Austin wasn't supposed to work that night, but the head nurse - her name was Helena, but most people called her by her nickname, Hell-on-Wheels - called anyway. Chris had called out, citing some family emergency or the other, and could he fill in? Austin looked over at Cassandra, his wife of just over two years, busy slapping the keypad on her laptop. Cassandra was stuck in the great rut of life, alternating between writing her novel and playing solitaire on the computer. She was in a bad mood. She was suffering from writer's block and had just lost forty-seven games in a row.

"Hey Cass," he called out to her, "Hell-on-Wheels just called. She wants to know if I can come in for second shift."

Looking away from her computer screen, she frowned. "But it's your night off," she protested in a whiny voice. "I thought you were gonna spend the night with me." She dragged the word me out into three syllables. It sounded ridiculous.

Austin shot her a look. It was not a mean look, but it was a look nonetheless, one that said Somebody's got to support us while you're writing your book. Cassandra had recently quit her not-quite-great-paying job to stay home and write her novel; according to her, it was the next piece of great American literature. So far, she had produced three pages of fiction and over twenty-four hundred games of solitaire. Which meant that Austin was the breadwinner, Austin had to work, and Austin had no other choice but to pick up any overtime offered.

She exhaled, obviously disappointed. She knew what his look meant. "Fine. Go to work. Go be a nurse and leave me here." She leaned back, tipping the chair backwards as she did. She flipped the screen back over to the writing page in front of her. It was blank. Page Four did not look very promising.

"Oh, Cass, come on."

She furrowed her eyebrows at him. "Go. Just go. I'll be fine by myself with my novel."

Yeah, he thought, annoyed. Your "novel" and solitaire.

He didn't want to be angry with her, he tried to reason with himself as he got dressed and pulled together some items for his shift. He just couldn't help it. Money was tight, and it bothered him that he regularly came home at eight a.m. from third shift only to find Cassandra still in bed. She said she would write from eleven in the morning until two in the afternoon, but when she said "write" she really meant type three sentences, scowl, erase all but one or two words of what she had just written, and then play solitaire for thirty minutes straight.

Her bad writing habits weren't what bothered him. The bad drinking habit that accompanied the bad writing habits did. Cassandra rarely ate anymore, claiming that she was "too absorbed" in the book-writing process to eat. Cigarettes took the place of eggs or cereal for breakfast, and instead of lunch she drank homemade vodka martinis, garnished with either a couple of tiny Spanish olives from a jar bought at Wal-Mart or, occasionally, leftover baby pearl onions from whatever frozen meal she'd prepared for dinner the night before. Then, after dinner, she'd slowly drink a bottle of wine, red or white but never pink, and alternate writing and erasing with playing solitaire until Austin left for third shift. She claimed that she worked well past the midnight hour and usually crawled into bed around three a.m., but he didn't believe that she was working that hard.

Austin wasn't passively accepting the new changes in his wife. He had called her out repeatedly on her new smoking and drinking habits. Before she quit her job, Cassandra had never smoked a cigarette in her life and only occasionally drank a glass of wine, which was why they had so many bottles stored up in the corner of their main closet. They'd gotten so many wine bottles as presents - for their engagement, their wedding, their anniversary, holidays, birthdays - that if they cared anything at all about wine they could start their own proper cellar, if they actually had a cellar. Now, though, she argued that she was "trying to channel Kerouac" or any of the other modern-day greats, and the only way to do that was to alter her perception of reality with nicotine and alcohol. "At least I'm not trying to do it illegally," she countered, trying to convince him that she was being responsible as long as she wasn't getting behind the wheel of a car or using any illegal substances. Or, for that matter, substances that were only legal outside the U.S. border.

Scowling, he pulled on a pair of track pants and a T-shirt, one made from that material that whisked the sweat away from the wearer's body. He resented the fact that he couldn't say no to overtime when he really wanted to, all because he couldn't, because he had to work as many hours as possible to support himself, his wife and her bad habits. If Cassandra had been making any money at all from her writing - contests, freelance, short stories, anything - then he might be more tolerant of her quitting her job. But as it stood, she wasn't contributing anything to their monthly expenses, and the rent increase on their run-down one-bedroom apartment had just gone into effect. If she didn't start bringing in some money soon, then, short of winning PowerBall, they'd have to downgrade to a studio.

Once dressed, Austin left the bedroom and headed straight for the refrigerator. Cassandra was still sitting on the couch, her laptop still in front of her. The screen in front of her was blank, meaning that Page Four was still going nowhere, right along with Cassandra's new-found career. He opened the refrigerator door and peered at the contents inside. There wasn't much in there in terms of food. He sighed and pulled out a container of non-fat cottage cheese. He had bought it for his wife in the hopes that maybe she'd eat something other than tobacco leaves and menthol for breakfast. So far, she hadn't. Might as well eat it before it goes bad, he thought. Better to let her smoke cigarettes for breakfast than throw the money he'd spent down the drain. He stuffed the container into a brown paper bag.

"You got enough to eat?" Cassandra called out from the living room, having switched over from the blank screen and now completely absorbed in her new game of solitaire. To him, she seemed to be asking the question out of obligation, not because she really cared. "I don't want you being hungry on second shift."

"Don't worry, Cass, I'll be fine," he shot back, trying to keep the irritation out of his voice. Watch your temper, he reminded himself. He was trying to be the supportive husband, but it never seemed to come out that way. His words had a life of their own once they left his mouth.

She winced, but said nothing. She could feel the ire in his voice, and she knew she was the source of his frustration, but couldn't she have her husband home just this once? She wished to herself that her manuscript would come to life, that she would have a sudden burst of inspiration and the pages would flow from her fingertips, but that wasn't happening. Cassandra sighed. Maybe quitting her job wasn't such a good idea. Maybe she should have thought this out further.

It seemed liked she never saw him anymore. She was home nearly all the time, smoking out of their little living-room window or sipping at a glass of wine (that nine-dollar Chilean malbec was quickly becoming a personal favorite) while she tried to find the inspiration to write exactly what she wanted. Despite all the time she spent in their apartment, she rarely saw Austin. She felt like she saw him more often when she was working that stupid dead-end job.

"Well, Cass, I guess I'm off."

She nodded, still staring at the screen. "Great. Drive safely."

She didn't look up as Austin gathered his car keys, wallet and cottage cheese and walked out the door, let alone kiss him good-bye, which was what she really wanted to do but didn't think her husband would welcome. She kept her eyes on the screen instead.

"Austin, I'm glad you could help out tonight," Hell-on-Wheels greeted him as he walked by the reception desk on the fifth floor. The fifth floor was the cancer ward of the hospital. It might as well have been called the hospice floor, since all of the patients taking up residence there were terminal and tended to be at the end of their lives. Depression mounted and crested on the fifth floor.

Her greeting was about as nice as Hell-on-Wheels could get. Describing her by her nickname, one would have thought that Helena was an embittered old nurse with a fondness for stomping on people, figuratively and literally speaking. That much was true. She was bitter and angry, and she had every reason to be - she lost her fiancé when the Twin Towers fell on September 11th, and she had been miserable ever since. Life hit her with an unfair turn of events, and to call it unfair truly didn't bring any justice to the situation.

"Hey, no problem, Helena," he chirped, careful to use her real name and not the nickname that could all-too-easily spring from his lips. He stopped at the desk, backing up in his tracks to do so. "I'm just glad you called. I could use the extra cash."

"So then, Cassandra's book ain't quite panning out, huh," Hell-on-Wheels commented.

"Um." He paused. He was frustrated with his life in the present, yes, but he felt bad about betraying his wife. All in all, though, he needed someone to vent to, and Hell-on-Wheels was as good a listener as any. "Yeah. She's having problems with it. Writer's block or something like that."

"Huh." She snorted obnoxiously. Hell-on-Wheels was clearly beginning to warm up. "Yeah, like those writers got it so tough. Try being a nurse sometime, and then start crying about how you got writer's block. Being a nurse'll totally blow your mind."

"True enough." Austin started to creep away from the head nurse and the reception desk, not wanting to get any further into this conversation. In all fairness, if he could admit it to himself, Austin did feel a sense of superiority over his wife. She had no idea of what he went through at work every day, not to mention how much he suffered and sacrificed just to get through nursing school. For her to quit her job to stay at home and write a novel seemed like giving up. Like she didn't want to work hard enough to hold down a job, no matter how low-paying (read: low-stress) it was.

In the back room, he placed his food in the community refrigerator, then slipped into his hospital-issued scrubs. As he tied the shoelaces on his ratty old work sneakers, he noticed Amber Lynn, the hospital's most recent hire, entering the room. She was young, maybe twenty-three years old, but was pleasant in personality and easy on the eyes. She was already dressed in her scrubs. "Hi, Austin," she said cheerfully when she noticed him. She placed her own lunch inside the refrigerator. "I didn't know you were working second today."

"Yeah, Chris called out," he answered as the refrigerator door slammed shut. "So I guess you're stuck with me."

She exhaled. "Hey, I've got no problem with that. You guys all know that my boyfriend just dumped me. I hate being all alone right now. It just makes me obsess too much about what went wrong."

He cracked a half-grin. "Uh-oh. Thinking can be dangerous."

She nodded, returning his crooked smile. "Yeah. It is."

He really didn't know that Amber Lynn's boyfriend had dumped her. What, was the guy stupid? Blind? Austin suddenly caught himself feeling comfortable around her, possibly too comfortable, and definitely more so than he'd felt lately around his wife. He made a mental note to keep that feeling in check.

Cigarettes. She was out of cigarettes, so Cassandra decided to jump on her bike and head out into the thick, humid late afternoon to the convenience store. She felt like such a loser, being in her late twenties and relying on a bicycle to get around, but that was her only mode of transportation at the moment. Really, what was her other option? Walk? There was no way she would walk, it was way too hot. She'd been forced to sell her only vehicle, a 1991 Dodge Shadow with a mere 65,000 miles on it, to help Austin with the rent a couple of months ago. He hadn't even seemed grateful.

It might be nice to move out of this neighborhood, she thought briefly as she unchained her bike. She wanted to keep it inside their apartment, but Austin had said no, so she kept it locked up outside with three separate chains, three padlocks and a prayer. She was almost surprised every time she went outside and saw it was still sitting there - they didn't live in the worst neighborhood, but petty crimes occurred more often than not.

As she pedaled her way down to the convenience store, she tried to form the story arc for her novel in her head. She knew it would be an inspirational type of story. Her main character, a woman whose name she kept punting between Michelle and Lindsay, was a young mother struggling with small children and breast cancer. That main character lived in Cassandra's head like she was camping out there, maybe even taking up permanent residence. It was like she ate, drank, slept, smoked, breathed this character. Cassandra knew every little detail about this woman - her age, her family history, how long she knew her husband, her children, her eye color, how often she went to the salon, how often she went to church, everything. Except she didn't know how to give her story any justice. And she didn't know why, lately, she knew this fictional character better than she knew her own husband.

The late summer heat wore her down, and once she'd pedaled her way to the convenience store, she was sticky with sweat. Chaining her bike up by the entrance, she walked in and encountered the cashier. Habib was grossly overweight, always sweaty, and dark-skinned in a racially ambiguous sort of way. He smiled at her, grinning like he knew her, but really, he only knew her in passing from the few times she picked up cigarettes. "You need more smokes, Miss Cassie?" he asked her, his voice thick with an indistinguishable accent.

She nodded. "Yeah. Marlboro Lights."

"Ah. You never change." Habib reached for a pack from the shelf behind him. "That's good. Don't ever change." He winked at her as she pulled her money directly out of her back pocket. She had already pawned her beige Coach bag and matching wallet, and besides, there was no place to put a purse on the bike.

"Um, we'll see," she replied uncomfortably, placing the rumpled singles on the counter. She didn't want to tell him that she'd just blown her entire dinner budget on cigarettes and would be smoking tonight instead of eating. She was sure the news would disappoint him.

"How's Mr. Austin?"

God, Habib is sure full of questions today. "Oh, he's fine. He went to work. Second shift."

He nodded. "Very good." He handed Cassandra her change and her cigarettes, both of which she crammed into her back pocket. "Come back soon, okay? You have a nice day."

"Got it, Habib. You too."

Outside, she unchained her bike for the second time and, also for the second time, was surprised that the bike hadn't been stolen. Shocking. Maybe this neighborhood wasn't so bad after all. Maybe they wouldn't need to move. Which was fortunate, considering they didn't exactly have the money or other means to move right now. She knew that Austin was mad at her for that, that he felt all of their financial problems were her fault - but really, were they ever financially sound? Even when she was working that God-awful job she hated so much, they had always lived paycheck to paycheck, so it wasn't like they were doing so much worse now.

Hopping on her bike and pedaling away from the convenience store, Cassandra's thoughts wandered between Austin and Michelle-slash-Lindsay. She knew she needed to do something in order to make her husband happy, but that something would mean selling her novel and making some money. Which meant that she'd have to get the inspiration to start writing her novel. Which meant that she needed said inspiration right now.

She was so engrossed in her thoughts that never saw the car coming.

The floor was quiet, which was a good thing. With the fifth floor, one could never be sure about exactly what would happen during any given shift, but so far there had been no emergencies. Austin's shift had been quiet. Which meant that Amber Lynn's shift had also been quiet.

Austin had never worked one-on-one with Amber Lynn before, and he was pleased to discover that he liked it. Amber Lynn was so pleasant and charming that he or anyone else, even Hell-on-Wheels, would be hard-pressed to dislike working with her. He found himself drawn to her; she was a welcome distraction from the frustration he was suffering in his marriage.

He tried to remember what drew him to his wife in the first place. He supposed the first thing he was drawn to was her appearance. Cassandra was beautiful, of course, with a head of thick honey-blond curls, brown eyes, berry-stained lips and skin just this shade of white. But it wasn't so much her looks, it was the pair of super-short jean shorts she was wearing, with a white T-shirt and white tennis shoes and a beige leather Coach bag dangling from her left shoulder.

Going beyond her looks, Austin had been mesmerized by his wife, at least until recently. She was smart and hard-working, though he didn't necessarily feel she was acting that way now. She had a quick wit, a dry sense of humor, and a way of looking at life that always made him re-evaluate the things going on in his own life. She was the type of woman that made him a better man just for having married her. He'd been crazy about his wife and felt equally blessed to be married to her, at least until she quit her job.

As he walked back to the nurses' station for his next assignment, he passed Amber Lynn in the hallway. She shot him a genuine smile, all white teeth and plush pink lips, and he fantasized about how soft those pink lips would feel against his. He wondered how much damage, if any, he was doing to his marriage by fantasizing about Amber Lynn. Well, it's not like I'm jumping her or anything, he reasoned to himself. It's not like I'm really cheating.

At the station, he shot Hell-on-Wheels a quick smile before picking up a patient chart. He was definitely in a better mood now than when he first arrived. At this rate, the shift would pass quickly, and he would return home sometime before one a.m. Cassandra would still be awake, and he planned to have a talk with her. He would tell her that they couldn't continue to live like this, with her sitting around the apartment, drinking and smoking and playing solitaire in lieu of doing what she quit her job to do. And then they would hash it out. There were only two possible outcomes, that they would either fix the situation or decide to separate, in which case, Amber Lynn had made it abundantly obvious that she was available. Austin hated to think like that, but he'd had enough. He couldn't continue living the way he was.

Hell-on-Wheels was on the phone, a serious look etched onto her face. She didn't notice his smile.

"She's been on the phone for a little bit," Amber Lynn explained, coming up behind him. "Looks serious. Wonder who's on the other line?"

Chart in hand, Austin turned around to face her. "No idea," he replied, staring at her lips again. They looked incredibly inviting. Again, what was her boyfriend's problem? Why would he break up with her? Why would anyone break up with Amber Lynn? If she were his girlfriend or wife, Austin was sure he'd take great pains not to lose her. Depending on the outcome of tonight's conversation with Cassandra, a relationship with Amber Lynn could be a distinct possibility.

Her eyes suddenly shifted over his shoulder. "She's off the phone," she mouthed as Hell-on-Wheels approached them.

"Austin." Hell-on-Wheels stated his name commandingly. Dread instantly shot through his body, making him feel as though he was in trouble. Which, so far today, he wasn't. He hadn't killed anyone, hadn't messed up any dosages, had made his rounds without error. Hadn't he? Oh God, did he get Mr. Anthony's dosage right, or did he mess up the conversion again? It wouldn't be the first time he'd done that.

"He-Helena, I swear I got the Ativan dosage right on Mr. Anthony," he stuttered, feeling the blood drain from his face.

Hell-on-Wheels shook her head curtly. "No, that's not it. I just got off the phone with the ER. You better get down there."

Glancing over at Amber Lynn for reassurance, Austin turned back to Hell-on-Wheels. "Why?"

"Cassandra's been hit by a car."

Cassandra's blood was everywhere. It wasn't from the myriad of scrapes and gashes she'd gotten from the accident, though there were plenty of those. It was mainly from the head wound; her skull had fractured when the car threw her off the bike and slammed her onto the asphalt.

The clipped, urgent phrases from the trauma staff floated around the emergency room: "Head wound. Get a CT, stat!" "Multiple rib fractures, need CT for possible vertebral involvement!" "Lots of blood loss here, need the O neg!" In the middle of it was Cassandra, bloodied and unconscious, unaware of how dire her situation was.

Alone, Austin rode the elevator to the first floor, begging it not to chug along like it usually did. The elevator wasn't listening, but it hummed reassuringly, comforting him. He thought about his wife and felt the guilt overwhelm his body. He had been fantasizing about Amber Lynn during his entire shift, about her lips and how he might start a relationship with her if he couldn't work things out with Cassandra, and all the while his wife had been hit by a car while out on her bike and nearly killed. And why was she out on the bike? Because, Austin realized grimly, she had sold her car to help pay the rent and had no other form of transportation.

Shame tore through him. Since Cassandra quit her job, all he'd done was look down on her. Yes, she picked up some bad habits, like the drinking and the smoking and the not eating. But when she couldn't pull her weight in terms of finances, she did everything she had to do in order to keep the roof over their heads. And he wasn't grateful, he was only ashamed that in this piss-poor economy, he had a wife who quit her job to stay home and write.

The only shame he felt now was over his own actions.

I've gotta make things right. By the time the elevator hit the first floor, he knew what he had to do. There was no telling how long Cassandra would be in the hospital or how high the bill would be, but at least they had medical insurance through his job. He would contact his landlord and see how quickly they could move into a studio apartment. He'd sell off a lot of their junk - Let's face it, we don't need it - and downgrade his vehicle to one that was less expensive and better on gas than the one he was currently driving. After that, he would never nag Cassandra about her writing or solitaire-playing again. Page Four could remain blank forever and he wouldn't care.

After frantically making his way past the ER personnel to get to his wife, Austin found her in the middle of the action. He stood frozen, his eyes bulging. He wanted to rush to Cassandra's side, to sit there and tell her that everything was going to be all right, but he couldn't, and he would only be in the way of the ER doctors anyway. The thought that he hadn't allowed to enter his mind suddenly came barging in: What if she doesn't make it?

"Are you the husband?" an ER nurse, one that Austin vaguely recognized, asked quickly. When he nodded, she pushed paperwork on him. "You need to sign the release forms."

He did, and the doctors started pushing her gurney down the hallway. "Where?" he asked helplessly.

Someone answered, "OR Two."

He stood by, alone, as he watched his wife and her team of surgeons rush down the hallway to the operating room. She might live, but then again, she might not. If she made it, he swore that he would be a better, more patient, more understanding husband who would make sure he never worked another shift with Amber Lynn again. If she didn't make it, well, that was too gruesome to think about. But if Cassandra didn't pull through, he knew he would go through the rest of his life feeling guilty and ashamed of how he had treated her during her last few months.

It hurt too much to dwell on.

Head reeling, he staggered out into the waiting area, where he plopped onto a threadbare seat and waited. Austin was so filled with conflicting emotions and guilt, he felt as though he were floating above the chair. The words from the paperwork haunted him. Hit by drunk driver while on bicycle. Fractured skull. Brain swelling. Blood loss. Multiple rib fractures. Possible vertebral involvement. He was, quite possibly, the worst husband in the world.

The hours passed slowly, and Austin felt like he was in shock. On her break, Amber Lynn came down to check on him, but he was too incoherent to hold a conversation with her. He somehow sputtered out the basics of the situation to report back to Hell-on-Wheels before the tears choked him.

"Shh, Austin, it's okay," she said soothingly, wrapping her arms around his shoulders. Grateful for the sympathy, Austin closed his eyes and laid his head against Amber Lynn's shoulder. She smelled good, like a combination of vanilla and musk. It was so different from Cassandra, who couldn't be bothered with perfume and always smelled clean and fresh, like bar soap. The thought broke him, and a new wave of fresh tears overwhelmed him.

When Amber Lynn returned to the fifth floor, Austin was alone again. He desperately wished he had a distraction, and pulled out his high-tech cell phone. It was yet another toy he didn't need and something else he could downgrade to save some money. He vowed that he would get a new phone and try to finagle his way out of his contract with his cell phone carrier tomorrow, but for now he needed something to do to keep his mind off his wife. He looked for the games on his phone and found only one. Solitaire.

Of course. He numbly began to play, touching the cards on the screen, thinking of Cassandra and how much she played this game. Earlier this evening, he was silently cursing her out for how many games she'd played instead of writing, and now he was playing the exact same game while he waited to hear word from her surgeons. He slumped over and closed his eyes at the irony.

When he opened up his eyes again, he could see one of Cassandra's surgeons in the distance. Wearily, he stood up, not sure of what the surgeon was going to say. Whatever it was, it was going to have a profound impact on him, and his life would be altered in many ways. But before his life could be changed, he needed to hear what the surgeon would say.

As the surgeon approached him, Austin held his breath. A million thoughts and visions ran through his mind - Cassandra on the couch, laptop in front of her; Cassandra on their wedding day, shining and beautiful; Cassandra handing him the money from the sale of her Shadow, disappointed and embarrassed that he wasn't more grateful - and he knew he had to keep his composure. He exhaled and swallowed as the surgeon stopped in front of him.