"Wilhemina Jordan, ninety-five years old, found unresponsive by family in the living room about an hour ago," said the paramedic as the home doctors and nurses took over CPR.

"Not quite a living room now, is it?" commented Grim. His crow merely stared at him in disbelief as the people beneath them worked on the patient, oblivious to their presence.

"Background of Type 2 diabetes, CKD stage 3, two strokes, MI about six months ago and severe congestive cardiac failure, NAFLD, early stage dementia, bowel cancer five years ago with colostomy, total hip replacement, discharged two weeks ago..."

"For full resus?" said the accident and emergency doctor. The paramedic hesitated and nodded. The family stood at the end of the bed, probably ignorant to how much they hindered the resuscitation process by blocking everyone's way.

"Wow. Seriously?" said Grim, aghast, floating closer for a better look at the medical personnel smashing the chest of a tiny, frail woman. "Pretty sure the old girl doesn't have any organs that are working the way they should..."

"What are all those letters the guy in green said?" Marcie asked, hopping closer on his shoulder.

"Oh, you'll learn them on the job. The girl's old enough to have bussed tables at the Last Supper. She's got diabetes, shot kidneys, shot heart, rubbish liver, all her large intestine missing, brain's not that great... and the family wants a tube shoved down her throat and her ribs crushed before she tops it." Grim rolled his eyes.

"Surely that's..." Marcie hesitated.

"Inappropriate? Yeah, look at the faces of the docs. They know the score. I don't know if even half of those who insist against medical advice on getting CPR and fancy pancy tubes realise they aren't choosing to live, but rather how they die. Well, choosing how this person dies, in this case."

The nurses continued to slam on the chest. The anaesthetist shoved a tube down the girl's throat, tying a knot at her lips.

"Pulse check," said the head doctor, squinting at the monitor. "PEA, okay, continue CPR. Look." He turned to the stricken family. "I'll be frank. She has very little reserve and I don't know what's caused this. Could be another heart attack. Or another stroke. Or a massive clot in the lung. Or her kidneys gave out. There's not much we can reverse and even if we restart her heart again--"

"She has to have everything," interrupted the daughter.

"Even if we bring her back, she'll never get off the venti--"

"She's an honest taxpayer and she's paid into the system! She's to get everything. I'm her power of attorney!"

Pandemonium, as usual. A doctor once told Grim that both A&E and ICU were in perpetual states of controlled chaos, and she was right. Doctors, nurses, porters, support workers rushed about, appearing calm and professional on the outside. Patients writhing on beds, some of them crying out. A few others in the resus room seemed to be circling the drain, but the Book didn't have their names... yet.

"How are these people so relaxed when there are so many sick ones around?" Marcie said in wonderment.

"Oh, they're screaming on the inside too, don't you worry," Grim said. "Dying in a room with family present is better than having your ribs crushed and tubes and stuff shoved everywhere and dying in rowdy old ICU, Marce. Mark my words. I've seen it done enough times. It ain't pretty."

"PEA again," said the doctor. "Push adrenaline. Resume CPR. Get an Autopulse, Jan."

"Have you tried turning it off and on again?" said Grim snidely, but nobody could hear him, of course. In the background, the machine took over human compressions and smashed repeatedly into the dead woman's ribs.

"She only got a new hip last week! We booked tickets to go to Disneyland and everything!" said the daughter, her voice rising in octaves.

"Wow, Disneyland. Pretty inconsiderate of her to conk it now then, isn't it?" Grim said. Marcie made a strangled noise on his shoulder.

"You have to save her!" The daughter's voice became shriller. "Please! Help her!"

"Well, they sure as hell aren't cooking breakfast right now," said Grim irritably.

After several more minutes of thumping and shrieks, Marcie said, "How long do we have to watch this?"

"Not long now. Just have to wait for the docs to call it."

"Why?"

"A matter of formality, if you will. It's only plus or minus a few minutes. Makes no difference to the lot up there." Grim pointed upwards with a bony finger.

"Right. That's five cycles, no ROSC. Time of death: 4:35pm," said the head doctor, shoulders slumping. The daughter's screams shook the windows of the hospital.

"How could you decide to withdraw treatment? You're playing god!"

The husband tried to comfort her, but she continued to scream, flailing fists at the doctors.

"Yeah, they're playing god by stenting your mother when she had those heart attacks, removing her bowels when she had bowel cancer, giving her medication to stop her from getting more strokes, allowing her another ten or so years with you... how dare they play god and stop me from doing my job?" Grim watched her being dragged away by the tearful family before taking his scythe and swinging it at the old girl.

The dead woman appeared before Grim, translucent and in a colourful floral dress, her cheeks a livelier shade than her fleshy counterpart.

"Huh, I figured something bad must have happened. I never got to have my tea!" she said in a light voice.

"Got any last words?" said Grim.

"Me? Nope! Had a good life, had some good kids. I've been ready to go for years now. Guess it's time!"

Marcie marked their parting words in the Reaping Book per protocol and Grim reaped her. She went, smiling.

"If she had been ready to go for years then I think that's something her family would have liked to know," said Marcie sadly. "It would saved... well, all this."

The wet-eyed nurses tidied up the old woman's body, whose skin sagged and mouth was slightly ajar.

"Don't you ever get sad about people dying?"

"Me? No, not really. People are sad because they're arrogant enough to think they can prevent death when, on a good day, they can only delay it for a bit longer. This family's won by miles and they don't even appreciate it. Life's just another sexually transmitted disease. I've seen too many."

Soon, the paramedics wheeled in a second person. Big guy, ashen grey, sweat pouring down his face.

"Sixty-five-year-old guy, background of diabetes, angina, and hypertension, sudden onset crushing central chest pain half an hour ago radiating down the left arm, associated with nausea and vomiting," the paramedic rattled off again.

"Hope that triple cheeseburger with bacon was worth it," said Grim. "I'm pretty sure a doctor's job is to prevent the human gene pool from evolving. Come on, Marcie. Our job's not done."

He readied his scythe again as the guy's eyes rolled into the back of his head and he slumped backwards. The nurses shouted, readying the drugs. Over the guy's head, the heart monitor turned from an organised pattern to a disorganised, jagged, up-down line. For a second time in ten minutes, the nurses and doctors jumped up and down on the man's chest.

"Rhythm check. VF," said one of the doctors. "Okay, resume compressions. Jan, charge up the defib. Everyone else step back."

The nurse by the machine pressed some buttons, then shouted for clear. Everyone stepped back.

"Delivering shock," chirped the machine.

"Waiting for them to call it again?" Marcie said in a small voice.

"Yup." Grim checked the blade of his scythe, humming a low tune. "Sometimes it takes a while, but deaths don't stop happening. We have, what, five waiting upstairs in the next hour? And sometimes--"

"We have ROSC!" yelled one of them below in triumph.

Grim stopped. "You're shitting me."

They peered down. Sure enough, the heart monitor resumed its initial pattern, no longer chaotic, and there was a little more colour in Big Guy's cheeks. He still had a tube shoved down his throat, like the old girl, and his chest was more than a little concave, but he was breathing. Blood soaked through the bed sheets beneath him and the shirt he wore on admission, which the medical lot had cut down the middle.

"Right, let's get him to the cath lab," said the anaesthetist at the head of the table. "Jan, give ICU a shout to ready up the bed."

"They got him back," said Marcie in wonderment.

"Yeah, happens sometimes. More often, they don't."

Grim phased through the ceiling, emerging through the ground of the floor above, but Marcie continued to look over her shoulder in the direction of the mothership of chaos..

"You know," Grim said suddenly, passing a sign, "I've always liked the dialysis unit in this hospital. Or as I like to call it, the 'die-alysis unit'. Little bit of reaper humour there, you wouldn't get it."

The crow chuckled dutifully, but she was too green to appreciate it.

"All these lot have been on the list for a good few months now. The dialysis prolongs their lives for maybe a few months, a few years. A lucky few get new kidneys, but, eh, most of those selfish pigs out there would rather take all their useless organs with them to the grave instead of giving them to these poor bastards."

"But they don't need them any more."

"Of course not. They don't need the money or their properties either, but you can bet your feathers they'll worry about those when they're standing in front of me. But, hey, managing human affairs ain't my job. Thank hell."

"We're... not going to the dialysis unit?" Marcie said in confusion as they floated past the entrance.

"No, not today anyway. Most of these lot will be discharged soo, regardless. Upwards or outwards.... One of the two."

"You're cold, Grim," remarked the crow.

"And you're still new to this. After a few thousand deaths a year in this hospital for the past few hundred years, you'll know what I mean. Humans are finicky, annoying creatures. At least fancy-schmancy surgeon was realistic about his life's prospects. Whether he dies now or dies in five years' time, he'll still be working fourteen hours a day, miserable with work, neglecting his family, surviving on coffee and cigarettes. It's the same ending." Grim wondered if his deadpan humour unsettled Marcie; she'd get used to it soon.

The crow appeared to be deep in thought. Grim ignored her, floating past the anxious patients twiddling their thumbs awaiting test results, the stressed nurses running after inpatients with demands and cries of pain, and doctors eating miserably at their desk pouring over their discharge letters.

"We're... going to the doctor's room?" Marcie said, squinting at their Reaping Book.

A sudden flurry of movements and shouts came from round the corner. The gloomy doctors leapt to their feet and sprinted in that direction. Grim followed at a leisurely pace, spinning his scythe as he went. The congregation was not far away, and soon enough it was obvious what had happened. A balding man wearing green scrubs lay on the floor, glasses knocked askew. A doctor. Not unheard of, dying on the job, with the hours they spent in a hospital.

"Give me the Book, Marcie," Grim said. The crow acquiesced. Grim also squinted at the pages, and then at the guy. "That's him. André Dibble."

Grim didn't wait for the call and swung the scythe at the body. A silvery-white figure floated up, wearing the most disinterested face Grim had seen in many years.

"Aren't you some fancy-schmancy transplant surgeon? You're not on my death list for another--" Grim double-checked. "--five years yet. And you're meant to die in a car accident from falling asleep at the wheel after your seventh night shift. Not of a massive heart attack in the middle of a break."

The surgeon made some non-committal sound, scratching the back of his salt-and-pepper-haired head. Unlike most of the people Grim came across, there was no wonderment in this guy who looked twenty years older than his true age of fifty. He didn't seem interested in the foggy dream-like world Grim inhabited, nor the people panicking around his dead body a few feet below where they hovered, invisible, nor the fact that he literally stood in front of the Grim Reaper and his crow.

"This is where you're supposed to answer me and plead for your life or something." Grim couldn't keep his voice mild. This guy's attitude irritated.

Surgeon appeared most disinterested. For the umpteenth time in a hundred years, Grim resisted the urge to smack a reaped soul with the blunt end of his scythe. Medical personnel made the worst reaping. 'You mean I died in the orthopaedic theatre? Goddammit, why couldn't it be vascular instead?' 'You chose the worse day, Reaper. I still have five more patients to see this afternoon.'

"Yeah, well, I didn't fancy getting a stent," Surgeon said.

Grim stared.

"Are you shitting me?"

Surgeon shrugged.

"You know your hospital has a team of cardiologists who could fix you up?"

"Yeah but come on, man. I don't want to be a patient -- I work with patients! I treat them well, but I don't want to be one of them!"

"You once told an alcoholic inpatient that opening a bar on the liver ward was--" Grim looked at the Book to ensure he got the wording right. "-- 'an excellent idea I'd totally get behind. Do you take investments now or later?'"

"He had alcohol-related brain damage. He wouldn't remember anything."

"And when another patient asked you how long they had left, you said--" This time, Grim didn't need to check to quote verbatim, but he made a show of it anyway. "-- 'Well, put it this way, I wouldn't buy a calendar for next year if I were you.'"

"I was right, though."

"I'm not a doctor, but..." Grim's face twitched. "Surely there's surely a better way of breaking the news of cancer to someone than asking for their star sign and then shouting 'Bingo!'"

Surgeon shrugged.

"And just last week, in answer to 'Is there anything you can do?' to that terminal patient, you said, 'I can put a bullet through your head.'"

"If you've seen what I've seen--"

"I reap dead patients like a farmer harvests crop." Grim rolled his eyes. "You know, if I could reach the bloody physical world I'd call the crash team for you--"

"Yeah, but I signed a DNACPR on myself."

"You fucking what."

Grim looked down. The doctors and nurses hustling around the dead surgeon's body argued amongst themselves, but nobody jumped on his chest or slapped on defibrillator pads. In one of the resident's hands was a red sheet with giant white letters screaming 'Do Not Attempt Cardiopulmonary Resuscitation' across the top.

"Wow," said the crow on Grim's shoulder. "You can do that?"

"Shut up, Marcie, of course not," snapped Grim. To the surgeon, he said, "You are kidding. There's no way--"

"Don't argue with me. I don't tell you how to reap dead people. You don't tell me if I want CPR or not. It's not a fun trip, especially for someone like me who smokes too much and sleeps too little. I probably already have a degree of COPD, coronary artery disease, and CKD. If I get brought back, I'll never operate again."

"What's--" Marcie began.

"He killed his lungs, heart, and kidneys," said Grim.

"CPR isn't some miracle cure like my patients seem to think, despite all our advice." The surgeon sighed, looking exhausted. "Look, if it was time for me to go, then, fine. Technology might be brilliant, but death comes eventually and I've had enough."

He wasn't wrong. Medics struggled to keep Grim at bay and he always won. It was a matter of time. Grim sent the surgeon on his way, five years earlier than expected. No doubt the administrative lot upstairs would give him trouble for making the numbers not add up. It'd serve them right to assign him to the hospital division for a hundred years.

"Why would someone that young want to die? Especially when he knows so much about human health?" said Marcie, sounding uncomfortable.

"You can't turn shit into ice cream. I guess that guy knows himself better than we do." Grim sighed, floating along to his next assignment. "At least he didn't go out kicking and screaming."

He hated those who tried to bargain -- with death -- more than anyone. Kids tended to accept their fate with relative ease. Most oldies, too. It was those who had reached their life expectancies, despite their diseases, who seemed surprised their bodies gave out in the end. Grim wondered if a career medicine just killed Surgeon's humanity or if he was born so sceptical. It had been decades since he'd met an adversary in the art of snark, and it was unexpected in someone only a fraction of Grim's age.

Marcie landed on his shoulder again and pulled out the Book with a dejected sigh. "Okay, where next?"

"Well, we have a choice. We can either go for the maternity ward, where some bright spark decided they liked the statistics from the old times when women lived to the ripe old age of childbirth, 'cos who doesn't love the kind and safe natural methods? Or we can go for the paediatric unit where a mum with a medical degree from Google University thought childhood preventable diseases don't exist and diphtheria is harmless and natural, and little Timmy will join all the other kids from Victorian London. Or the overdose who wants to end the party with a bang."

The crow shook her head, appalled.

"Suck it up, buttercup. The shift's only getting started!"