The steel door to Dr. Timothy Hobson’s office was heavy enough to allow Mark Stanton to recognize the effort it took for him to open it, to begin this appointment long in the making and long in the dreading. It was fitting the doctor’s office was far removed from the light, airy feel of the hospital’s remodeled wing and impressive atrium. Buried deep in the hospital’s bowels, Mark Stanton could suffer in peace or in isolation, depending on how you looked at it.

“Good morning, Mr. Stanton.”

“Good morning, doctor.”

“Please, have a seat.”

Dr. Hobson’s office was right out of central casting:  anatomical drawings of every part of the human body, shelves burdened with oversized books, piles of paper adding a veneer of organization to chaos, and framed degrees just far enough out of sight to underscore their irrelevance in the moment. As the doctor shuffled files and folders, Mark Stanton noticed the pictures of the doctor’s family on the rear credenza. The smiling wife, the two kids, the dog, the posed perfection.

Mark guessed the doctor’s children were around the same age as his daughters, and he was caught off guard by the disquiet roiling inside him as he watched the doctor fuss about his desk. The total lack of awareness, the entitlement Dr. Hobson enjoyed with his perfect wife, perfect children, cut right through him. The doctor, twenty years his senior, enjoyed every perk of life Mark did, and then some. And, now, the rest of his life and what was left of the perks, lay in his hands.

“Here they are, I apologize,” Dr. Hobson plead.

Mark Stanton simply stared at the doctor.

“Mr. Stanton, thank you for meeting with me today. As you know, two months ago, your wife Katy suffered a traumatic brain injury. Her car crash caused what we call a diffuse axonal injury. When she first arrived at the hospital, we could not detect this type of injury because it does not show up on a CT scan. This is a microscopic injury, affecting the nerve cells in the brain, and it is the most common form of injury in high-velocity traumas like the one your wife suffered. This is the reason she has been unconscious for the last two months.”

Mark Stanton simply nodded.

*****

“Mark…”

“Hey babe, what’s up?”

“Sorry, hey, I just dropped Beth and Sarah off at….Hey, watch it asshole!”

“What?”

“Some jerk almost ran me off the road. Anyway, ummm, it’s been a morning.”

“Are you okay? You crying?”

“I’m just, I’m just having a morning. Sarah got into all the donuts. Mark, there was powdered sugar everywhere. She looked like a ghost with pig tails.”

“You should have snapped a picture and posted it. Bet she was cute.”

“She wasn’t cute, she was annoying. I was in such a rush because, dammit, pull over honey, I’m in a hurry….”

“Katy, calm down. It’s okay. Be careful.”

“No, it’s not okay, Mark. I’m glad you’re comfortable in your desk chair, but I’ve had to get the girls ready this morning, and I’ve got work too, okay. I…”

“Okay, okay, okay. I hear you. I hear you.”

“I had to help Beth with her school project…”

“Those mandibles were pretty cool, huh?”

“Focus Mark! Between Beth’s ants and Sarah’s body coated in powdered sugar I left the house without Sarah’s medicine. Now, I’m rushing back to get it. I’ve got a meeting at 9am. I think I’ll make it barely, but I need you to…”

“Yes. What?

….

“Katy? Hello?”

….

“Katy, I can’t hear you, are you there?”

*****

“Mr. Stanton, are you okay?” Dr. Hobson slid his glasses off and looked at his patient’s husband staring right through him.

“Yes, I’m sorry, doctor. I, umm, let my mind wander.”

“I know this must be very hard to hear. I’ve reviewed your wife’s entire medical file for the past two months. I cross-checked every note. I see no evidence of self-awareness or the environment, and, upon examination, she demonstrates no signs of interaction. There are no purposeful responses to external stimuli.”

“And the blinking and crying? I sit by her bed and I see her eyes move. She knows I’m there, doctor.”

“I understand, Mr. Stanton. I know how hard this must be for you.”

Mark Stanton shifted his gaze to the credenza again, eyed the doctor’s impossibly beautiful wife and children, and thought, “Do you?”

“It’s not uncommon for patients with such injuries to exhibit certain signs.”

“Signs?”

“Yes, we see eye opening, pupil movement, yawning, even chewing and swallowing movements. Patients may cry, move their eyes, and make facial expressions that appear to be smiles or frowns.”

“But?”

“They aren’t crying, moving their eyes, smiling, or frowning.”

Mark Stanton looked down at the floor.

“Mr. Stanton, patients in a vegetative state like your wife are not moving or acting volitionally. We may see a primitive motor response to pain or we may see an object grasped when it is placed in the palm, but these are not acts of volition. You are seeing a simulation of awareness, not actual awareness. Mark, I am very sorry to tell you that your wife’s vegetative state has been persistent, and, after this amount of time, given the nature and extent of her injuries, I can come to no other conclusion than your wife’s vegetative state is a permanent vegetative state.”

Again, Mark Stanton eyed the photograph of the doctor’s family, focusing on the doctor’s wife.  He fingered the button on his shirt cuff and shifted in his seat. As he contemplated tying his shoe and strafed his tongue against the bottom of his teeth, he understood that, as long as he occupied his mind, he would not be required to ask the next question. He could slow the hands of time and fall into a moment where he had a wife, where life retained the possibility of normalcy, where he could romance the idea that the doctor was wrong, that it was a mistake.

“I know this is a lot to take in, Mr. Stanton.”

A knock on the door broke the spell between the two men, and Nurse Cecilia entered with Beth and Sarah in tow.

“Daddy!” Sarah proclaimed, as she rushed over to him.

“Hello, sweetie.” He stood and embraced both his daughters, twisting to envelop both of them.

“Mr. Stanton, your sister went on to work. She left the girls’ school things out by my desk. I’ll be happy to watch the girls while you and the doctor finish your meeting.”

“Thank you,” he replied, watching Nurse Cecilia walk over to the girls and gather them towards the door.

“I want you two to be big girls, okay. Stay with Nurse Cecilia; Dr. Hobson and I need to talk a little bit more.” The blinking lights on Sarah’s shoes caught his attention, as Nurse Cecilia stood behind, hands on the girls’ shoulders. The light from Sarah’s sneakers flashed off the nurse’s white pants and white shoes.

“I’ll keep a close eye on them, Mr. Stanton. Come on girls.”

Only once the girls turned their backs and headed out with Nurse Cecilia did Mark Stanton permit himself to tear up. He gave himself credit, though, for making it that long.

“Mr. Stanton, we need to talk about where we go from here.”

“Go?”

“Your options.”

Mark Stanton resume staring.

“We can continue as-is, but I see no reasonable medical probability for any improvement in your wife’s condition. Or, and I know this will be difficult to hear, we can remove your wife’s artificial nutrition and hydration.”

No amount of psychological games was a defense to the doctor’s words, and the impossibility of the situation allowed for Mark Stanton to simulate bravery and look the doctor in the eye.

“If we remove your wife’s nutrition and hydration, she will pass away within one to two weeks. She will not die of malnutrition, but, rather, she will pass due to dehydration and electrolyte imbalance. I understand it is little solace, but it is my duty to let you know that, if we pursue this route, your wife will not experience thirst or hunger. She simply can no longer experience those sensations.”

Mark Stanton heard every single word, and each bounced around in his head.  As each new word entered his skull, it joined the chorus of pre-existing words zig-zagging in colorful volleys across his brain. His wife’s lack of sensation became, to him, nothing but sensation.

“The removal of nutrition and hydration may result in your wife slipping into a coma, but it may not. We simply cannot tell. The only outward signs that you may see would be a dryness of the skin and mucous membranes. She cannot perceive discomfort, but we would, of course, continue to provide any other comfort necessary for her in your eyes.

“I see,” was all Mark Stanton could manage to push beyond his moist, hydrated, sensate lips.

“Of course, this decision is something you will want to talk over with your family, your friends, and any faith leader, if you have one.”

“What?”

“I’m sorry, minister, rabbi, priest. You may want to discuss this decision with them. Many people find great comfort in talking this decision over with a member of the clergy.”

“They do. I see.” Mark Stanton looked down at his hands – hands that, twenty years ago, served as an acolyte in his church. Was Pastor Don even still alive? When was the last time he even went to church? If he found Pastor Don, how would that chat proceed exactly? “Hi Pastor Don, remember me? That’s right, I loved lighting those candles. Oh, why am I here? Well, you see, I need you to tell me if it’s okay to kill my wife. Before you answer, will my years of absence from the church impact your response?”

“Mr. Stanton, you take all the time you need.” The doctor pulled out a small gray console from his desk drawer. “With the recent remodel and additions to the hospital, we have upgraded all of our computer software and hardware. All of our records are stored electronically. When you are ready, be it today, next week, next month, you can enter your choice on this console. I can take you to the right screen, and it will give you three options. From there, you can choose to continue current care or remove nutrition and hydration. You just click the button.”

“What’s the third option? I see three buttons.”

“In cases of significant brain trauma, we can, occasionally, pursue experimental treatments, such as deep brain stimulation or surgical steps, and, if that were an option, you would select the third button. Unfortunately, in your wife’s case, I am sorry to say that that is not an option. None of the tests we’ve run, like the MRIs, show any evidence of cognitive activity.”

Mark Stanton studied the console, hermetically sealed in plastic and glass. It was no bigger than his e-reader or his daughters’ tablets. It was such a tidy package, with all the attendant and requisite eye-catching gleam of new technology. His choice to end his wife’s life, to end his marriage, to end his daughters’ mother would be akin to buying a ninety-nine cent song.

“I know this is difficult, Mr. Stanton. It is not an easy choice. I have all of your wife’s records, and, after you’ve had some time to think it over, we can meet again. If you would like a second opinion, I am more than happy to forward your wife’s charts to anyone you wish.”

The doctor set the small, handheld console down between himself and Mark Stanton.

*****

Two Years Later. Mission Township Courthouse.

“Your Honor, the prosecution’s last witness is Dr. Timothy Hobson. We would call him to the stand at this time.”

“Your Honor, defense counsel renews its objections to this witness, as stated in our pre-trial motions and brief,”

“You can stop right there, Mr. Riley. As you and the prosecution know, the court received, read, considered, and ruled on all of the objections in your pre-trial motions. I see no evidentiary or other legal barrier to the doctor’s testimony.”

“Your Honor,”

“No thank you, Mr. Riley. You need say no more Your objection has been noted and preserved in the record for purposes of appeal. Bailiff, please escort Dr. Hobson into the courtroom to the witness stand.”

“Thank you, Your Honor.”

Dr. Timothy Hobson walked into the courtroom and walked the short distance to the witness stand. He kept his eyes fixed on the judge and the jury, but he could feel Mark Stanton sitting in the rows to the right. He knew Beth and Sarah would be right by his side, too.

“Dr. Hobson, please raise your right hand.”

*****

“Dr. Hobson, as of 2014, how long had you worked with Nurse Cecilia Boniface?”

“At that point, I guess it had been around one year.”

“Just a year?”

“Yes. Beginning in 2010, the hospital began a large expansion and renovation. Staff were moved around to different departments. In neurosurgery, we were always losing and gaining different staff members as the nurses and assistants were shifted around the hospital to cover for one another.”

“So, you started working with the defendant at some point in 2013?”

“Yes.”

“At what time did the hospital install its new medical records system, doctor?”

“2013.”

“So, around the same time you began working with the defendant?”

“Yes. Actually, she started working for me just before we got the new system. At that time, it was a great relief to me, honestly. The new electronic medical records system was complex and difficult to learn. Nurse Cecilia,”

“You mean, the defendant?”

“Objection, Your Honor,” defense counsel interjected.

“Mr. Asher, the witness can answer in his own terms. Dr. Hobson, please continue.”

“Well, Nurse Cecilia had been working in pediatrics before she was rotated into neurosurgery, and pediatrics had been using the new medical records system for months before it was installed in our department. Since she was experienced with the system, it took a lot of pressure off of me. She was able to demonstrate the system to me, and help me when I needed it. I appreciated it. At the time.”

“At the time, doctor?”

“I mean, before I learned about everything.”

“And what do you mean by that Dr. Hobson?”

“I always relied on my nurse to organize and update the charts for all of my patients. In the new system, it was a complicated process to pull in testing from other parts of the hospital, such as an EEG or an MRI. Nurse Boniface was experienced with the system, like I said, so I relied upon her to update the charts. As far as I knew, all of the charts were always updated. I could see update dates, but…”

“But?”

“But the update dates did not reflect all of the chart activity. The dates were accurate, but it did not tell me if evidence had been updated and, then,….changed.”

“Changed, Dr. Hobson?”

“Yes. Changed or deleted.”

“Dr. Hobson, did you provide care for a Mrs. Katy Stanton?”

“Yes, I did.”

“Could you tell the court why Mrs. Stanton was in the hospital?”

“Yes, Mrs. Stanton was involved in a high speed automobile accident. As I understand it, her vehicle ran a stop sign and the driver’s side was impacted by an oncoming car. She suffered a traumatic brain injury, and that’s when she came under my care.”

“Dr. Hobson, what was Mrs. Stanton’s diagnosis?”

“After her condition stabilized, she entered into a persistent vegetative state.”

“Doctor, explain that term to the court.”

“The diagnosis refers to a disorder of consciousness. Patients in a vegetative state do not enjoy true awareness of their surroundings or consciousness as we understand it.”

“So, it’s a coma?”

“No, it’s not a coma. A coma is where the patient lacks both awareness and wakefulness. Patients in a vegetative state may have awoken from a coma, but still have not regained awareness. In the vegetative state patients may appear to open their eyes or mouth, but they completely lack cognitive function. Patients that enter a vegetative state as the result of a traumatic injury, like Mrs. Stanton, can awake from the vegetative state within a year of the injury, but that timetable is only when there is some evidence of cognitive activity. If there is no cognitive function detectable, the state becomes permanent in only 2-3 months.”

“Dr. Hobson, you just mentioned cognitive function. How would you have tested Mrs. Stanton’s cognitive functioning?”

“Well, I first checked Mrs. Stanton’s clinical signs, such as eye tracking and pain responses.”

“And what did those signs tell you doctor?”

“Mrs. Stanton was unresponsive to all stimuli, which is not uncommon given the nature and extent of her physical injuries. She would, without provocation, open her eyes or occasionally her mouth, but she never did so when provoked.”

“Would the clinical signs from your examination have been the best information concerning Mrs. Stanton’s cognitive functioning?”

“No.”

“What would be the state of the art in your field for that, Dr. Hobson?”

“A PET scan or functional MRI would be considered the state of the art.”

“Did Mrs. Stanton ever undergo a PET scan or a functional MRI at your hospital, doctor?”

“Yes.”

“And, what did those tests reveal, Dr. Hobson?”

“At the time, when I reviewed the results of all of Mrs. Stanton’s PET scans and MRIs, they revealed no cognitive functioning whatsoever.”

“At the time, doctor? What do you mean?”

“I mean that I came to learn that the results I was viewing had been altered in our computer system.”

“Altered?”

“Yes, the results I reviewed at the time were changed to reflect no brain activity.”

“And what did that mean, Dr. Hobson?”

“That means that Mr. Stanton made a choice he never should have been allowed to make.”

 

Mark Stanton did not realize how tightly he had been gripping the wheel of his car until the muscles in his forearms began to ache. He slowly peeled his fingers off the wooden wheel, alternately opened and closed his hands, stretched his neck, popped his knuckles, and breathed.

The drive was not a taxing one, just 12 miles down Route 7. A flat, winding trip along the blue-green lake, Lake Tvivel. In his youth, his family spent every weekend on the lake, swimming, camping, baking under the sun. “Tvivel” meant “doubt,” and those carefree days on the water two decades ago were, unbeknownst to him, withdrawals of unburdened living he was making. Now, it was his time to pay up.

He turned off the radio, rolled down the windows, and felt the brisk air circle through the car. It was early morning, there was no traffic, and he could think. The lake was always still. Today, he thought about his wife, Katy, and his daughters, Beth and Sarah.

As he reached the northwest corner of the lake, he turned off Route 7 and headed into town. Turning left onto Maple Lane, the plastic butterfly holding pictures of his daughters, swayed to the right under his rearview mirror, and when he motored down the street, it rocked back and forth, a gentle reminder of what his choices meant.

*****

“Mr. Stanton?”

Mark Stanton groggily looked up through blinking, bleary eyes to see a tall, blond woman standing before him. It was 7:00am, and he had arrived a half-hour earlier.

“Mr. Stanton, he should be in shortly. I just wanted you to know.”

“Thank you” was his semi-conscious reply.

*****

Mark Stanton walked down the long, grey hallway. The building was old, but had recently been updated with a hi-tech wing and retro-fitted walls in the older corridors illuminated by soft lighting around the edges. It wasn’t the antiseptic palace he remembered visiting in his youth, but the modern touches did little to make one feel comfortable. Or warm. It was as if the pendulum had swung from cold and uncaring, right past homey and understanding, and into fashionable stark modernism.

He chewed on his lip, and, as he rounded the corner, he indulged his self-centeredness and wondered if the renovations to the building weren’t so bad. Maybe he was the one that had swung past homey and understanding. Demanding job, wife that worried enough for both of them, a young daughter with unique medical needs, a mortgage — it was nice and blessed and boring and suffocating all at the same time. It wasn’t as easy as it was supposed to be, it wasn’t as fulfilling. The bigger house, the better cars, the promotions at work, they never seemed as glorious as he was lead to believe.

But, most of all, it wasn’t fair. Not now.

Mark Stanton followed his path to the end of the corridor, turned left, and walked another 100 feet. He had arrived at a gleaming glass-encased wing. He sat alone, noting the light filtering into the atrium. The space was actually full of light, semi-comfortable chairs, abstract paintings just unique enough to make you wonder if they weren’t painted by a machine, and potted plants that were probably real.

He had just bitten one of his fingernails to the quick when a woman came out into the area and called to him. He nodded his head and walked up to the squat, black-skinned lady, with long hair flowing over her shoulders and eyes that were not as friendly as he wished.

“Mr. Stanton, my name is Cecilia. He will see you now. Please follow me.”

He nodded, and began to follow her down a winding series of corridors, descending several flights along the way. Her white pants and white shoes caught his attention, against the dusty grey floors.

“I understand we have your daughters, Mr. Stanton.”

“Pardon me?”

“I’m reading a note . It says we will bring your daughters to this meeting when they arrive.”

“Oh, yes. I, um, I think that’s the plan.”

“We’ll take care of them. Don’t you worry,” Cecilia said as she stopped at a door and turned to face him with her uncaring eyes. “He is waiting to talk to you. Go on in.”

Mark Stanton peered at the old steel door in front of him, painted a grayish-green. He was in the bowels of the building now, far from the gleaming glass of the new atrium, and, as he looked down, he could see the light from under the door crossing the white shoes of Cecilia.

It was a Thursday morning. He should be getting ready for work. Katy should be dropping the girls off at school. He should be having a bland cereal with coffee that isn’t quite right. He should be making a list of chores to do around the yard this weekend. It should be a nothing of a day. Unremarkable. Full of meaningless choices. And, so, he could only think, how does one prepare for this?

“Mr. Stanton, are you worried about your daughters?” Cecilia questioned.

Mark Stanton noticed they were alone in the hallway. Her eyes robbed her question of warmth and only made him feel more isolated.

“Wouldn’t you be?” was the reply that left his lips before he could really think about it.

“Yes,” she said, and it was not until he began to push open the heavy steel door that her unexpectedly chilling reply registered with him.

[On Choices concludes with Part 5, coming soon.]

Katy Stanton blinked herself conscious, to become aware that she had stuffed herself into the corner of her cell. Wedged between illuminated steel plates, she stared at the console in the middle of the room. Beyond its three buttons stood only another illuminated steel plate wall. She scanned the room, yet again, hoping to locate anything resembling an exit, but, beyond an obvious slot at the bottom of the far wall, the room was featureless save for the speaker holes in the ceiling.

“Mrs. Stanton, you’ve been asleep for a long time.”

The voice was dead, the same dead voice that had welcomed her into the hell hole and explained her options for leaving.

“Are you ready to make a decision and press a button?”

Katy could not decide whether she heard actual glee in her tormenter’s voice or whether it was all in her head. She braced her hands against the walls on either side of her, her wrists still wearing the rope-like burns, and she pushed herself up.

“Who are you?”

“The rules of the game are very simple, Mrs. Stanton. Press any button on the console for your freedom.”

“Where am I?”

“If you press the first button, we will kill your older daughter. Press the second button, and we will kill your younger daughter. Press the third button, and we will decide which of your daughters to kill.”

“What have you done with my daughters?”

“Any button releases you from this room. You will be free.”

For the first time since awaking in her steel box, Katy Stanton stood up. The pain in her right eye and in the back of her skull intensified, but she stood erect, still wedged into the walls. The dead voice rang around the square room, and she found herself backing up, wedging her slender aching body into the corner even more, as if seeking an escape from the voice or perhaps comfort in the confinement of the walls. “Why?” meekly escaped her lips.

She waited, but received no response. There was only the room. There was the console, the non-specific lighting source, the slot at the bottom of one wall, the speaker holes, and her choices. That was the reality of her disbelief. She took a step out, wincing in pain as her red, raw scabbed wrist peeled off against the wall. She slowly paced the room, skirting along the outer walls far from the console in the middle of the room. She ran her fingertips along the wall, only to find smooth, cold steel.

As she reached the end of one wall, her hand ran into the corner between two plates, and the feeling of enclosure ripped her mind from the room to sitting in her minivan, in her driveway, her hand in her purse clutching her keys. Sarah and Beth were in their usual seats, and, behind Beth, her school project — large ant mandibles and all.

“Mom, are you okay? We’re going to be late.”

“Yes, Beth. Sorry, I guess I wandered off there. Have we got everything? Sarah, did you grab your lunchbox?”

“Yes, Mommy!” Sarah Stanton proclaimed with lips that, despite her best efforts, still betrayed her dive into the powdered sugar donuts earlier. Katy could feel Sarah kicking her seat with her red tennis shoes with the blinking lights in the heels.

“Okay, well, maybe I’m not forgetting something. Team Stanton, let’s head to school.”

It was that day. That was the last day Katy Stanton could remember before waking up in this place. Her fingers still wedged into the corner, she withdrew her hand and turned to face the console. She was driving her daughters to school, and now she was facing a console with, apparently, the power of life and death. Nothing existed between those two things.

“Mrs. Stanton.”

Katy looked up at the speaker holes in the ceiling, again finding herself suspended in a reality of disbelief. Her right eye socket pulsed, shooting pain deep inside her head. The pain obliterated all thought except one: How does this tormenter connect this steel cell and her morning drive to her daughters’ school?

“Mrs. Stanton, you have not yet pressed a button on the console.”

“I’m not going to press a button and kill my own child, you asshole.” Katy Stanton heard herself, and could not believe her words . She could not access sadness, she could not cry, she could not bargain or beg, she could not understand anything but to lash out. The pain in her wrists, in her eye, and in her head made her nauseous, but not as much as the knowledge of the choices before her.

“Mrs. Stanton, please sit down. For your daughters’ safety, you will do as I say.”

The dead voice had come alive, agitated, almost defensive. It was a small victory, a small level of control, however fleeting, but Katy surrendered that modicum of power, as any parent would, and slid down the wall, surrendering her damaged wrists to her knees.

“Now, Mrs. Stanton, perhaps I have not been clear: we have your daughters.” And with that, the slot at the bottom of the steel plate on the far wall raised two feet off the ground with surprising speed. The view was unmistakable: six legs, two black patent leather tap shoes, two red sneakers illuminated in the back with blinking lights, and two other legs wearing white pants and white shoes, obviously an adult.

“Sarah! Beth!” Katy exploded off the wall, crawling like a wounded big cat, tripping and stumbling as her damaged wrists failed to support her weight. “Mommy’s here!” was her cry as she staggered across the room. As Katy bounced across the floor, her right foot knocked against the bottom of the center console with the three buttons, causing her to fall to the ground with a thud. “I’m here!” was Katy’s cry as she hit the ground, never losing sight of the six legs revealed by the two foot-high opening in the wall. She saw Beth’s legs shifting her weight, crouching down to peer in and find her mother. As Katy finished her fall, with the rest of her weight collapsing and pushing her body forward on the slick floor, she saw the seashell curls of Beth’s hair begin to dip below the bottom of the wall. “Beth! Baby!”

But, as she screamed and called to her older daughter, Katy also saw the stranger’s legs shift his weight, followed by the unmistakable scream of Beth. And, then, as soon as it had dipped below the wall, Beth’s hair withdrew from view. The white trousered legs stepped in front of her girls, little Sarah began to wail, and the slot slammed shut.

“No! No, no, no!” Katy screamed as she gathered herself and made it to the wall. Her hands frantically pulled at the seams of the panel. She dug her fingernails between the wall and the panel, pulling and pushing so hard her nails broke and bled. The dark red scabs on her wrists combined with the bright red flowing from her fingertips in a profane tapestry. “My babies. My babies.” The pulsing pain in her right eye arrowed deep into her skull, gathered power from the injury to the back of her head, and surged through her body, climaxing in her bloody, weakened hands pounding against the wall as she released a gutteral moan.

“Mrs. Stanton, do I have your attention now?”

Katy stopped willing her body to move, but she shook and pulsed uncontrollably as she again slid down the wall, utterly spent.

“Mom,” Beth cried out over the speaker, “Help! Sarah needs her shot!”

Katy snapped away from the throbbing horror dictating her body’s movement. She instantly knew Beth was in the same room as her tormenter.

“Beth! I’m here! Oh, please, oh please,” Katy began to sob and find the resolve and bravery to beg. “My daughter is sick. She needs albumin injections to live. Beth knows how to do it. Please let me talk her through it. I’ll do anything. Please.”

Katy Stanton was greeted with silence. No hiss of empty air from the speakers above. Nothing.

And, then, finally, “Mrs. Stanton, you can do something. You’ve known all along that you can do something. You may press one of the buttons on the console.”

Katy fixated her gaze on the console. It stood four feet off the ground, supported by a thick pillar. The dark gray of its hard plastic base and outer console shell resembled the wall color to such a degree that she could squint her eyes and render it part of the far wall. It was a cruel feature to be able to visually wish it away. The upper console was a foot square, with three small green plastic illuminated buttons sitting atop a black background. There was no text on the console, no direction as to the impact of each button, but, in Katy’s mind, reading left to right, she clearly saw “Beth,” “Sarah,” and “Beth or Sarah” above the buttons. The console’s absence of distinguishing features stood in stark contrast to its quite specific impact.

“Mrs. Stanton, you now have 15 minutes to make a choice. If you do not, I will kill both of your daughters and make you watch.”

Katy Stanton was in a place of three dimensions. Her prison had width, height, and depth. All the same, all cold steel. There was no escape. There was no difference, no matter where she looked. And her tormentor had just added a fourth and crueler dimension: time.

[Two months earlier]

“Mom!” Beth Stanton yodeled as she marched her 12-year-old black patent leather tap shoes down the stairs. “Mom!”

“I heard you the first time; the second, third, and fourth times were unnecessary young lady.” Katy Stanton reprimanded her oldest, but if she was honest, she deserved it. She had been ignoring Beth. And probably for a long time. She finished tying her younger daughter’s shoes, strolled into the family room, and found Beth sprawled on the floor in front of her science project. She was fairly certain she uttered her “Damn” sufficiently under her breath.

“You promised me you’d help me tape these photographs. My project is due today.”

“I know, I know, Mr. Willoughby and the rest of the class need to hear all about ‘The Amazing Life Cycle of the Army Ant.'” Katy watched Beth lay out photograph after photograph of enormous thoraxes and antennae. As she twirled among the brightly colored poster board festooned with plastic orange insects roving about, Beth’s hair tangled on the large ant mandibles Katy’s husband, Mark, had worked for hours on the night before.

“Don’t make fun, mom! Bet you didn’t know that army ants are always on the move. Did ya, huh? They don’t have a home or a colony. They never stop!”

As Katy watched her older daughter punch the air to accentuate her non-stop energy, she smiled. Beth was her spitting image: lanky, a smattering of freckles across her face, hair that ended in curls like seashells. Beth freed her hair from the ant mandibles and tapped out of the room. Katy allowed herself a few stolen moments of regret, understanding she was losing a baby to her teen years soon enough, until the sound of the kitchen chair jerked her back in the moment.

Katy walked into the kitchen to find her 6-year-old, Sarah, covered from head to toe in white powdered sugar, half a donut protruding from her mouth, with her hand reaching for the last donut.

“No mam, no you don’t!” Katy commanded, as she expertly weaved in and around the ghostly shell of sugar encasing her youngest, returning the kitchen chair to all four legs on the ground, and sliding the donuts out of harm’s and Sarah’s way.

“Mommy, I just wanna,” Sarah cried.

“No mam. Not today. I need you to go wash your face, and”

“Mom!” Beth had returned, sans her tap shoes. “You promised to help me with my science  project.”

“Beth, I just need a minute.”

“You always need just a minute. It’s always just a minute with Sarah.”

Beth recognized the laser-eyed look her mother gave her, but Beth didn’t see that her mother worried she was right. Katy Stanton relaxed her shoulders, breathed, and guided Sarah toward the hall bathroom.

“Listen Beth,” she intoned, as she walked over to the realm of orange plastic ants, “I know it’s hard, but we’ve talked many times before about this. You know your sister needs extra care.”

Katy Stanton began taping a thorax next to a close-up mandible shot, making sure not to disturb the marching ants up and down the poster board. Beth wandered closer, handing her the last photo.

“I know sissy’s sick. I’m sorry.”

“It’s okay. And, there you go. Your ants are on the board, and not in your pants! Now, put this in the van, I’ll grab Sarah, and we’ll head to school.”

Katy watched Beth lug her project through the family room, mindful of the over-sized mandibles, and float out of view. “Congenital Nephrotic Syndrome” was the name doctor’s gave Sarah’s disease, but, no matter how many times she explained what it meant, why Sarah needed daily injections, and how the extra attention didn’t take away from their love of Beth, it never seemed to stick.

“Mrs. Stanton.”

Katy Stanton’s cheek was crushed against the steel floor as the voice overhead boomed, her arms and legs splayed around her like a cut marionette.

“Mrs. Stanton.”

She blinked open her eyes — her right eye throbbing — and became aware that she had been unaware for quite some time. As she pulled back her cheeks in a grimace, the collection of dried blood and spit coagulated in the corner of her mouth split.

“Mrs. Stanton.”

Katy pushed herself up, acknowledged the new throbbing sensation at the back of her head, glanced at the rope burns around her wrists, and grunted a half response.

“Mrs. Stanton, we have your daughters.”

Katy Stanton found herself in a room of near perfect symmetry. Fifteen feet square, the grey steel walls wrapped around her smoothly, with only a small slot at the bottom of the wall she woke up facing and notable speaker holes in the middle of the ceiling. Low light lasered around the edges of the wall, more industrial than futuristic. The floor was clean, if dusty. And, as she drug her knuckles through the dust to sit up properly, she saw no way into the room, and no way out to reach her daughters.

“Mrs. Stanton, your daughters are safe.”

She grimaced as she reached around to feel the knot on the back of her head, and her fingers traced over dried blood, discovering the artifact of some event for which she had no memory.

“Mrs. Stanton, the rules are very simple. Behind you, you will find a console. On it, there are three buttons. Press any button, and we will set you free. If you press the first button, we will kill your older daughter. Press the second button, we will kill your younger daughter. Press the third button, we will decide which of your children to kill.”

Katy Stanton turned her head to view the console, but she existed only in that moment in a reality of disbelief. The horror would came later to her thirty-year-old soul. All she could do now was verify her disembodied tormenter’s instructions. There were three buttons.

“Mrs. Stanton, the choice is yours.”