Work Text:
The unconscious body on the surgical table belongs to a healthy man in his mid-forties. His name is Elliot Rosenthal.
Dr. Gordon’s newly appointed scrub nurse, Lilian Shaw, scowls behind two layers of PPE and holds her gloved hands in the body cavity. She watches intently, her grip steady as she applies suction, while Dr. Gordon runs the polyglactin Vicryl between his forceps and suture clips, pinching the middle of the curved needle. He patiently secures the ninth stitch. By Lilian’s estimate, the man on the table between them will need four more passes of the needle before they move on to the next set of sutures. After they are done with him, he will be carted to a dark room until he regains his faculties. Once he does, his game will begin.
Although she is seldom kept informed about the exact nature of each of their victim’s trials, Lilian knows with certainty the kind of hell that awaits Mr. Rosenthal when he awakens next. One month of conditioning and recovery had passed since she narrowly escaped with her life from a trap of her own.
⠀
Lilian has long since become nose-blind to the dull sting of bleach. Among the equally wretched odors that once stirred her, dazed in a cold sweat, from drug-induced stupor, that oppressive smell of bleach permeated the cement all around her as if it were soaked through like a sponge.
The tang of blood in her mouth made her stomach churn, the gut-reaction to gather the warmth pooling in her bottom jaw and spit-launch it stemmed by the bolt pierced through the muscle which immobilized her tongue. Lilian forced her eyes open, panicked.
Despite the double vision, which refused to grant her any clarity, sensation returned to her: a throbbing pressure against the inside of her skull, a sharp ache in her chest, the raw sting of friction in her throat as she tried to speak—and, when speech failed her, yell. She lifted her hands to her face and refrained from moving her lips, as each tug of cheek flesh sent searing jolts radiating from a pair of mechanisms threaded right through her.
Lilian’s fingers grazed the cables and she flinched, blinking to push the tears from her eyes. Wire-thin cables, barely slackened to allow her the luxury of movement, protruded from a pair of puncture wounds on either side of her face. She felt, without having to touch, the grating burn of the piercing augments as if they were sinewy extensions of herself, exposed and vibrating with a horrible tension as she trembled around them. Quickly, wrenched into servility by the surges of white-hot pain, Lilian retreated from the idea of struggling.
Her body rested against a crude metal frame bolted to the floor. Old cracks in the concrete below trapped puddles of blood that dribbled over the curve of her lips. In front of her was a tray-top cart upon which there was, laid out, an array of sterile instruments and surgical supplies.
One item, which stood out from the rest, however, was a silvery tape recorder. Peering closely, Lilian spied a cassette loaded into the case. Words in permanent ink had been handwritten upon a strip of masking tape that adhered to the outside of recorder itself.
PLAY ME AND LISTEN, they read in bold, capital letters.
Frantic, Lilian choked out a sob, if only because, no matter how hard she tried, her rapid breaths and the column of stripped-bare nerves that was her trachea, aflame with agony, would not permit her to wail.
She did not have any time to waste, let alone enough time to recall the few miraculous cases she had seen firsthand; dismissed-as-apocryphal ‘E.R. to O.R.’ patients admitted with deep dissecting hematomas, gaping flesh wounds, and intra-arterial barbiturate-induced necrosis, that clung to life as the nascent stages of septic shock threatened to ravage them from the inside out, whose conditions were rumored to be the work of the prolific Jigsaw killer.
Helpless to do anything else, Lilian reached for the cart. In a fleeting moment of disbelief, she clutched the tape recorder to keep from fumbling it and a guttural noise bubbled up in the back of her throat. There was a harsh click which sounded as she brought the pad of her thumb down on the recorder’s play button. The crackled whirring of a cassette squealed through its tinny speaker and sent a nauseating chill across the clammy surface of her skin.
Hello, Lilian. Today is the anniversary of your greatest mistake. Welcome to a final chance at salvation.
When you received your hard-earned nursing degree, you took an oath to lead a worthy life and exercise your profession honorably. Angel of Mercy Hospital allowed you to get away with breaking the rules but, in here, you’ll have to follow them.
Embedded in the dorsum and styloglossus muscle of your tongue is a device mounting the pair of trip wires currently lodged in the buccal tissue on both sides of that liability case you call a mouth. In front of you are the same tools you have prepared and sterilized for surgeons and residents your entire career. Now, it’s your turn to use them.
You will have three minutes to perform an anterior subtotal glossectomy to release yourself from the device before the trip wires are pulled, and the pressure caps located in the walls on either side of you detonate the explosives that will turn this whole room to rubble.
The licensing board won’t be coming to your rescue this time. Can you prove your life worthy, Lilian?
A sudden oppressive buzz of electricity ripped through the anxious hum in the air and the red glare of a seven-segment display made her gasp. As soon as it appeared, the timer began counting down.
The clock is ticking. Live or die, make your choice.
Lilian’s hands trembled around the recorder, dropping it to grab for the cart once more. The clatter of it, as it falls to the concrete, made her flinch but failed to faze her as she blinked with force to clear her eyes.
She had only moments to assess it all: the retractor, forceps, a scalpel loaded with a twenty-two blade, a pair of clamps, and surgical scissors laid out before her. Lilian spared one last look at the timer and gripped the scalpel in her right hand. The digits slipped away one after the other in time with the pounding of her heart, the thrum of blood-flow pulsing in her ears. With her left thumb and forefinger having found purchase in the ringed handles of the forceps, she exhaled and clenched her tongue between its curved jaws.
Then, with another cacophonous groan which emanated from her throat, Lilian steadied the twenty-two blade in her hand, the dull side braced against the taut knuckles on the inside of her right pointer finger. She forced her head skyward, her jaws apart, angling the scalpel toward the back of her throat. With one last flex of the muscle, she cut, deep and hard.
The first incision was a stab, quick and violent, but she kept the blade wedged inside the tissue, which throbbed in protest of its imminent removal. Her left hand tightened around the handle of her forceps, pinching the plump meat of her tongue as if she were holding it in a vice. The next was deeper, pushing a flow of blood into her gullet. Lilian’s involuntary squalls became a gargle of red, sputtering with each trickle that poured down her throat. Though she held her hands steady, a horrific mess of saliva and blood shot outward and cascaded over her chin.
She cut again, this time contorting the configuration of her fingers to slice behind the implant anchored in the middle of her mouth. Using the strength of her entire arm, Lilian proceeded to carve through her tongue, shrieking all the while. She kicked, ferociously, and her feet rattled against the metal frame holding her upright, as she cut with reckless abandon into her salivary gland.
Her grip only tightened, doubled down, fighting the panic rising in her chest and the urge to bite like hell around her hand as it sawed through the soft tissue on the floor of her mouth.
Each time the tip of her scalpel grazed the cylinder piercing her tongue, Lilian let loose a gagged whimper, her eyes futilely darting to either side of her in a vain attempt to see if she had just sealed her fate. She couldn’t see a thing, continuing to mutilate the bulge of her swollen tongue.
In a fit of determined fury, she tore through the last remaining fibers and screamed.
With most of the muscle severed, her left hand fell limp in front of her and the forceps dropped from her fingers. As best she could, Lilian hushed herself and coaxed her own breaths in and out, slowly, through her nostrils. With some reluctance, she cast the scalpel aside and reached into her mouth.
Her neck flexed once, then twice, before Lilian resolved to hold her breath, unable to deter the act of swallowing. Her fingertips found the rigid edge of the target, the foreign body of metal wading in blood and the froth of her spit in the basin of her lower jaw—and, on its underside, a small button.
She squinted, on reflex, taking in a slow breath which still managed to send a torrent of pooled blood splashing against her pharynx. With what little remained of her tongue, the mere stump of a lingual tonsil, she could taste the iron with each reflexive gulp. Lilian took the device between her fingers and pinched, pressing the release.
With her eyes screwed shut, paralyzed in terror, she listened. The electronic beep, which gave way to the soft clinking of metal unlatching itself in the confines of her mouth, preceded the smooth, reeling sound of the cables retracting. Lilian flinched, jerking her head back and forth, as the wires were yanked from the insides of her cheeks.
She stumbled backward, pushed by her bare feet against the wall to her rear. Letting her head fall forward, falling down onto her hands and knees, the blood-marinated mass that had been her tongue slid from between her lips and splattered, wet, on the dark corner of the floor. Thirty-four seconds remained on the display at the front of the room.
In one sense, she was freed. In every other sense, Lilian wondered, as uneven footsteps and the tap of a cane shuffled toward her in the dimness, if she would have been better off in the would-be concrete tomb.
⠀
The man who stood before her then stands in front of her now, across the open body cavity of Mr. Elliot Rosenthal.
With precision and ease, Dr. Gordon threads the needle through the smooth muscle of gut, securing a tenth Vicryl stitch along the continuous row, delicately closing the uniform incision.
Gesturing to Lilian’s hands with the instruments in his own, Dr. Gordon maneuvers them out of his hold.
“I want to see you do the rest,” he commands her. “Then, prep the Monocryl.”
Surrendering the suction and irrigation probes into his hands one at a time, trading them for the forceps and suture clips, Lilian stills her fingers and misses not a beat.
She pierces Mr. Rosenthal’s insides, dragging the braided filament behind the curl of the needle in and up, pulling it through behind the lock-stitch of the last pass. Up the needle comes, the sutures gelled with bile, pinched gracefully by the elegant jaws of the forceps in her grasp.
"Nicely done," Dr. Gordon says.
Again, the needle descends.