This is one of a collection of stories that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies more than either mysteries or horror, and would appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. In each story, a protagonist makes a wish that comes true with fatal results for someone, often the person making the wish. Nothing supernatural, but just how things work out. (Or is it?) The technical details surrounding the fatal (or near-fatal) event are drawn from real cases in the US OSHA incident report database or similar sources and are therefore entirely realistic, even if seemingly outlandish. The plots draw lightly from cultural beliefs around actions such as pointing at someone with a stick or knife, wishing in front of a mirror, or stepping on a crack.

Editor’s Note: This week’s story marks the 50th Medical Fiction piece to be published by Physician’s Weekly. The first 20 stories are available as a collection here — and you can also read them here.

Dirk worked as a junior lab technician at a carcinogenesis research center. He was also a serial lunch thief. Dirk often stole food from the fridge in lab 4-13 and was unrepentant. In fact, he rather enjoyed the faint thrill of stealing food from his female co-workers and their resulting squeals of frustration.

A busy nightlife, a shortage of forethought, and a tight budget often resulted in Dirk having neither food nor funds when lunchtime pangs arrived. He was a skilled lunch thief, picking moments when the fridge was unobserved. Even if someone had been watching him, though, they probably wouldn’t have noticed his swift and stealthy moves. He was a master of the underhand slide, the side grasp, and the cover and slip techniques. All in all, Dirk could make a Reuben sandwich or a tray of pinwheels vanish like a culinary conjuring trick.

The use of the lab fridge for storing food was against facility policies, but it was very convenient for the lab workers. The lab manager turned a blind eye to sealed food containers and the occasional cake and understood that having to go through the laborious security and hygiene processes just to get lunch was a bother for staff. She was less thrilled with open containers of food nestling up against samples or reagents and especially not keen about the frequent fights over missing food. Everyone knew that formal complaints would just get all food banned from the lab, so the victims grumbled to themselves and swallowed it.

The main perpetrator was also not complaining. In addition to free food, Dirk got a kick out of making Rachel and Sue seethe a bit. Rachel made really great sandwiches and Dirk loved it when Sue brought in Chinese food. Rachel did indeed seethe somewhat, while Sue muttered about there being a special place in hell reserved for lunchbox thieves. Shannon, on the other hand, fumed and frequently and vehemently objected to food being in the lab fridge. At five-foot nothing in her work shoes, she was limited to which shelves in the lab fridge she could use without a step stool, and people kept hiding their tastier food behind her reagents on the lower shelves to avoid the dreaded lunch thief. It meant that her shelves were always crowded, made removing some of the flasks difficult, and made her hungry every time she used the fridge.

This week, Shannon was using tetramethyl ethylenediamine, or Temed, to prepare an acrylamide gel for electrophoresis. To avoid repeated trips through security, she filled a 1,000 mL glass flask with Temed and found a spot on one of the lower shelves in the lab fridge. She pushed open a gap between a tray of brownies in a clear plastic bag and a brown bag that smelled like it must contain the world’s best crispy eggrolls. Shannon sighed inwardly as the bottle stopped short against a solid lunchbox and a three-tier stack of stainless steel food containers. She wiggled things around until she could get the Temed bottle in. To make sure there was no doubt about it being work-related and belonging to her, she stuck a green leprechaun sticker on the Temed bottle, and drew a skull and crossbones surrounded with flames next to a suitable Hazmat diamond. “Cursed be they that steal my solvent!”, she laughed as she wrote on the label. Shannon turned to face the quietly industrious lab staff and cleared her throat theatrically.

Bobbing on the balls of her feet, she projected her voice above the white noise of the lab. “Random science fact. Did you know it takes about 1,500 liters of water to produce 1 kilogram of flour, but only 210 liters of water to produce 1 kilogram of sugar cane? Brownies require a lot more water than the recipe calls for!” She bowed to the sound of applause. “Also, food should never, ever, in a million years be in the same fridge as reagents. Thank you!” She bounced away briskly, a sliver of fiery-red hair peeking out beneath her pale blue polypropylene bouffant lab cap.

By afternoon, Dirk was ravenous. He had enjoyed a late night with friends and had overslept a little. With too little time to make sandwiches, and too little spare cash at this point in the pay cycle to buy food, his own lunchbox was as empty as his growling stomach. Dirk conducted a quick reconnaissance through the glass door of the lab fridge while the room was empty and spotted a tray of Rachel’s fudge brownies. As a diversion in case anyone entered the room while he was completing a food transfer, he placed his empty lunchbox on an upper shelf, half turned. With a smooth and practiced underhand slide, Dirk plucked the tray of brownies from the fridge, ready to drop into his lab coat. As he pulled the Styrofoam tray of fudge brownies, its plastic bag that was trapped under the Temed caused the bottle to tip and fall from the shelf.

The bottle of Temed shattered on the hard floor between his feet, releasing a gush of liquid that soaked his trouser legs and crotch, and a splash hit him in the face. Dirk hardly noticed the searing pain in his crotch because of the overwhelming agony of specks of the fluid in his eyes. Blundering blindly from the fridge, he knocked glassware from a lab bench, crashed into the fume cupboard, and tipped over a desktop model. A gently hissing burner skittered across the floor, and on the rebound, bounced up against his shoes. Dirk’s Temed-soaked pants promptly burst into flames.

It seemed like an eternity to Dirk, but within 3 minutes, Rachel was at his side. Hearing the breaking glass and high-pitched shrieking, Rachel had sprinted toward the locked room, pausing only to snatch a CO2 extinguisher from its nook by the doorway. She fanned Dirk with white plumes of CO2, donning a respirator once the flames were out to start decontaminating him and the surrounding area. In the meantime, Sue hit the alarm button and called the Environmental Health and Safety Hazmat response team and emergency services. Working together, Rachel and Sue bundled the writhing Dirk under an emergency shower station and drenched him. Although the emergency services team arrived quickly, and Dirk got to the emergency department within twenty minutes, there were already severe chemical and thermal injuries over his inner thighs and groin, and the skin was a red mass of oozing blisters.

Initial efforts to treat the severe burns were complicated, and due to bacterial and fungal contaminants in his pants and underwear, secondary infections took hold that were resistant to antibiotic treatment. Beyond sporadic episodes in which he briefly rose in consciousness and yelled about chocolate fudge brownies, Dirk did not regain full consciousness and was spared the pain and awareness of his plight. Over the following days, despite increasingly heroic efforts by the ICU team, his condition grew steadily worse, with necrotic skin peeling and sloughing from his inner thighs and genitals. On a Saturday evening, with the sunset bathing the hospital in glowing red and amber, Dirk passed away as a result of complications of Fournier’s gangrene, never to steal another sandwich, ever again.