Buspirone taken with ativan

I have an appt with a psych nurse practitioner tomorrow and I’m feeling both excited and apprehensive about potentially starting medication for my GAD. I have been prescribed Ativan and Klonopin before as “as needed emergency basis”, mainly for moments of crisis/attacks but have never taken medication regularly for anxiety.
Curious to hear from you all, what medications have you tried and have helped? Definitely realize that everyone responds differently to medication but it would be helpful to hear some first hand experiences. Are there any questions I should make sure to ask during the consultation appt?

(19M, 5'9 155 lbs.) Hi, this is gonna be a bit long, but let me explain the entire situation so far:
Going back about a year or so, I started noticing an elevated heart rate above what I usually would have. I have an apple watch that allows me to check my heart rate, and around this time I started to get notifications that my heart rate was above average (in the 120s to 130s range while resting as opposed to my normal 60-80 range). This happened a few times along with some very minor chest pain / tightness, however after laying down for a few hours / going to bed it would usually return to normal. Around the same time I got diagnosed with anxiety and ADHD and placed on an SSRI to help my anxiety after trying ADHD meds and not liking them. I never really had any incidents with high heart rate after that, so I had assumed it was just anxiety causing it (and that may still be the case). A few months went by and I ended up starting college and got myself a girlfriend. As I ended up finding out, SSRIs, while great, have the unfortunate side effect of erectile dysfunction, so I weaned off my meds so I could prioritize my love life. There were a few incidents after this where my heart rate was above average, but again I just chalked this up to anxiety, as it would usually go away on its own. At one point I went into my on campus doctor's office just to verify my heart was okay after an elevated heart rate the night before, and they gave me an EKG which came up clear. Months go by, and things are fine, besides a slight uptick in anxiety. Unfortunately however, my relationship began to crumble and my anxiety skyrocketed, and we eventually broke up, which led me to talking to my doctor and getting placed back on anxiety medication. However, I really didn't like how SSRI's impacted my libido, so after trying a few more SSRI's I was placed on Buspirone. I love Buspirone, and it's made a noticeable difference on my confidence / reducing anxiety. When I take my full dose at once (30 mg), I tend to get a bit dizzy / nauseous, however when split up into 10 mg taken at breakfast lunch and dinner I have no noticeable side effects. I will say (and I don't know if this is in any way important but I'm just naming everything possible), I have noticed that since stopping the SSRIs and starting Buspirone I tend to ejaculate VERY fast which is abnormal for me, and although I would like to fix that it is not my main concern. Moving on though, after about a month or two after being placed on Buspirone, we get to where my heart problems start. As someone who had never used any substances my entire life, leaving home and going to college gave me the freedom to try new things, and although I know it's not great, on weekends me and my friends will get together and drink or occasionally smoke weed / take an edible. I was worried at first about interactions with my medication, but after some research all anything online could tell me was that I may get drunk faster / more nauseous and dizzy, which wasn't too big of a deal for me. I had tried weed earlier in college and didn't like the way it made me feel, however after being placed on Buspirone I decided to try it again and actually enjoyed the feeling, so I started doing it more on the weekends as opposed to just drinking, which leads us to the incident. Me and some friends had just sat down to watch a movie, and all taken an edible. Time passed, and I started to notice that my heart rate was extremely elevated, way more than I was usually used to. I checked my heart rate, and found that my watch was displaying an average of 160 bpm. At first I thought I was just having a bad high and tried to calm myself. I laid on the floor and put some ice on my forehead, but nothing was helping. I checked my heart rate again and saw that my watch was displaying 190, which really freaked me out as that was way higher than I had ever seen before. I had my sober friend call Public Safety for me, and they came to my dorm room and did a basic check up on me. They said that I had a fever, and when they took my heart rate they got something in the 160s range. Their explanation was that my anxiety, when combined with being high and likely being sick made my heart rate elevated, which made sense at the time. I went into my college's health services to follow up the next day since my heart rate was still elevated (in the 120s-130s range), however they again told me it was probably just anxiety. A few days went by and my heart rate was STILL above average, so I decided to double check with my real doctor off campus. About a day before this I had also stopped taking my medication to see if it could be the cause for my elevated heart rate. The doctors took my vitals and immediately noticed that had very high blood pressure and an elevated heart rate, to the point where they sent in a second doctor to recheck my vitals and make sure it was correct. After talking to me and having me give a run down of my symptoms, they had me schedule an appointment with a cardiologist and told me that if I ever experience chest pain and a heart rate above 100 bpm that wouldn't go down to go to the hospital. I had also told them about how I stopped taking my medication and they told me that that was fine and to tell the cardiologist about it. About a week passes, and I have my cardiologist appointment in a few days. I had been up the night before working on my final exams, so I hadn't gotten much sleep, and besides a breakfast sandwich that I had for lunch I hadn't eaten much either. I had been experiencing chest pain all day, but I assumed it was being caused by my lack of sleep, so after classes I went and took a nap. After a few hours I woke up, and immediately noticed that I still had chest pain. I checked my apple watch, and my heart rate was displaying roughly 90-110 bpm while laying down, which on top of the chest pain made me worried since my doctor had told me that that was cause to go to the hospital. I called my parents to tell them about it, and they drove to the school and had me sit in the car and eat some food they had made to see if it would help at all. However, even after this, my heart rate was still above 100 bpm and I still had chest pain, so my mom made the call to bring me to the hospital. While on the way to the hospital, out of nowhere my heart rate increased to about 170-180 bpm, which freaked me out. We arrived at the hospital, and they immediately gave me an EKG to make sure I wasn't going to drop dead. During this time, I also was shaking a lot and couldn't make myself stop. Eventually they took me into a room and decided to run some tests on me. The tests they did are as follows: BASIC METABOLIC PANEL, CBC WITH DIFF, TROPONIN NH, D DIMER DEEP VEIN THROMB LEVEL, TSH REFLEX, X-RAY CHEST PA AND LATERAL, and ECG-12 LEAD. While I'm not a doctor, from what they told me and from what I can see, everything turned up pretty normal. My potassium was a smidge low, as well as my MCV and MPV, and my Monocyte (absolute) was a tad high, but generally nothing to worry about. The website where I'm viewing my test results display my ECG as abnormal and an attached document says I have left atrial enlargement as well as sinus tachycardia, but they only mentioned sinus tachycardia in the hospital so I assume that it was just the machine reading my test results and giving its own diagnosis. Long story short though, I left the hospital a few hours later, and although I still had a slightly elevated heart rate they said I was fine to go about life normally and to follow up with my cardiologist. Cut to the present, and I just met with my cardiologist a couple days ago. I gave him the general rundown of the above story (but didn't mention the edible as a precursor to the 190 bpm heartrate as my mom was in the next room over and the door was wide open), and after checking my vitals he told me that although I did have an elevated heart rate and high blood pressure, my chest pain probably wasn't a huge concern and that he wasn't too worried it was anything life threatening. He told me I could resume taking my meds (which I had temporarily replaced with ashwagandha supplements while I waited for the appointment and have since stopped taking), and had me wear a little device that monitored my heart rate for 24 hours, which I'm set to return in a couple days. He also told me that when I returned it he would check my results and give me an echocardiogram and go from there. So, with any luck, he should be able to figure things out then. However, I wanted to post this to see if anyone could help me get any ideas on what it could be that I could run by him to help speed things up. Oh and one last thing, if you can't think of anything in regards to what could be causing my elevated heart rate, I actually would like to know why I'm ejaculating so fast so I can fix it because its gotten to the point where I can't even enjoy masturbating because of how fast I cum.
In case I missed anything, here's a list of my symptoms (although I have no idea if they're all correlated):
- High heart rate (anywhere from 90-190 bpm)
- High blood pressure
- Chest pain / tightness on my left side and does not hurt more when I breath in / out (every now and then pain extends to my neck and shoulder)
- Frequently tired
- Insomnia (could be correlated with the above symptom lol)
- Get out of breath faster than usual
- Anxiety (already had this though)
- Mild depression (probably from my breakup)
- Lack of motivation (probably from my ADHD)
- Very rare and random spasms in my neck
- About 10 pounds weight loss in the past few months
- Headaches (could be from the meds)
- Sexual Dysfunction
- Minor rash under my eyes that’s been coming / going
- Eczema / rash flare ups past few months above my eyes, on my inner elbows, on my hands, and on my neck that I’ve been able to get rid of with a steroid cream
- Wrists, elbows, knees and ankles (although many joints in general) tend to bother me / crack a lot
- Glands under my neck are frequently swollen
- Rashes on the tops of my feet and toes
- Multiple gray / white hairs appearing in the last few months
- Probably something minor that I'm forgetting but if I can't think of it it probably isn't important (will update this list if new symptoms arise)
Brief family history:
- Grandma (moms side) has rheumatoid arthritis - Grandma (dads side) had multiple sclerosis - Great Grandma (moms side) had Alzheimer's - Aunt (moms side) has an undiagnosed heart problem - Aunt (moms side) has rheumatoid arthritis and Reynaud's, inconclusive testing for lupus - Aunt (dads side) has something? something to do with swelling of feet and ankles? not too sure - Mom had anemia
​
My personal theories (I'm not a doctor though so obviously not too sure): Autoimmune Disease + Dysautonomia: - From a list of symptoms, I have experienced all of the following at some point over the last month: Lightheaded when standing up, nausea, brain fog, fast heart rate, high blood pressure, changes in bowel movements over the course of the past few months (both constipation and diarrhea), fatigue, sexual dysfunction, chest pain and discomfort, shortness of breath, heart palpitations, sleeping problems, dizziness, sweating a lot, watery eyes, frequent headaches, changes in body temperature, drooling (when I sleep), mood swings, anxiety, and sensitivity to light. Based on this a potential theory could be an autoimmune disorder on top of a heart condition? Also explains the elevated monocyte (absolute) levels. Serotonin Syndrome: - I was doing research and discovered that Buspirone, when taken with other medication that increases serotonin, can cause serotonin syndrome. After another google search, I found out that weed can increase serotonin levels. The only hole in this theory is that I stopped taking Buspirone after the initial spike in heart rate / blood pressure but had no noticeable changes.
TLDR: I have a high heart rate and blood pressure and can't figure out why

I am F16 and I’m ashamed to say I tried a variety of (what I thought were) “safe” drugs between the ages of 12 and 15.
This included alcohol, Xanax, Ativan, hydrocodone, Percocet, Zopiclone, and Vyvanse. All taken from parents medicine drawer.
I never intended to become someone who uses drugs a lot, I was depressed during covid and wanted to try it out because the association between depression and drugs was pushed by many shows I’ve watched and I felt like it was meant to happen. I know it’s messed up I was very messed up. I haven’t touched any substances like that in 8 months and I never intend to again.
I understand these drugs can mess up peoples mental health and physical health, however due to how rarely I was using them I really didn’t think that could happen. And I didn’t make the corelation until recently.
• Percocet and Vyvanse were only take once.
• Xanax and Ativan were taken four times total with months in between.
• Hydrocodone was used more regularly, I think once a week, but only till the bottle ran out.
• Alcohol was high “dosage” (4 or more drinks) but many months in between. I think I drank 3x only.
• Zopiclone was used twice a month for a few months for sleep needs (I did my research) and also the feeling before sleep.
To me, I know this is bad, but I don’t think this was often enough / enough amount to have a permanent affect on me. But I was young so now I am worrying about its effects on my young brain.
Did I really mess myself up forever?
I now have OCD, Depression, and DPDR.

Sorry in advance for the really long post.
This all began at the start of 2022. I had a seizure in January but didn't know it at the time. March 2022, I have a seizure at a job site and get fired because of it (the company pulled some shady stuff to avoid me suing them for discrimination. Nice.) but was sent to a neuro who gave me Keppra. Bad idea. One of the worst drugs I have ever taken, you couldn't get me to touch that drug again if you paid me. So we switched to Vimpat. It worked well enough for a while (until it didn't) but it still gave me side effects. I didn't want to kill myself or fight strangers, but I didn't feel right. I still felt so heavy, and almost like a brick was inside my brain; I wasn't foggy, I was just downright incapable of understanding somethings. So then we switched to Lamictal. Then zonisamide with the Lamictal. And that didn't work, so we keep trying. Now I'm on Briviact and Lamictal, I've been seizure free for over three months now (the longest time since the start of January 2023! But it's taken us so long to get there, and I hated being a guinea pig and having to take six different medicines before we found a cocktail that seems to work.
Now, the stupidity. Much of my identity is based in my language skills (both in my native tongue, English, as well as my second languages) as well as my writing. Obviously there's much more to my life than just those things, much more than that, but that plays a big part in just who LinguisticHappiness is (name makes sense, huh?). But I can hardly think anymore. Lucky me that my TLE hits my language centers the hardest and I'm more or less globally aphasic when I'm in my post-ictal state. I trip over my words all the time. I make speech errors I never made before, like metathesis is my new chum the way it comes with me everywhere. I can't translate my feelings or thoughts into words. People who know me know how I am and understand this and feel for me, but when I meet new people now they assume I'm just a dumbass. I had a coworker talk down to me and try to explain how to speak English better and how to sound smarter. That was very much a confirmation of my fears. I forget what's happening all the time now. I'm a regular cannabis consumer, but I've cut down on it a whole lot since it gives me awful brain fog in tandem with the anticonvulsants, understandably. That hasn't helped a whole lot. Even removing the cannabis a lot, my short term memory is awful. I could be stone cold sober, put something down on the table, and five seconds later have absolutely no idea where it went. If I get slightly distracted in a conversation, the topic leaves my head just as fast as (or even faster than) it popped up in my head in the first place. I'm forgetting words more and more. I'm forgetting conversations I had even an hour prior. I'm forgetting basic information about people I met months ago. I started taking jiu jitsu classes recently and before all this I never had a problem seeing something and translating it to movement of my own body, and now I have difficulty sometimes following simple directions from the instructor.
I feel like a fucking moron. My brain feels more and more useless by the day. Someone else posted a day or two ago about how epilepsy has taken a lot from their life and how their "ideal" lifestyle (from the doctor's POV) would be dull and uninteresting, and ultimately unachievable. No stress, 8+ hours of sleep every night, never missing a dose, never touching alcohol, never staying up late, never going on hikes by yourself again... What's the point of taking these medicines if they're just going to make me miserable? Why try to improve my quality of life in one area just to worsen it in another? Why do I have to put all these chemicals into my brain when other people don't? Why can other people just get up and go traveling to whatever country they want whenever they want while I need to check with foreign governments to make sure I can bring my medicine and how to do that and I can't?
For someone who has difficulty translating her thoughts into words, I sure did say a lot. Sorry again for the essay. I just haven't been able to talk about this with anybody who understands it. Even though things are marginally better with the pharmaceutical cocktail I'm on now, but it's far from perfect and I still end up crying a night or two each week from this. This life I live now is much better than living in constant fear of seizures, scared that "uh oh, I feel a little woozy, do I need to warn someone and get down on the floor and take my Ativan right now?" but it's far from perfect and still not at all like life was before. I hate living in fear. I hate feeling like a complete idiot. I hate feeling trapped and limited. Even here I feel like there's so much I'm forgetting to say. Fuck epilepsy and fuck anticonvulsants.
Thank you for taking the time to read this, guys. I really appreciate all of you.

More/less, I kind of know you got to be on a med for a bit to get an idea of how it truly effects you. Welp, tonight was the first day that my buspirone gets taken twice a day, effectively doubling the dose (you take it once a day for a week before that).
I felt kinda' crappy during that first second dose (confusing enough?). I'm just looking to hear a general pep talk from anyone who's familiar with meds that knows oftentimes you feel bad before you feel good. I'm not using this as medical advice - Just interested in peoples' general experiences.
Like I said: I kind of know that's the case, but it's oftentimes comforting to hear someone more experienced tell you it. So, if anyone out there wants to reassure me that oftentimes meds get better after you give them time, I'd be interested if that's oftentimes the case...

I have Autism Spectrum Disorder, ADHD, Depression with Anxiety, and Schizoaffective Disorder.
I recently stopped taking ADHD stimulants because I decided it wasn't good for my mental health, especially for my anxiety and paranoid delusions.
My psychiatrist has prescribed me 0.5mg of Klonopin (Clonazepam) to be taken once daily, and a second tablet taken as needed. The benzos I have been prescribed before are Klonopin, Ativan, and Xanax. Is anyone else here taking benzos and is also prescribed either (or both) Mirtazapine/Olanzapine? I'm asking because it seems like the Mirtazapine/Olanzapine decreases the strength of the benzos. My current Klonopin prescription is helping a lot with my anxiety and general mental health, but I think I might need to increase the dose.
I've had many psychiatrists and only one of them was able to describe to me something about how my other meds affect GABA and might make the benzos less effective, and there is little information online about this.
Anyone else having this experience?
Also, I've been reading online about Valium vs Klonopin, and it seems like Valium works better for some people. Has anyone here taken Valium and Klonopin at different times and can you describe the advantages/disadvantages of both?

Cate, Yellowknife, Canada 33yo Female 5’6'', 118-120 pounds Meds (went from none to): Propranolol 20 to 40mg/day Ketotifen (1-4mg/day) Rupall (20-40mg/day) Very new since yesterday: Amitriptyline 10mg As needed now (hate them but was told to take to avoid CNS and ANS and PNS attacks): Valium 5-10mg as needed (I don’t take it everyday at all and just started taking it AFTER my venous gases were taken so they didn’t do what you will read about)
Supplements: Curcumin LongVida Quercetin Resveratrol Benfothiamine L-Carnitine Ubiquinol NAC NADH
Hi!
My name is Cate. I am 33yo and I am from Canada. Just to give a little bit of a background, I was always an extremely active person. I have a dog I used to walk and hike with hours a day. I would happily trade a party with friends just to go walk with my dog. I always was a highly sensitive person nervous system wise. When I was young, I would tell my mom to 'turn off the sun' (lol). I lived well with it though. I became a social worker. Worked crazy hours. I’ve had insomnia for years since a first nervous injury after getting EBV. I recovered though. I moved to a very small town 7 years ago and I live with my dog. I love Life and the outdoor. The only health issue I had was a sensitive nervous system and some rosacea. I also know now that I was prone to dysautonomia but I was extremely active so having low BP and athletic HR (50bpm) wasn’t unusual. I would sometimes get dizzy when standing but not always and never had tachycardia or palpitations from it. I also had slightly stretchy skin so was prone to EDS. I know now, you’ll soon understand why. Back in 2018, I took Accutane and burnt in the sun. I developed mild SFN but it went away with time and my life was normal. More than normal. It was great! :)
In December 2023 I was prescribed Doxy for my Rosacea. I took it once and had to stop as I felt warm patches of skin on my body. It reminded me of the SFN. So I didn’t take a chance. However, I noticed in the weeks after that I had developed a weird anxiety and some insomnia (nervous system injury #1). A few weeks later, I was told to try Metronidazole. I used it for about 2 weeks. All hell broke loose. It started with pins and needles in hands and feet. Never had that before so I didn’t think much of it. Then I became very dizzy. And my mood changed. I was crying for no reason, historically. And I started having burning skin on my limbs. I stopped the meds. But it was too late. I had developed palpitations, lower voice, weak legs, etc. I had a neurotoxicity. (Nervous system injury #2) My doctor didn’t want to believe it was that but was thinking GBS. I was however hyoerreflexive so it wasn’t GBS. But he prescribed some Ativan. I took it but quickly it wasn’t doing what it was supposed to do. After even just a few days I could feel more anxiety. It was awful. So I stopped taking them after about 10 days. Things went from bad to worse: terrible panic attacks, flashes of light and stroboscopic type of images when closing my eyes, insomnia but to the point of not sleeping for a month, pelvic floor pain, myoclonus jerks, full body internal vibration, sensitivity to sound, it was scary. (Nervous system injury #3). I forgot to say but my periods also never came.
I was sent for an MRI and obviously my MRI was ok. But things were NOT normal. My palpitations were so bad, my heart would skip beats, I was so dehydrated cause I became hyperadrenergic. I also started to have anhedonia and my GI motility stopped. I could not feel hunger anymore. It was weird. But I wasn’t short of breath. Just had palpitations. Doctors told me I have FND, but it was not FND. FND doesn’t stop your periods, doesn’t mess with your hormones, doesn’t give you continuous insomnia for a month. And I never had a limb not functioning or had a seizure. Therefore. I left to find more and better answers. I knew it as the nervous system but I am not a doctor so had to rely on them for help.
I went back to my home town. I was a mess but physically I was fine. I was eating, digesting, but I had become more short fuse, still having the myoclonus, and all the other weird symptoms with some derealization and sound sensitivity. But I could still laugh etc. I went to see a doctor and he thought maybe it was a bad withdrawal so I was put on a high dose of Valium. Obviously all of my symptoms vanished but others showed up: I started having hand tremors and benzos would act very paradoxically on me. It was increasing my BP and HR, made me cry all the time and become aggressive. I had to come off then. I stayed on them for 6 weeks from 40mg (that’s crazy, I was taking 1mg of Ativan..) to 25mg and was then switched to Gabapentin. The hospital who did that however decided after a few days that I didn’t need the Gabapentin anymore and removed it. I thought I was gonna die. I started having tremors on my face and even to my tongue. I started being very agitated (obviously, I was going through a terrible withdrawal!) and was told they would inject me with antipsychotic. I honestly have never been this traumatized in my life. I restarted the Gabapentin and took it for a month. Hated it too cause ai was super paradoxical to it as well. Most people feel calm on Gabapentin. I felt so agitated and developed weird body movements like my head would twist involuntarily and my fingers were moving from left to right, especially on my left hand.
I stopped the Gabapentin after tapering. In a few days, I was back to normal. I was so happy. Could walk my dog daily, drive, go to the grocery store, I had found myself again. Until I went on a hike. It wasn’t a long hike but it was more demanding than the walks I was doing on flat ground daily. I would walk for several hours but never to the point of being anaerobic. On that hike I did though.
After the hike, I started feeling jittery. My nervous system didn’t like that at all. I went to bed, put on a meditation and fell asleep. That night is still traumatic lol. I felt electric zaps all in my body and spine. I sweat so much. I woke up drenched and with pain everywhere but mostly, every joint in my body cracked. Every single one. I had never been in pain like that in my life. But also, the palpitations were back but much much worse. And also high BP, which I never had even during the beginning after the neurotoxicity started. I wasn’t able to function anymore. I saw my GP and he didn’t like what he saw. I was completely dehydrated, muscles and joints were all painful, crazy palpitations, high blood pressure that I never had before, could hardly walk. He sent me to the hospital. He also confirmed this isn’t FND for the same reasons I mentioned before, and he knows me very well. All my muscles literally melted almost overnight. Like literally melted. And my skin had become stretchy as if all my connective tissues broke down (EDS flared up but like literally overnight).
Once at the hospital, they finally took things more seriously. I was started on on IV fluid for low potassium (very weird cause I make my electrolytes every day and never had an issue with that. You’ll see, it’s relevant). I also had elevated proteins in my body. Very weird too cause I wasn’t eating more proteins than I used to. I also had low WBC. My hormones were obviously all over the place. I was actually due to start my period and it never came. I stopped pooing again and stopped digesting my food. I know that’s dysautonomia. I had started to feel slightly better after a few days and walked a bit in the hallway. That night.. other ‘attack’. I don’t know how to call them. A few days after that, I still had pain in my muscles and was scared I was denervated (Metronidazole does that), so I though I would speed up the process by giving myself a full body deep tissue massage….. worse mistake of my life. Worse attack that night and the next day I had burning pain all over. Worse palpitations. All over. I also am now in a wheelchair because if I walk even a few minutes, I get an attack that night and wake up with even more weird stuff.
Fast forward to now. I am in Vancouver, Canada. As there isn’t many specialists in my small town (there isn’t any lol). I am worse than ever. My bloodwork look horrendous. My venous gases show I am in acidosis. I cannot breathe if I sit up or stand so I am laying down. My fasting glucose is at 6. I wore a CGM for months and I had perfect blood sugar and was never insulin resistant. I have low MPVs. Low potassium always despite eating bananas and drinking electrolytes all the time. My skin is completely dehydrated and flaking. I get palpitations even laying down.
I had a nerve conduction test and so far so good, I still have nerves. This is not just dysautonomia. Even at my worse, I didn’t have palpitations laying down in bed. And never to that extend. I have developed every problems of the Pentad like it is called: EDS, Dysautonomia, MCAS, Autoimmunity and I don’t remember the last one but I have it too.
I know this is an over reactive/over sensitive nervous system. That’s quite obvious. I have been running on NS injuries after NS injuries for almost 5 months. Also, my breath smells like ketones now I was told. I eat normally.
However, there is more. I forgot to say, on top of that, I have a pituitary tumour (but we know it’s not that causing the issues as when I was on benzos, my periods came back!), I have a thyroid nodula but it’s non-secreting (have had it over 10 years now) and I have a history of hypothyroidism for which I took meds for two months and then I never had an issue with it again. They tested it at the hospital and it’s ok. There is some auto-immunity in my family. My sister had a bout of RA after she gave birth, my mom has EDS for sure and also had Endometriosis, she also has orthostatic intolerance which is the very beginning stage of dysautonomia, she has rosacea prone skin too. Etc.
I know this cascade triggered viral infections and auto-immunity, but what do I do? These things are understood by only a small minority of doctors and I don’t know where to start. I think I will never get better if we don’t figure out the cause of my problems with the insulin and mostly why I have respiratory acidosis!
I don’t have ANA activated so far in my bloodwork for the main stuff but clearly I know what’s up..! I know EDS is considered a genetic condition but I strongly think as many doctors that they are auto-immune related. Never had any problems with that until my nervous system broke down which also activated inflammation and my immune system to start having real troubles.
Let me know where to start please, I am scared of dying in the hotel room. I am tired of being in bed but I know I am making things worse when I walk. I am developing ME/CFS, I know it, but it still won’t say why I am hypoventilating 24/7 with low potassium and low MPV and low WBC with high proteins. I am freaking out that my life and health are literally going to hell because of an antibiotic..! For a perioral dermatitis 😂..! I am remaining calm but.. not gonna lie.. it’s no fun.
Thanks for your help!!!
Cate xx

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.

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.

Repost from MedicalMalpractice [link]
So about half a year ago while I (27 AFAB at the time) was at work my arm began tingling. It happened while I was crocheting so I attributed it to poor posture but took note of the time (just after 3pm) and continued working until 5pm. By the time I got off work my pinky and ring finger on my right hand became difficult to use. I drove home (hindsight this was really stupid of me to do) and an hour later when it hadn't gotten better I asked my brother to take me to the ER.
While there I told them that given the symptoms I was having (numbness on one side, and partial paralysis) and that I had started a new birth control a month prior that I was worried about the possibility of a stroke. They checked for the more obvious signs of stroke (facial droop, delayed eye dilation, blood tests, etc.) and noted that I had weakness in my right arm as well as tachycardia. They asked my brother about my behavior and if I was acting off, which he said I was not.
When the blood tests came back they informed me that my d-dimer was elevated. I wasn't told how much it was elevated. They referred me to CT to check for a pulmonary embolism. CT showed a normal healthy chest and I was sent home with a diagnosis of pinched ulnar nerve.
Over the next two days I proceeded to be incapable of eating or drinking anything, if I slept it was not for more than an hour at a time and I woke up in a cold sweat. My arm went from tingly and partially paralyzed to dead meat attached to my body. I could not move it, and could only lift at the shoulder. I woke my brother up at 3am to take me back to the ER. I informed them of the new symptoms, as well as the worsening of the previous symptoms.
This time it felt very dismissive. I was not being heard. I got sent to MRI to check again for a pulmonary embolism which again showed nothing. I told them I felt like I had really bad brain fog and my arm felt like it was in ice water. I was told this was normal for a pinched ulnar nerve. They gave me nerve glides to do, a prescription for 600mg of ibuprofen, and a referral to a neurologist. I asked them before I left if it was a good idea to fly as I had a vacation starting the next day, I was told it was fine.
So I went on my vacation, flying from one coast of the US to the other. It was 7hrs after I landed and was picked up from the airport where it started to go downhill and rapidly.
I still couldn't eat, and I knew I wouldn't be able to sleep so I bummed a gummy off a friend and started getting ready to go to bed. After this is a complete haze for me but I will list the events as I was later told:

• While walking to bed I blacked out. This was me dropping while I had my first tonic-clonic seizure of the night. My friend miraculously caught me and made sure I didn't hit my head, while my other friend took charge of the situation.
• My seizure lasted approximately 2 minutes, and when it looked like I was coming out of my postictal state pretty quickly they decided to drive me to the ER
• At the ER I had another seizure while they were taking me to get a CT scan of my brain. After this I was taken to MRI. I was considered medically confused and was incapable of staying still. I was given two doses of Ativan to try to keep me still long enough to get something from the MRI
• MRI was sent to a neurologist at another hospital who was able to see on the VERY blurry images that I was having a stroke. She teleconferenced in to assess my state, asking the nurse to essentially check if I was brain dead. My friend who was with me the entire time was the one to actually wake me up.
• I was then transferred to a bigger hospital's ICU for care when I was stable.

I dropped on Tuesday night. I remember bits and pieces of Tuesday night, and the following Wednesday, but I was not conscious and aware until Thursday morning. I woke up, realized I had a catheter, and I was P\SSED*.
In the few hours after the medical staff learned I was actually with it. I was informed not only that I had a stroke, but that I had a rare form of stroke. It was a Cerebral Venous Sinus Thrombosis. They were shocked that the previous hospital had not continued to look for something and dismissed me. I was then informed that my d-dimer was 1.03 (where a 0.50 was the maximum threshold for a normal d-dimer), my glucose upon being admitted was severely elevated, and they didn't know how bad it was because they had not yet been able to get a clear image of my brain. They later did and most of the damage was surface level and I came out pretty good for a CVST.
Throughout my ICU stay I learned I was extremely lucky to be alive, you can't trust every doctor, and to always be accompanied by someone who will advocate for you. Also birth control sucks and my friends are amazing.
I spent my 28th birthday in the ER.
I now live in the state where I was finally diagnosed properly and I am communicating with a lawyer for a malpractice lawsuit. I have had up to 20 appointments a month just for things related to my stroke and am coming to terms with things that just might not get better. I'm taking 4 different medications for the after affects of the stroke, and I might just have to remain on 3 of them as it's possible I now have an epileptic disorder. We wont know for sure until my brain is given more time to heal but my recent EEG still shows abnormal brain activity.
I think overall I have a pretty solid case, especially given the shock of the paralegal as I explained what happened. But sometimes I second guess it and it worries me. I'm still waiting on their Nurse Expert to look at my file.
Additional notes: they were told both times I had a migraine with aurora. It took 2 months for me to regain usable function in my right arm. I have reduced feeling in my entire right side (I can feel if things are touching me, but not temperature or if it's sharp). I have noticeable memory issues, I can't remember appointments on my own, if I don't write down something that happened that day I will forget it by the next day. It's also a gamble what I remember on my own and how I remember it.
I'm 28. This shouldn't be an issue I have to face and I probably wouldn't be facing it to this degree if it was originally diagnosed the first two times I went to the ER.

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.

I’m scheduled for a SA tomorrow I’m Canada. I understand I’ll be given Ativan if needed for anxiety and then through IV fentanyl and midazolam. The cervix will be locally sedated. I understand this is pretty standard in Canada and many women here have let me know their pain levels were very tolerable.
I’ve made the mistake of now reading a bunch of very negative experiences today and I’m finding myself with crippling anxiety. I’m so scared about the possible pain during the procedure. And I just wonder how it’s possible that some people have such terrible experiences despite getting similar medication?
What can one do to be taken seriously if pain is barely tolerable? Is it common to ask for more pain medication if needed?

I will make daily updates in here. It's been quite a journey for me. Will post my history prior to effexor below.. So far am on day 3.
Day 1 - 5/13/2024
Took at 10:00
Anxiety was sky high when I took but settled some 45 minutes after taking.
12:00 feeling jittery and kinda spaced out?
14:00 extreme anxiety
17:00 nausea / dry heave
18:00 headache
Stomach rumbling at night which was kinda funny listening too tbh.
Day 2 - 5/14/2024
Took at 10:10
Really bad anxiety after taking.
Felt really weird before noon
At noon stated reading a book called Hope and Hell for your Nerves by Dr. Claire Weeks.
From 12:30 - 13:45 I felt an overwhelming calmness that freaked me out kinda. I felt at peace, really strange.
16:00 nausea when I yawn
Increased jitters and burning chest (anxiety) at night while settling down for bed.
My story and history :
since December I have been suffering with anxiety which has progressively gotten worse to the point where it has made me depressed as well. As of this post I am at an all time low and am in desperate need of relief. If you make it to the end I will explain what I am going through.
I am a male in my late 30s and have had two bouts of anxiety / depression in my life both of which lasted 3 months (2015 and 2020), and were cured with therapy. This time seems different..
I have a very stressful job which requires me to work 7 days a week with the only break being when I take vacation or slow times in the industry. It pays really well and helps me provide my wife and two young kids a good life so I put up with it in the hopes I can manage the stress better in time. I mention the above because I truly believe it has alot to do with the state I am in now.
I have always been caring, outgoing, light natured, and humerous throughout my life and also pretty sensative. I really want to go back to that and hope treatment will help.
I also realize I am my own worst enemy in getting treatment as you will see in the paragraphs below.
When I was a teenager into my early twenties I was carefree and would try most drugs to fit in. Extacy, lsd, mushrooms, pills, etc.. Never touched the extremely hard stuff. Marijuana was my best friend and I smoked a ton of it. Hello panic attack! I remember the first time I got one after smoking Marijuana in my early twenties. It was horrible! I couldn't smoke Marijuana anymore afterwards because it would induce a panic attack. I told myself it was God's sign telling me to stop so I did. I haven't smoke Marijuana since.
Fast forward a few years from then I was introduced to a medical condition called gout. It is very painful and the first time I was treated for it I was given narcotic pain medication and an anti inflammatory. I took both when I got home and it provided relief. Being this was my first experience, I wanted to research gout a little more and I did just that on the internet. Here comes the part where my life changed for the worse..
For some reason, I also asked google if you could overdose on the pain medication I was currently taking. No clue why I wanted to know but as soon as I read you could, I instantly had the worst panic attack I ever experienced.
Ever since that point in my life I have refused to take medication in fear of another panic attack. From that point forward, my mind associated taking medication with panic. For the years afterwards I always had a panic attack when I tried to take anything including something as simple as advil.
Anytime I would be prescribed something I would obsessively research it, watch videos on it, read reviews, etc.. I would psych myself out and not take it.
Fast forward to 2015 when I finally moved out of my parents house. I won't go too much into it but I had my first bout of extreme anxiety and depression from it. It was a big change for me and it took a few months to pull myself out of it with the help of a therapist.
Life was absolutely WONDERFUL after that. I was on my own, found the love of my life, got married in 2018, and was the happiest I had ever been.
2020 was my second episode of anxiety and depression. In a matter of 6 months I lost my grandmother, godmother, my one year old boxer puppy, and my father in law. I also had my first child. Not to mention it was covid time...After everything settled down from the chaos it hit me like a ton of bricks. Bam!..anxiety and depression. It was awful and I knew I needed help. I started therapy and it helped tremendously. It was suggested that I also see a pyschiatrist. I did and he prescribed me prozac to take along with therapy. I was not going to take it. We all know how I am with my phobia of medication.
One day I said screw it and out of nowhere threw it in my mouth and swallowed. I expected the worse. Nothing happened...I continued to take it for 4 days and didn't notice anything bad happening to me. I was happy about that.
The 5th day I had a panic attack because I started to feel really strange. I don't remember exactly how I felt but I remember calling my sister and telling her I feel really weird. She assured me it is normal and to keep on which I did.
The 6th day I took my pill in the AM and all was well. I was tired so I stayed in bed. Out of nowhere I felt a rush of bad bad bad energy take over my body. It is hard to explain. It was like a rush of anxiety but with it was a sense of hopelessness and dread. I had experienced in my first bout back in 2015 but not this severe. I was scared and called my psychiatrist and left a message. I immediately went to my mother's and cried cried cried. The feeling subsided. My psychiatrist called me back very quickly and when I explained what I felt he told me to stop taking it and to take the ativan he prescribed if needed.
I stopped the medication and never took an ativan. I got better over the next couple months through therapy and all was well.
I did have a tiny breakthrough and convinced myself to take a medication to stop my reoccurring gout attacks. It is called allopurinol and is regarded as one of the safest medications out there. It took alot of courage and of coarse I read every review there is on it but I eventually just threw it in my mouth and fell asleep. Have been taking it daily for two years now.
Fast forward to December of last year 2023. The stress from work and medical issues throughout 2023 must have built up and I had a breakdown. I started to get anxiety and small feelings of the hopelessness I mentioned above. December into January into February I dealt with it and kept telling myself it will pass like the other times. It didn't and kept getting worse. I finally sought help from a psychologist in late February / early March. After the first few sessions I would immediately get a high from the previous hours talk. It was fantastic but eventually wore off a few hours later.
The anxiety I was experiencing / am experiencing is absolutely horrible. Non stop jaw clenching, chest pains, tension, blurred vision, lack of good sleep, extremely heightened senses, etc. I am good at telling myself it is anxiety and will go away. I don't freak out over it into full blown panic but I feel like I am always borderline panic while also being exhausted. It's very uncomfortable. I have had multiple health checkups and all is fine.
I decided to call my old psychiatrist because it had been 3 months with minimal relief. I was told he was retiring and he referred me to someone else who I am now seeing.
He prescribed me Paxil and klonopin in marxh and of coarse my phobia stopped me from taking it. We did a gene test to see which medicine would work for me and paxil was a good fit. I just couldn't do it. For the next few weeks I seemed to be getting better by getting out and doing things. I even started fishing again which was a huge passion of mine. Things were looking up!
Anxiety was going from an all day thing to maybe a couple hours type of thing! I was hopeful...
Let me introduce you to my buddy kidney stones...
Middle of April I woke up to EXCRUCIATING pain. I eventually went to the ER that day after hours of suffering and they told me I had 2 kidney stones. They sent me home with the same narcotic pain medication that started my panic attack journey when I was younger and also some other medication. From that Tuesday to Thursday I was in crippling pain and refused the pain medication. It got to a point where I almost blacked out from the pain so I had no choice but to take it. I popped it and finally got some sleep. I think I didn't freak out after taking it because my body was in shock from the pain. I woke up 30 minutes later to the excruciating pain again and said enough was enough. I went back to the ER and they did an emergency surgery and put a Stent in me to stop the pain. It worked and was a huge relief.
After catching up on sleep and recovering, I started to get my anxiety back. The next two weeks while waiting on my second surgery my anxiety, which was on the right path prior to this stone, came back to it's previous 10/10 levels. Jaw clenching, blurred vision, etc..
I toughened it out AND not to mention, completed a full 14 day coarse of a strong antibiotic due to a kidney infection! I was so proud of myself. With my newfound proudness, I called my Pyschiatrist and set up an appointment for the following week after my second surgery to discuss some things.
I had my second surgery last Friday the 3rd and they removed both stones. I went home Friday night with another stent in me which I was told to remove from home on Monday by pulling a string that was hanging out of my penis head (sorry for TMI) which in turn pulls the stent from my kidney down and out through my penis. I did that on Monday and it wasn't bad at all.
The Saturday after my surgery went fine. I'm sure I felt good because I was still coming off anesthesia but boy o boy that Sunday I woke up after sleeping 12 hours to a horrible panic attack. Imagine waking up from a dead sleep to the biggest adrenaline dump you could imagine. It was awful and lasted ALL day! I experienced derealization and every symptom you can think off. I should have taken a klonopin but my phobia told me it would make it worse so I didn't. It settled down into the evening and I was absolutely exhausted.
Monday I woke up to another panic attack but not as severe and Tuesday another panic attach which was even less severe. Wednesday the same and this morning has been the first morning I haven't woken up to an adrenalin dump. With that being said, this whole week has been absolutely horrible with 10/10 anxiety. I rarely get breaks from it. At night it calms down and I feel normal. Because of that, I chase that normal feeling and stay up way too late lol.
Anyway, leading up to my psychiatry appointment today, the last few weeks I have been obsessively looking up the 2 ssris and 1 snri my gene test said I was compatible with. Prozac (go figure), paxil, and effexor. I was also compatible with welbutrin.
Paxil I am terrified of because it is supposedly the dirtiest and worst for weight gain (I am a 240lb male).
Prozac I tried previously and I think I didn't give it enough time. I am not 100% sure that dread / hopeless feeling was suicide ideation but the feeling is in a class of its own compared to my normal anxiety.
Effexor I am scared of because of the withdrawel and alot of YouTube reviewers said it made them feel high and wired for the beginning. The horror stories of coming off it scares me too.
Welbutrin I hear great things about but heard it is bad for anxiety which is my main concern.
My overall fear is that any of these will make me lose control and make me not myself. I am also scared that I don't remember what normal feels like and feeling normal will scare me. Crazy to say that. Ultimately he prescribed me Effexor 37.5 for 2 weeks and then upping it to 75mg. He said to take the klonopin if I need it starting up. I have 15 of them.
I know I need to do something because I can't live like this. My wife, my 4 yr old, and my 2 yr old need their father and husband back. It's not fair to them. I'm tired of staying in bed all day. I'm tired of not caring if I wake up. I'm tired of not being the best employee I can be, I'm tired of not being in contact with my friends anymore, I'm tired of not caring about my hobbies, Im tired of being tired, and most importantly I'm tired of feeling like this.
I will start the effexor and update this thread with my progress.

So about half a year ago while I (27 AFAB at the time) was at work my arm began tingling. It happened while I was crocheting so I attributed it to poor posture but took note of the time (just after 3pm) and continued working until 5pm. By the time I got off work my pinky and ring finger on my right hand became difficult to use. I drove home (hindsight this was really stupid of me to do) and an hour later when it hadn't gotten better I asked my brother to take me to the ER.
While there I told them that given the symptoms I was having (numbness on one side, and partial paralysis) and that I had started a new birth control a month prior that I was worried about the possibility of a stroke. They checked for the more obvious signs of stroke (facial droop, delayed eye dilation, blood tests, etc.) and noted that I had weakness in my right arm as well as tachycardia. They asked my brother about my behavior and if I was acting off, which he said I was not.
When the blood tests came back they informed me that my d-dimer was elevated. I wasn't told how much it was elevated. They referred me to CT to check for a pulmonary embolism. CT showed a normal healthy chest and I was sent home with a diagnosis of pinched ulnar nerve.
Over the next two days I proceeded to be incapable of eating or drinking anything, if I slept it was not for more than an hour at a time and I woke up in a cold sweat. My arm went from tingly and partially paralyzed to dead meat attached to my body. I could not move it, and could only lift at the shoulder. I woke my brother up at 3am to take me back to the ER. I informed them of the new symptoms, as well as the worsening of the previous symptoms.
This time it felt very dismissive. I was not being heard. I got sent to MRI to check again for a pulmonary embolism which again showed nothing. I told them I felt like I had really bad brain fog and my arm felt like it was in ice water. I was told this was normal for a pinched ulnar nerve. They gave me nerve glides to do, a prescription for 600mg of ibuprofen, and a referral to a neurologist. I asked them before I left if it was a good idea to fly as I had a vacation starting the next day, I was told it was fine.
So I went on my vacation, flying from one coast of the US to the other. It was 7hrs after I landed and was picked up from the airport where it started to go downhill and rapidly.
I still couldn't eat, and I knew I wouldn't be able to sleep so I bummed a gummy off a friend and started getting ready to go to bed. After this is a complete haze for me but I will list the events as I was later told:

• While walking to bed I blacked out. This was me dropping while I had my first tonic-clonic seizure of the night. My friend miraculously caught me and made sure I didn't hit my head, while my other friend took charge of the situation.
• My seizure lasted approximately 2 minutes, and when it looked like I was coming out of my postictal state pretty quickly they decided to drive me to the ER
• At the ER I had another seizure while they were taking me to get a CT scan of my brain. After this I was taken to MRI. I was considered medically confused and was incapable of staying still. I was given two doses of Ativan to try to keep me still long enough to get something from the MRI
• MRI was sent to a neurologist at another hospital who was able to see on the VERY blurry images that I was having a stroke. She teleconferenced in to assess my state, asking the nurse to essentially check if I was brain dead. My friend who was with me the entire time was the one to actually wake me up.
• I was then transferred to a bigger hospital's ICU for care when I was stable.

I dropped on Tuesday night. I remember bits and pieces of Tuesday night, and the following Wednesday, but I was not conscious and aware until Thursday morning. I woke up, realized I had a catheter, and I was PISSED.
In the few hours after the medical staff learned I was actually with it. I was informed not only that I had a stroke, but that I had a rare form of stroke. It was a Cerebral Venous Sinus Thrombosis. They were shocked that the previous hospital had not continued to look for something and dismissed me. I was then informed that my d-dimer was 1.03 (where a 0.50 was the maximum threshold for a normal d-dimer), my glucose upon being admitted was severely elevated, and they didn't know how bad it was because they had not yet been able to get a clear image of my brain.
Throughout my ICU stay I learned I was extremely lucky to be alive, you can't trust every doctor, and to always be accompanied by someone who will advocate for you. Also birth control sucks and my friends are amazing.
I spent my 28th birthday in the ER.
I now live in the state where I was finally diagnosed properly and I am communicating with a lawyer for a malpractice lawsuit. I have had up to 20 appointments a month just for things related to my stroke and am coming to terms with things that just might not get better. I'm taking 4 different medications for the after affects of the stroke, and I might just have to remain on 3 of them as it's possible I now have an epileptic disorder. We wont know for sure until my brain is given more time to heal but my recent EEG still shows abnormal brain activity.
I think overall I have a pretty solid case, especially given the shock of the paralegal as I explained what happened. But sometimes I second guess it and it worries me.