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.


Dr. Chad Henry was an up-and-coming orthopedic surgeon and altogether a Type A personality.  Chad saw life as a series of conquests, and whether it was golf, hunting, or dating, Chad was after a trophy. It was even money, whether he would become the head of the department in 10 years or go join some group of surgeons operating on boutique skiing injuries who make out like bandits every winter.

It wasn’t that he was abrupt or brusque with people that most left an impression, but rather the insufferable and arrogant condescension that somehow always tinged his words when dealing with anyone other than another surgeon or management. This began to cause issues with other staff, and several complaints had been made by nurses about his treatment of them. In particular, he seemed to be most caustic with the newly appointed group of advanced practice nurses. The APNs had been hired to take some of the workload from the physicians, including performing a range of minor surgical procedures under physician direction. This was planned to allow the overall performance to improve as well as fill some gaps in service and generally improve patient access and reduce wait times. Chad saw the APNs as interlopers and was often abrasive and demeaning toward them. Although most of the nurses and the APNs themselves bore this stoically as just one of the less pleasant parts of the job, one APN and the nurse manager complained. The CMO heard out their complaints and sympathized with them, but after all was said and done, Chad was a very proficient surgeon, highly rated by his peers, and had good Press Ganey scores. The CMO suggested that this was all just part of the “settling in process” and that, in time, the surgeons would come to see APNs as part of the team. Another complaint from the Quality & Safety team was about the multitude of glassy-eyed hunting trophies in Chad’s office. They said there had been environmental safety reports made that the trophies smelled bad and represented a safety issue. Again, the CMO sided with Chad, pointing out that the trophies, while not everyone’s idea of sport, were far removed from patient areas or clinical rooms.

Things progressed slowly and fitfully, gradually creeping toward the kind of “settling in” that the CMO had predicted. Chad was, however, not quite following the trend. If anything, he was becoming more hostile rather than less. Some staff suggested wryly that the APNs did not “bow down and worship sufficiently,” while another suggestion said something or other about Chad flirting heavily with one of the APNs, who told him to “knock it off.” Either way, what was clear was that most of the surgeons had found ways to shift some tasks and fill some gaps in services and patient access by using the APNs. Those surgeons had found ways to incorporate the scope of work of the APNs and to integrate them into services and workflow. Chad was not one of those surgeons.

Things came to a head one morning when Chad arrived at the clinic to find one of the APNs draining an abscess on the foot of one of his patients. The APN reasoned that, although this was not strictly an orthopedics problem, she felt that draining it at once would save the patient a trip and improve their access to care. Not only did Chad scream at her, but he physically chased her out of the consulting room. Within the hour, the CNO was demanding a formal apology from the CMO, Quality and Safety had filed a workplace violence report, and the nursing union had threatened action. Chad was put on a week’s compulsory leave and the machinery to sort out such events ground into motion.

As it happened, he had already been eyeing out a private surgical group that specialized in sporting injuries. They had a sweet game going. In the winter, they got skiing and snowboarding spiral and compound fractures; in the summer, they got football and motorcycle injuries. They had joint replacements for old tennis players, a few industrial cases, and some imported rugby injuries. They also had a new thing that looked very promising: Lengthening legs. There were an increasing number of well-heeled people who were tired of being short, for whom shoe inserts were just not enough and Cuban heels too obvious. They wanted the real thing, and they had the money to pay for it.

Chad applied and found there was strong competition for only two spots on the team. They wanted more than just a good surgical track record and experience; they wanted young, virile, ambitious players who had a steady hand on a surgical robot, nerves of steel, and a mind for business. The first interview took place on the golf course and involved chatting about experiences, current cases, and future goals. It also involved letting the interviewer win without it being obvious. Chad passed the test. The next interview was at their office and used an innovative combination of virtual reality and an adapted surgical robot. First Chad walked them through the three cases they had sent each remaining candidate ahead of time. He detailed the risks, his approach, and the expected outcomes and revenue. Then he performed one of the surgeries using the VR setup and discussed it afterwards to identify any issues and mitigations, as well as answer questions about his choices and execution. Chad passed this test, too, and was selected as one of the five remaining candidates. The final interview involved a trip to a game ranch in Namibia that included some hunting, a tandem skydive, and a lot of drinking. The two candidates who showed themselves the best would be hired at a salary that was double what he currently earned.

Chad was in his element. Not only would he get to shoot a trophy, but he was also on a fancy safari at no cost to himself. The game farm set-up was something out of a luxury travel guide. Each of them would stay in one of the quaint round thatch-roof buildings that the farm manager called a “rondavel,” and evening meals were fancy game barbeques. The climate was hot and dry during the day, with crisp evenings and chilly nights, which he found invigorating. There was also a party of aircrew that had won some sort of prize and were staying in their own rondavels, but joined some of the game viewing drives and the meals. Chad soon hooked up with Cindy, a tall, blonde, vivacious flight attendant who regarded her job as a way to find someone with money and little spare time.

Chad made progress through the tacit employment tests. He showed no fear during the parachute jump, even though he was gritting his teeth and had to focus hard on keeping his voice even. The jump master was an ex-military sergeant major who spotted Chad’s distress and control and rated him well. One of the other five couldn’t mask his fear and another showed none at all. To the sergeant major, that meant the first lacked self-control and the second was likely a psychopath. On the hunting trip, Chad bagged an eland and a sable. He was clearly enjoying himself, had good firearm safety habits, and didn’t need any help to place a kill shot. The hunt was judged by the farm manager and an ex-military special forces sniper. The manager focused on the hunting itself, the ability to pick a suitable target, and a humane kill and hunt etiquette. The sniper watched for firearm safety issues and weapon handling. Here, Chad did well, too; his gun control was good, he picked a good specimen but not the prize one that the employer would probably want for himself, and he executed the shot well. One of the other candidates scored low because they let their muzzle scan the trackers and took their safety off too soon. Two others chose bad opportunities and one just shot the animal in the stomach, requiring the attending professional hunter to intervene with a kill shot. Chad was almost surely one of the two at the top of the leaderboard.

On the third day, the after-dinner event was to be something memorable. About a hundred yards behind the rondavels was another structure that overlooked a large pond that many of the animals used as a watering hole. Inside the spartan but comfy structure were seats for viewing the sunset over the watering hole, which was a sight. The sunset started with a red glow painting the veldt beyond, and crimson and gold edges on the thorn trees. It ended with a darkness that Chad had never seen before and a breathtaking view of unfamiliar stars. The manager pointed out that the watering hole and surroundings were pretty safe since no lions were in that area, and they had no crocodiles or hippos in this part of the farm. However, he took pains to emphasize that this was still a wild area, this was still Africa, and the veldt around them still had snakes, scorpions, and a long list of things that could bite. Also, he repeated a previous warning: “Don’t go near the ostriches or the porcupines if you see them. The ostriches will kick you!” He explained that a few years back, a guest had tried to pet a porcupine and they needed to call a chopper to take him all the way for surgery to remove quills that were embedded in his face and chest.

The viewing from the hide was indeed spectacular, and as the deep red sun dipped behind the watering hole, they could see a family of giraffe elegantly loping by. The rim of the watering hole was thick with dozens of antelope, warthogs, and large birds. The evening was filled with sounds of the African wild, and a menagerie of birds yelled at each other. Chad was impressed, but slipped out quietly while the others marveled at the sweeping view of the stars and bright moon while sipping brandy. Chad had other plans, a date to meet Cindy, who was at that moment waiting for him in his rondavel with a bottle of sparkling wine on ice, a pair of champagne flutes, and a big smile.

Nobody noticed him go, and for good reason. As he left, a bull barked, and everyone reached for their night vision scopes. The manager kept a steady stream flowing of information, anecdotes, and snacks, and the rich brandy mellowed them for the next show. The manager turned on a spotlight that illuminated an antelope carcass he had hung from a tree just short of the watering hole. Before long, a pack of hyenas slowly made their appearance. It started with yips and squeals coming from several directions in the dark as the pack converged, interspersed by the cackling laugh of the adults in the pack, perhaps sharing an inside joke or celebrating another night of hunting. For people experiencing it for the first time, the show was a mixture of exhilaration and fear. The hyenas were clearly visible in the spotlight, and at times came so close that the spectators could hear them breathing and smell the faint soapiness of their warm bodies. The beasts squabbled and yipped at each other as they tore the carcass apart, and they put up mock fights over the legs. The manager explained that the pack was quieter and more restrained than usual, meaning they must have already scavenged a lion kill earlier that day or made their own kill before coming to the watering hole. He explained that, contrary to popular belief, hyenas were actually primary hunters in their own right. They tended to scavenge in the day, but at night they were hunters, and did so collaboratively.


Editor’s Note: Want to be featured in a medical fiction piece? Use the form below to let us know!


As the manager shared more anecdotes about hyenas puncturing the tires of airplanes parked at the local airstrip, and recounting local hyena legends and myths, the spectators were entertained and awed by the popping and crunching of bones and the wet sounds of meat and gristle being torn off in chunks and swallowed whole. Hot, meaty breath drifted from below, and mingled with the perfume, perspiration, and bug repellent exuded by the eager audience in the hide. When the show was over, the Land Rover backed up to the hide, and the manager carefully helped everyone into their seat. Someone remarked that it was probably not a good time for a moonlight walk, and the manager laughed somewhat nervously in agreement.

The next morning, the aircrew were up before the others. This was their last day, and they intended to make the most of it. When Cindy appeared, there was some joking about her hot night and some stage winks at the word “hot.” As the others slowly trooped in for their full English breakfast and Kenyan coffee, Cindy sneered and said that she had been stood up. She had waited around for Chad, but when he didn’t show, she raided his minibar fridge for snacks and took herself and the bottle of bubbly back to her own room for a private party. Surprised glances were exchanged, and the flight engineer started wondering aloud “where …,” but further discussion was cut short by a series of piercing shrieks outside.

As they trotted to where a small group of workers had gathered by the hide, one worker pointed to a spot just below the hide where a partial skull, a few teeth, and a pile of stained and shredded clothing explained why Chad had not made his date with Cindy. Chad’s final trophy was to be remembered for decades to come in the fireside anecdotes and warnings about hyenas and their hunting habits.