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Donaldson closed his eyes, focusing on his remaining ear, trying to tune into the sounds around him. The ward was quiet. Best as Donaldson could tell, about half the rooms on this wing were empty.

Slow week at the country hospital.

That would change in just a few minutes.

Donaldson eyed the brace holding his shattered arm together. Winslow had called the contraption an external fixation. Made of heavy gauge surgical steel, it ran from his shoulder to his wrist, four metal rods surrounding the limb. They were attached to four large squares that encircled his arm. In each square were several screws. These screws pierced Donaldson’s skin and held his bones in place as they healed.

He counted nine screws in all. Each had a tiny, flat knob on the end to manually adjust the tension. It sort of looked like the scaffolding employed to hold dinosaur bones together in museums. But shinier.

Shinier, and very heavy.

Okay. Here we go…

Donaldson wadded up a corner of his blanket and shoved it into his mouth, tasting fabric softener. Biting down hard, he tentatively reached for the first screw.

Touching it brought a spark of agony, and he immediately withdrew his hand. Sweat popped out in fat beads on Donaldson’s forehead. He let out a deep breath through his nostrils, blowing snot like a horse.

Do it.

Just do it.

It’s the only way.

Donaldson pinched the screw head again.

Then he twisted.

The pain was akin to having a tooth drilled. Deep nerve pain. Bone pain. A pointed, foreign object, sticking deep in the marrow, prompting a guttural moan that the blanket didn’t entirely muffle.

Donaldson glanced frantically over at the cop, hoping his outburst hadn’t woken him.

The cop didn’t budge.

Blinking away tears, Donaldson twisted the screw again, and this time the burst of pain was so acute, so otherworldly, his whole body began to shake.

Withdrawing his quivering hand, Donaldson immediately realized what had happened.

Damn it, you idiot!

It’s supposed to be righty-tighty, lefty -loosey!

He’d been inadvertently driving the screw in deeper.

Screaming curses in his head, he forced himself to grip the screw once again, turning it the correct direction this time, not stopping until the pointed barb tugged free of his skin. The hole it had been nestled in oozed dark blood, the pinpoint of suffering replaced by a duller, but equally unbearable throb.

Done.

Only eight screws to go.

The next two were hell.

The one after that made him redefine what hell actually was. Tears streaking down his cheeks, biting the blanket so hard his jaw ached and his gums bled, Donaldson fumbled with the screw holding the top bit of his shattered ulna in place. But the screw was lodged in the bone so tightly that Donaldson felt his ulna twist as he turned it. He could even see the bone wiggle underneath the skin, as if a mouse had burrowed into his flesh and was trying to escape.

Donaldson’s hand shook so badly he couldn’t get a firm grip. His face felt cold and clammy, and he recognized he was going into shock-something he’d witnessed many times in his victims.

Fight it. This is your only chance.

Donaldson turned the screw.

The broken bit of ulna turned sideways, almost perpendicular to his forearm.

He shuddered in agony, and then passed out.

Donaldson awoke trembling and confused, his face so drenched with sweat he looked like he’d just stepped out of the shower. He cast a frantic glance at the cop-still sleeping-and then the clock.

2:20.

Only ten minutes until Nurse Winslow made her rounds.

He had to hurry. There were still five screws remaining.

Donaldson hadn’t cried since he was a child. He remembered being ten years old, his father’s belt drawing blood on his ass, his thighs, his back; whipping him for killing a neighbor’s dog, whipping him so hard and for so long that Donaldson missed an entire week of school.

That was the last time he’d ever cried. His father had whipped him many times since, but Donaldson had vowed to himself he’d never show weakness again. He’d internalize the pain. Keep it inside.

It was a vow he’d kept for over forty years. A vow he now broke as sobs shook his body and mucus streamed down over his blubbering lips.

The screw seemed to twitch with his pulse, vibrating just a bit, the bone beneath the skin so obviously out of place it was almost funny.

Donaldson tried not to hesitate. But twisting was unbearable. It would cause him to pass out again.

So he took a deep, stuttering breath, gripped the screw head, and yanked.

The screw popped free, tearing out a thread of flesh, the blood spurting rather than oozing.

Wailing like a baby now, Donaldson attacked the next screw. The pain became the only thing he knew. His entire world. He twisted and pulled and pried at his tortured arm, blinded by tears, thrashing his legs and feeling the skin grafts tear, shaking his head side to side and actually bending the metal brace that held his neck immobile.

It was coming… coming…

Did it!

Donaldson wiped his blurry eyes.

Three screws left.

It was worse than a tooth ache. Worse than being kicked in the balls. Worse than his father’s belt. Worse than being dragged behind the car.

Just two more.

Both arms shook so badly now that Donaldson couldn’t get a grip on the screw head. He had to keep wiping his slippery, blood-soaked fingers on the blanket. When they finally locked on, he got confused and twisted the wrong way once again, tightening the screw, ratcheting up his suffering to the nth degree, causing his eyes to roll up into his head. He used the pain, knowing it couldn’t get any worse, turning it quickly and spitting out the blanket and vomiting bile as the screw mercifully pulled free.

Okay…

Just one more…

The last one…

This was the longest of them all, pinned into his wrist.

Deep.

So deep.

Too deep.

Can’t do it.

Can’t fucking do it.

The very thought of touching that final screw, let alone manipulating it, made Donaldson gag again. He needed morphine. He needed it more than he ever needed anything in his life. He could call the nurse, and she’d give him a shot. It would knock him out. He wouldn’t hurt anymore.

But then they’d reset the screws.

Donaldson knew he couldn’t bear that.

He closed his eyes, lips pursed together as he sobbed, and in his pain-delirium he was visited by an angel.

In Donaldson’s mind, the angel had big, white wings. A glowing halo. A beatific smile.

And pink Crocs.

“Looks like I win, old man,” said the Lucy Angel.

Donaldson’s eyes flipped open.

No. You’re not going to win, little girl.

He attacked the last screw with a hatred so fierce he could handle the agony.

It took twelve complete turns to get the son of a bitch out.

And then Donaldson was done.

His arm no longer looked human. More like a giant, pulsing earthworm, gooey with blood, the skin purple with hematomas. He carefully pulled off the brace, threading his ruined appendage through it, laughing as he hefted its weight. Solid surgical steel, at least five pounds of metal, screws protruding out like spikes on a medieval war mace.

Hysterical, Donaldson’s tears turned into hoarse laughter.

You fuckers made sure there were no weapons in my room.

But you forgot one.

He focused on the cop.

Still asleep.

The clock.

2:27.

Three minutes until Winslow showed.

Donaldson yanked off his head gear, bent and twisted from his thrashing, and set it on the pillow behind him as he heaved his bulk into a sitting position. He swung his legs over the side of the bed, the bandages from his skin graft surgery soaked in blood.