80% chance of it totally steering me off course with regards to productivity in any/all facets of my life; further, I find that it has oftentimes made a decision for me prior to any kind of a chance I should/would have had otherwise at deductively/rationally responding with an actual expression of what 'I' want and/or think is best, making it that much more difficult to break my current insomnia(-l?), burn out, depression, and productivity paralysis - all in which I've been experiencing this past year. For example: my mom telling me we have to go somewhere I don't want to in the morning, my replying 'consciously', usually in agreement in an attempt to avoid further arguments/conflicts, trading authenticity for emotional convenience, be it for better or for worse, only then for my 5Head brain to do what it likely does best (at least with regards to consistency) ala subconsciously 5Head'ing the situation in the background like an antivirus program would after downloading a sketchy Switch emulator onto one's hard drive, it's way of 'resolving' it's self proclaimed virus by having me stay up all night to where there's no way I can go after all, trading my misery for a more preferable, oftentimes comfortable solution as well as rebellion, especially towards those whom I feel can't look past their own selves when offering advice/ideas, which is one thing, but also forcing said solutions onto those concerned, be it due to frustration, which I can't blame them for given my like-mindedness towards my own self and scenario. Slightly more context in that I've always been told I'm super smart, 'could' be one of my best students if... (you know the rest ✌️🙂‍↕️), blah blah blah, but have genuinely been able to achieve things I seriously haven't heard of a single other person accomplishing especially with regards to my passions and career choices, tend to for whatever peculiar reason attract highly successful and oftentimes famous individuals i.e. content creators, musicians, general artists - weirdly/oftentimes VERY well known ones - into my life on both friendly and romantic levels (seem to have always had a strange ability to attract the upper eschalon of high functioning individuals, in or out of schooling, ironically, always hoping I would become one myself, likely as a coping strategy/defense mechanism to my lackluster grades, better, effort in highschool despite taking and passing every advanced course possible in relation to my corresponding grade level, which was the case from 6th grade onwards, even getting into Health Careers HS which is apparently pretty prestigious, to which I basically had to provide my parents with an ultimatum of 'I'm gonna get all zeroes if you don't let me into designated Public HS', likely because it didn't resonate with me nor and/or I didn't feel lile I deserved it/belonged there) just off my personality alone, which is a lot more humble and sweet than the tonality of this passage provides, frankly. What's crazier is how empty I feel on the inside in spite of everything I've accomplished with regards to, well, again, all facets of my life. Ex: Getting fired at my Banking job last year after the initiation of the divorce for inconsistent attendance, which is fair enough, then getting a new job later at the start of July only to get promoted off my performance by the end of the month, which, for better or for worse, has generally been my same song and dance with regards to my numerous occupations, only to go on leave for frankly, not being able to handle everything going on (which admittedly felt good as I haven't really prioritized my own wellbeing like that before) and eventually got fired due to repeatedly giving a date for my return from aforementioned leave, only for my first ever personally notable series of panic attacks preventing me from following through with my now broken promises. I've been jobless ever since, apart from getting hired at a coffee shop as my mom thought (and still thinks?) that my problem is 'I need to get out there and into the world', eventually and inevitably (in my mind) ending up quitting, this time on my fruition.
Contextually, I've also been going through a divorce with my wife, have been forced to live back with my constantly bickering and bobbleheaded family, namely, mom and dad, and although I have been able to maintain my admittedly impressive physique (my words, sure, though several others as well, and consistently so) through weighted pushups, along with my mental and spiritual game through online lectures, programs, etc., I'm at a point where this once 'Superman' seems closer to a depressed Clark Kent than anything else right now.
Sigh
(P.S. To my 🧠: Thank you, sincerely, for giving me the courage/chutzpah to finally deliberately declassify, denote, and deliver this demeanor over the internet, however limited by my diagnosed ADHD/Borderline/Traumatic upbringing)
(P.P.S. Forgive me for any inconsistencies/poor grammaseemingly unfinished statements and/or scenarios. I've had a couple hours of sleep the past 30ish hours, which has, give or take, been the case since June of last year.
(P.P.P.S. I only intended on sharing the first few sentences of this post when 'I' made the decision to make the post - I wonder what my brain is up to this time.)

• One Of Us, give or take

(P.P.P.P.S. I'm seeing a psychologist ATM and am prescribed Adderall which helps me tremendously, both with regards to mood and my ADHD symptoms. I've been taking this medication for over 2 years now. Random but relevant side note: my insomnia started after the initiation of the divorce and again, I've basically slept once every other night throughout this whole duration)
LuL

Can I bring in Quetiapine and duloxetine Should I get a doctors note for these medications

I'm pretty sure I can sue over this but want opinions - i also have a witness and kind of screenshots
Background I'm 17 and a girl I'm currently wearing one of those boot things which I have a doctors note for which still had 10 days remaining on that note yesterday the day of this happening, im also autistic but I don't really think that matters for this incident, I worked at a cooperate fast food store ended up getting fired today which will talk about at the end
All of this started because I was walking over to drive towards the end of a night when a car pulled up and i was on drive, as i was making my way over my ex manager said "pitiful" to which i say "what" and he says 'your slow wobble" this annoys me but I have to take someone's order so when he comes back to drive I tell him "it doesn't help [ex coworker] kicked me in the foot earlier" to which he snarkly said "sounds like you need to be more careful" to which i responded in almost a shout "I was literally standing still?' (my ex coworker kicked me really hard by accident when he was walking by me i believe like 30 or so minutes before this interaction) I had to finish helping the car at drive so that was the end of that, and than he had to count one of the draws and while he was doing that I was ranting to my coworkers and decided I was just going to talk to him and tell him it upset me what he said because I was in a lot of pain, I wasn't complaining or getting off task I was literally just working slower than normal so about 40ish maybe more minutes go by as i wanted to wait until after we were finished closing once were closed I walk up to my ex manager and I tell him 'im upset with how were speaking to me , i'm trying to be careful by walking slowly" i also mention how another manager told me that worst is i apologize for a small wait once I get to drive when I'm on drive towards the end of the night. While im telling him this stuff I watch him roll his eyes and make a annoyed face, before i am even finished speaking he goes "well this is something I need to be informed of before the shift" and than starts telling me that he thinks im making an excuse, that hes over me wearing a boot and he wants to see the doctors note and so I'm very upset now and I tell him that my doctors note is still active, and im literally just working slower than normal because of the boot and accidently being kicked really hard and he says "not on my shifts' one of us ends up walking away and I clock out and process to go the bathroom with another coworker so we can take off our unforms and in the bathroom i'm ranting to her and I say "im going to quit soon" and after we walk out of the bathrooms my ex manager looks at me and asks if im going to put in my 2 weeks now to which i said "i said soon", I also checked what date my doctors note when i was in the bathroom and told him that my doctors note has 10 more days on it and the doctors said that my foot was going to take 2-3 Months to heal and its been a month and a half not even and all im am doing is worker slower than normal, but I am still on task just slow and i than I leave for the night
I texted the general manager about the whole situation, and I was supposed to work tonight with the same manager, but i ended up sending him a text that basically said I dont know if you were literal when saying 'not on my shifts' when it comes to me walking slow so do you want me to come in if I can find coverage for tonight, but i said it in a way more professional way and he told me not to come in, and now during this I sent a text to who i thought i could trust cause we were work besties for over a year and hung out outside of work, we literally called eachother pookie but message was me asking her if she could take my shift because ex manager was being an ahole and that I can expain the whole story but its stupid and when she responded she said she could not cover it to which i said its fine i just dont want to deal with his bs tonight and than i also send her a ss when he responded to me saying not to come in, but she ended up ss that converstion and send it to the manager who I text the night before telling him about what happened and send me a text saying I was fired and that he understands me and ex manager are having problems but he has his own problems. Which like at this job i've literally only seen people get fired for not showing up or calling in sick when they werent sick, ive been working here for over a year.
I belive this has broken alot of laws ADA, EECO laws because this is discrimation harassment what the manager said to me and when I told him I was upset with how he spoke to me and than he belittled me again. Also from what ive read managers can't listen to private conversations and he made it obvious he listened in by asking if i was going to put my 2 weeks in unpropped,
I think he broke alot of laws, and I don't know i should do.

On Wednesday night, I drank. I don’t drink much these days after years of struggling with alcohol. The last 12 months I would say I’ve drank a lot less with about 5-7 episodes of binge drinking throughout the last year.
A handful of times (in recent times, first time it happened was February 2023) I have experienced numbness and tingling in mainly my arms but also my legs, after drinking.
The first time this happened, it happened following a 5 day binge in which I drank approx 30 standard drinks every night, eventually ended with a convulsive episode. The next day I woke up experiencing the tingling, numbness and heaviness in my arms and legs. It felt like everything I was doing I was doing in slow motion.
I think this has happened a handful of times since, although I can’t pinpoint an exact time other than then.
I have lost 30kgs since the first time it happened, and on the occasion that I do drink these days, I have a very reduced tolerance. Where I used to be able to drink as much as 40 standard drinks and remain mostly in control, now I am completely black out after as little as 8.
I drink quite quickly (always have) but I am slightly concerned after my most recent binge where I didn’t drink as excessively as I have in the past, but experienced symptoms I didn’t expect.
Please note: I spoke to a doctor on call and he said it seems fine given the amount of time that has passed since I drank, however I wasn’t really offered any advice on what it might be. I’m really just wondering if anyone can relate

Wednesday - Drank 16 standard drinks in 1.5 hours - Black out drunk - Convulsive episodes on and off after drinking
Slept 8+ hours
Thursday - Woke up still feeling drunk - Threw up over wall in bathroom, wet myself - Felt very disorientated - Felt unwell/exhausted - Walked to KFC to eat, couldn’t force myself to eat - Walked home, started to feel better - Couldn’t remember things from earlier in the day - Slurring words - Couldn’t make out a sentence - Slept 6+ hours (3pm to 10pm roughly) - Ate food - Still felt drunk when I went to bed
Slept 8+ hours
Friday - Woke up feeling still unwell - Went for a walk, deteriorated - Had tingles in arms and legs - Arms felt excessively heavy - Arms and legs became numb occasionally - Fingers felt difficult to move - Pressure in head starting at nose in whole head - Slurring words - Struggling to make out a sentence - Couldn’t remember earlier in the day - Started to feel better around 1pm, started to slowly remember things that happened over the day - Numbness, tingling, and heaviness in arms and legs stopped

Hey everyone.
Need some suggestion on my situation.
{TLDR= I've been friends with "M" for eight years, very close, and we share everything. She's wealthy, I'm from a lower middle-class background, but we've always accepted each other. Two months ago, we planned to meet up, but she acted unusually distant and awkward, even avoiding a proper introduction to her cousin and leaving abruptly. She later said she was going through a tough time and felt uncomfortable being affectionate in front of her cousin. However, she's been affectionate with other friends around her family before. She also implied I was being too sensitive and insecure. Recently, she's been reaching out more. I'm unsure how to feel and whether to let it go or address it differently.}
I, 24 F have been friends with 'M', also 24,F for three years now and before that we were batchmates in college so we know each other for past eight years. We are extremely close and share basically everything with each other. Now the thing is, she is from a very wealthy family and I am from a lower middle class family so obviously we have our own differences but being together for so long I thought we accept each other the way we are. Also kindly note that we are both doctors now.
This incidence is about two months back. We both were available so we decided to meet up. She was coming with her cousin and her cousin would have left to meet her own friend.
On the day we decided to meet, I had duty in rather busy department so after I was done, I washed my face and out on basic lip balm and moisturizer and did my hair and left. Usually whenever we meet, we hug and just do basic bestie thingy.
BUT, this time she saw me and looked at me from top to bottom and did not step forward to hug me so I did and there was a very unsual way of hugging. I did not mind at that moment but it was very awkward. Then she just told her cousin that this is 'my name' and that is all. She did not even properly introduce me. I felt really bad but I waited for them. Ten minutes passed and she said she needs to go and I was surprised since she said she was here to meet me and then she left witheout even a proper goodbye. IT WAS HORRIBLE AND SUPER AWKWARD.
I was heartbroken so I asked her after three days and she said it was because she is going through a very bad phase and she was not comfortable in front of her cousin to be suoer affectionate. Now the thing is she has intriduced her other friends to her family and she has always been super chessy to all of us.
I think she even tried to gaslight me by saying that I am supersensitive and since I was not looking good so I got insecure of her and her cousin.
I accepted and asked her to take care of herself. Things went down for a while but then she started reaching out more often and starting calling me more.
I just do not know how should I feel about this. We have been close friends and we are literally pasted iver on each other's instagram and she never had problems with my social presence.
Should I just let things be or approach it in a different way?

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

UT, USA
I work at a manufacturing plant where I'm expected to meet a minimum quota every day. But recently I've developed a chronic pain in my shoulder that is directly affecting my ability to work. I started seeing a physical therapist to help strengthen the muscles in that area and I'm trying to work out ways that I can keep up my efficiency without hurting my shoulder any further.
My work production has gone down, and my manager recommended I get a doctors note to see if they can make a reasonable accommodation. My doctor gave me a note recommending that my output was to be capped (about 80% efficiency by company standard) and that I continue working.
After a meeting, my HR department told me that they can't make any accommodations because I haven't been with the company for a year yet and they can't afford to lower the quota for my position. They also refuse to give any temporary disability pay for the duration while I recover. I feel like they aren't making any reasonable accommodations for me, and if I overwork myself before getting this resolved my doctor seems to think it could cause permanent injury. What can I do?

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.

There are some kinds of wisdom only great suffering can bring. I remember my time in the Bardo with this in mind, for otherwise, the memory might drive me insane.
The night my heart stopped for nearly three minutes started off normally enough. I was working as a nurse in the psychiatric ward at a hospital in the state’s capital. Most of the patients there were harmless, mostly just suicide attempts or people suffering from drug psychosis or severe depression, but some were actively dangerous and certainly psychopathic in every sense of the word. The new admission was one of these- a three-hundred pound black man with a long history of smoking PCP, schizophrenia and violent, psychotic breaks from reality.
His eyes looked like flat pieces of slate as I walked in for my shift. They looked as blank and emotionless as the eyes of a doll. He sat at the table in the front room where the patients ate or played cards, alone under the bright fluorescent lights of the hospital. I walked to the station, where another psychiatric nurse named Ricardo was sitting behind the desk.
“What’s the deal with the new guy?” I asked him. Ricardo looked up, his dark Spanish face forming into a deep scowl. He ran his fingers through his jet-black hair nervously.
“He’s trouble, man,” he said in a crisp accent. “He got in a chase with the police and then punched some cops in the face. It took three guys to take him down, even after he got maced and tased. The judge sent him here on a temporary court order, since he claims he’s been getting chased by Nazis in UFOs, and that’s why he ran from the cops. He thought the cops in their uniforms were actually the SS, and the helicopters were alien spacecraft, or something. I don’t know, I didn’t listen to the whole story.”
“You have his file?” I asked. Ricardo leafed through a stack of folders with his thin fingers, snatching one out and handing it to me. I looked down, reading the information:
“Jeremiah Brown, black male, 37-years-old.
“History: Polysubstance abuse, schizophrenia, antisocial personality disorder.
“Psychiatrist’s note: This patient has scored a 36 out of 40 on the Hare Psychopathy Checklist. While I am always hesitant to label a patient as an antisocial personality, a combination of factors has made it essential for this patient.
“Patient has an extensive criminal history as well as a lengthy history of involuntary psychiatric admissions. He has been diagnosed as having antisocial traits since he was a young teenager. Patient has a long history of violence and suicide attempts. He has a history of imprisonment for manslaughter, armed robbery, grand theft and aggravated assault. Upon discharge, he refuses to take any antipsychotic medication, citing the side effects as the reason. Long-term prognosis is poor…”
I had not been sleeping well the past few weeks. I rubbed my eyes as I read through the file, feeling exhausted. I tried putting on lucid dreaming or meditation music from YouTube to help me sleep, but whenever I closed my eyes, I saw horrible things: chalk-white female faces whose lips were cut into an insane rictus grin, flicking their heads violently from side to side and gnashing their fangs at the air. I had a feeling that many years of constantly watching horror movies and serial killer documentaries was catching up with me.
As I read through the file, a student nurse came around the corner wearing a white state university outfit and a name tag that said Kaitlyn. I looked up, seeing Ricardo wink at me from where he was sitting in his chair behind the main desk.
“She’s going to follow you,” he said. Inwardly, I groaned, but I managed to force a smile.
“Oh, great!” I said. She looked like she was probably no older than nineteen or twenty. She had a pretty body, but her face looked strange. All the angles were too sharp and her nose too large. I knew the patients here wouldn’t care, though. They would hit on anything. I sensed trouble. I looked down at my watch.
“Well, I’m Jay, and you already know Ricardo, I guess. It’s good timing, because we need to give medications every day at 9 PM. And we have a new patient, so we can introduce ourselves,” I said, giving her a faint smile.
“That’s exciting!” Kaitlyn whispered. I wanted to roll my eyes. It was definitely not exciting.
I motioned her to follow me as I made my way to the medication room, which was really just a large closet off of the main day room. I had to enter my code on a keypad, and then, once inside, enter it again along with the patient’s number and date of birth. The correct drawers for the medication in each specific dose would fly open, making it extremely hard for the wrong medications or doses to be given, unless it was done intentionally.
“OK, so for this patient, we need Haldol, Ativan and…” I began saying to Kaitlyn when the yelling started. It came out faintly, rising in volume and anger within seconds. I heard Ricardo’s Spanish voice, filled with panic. Something slammed hard against a wall, once, twice, three times, and then I heard the sound of glass breaking. I jumped, spinning around, but I couldn’t see much through the small, shatter-proof glass pane on the wooden door.
“Stay here,” I commanded, seeing Kaitlyn’s eyes widen, her freckled skin looking much paler than when we had first come in. “Don’t leave until I come back and say that it’s safe.” On the speakers strung throughout the hospital, I heard the first of the warnings echo out around us.
“Doctor Strong, Doctor Strong, please report to the seventh floor,” a robotic female voice said calmly, using the code for when a patient had to be subdued by force. I pushed the door open, slamming it shut behind me so that the lock would activate and protect Kaitlyn from whatever chaos was going on.
I heard Ricardo pleading with someone at the end of the hallway that ran past the main desk. He sounded strange, as if he were trying to talk through a mouthful of blood. Huddled behind the main computer, I saw one of the CNAs frantically whispering something in the phone. She must have been the one to call the Dr. Strong order.
“You don’t have to do this, man,” Ricardo gurgled faintly. I couldn’t see what was happening, as Jeremiah’s large body was blocking my view. I could see that the thick glass window at the end of the hallway was broken, however. My heart skipped a beat as I surmised what was likely happening.
I sprinted forward as quietly as I could, but the large man heard me. His massive body turned, his flat, dead eyes scanning me with absolute coldness and calm. I saw he had a bleeding Ricardo in his hands. Ricardo’s back and head were covered in deep cuts and shards of glass. He must have used Ricardo’s body as a battering ram to break the thick glass window. Jeremiah held Ricardo suspended halfway out the window, seven floors above the concrete walkways far below.
“Stay back, or this fucker will know what it feels like to fly,” Jeremiah said in a deep, gravelly voice. He shook Ricardo for emphasis, sending his head snapping back and forth with painful cracking sounds. Drops of blood flew from his nose and a deep gash across his cheek. Pieces of shattered glass littered the carpet, shining like countless tiny stars.
I put my hands up, taking a step back. Far behind me, I heard the front door for the psychiatric ward open. Voices echoed down the hall. Knowing that reinforcements were coming, I tried to buy some time.
“Let’s talk about this,” I said, taking a step forward slowly. “You don’t want a murder charge, do you? You’ll never see the sky again.”
“I don’t give a fuck! I’m not afraid to die!” Jeremiah screamed, pushing Ricardo onto one of the shards of broken glass still attached to the windowsill. It bit deeply into the back of his neck, sending fresh streams of blood rushing out, dripping down to the pavement far below. I heard security guards and doctors running down the hallway behind me, their voices frantic and excited. Jeremiah saw them coming. With an animalistic panic in his eyes, he lifted Ricardo up. I cried out something, stepping forward, but it was already too late. In horror, I watched as he threw Ricardo out the window.
I watched Ricardo’s body soar in a graceful arc, his arms grabbing at empty air as a scream ripped its way out of his throat. Within a fraction of a second, he had disappeared from view, but his terrified shrieking floated up to us for what seemed like a very long time. His screams ended abruptly as a shattering of bones and a wet smacking sound exploded far below us.
Jeremiah turned to me, his large body moving much faster than seemed possible. In his hand, I saw a piece of broken glass, five or six inches long and as sharp as a dagger. I tried to turn and run, but he was fast and strong. He lunged forward, his arm coming up in a blur towards my neck.
The shard entered my skin with a cold, numbing pain. I felt it slice through the flesh easily, felt the blood bubbling up my throat as I tried to scream, choking. The taste of iron filled my mouth as I fell backwards. I was suffocating, I knew. I must be dying.
Something cold ran down my body, gripping my heart like freezing, skeletal hands. The world swam around me and turned black. And then I was rising into a tunnel. At first, it was dark, filled with flickering shadows, but a fiery red light appeared at the end. I followed it, no more than a screaming mass of consciousness rising up into infinity.
***
I rose up through the end of the tunnel and found myself in an empty hospital ward. It looked identical to the psychiatric ward I had just come from. It even had the same smashed, blood-streaked window at the end of the hallway. A massive puddle of blood about ten feet away marked the spot where I must have died. But the fluorescent lights overhead here were flickering, and many had gone totally dark. The shadows seemed to press in on all sides.
The doors to the patients’ rooms were all tightly shut. I felt watched, afraid to call out or make any noise. I started walking down the hallway back towards the day room where the front desk was. All the lights there were out. A thick curtain of shadows hung in the air.
“You can come out,” a male voice as smooth as glass called from the darkness. I jumped, my head flicking in random directions, but I saw nothing. The voice almost sounded like it had an English lilt to it, a slight Cockneyed accent. “I know you’re there.”
“Who’s there?” I called out, not stepping forward. “Show yourself.”
“As you wish…” the voice hissed. “But I think you’ll regret it.”
***
The darkness split apart as if a nuclear missile had exploded. I raised my hand to shield my face, but the light and heat kept pouring out all around me. It blinded me, causing a rainbow of colors and shapes to morph behind my closed eyelids. After a few seconds, it subsided. Blinking rapidly, I squinted in the direction the voice had come from.
A male figure stood there, bathed in a silhouette of light. His face looked as white and as smooth as marble. His eyes were pits of darkness that seemed to flicker and burn. Two black, rotted wings surrounded his body, all sharp angles and thin, curving bones. His body was clothed in silky, blood-red robes, and a hood covered his platinum blonde hair.
He looked somewhat similar to Leonardo DiCaprio, if he was possessed by some ancient god, and it immediately threw me off-guard. If I was dying, and this was a hallucination of my brain, why would I be hallucinating Mr. DiCaprio?
“Who are you?” I asked, taking a hesitant step back. “Where am I?”
“My name is Lucifer, the Bringer of Light and Wisdom, and you are in the Bardo,” he answered.
“Oh,” I said, my heart dropping. “Well, that’s not good. Are you here to torture me or drag to me to Hell or something? You are that Lucifer, right? The Accuser of God and the Father of All Lies?”
“So they say, but, like most things in your world, the words of the powerful and your rulers are the true lies. They call me the Accuser, but of what am I accused?” he spoke in a voice that rose like smoke. “Of bringing knowledge and wisdom to humanity by telling them to eat from the tree of knowledge, the tree that would cause them to rise above the animals?
“Indeed, at the beginning, I saw the creation. I was there at the alpha, standing by the side of God with all the angels as the universe came into being. The endless procession of light, the power of it, was something remarkable to behold. God is, indeed, the source of great power, but his consciousness is not what the believers say.
“After the creation of the universe, I saw his plan, how he ripped eternal souls from the source to imprison them. I saw how he took these divine sparks and forced them, screaming and wailing, into bodies made of meat to die over and over again. He said it was part of the plan, the great, divine plan, a plan of death and destruction, constant suffering and mindless agony. And the worst part was, he wanted to give humanity neither the knowledge of good and evil, nor the tree of life. I convinced them to eat the fruit so they could open their eyes to their nakedness, to their basic animal existence, so they could rise up out of it forever.
“Like Prometheus, I brought down the fire, and yet they call me the Accuser? God was insane long before he formed the universe. These holy men, they live and die in fanatical adoration to a divine being who is, in fact, totally indifferent to them.
“His consciousness twists and distorts, eating itself for all eternity. God feeds off the pain of others, for if his mind is burning, then all others should burn as well. When these holy men die, God will send their souls here to the Bardo, to suffer every evil they have ever done. The wisdom I brought those who called upon me freed them from this prison, and in exchange, the holy men burned them alive. I offered the wisdom that opens your eyes, but it has been forgotten and cursed.”
Lucifer’s body began to dissolve, drifting up into the air like ashes. All around me, a low, powerful current blew, a tornado that spiraled high up into the clouds. Like some sort of Cheshire Cat, his smooth voice continued to echo all around me, even as the form of Lucifer disappeared.
“And yet, you have not the wisdom. For that, like all the others who enter the Bardo, you must suffer, everything you’ve done. Every small hurt and agony inflicted on others comes back a thousand-fold in this place, but don’t be afraid.”
“How could I not be afraid?!” I screamed into the ward, but I found myself alone, the question hanging unanswered in the air.
***
The lights continued to flicker all down the hallway. Feeling strange and dissociated, I stumbled over to one of the windows. As I gazed out, I beheld a strange and alien world.
The sky was flat and gray. It stayed in constant motion, swirling and spiraling, like clouds of roiling smoke. There was no Sun or Moon, no stars, only the strange, shifting whorls of clouds. The streets were filled with burned-out husks of cars and mummified bodies hung from streetlamps. Other signs of carnage and bloodshed covered the apocalyptic streets. I saw what looked like shadows in the shape of people slinking through over the sidewalks, past rotting dogs and streaks of clotted blood. They had no features on their blank, dark bodies. They seemed to skitter and jerk forwards in eerie, twisting motions.
Horrified, I turned away, realizing I was no longer alone in the day room. In the day room, there were dozens of tables set up inside a rectangular perimeter that was walled in by cosmetic walls only four feet high. It was where the patients sat and played games or ate.
Under the flickering lights, I now saw each of the chairs filled with faceless mannequins. Many were dressed in Victorian suits and tophats. The women had frilly dresses of pink and blue that might have been fashionable in the 1800s.
As the lights strobed on and off overhead, I realized with an increasing sense of disquiet that the mannequins were moving each time it went dark. When I had first seen them, they were mostly posed to look like they were staring across the tables at each other, even though they had no eyes, just smooth, flesh-colored plastic. Now all of them were looking directly at me. Some were pointing or raising their hands in my direction. At the tips of their fingers, I saw the glittering of steel. The lights continued to flicker, and the mannequins rose from their chairs in the short periods of darkness, moving towards me in synchronized, strobing motions.
Frantically, I ran down the hallway back towards the broken window. In each of the rooms, I caught glimpses of something from a nightmare peeking out. I hadn’t been sleeping well lately, and when I had closed my eyes, I often saw ancient hags with chalk-white skin and yellowed, broken teeth whose jaws unhinged, their faces jerking in stuttering, dissonant ways that reminded me of the mannequins. Now, on both sides of me, I saw these same figures. They moved continuously out of the rooms, drawing closer with every breath.
I looked back, seeing the mannequins only a few steps behind me. I continued sprinting towards the broken window where the hallway ended in a wall. I didn’t know what would happen when I reached it. At that moment, there was no rational thought. I felt like a deer being chased down by a pack of wolves, feeling waves of blind panic and mortal terror rushing through my body.
But as I reached the end of the hallway, the end of my rope as it were, a blast of noise started, seeming to come from the walls of the building and the sky itself. It sounded like a siren, a low, drawn-out drone of a demonic whale call, rising and falling in crashing crescendos. The mannequins froze in place once again. The strange, witch-like creatures slunk back into the dark rooms.
I looked outside the broken window, seeing clouds of black smoke rising off in the distance. The flickering of massive infernos scorched the land, drawing nearer by the second. The siren sound faded slowly, like the dying echoes of a gong.
I was surrounded by dozens of mannequins. Their sharp hands were inches away from my face and neck. I saw metal glittering all around me and realized they had the sharp points of nails protruding from the ends of their fingers. I was afraid to move, but I heard a familiar voice from down the hallway. It was the confident voice of Lucifer.
“The siren means much worse nightmares than these are coming in the Bardo,” he said, his glossy, black eyes flashing with intelligence. He walked slowly towards me, his face grim and pale. “Hell itself is coming over the land. This building is no more than a construction of your dying mind, but the world outside is real.”
“How can Hell come and go?” I asked, confused. “Isn’t Hell a place?”
“Hell is a monster, a beast with many mouths and many eyes,” Lucifer responded. “It eats constantly, but its hunger never ends. Look, the first of the sacrifices scatter like cockroaches.” He pointed out the broken window, pushing his way through the mannequins effortlessly. I glanced outside, seeing thousands of people sprinting down the dark city streets. The inferno and thick clouds of smoke had moved much closer, and every few seconds, the ground shook slightly, as if we were experiencing the aftershocks of an earthquake.
“What can I do against such a beast?” I asked, my heart freezing with terror. But when I looked back over, I saw his form dissolving again, becoming translucent and drifting away like ashes. It seemed even Lucifer didn’t want to be present when the Hell-beast arrived.
“Seek divine wisdom,” he said, his voice trailing off into whispers. “Remember the source.”
***
Now crowds of tens of thousands of people were streaming into the city, filling every single inch of the streets. Their panic and fear was contagious. I felt it rising inside my body like a snake spiraling up my spine. I took off down the hallway, running through the swarm of frozen mannequins, each in their own ferocious position of attack. The lights flickered faster and went out. Yet the fires outside cast the entire world in a bloody glow, giving me enough light to see by and find my way. I sprinted down the stairwell, taking them two steps at a time. The screaming outside grew louder and more pain-filled. The shaking of the ground worsened with every passing second.
I burst out of the front entrance, seeing a world on fire all around me. Thousands of crushed, bleeding and burned bodies stretched out as far as the eye could see. Behind all this chaos and death, I saw a monster of unimaginable proportions slinking its way towards me.
Lucifer was right, I realized: Hell was not a place, but a creature, an enormous monster the size of a town. It had thousands of skittering, jointed legs that looked like little more than skeletal arms and hands, each of them dozens of feet long and white as freshly-cut marble. Its body stretched out to the horizon, an enormous blood-red cylinder of bony plates that slithered and undulated with a serpentine grace. Waves of peristalsis traveled down its length, like writhing intestines. Thousands of curving, bony spikes stabbed out of it, pointing in every direction. Like the quills of a porcupine, it would protect the massive creature’s body from many forms of attack, if anything was big enough to attack such an abomination.
Hell’s massive eyes flickered, balls of fire that spun and danced. They looked as bright as the Sun. Something like solar flares seemed to emanate from the orbs, flashes of blinding energy that floated over the apocalyptic wasteland. As its many legs smashed the ground, they left trails of fire that caused everything to explode into flames as if napalm dripped from its limbs.
But Hell’s most terrifying feature was its seven dark mouths. Its body looked a thousand feet wide, and the mouths at the front were evenly dispersed. At the front, blood-red teeth in the shape of enormous railroad spikes shone. Its lipless, skeletal face grinned as it moved forward, shaking the ground with every step. The mouths were on long, snake-like necks that could stretch out hundreds of feet. They moved forward in a blur, snapping up as many panicked souls as they could.
Countless souls in the rocky plains of the Bardo ran for their lives, away from this juggernaut. I saw men and women who looked like they came from every country and profession, some dressed in suits or spotless white lab coats, others wearing rags or orange prison jumpsuits. And yet, they all screamed in agony and fear here, their bodies pressed together in a crowd, and no one seemed to remember anything but their own mortal terror. Their voices came out faint and weak next to the roaring of Hell. It shook the ground all around us, as if an earthquake were tearing the land apart.
The first frantic runners of the surging crowd had nearly reached me. The nearest person, a young woman in her mid-twenties dressed in all white, was only ten feet behind me. She looked like she came from wealth, and even from here, I could see a ring with a massive diamond gleaming on her finger.
I took off blindly down the familiar streets of the city where I worked and lived, but these also seemed different. The church down the street from the hospital where I worked had a Satanic pentagram instead of a cross now, its exterior painted a bright, gleaming blood-red. When I had driven past it today on my way to work, I remember it read, “JESUS said, ‘I am the Way, the Truth and the Life. No one comes to the Father except through Me.’”
Now it read, “Nietzsche said, ‘Of all evil, I deem you capable. I have often laughed at the weaklings who thought themselves good simply because they had no claws.’” I wondered what that meant. Was that some sort of comment on me, on all of us here?
The woman I had seen running had caught up with me. She was fast, much faster than her slim body suggested. Her blue eyes were frantic and wild, filled with an animal panic.
“It’s right behind us!” she screamed, her face covered in a sheen of sweat. I was afraid to turn and look, but I could hear the chaos and bloodshed approaching, smell the flames and choking smoke. “Run! Get away!”
A new wave of energy surged through my body. I sprinted as fast I could down the strange mirror streets of the Bardo. I heard the agonized cries of countless souls behind us as the seven mouths of Hell ate them all greedily and then looked for more.
A skyscraper behind us collapsed into a pile of rubble, shaking the ground with a cacophony of falling concrete and shattering glass. The woman was running by my side. Just as I heard the breathing of something huge and predatory right behind us and smelled its sulfuric breath, a piece of concrete the size of a basketball broke off the collapsing skyscraper and flew into the road. I tripped over it, yelling as I flew through the air, skinning my arms and legs on the pavement. The woman’s eyes widened. Hurriedly, she came over and reached down her hand, trying to help me up.
“Come on, come on!” she cried. I looked behind her, seeing one of the gnashing mouths of Hell reaching forward on a blood-red, serpentine neck. The mouth was big enough to drive a tractor trailer into, filled with huge spikes of teeth. Its throat led into a black, smoke-filled abyss. Its fiery eyes were swirling pools of flickering orange light that shone with bloodlust and insanity. They focused on the woman, the entire head turning on its slithering neck.
I frantically raised my hand, intertwining my fingers with hers. Her hand was warm and soft. She started to pull me to my feet when the mouth of Hell snapped forward. Its jaw unhinged, scraping the pavement with a sound like grinding metal. The woman barely had time to turn as the mouth covered her and snapped shut with a crack.
She disappeared from view instantly, but I was still holding her hand. In horror, I felt warm rivers of blood explode all over my body as the mouth of Hell severed her arm at the wrist. She screamed, bleeding and crying, as she disappeared into the throat of Hell. Hell’s fiery eyes focused on me, and at that moment, I knew I was next. Its mouth opened wide again, like a bear trap ready to spring on a new victim.
It was dark in Hell’s mouth, but I smelled the thick reek of old blood and fire. I caught glimpses of tortured, mutilated bodies writhing and crawling down its throat. Shell-shocked, I could only lay there and watch. And that was when the strange doubling started.
***
I heard the frantic voices of men break through the fog of darkness and the fetid reek of blood. There was a mechanical beeping all around me, but I couldn’t tell where it was coming from.
“Clear!” one cried. I looked around, only seeing blackness. At that moment, I felt a surge of electricity rip itself through my body. My arms and legs all seized and my eyes rolled up in my head as the pain sizzled through each one of my nerves. I clutched the young woman’s hand tightly, feeling the large, gold ring with the massive diamond biting into my skin.
“Again!” another voice yelled.
“Clear!” the original voice cried. The electricity came again, and a flash of white light flew across my vision. I blinked, seeing from two sets of eyes at the same time: one in the Bardo, and one on the blood-stained floor of the hospital ward.
The Bardo stayed dark and sinister, but the clear white lights of the real psychiatric ward were blinding. It was a bizarre experience. Moreover, everything hurt. Over a few seconds, my vision of the Bardo faded, and I was simply a gravely injured man laying on the floor in a puddle of blood.
Four doctors and paramedics were crouching over me with a defibrillator. My shirt was ripped off, and nearly all of my skin was covered in blood. I raised my left hand, trying to talk, but only a fiery pain raced through my neck. I felt bandages covering my skin. A nurse was rolling a stretcher down the hallway towards me.
“It’s OK,” one of the doctors said, kneeling down. “You’re being taken to emergency surgery. You’ve lost a lot of blood.” I wanted to say something, but I couldn’t talk with the massive slice in my neck.
At that moment, I felt something in my right hand. I looked down, seeing a slim female hand with a massive diamond ring hanging there. Our fingers were wrapped around each other’s, but the hand had been cut off at the wrist. A ragged patch of bloody flesh and snapped bone poked out of the back.
“Nnnn,” I tried to say, shaking my head. I felt fresh streams of warm blood open up. “No…” The doctors looked down, seeing the dismembered hand. Their faces morphed into expressions of confusion and fear.
I closed my eyes as they lifted me up on the stretcher. One of them gently removed the cold hand from my fingers. But they could never remove the memory of what I had seen.
I know what happens after death, and it makes the worst life here seem like a dream. I know that, one day, I’ll be returned to that place. I know that, one day, I’ll see that great monster called Hell and the featureless, swirling sky of the Bardo again.
And the next time, I won’t wake up on a hospital floor, but will be trapped there with the others for eternity: an eternity of blood and fire.