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.

Lilith had become bored. She was as healthy and energetic as a 30-year old, and not even other vampires would guess that she was over 2,000 years old. Her experience over the centuries had included being an artist, an educator, and a physician, and while she enjoyed watching people, she had settled into a rhythm that was almost routine. Her experiment with high-dosage estrogen treatments for her coven of aged vampires had been a success, and they were as healthy and as fit as they had been several hundred years ago. She had rescued the remaining vampires from certain doom by dosing them with unheard of levels of estrogen, which reversed their decline. At those doses, the ancient and decrepit patrician vampires quickly regained their vitality, but were indelibly feminized as a result. With the vitality that Lilith experienced, boredom had arisen, having defeated all her major challenges. Apparently, she reflected, energy needs challenges against which to push; otherwise, one’s sense of self deflates like an old diving suit with a puncture. She always enjoyed a good argument or a challenge, and what was about to happen was indeed challenging.

What arose as a practical challenge was the irritation of an outdated and dysfunctional patriarchy that was evidently part of the foundations of American healthcare. She had just adjusted her clinic to focus on women’s health (necessary to manage a small crowd of newly feminized vampires) when it started attracting protestors. The first motley assortment of people outside the clinic seemed fixated on shouting at arriving patients about not getting abortions. It was unexpected and ironically funny, but took the clinic down an unfamiliar path. It was deliciously ironic that anyone would lecture a bunch of previously male and ancient vampires on birth control, but it drew unwelcome attention. Even more unexpectedly, it drew new clients. Under her new identity as Dr. Kay Bengtson, MD, OB/GYN, Lilith could not turn away actual women seeking care without raising suspicion or incongruity, and so she began to add regular humans to her patient frame in addition to the two dozen refurbished vampires in her coven. The added patient census also meant hiring additional staff and expanding the clinic to attend to real, fully human patients. With an active mind, superior attention span, and more than 20 centuries of experience, Dr. Bengtson ran an exceptional OB/GYN clinic, and grateful patients referred it far and wide.

What these patients told her, however, was astounding, alarming, and infuriating. They related horrific tales of lack of access to care, indifferent practices, and a bureaucracy and political environment that she hadn’t seen since Vlad the Impaler had nailed a visitor’s turban to their head. While she was surrounded by the devices and methods of modernity, including an MRI, fancy ultrasound machines, and a microscopy lab, she was astonished to see that the politics and processes of women’s health were no better now than they had been during the Roman Empire. With firsthand knowledge, she could confidently say that Byzantium had a simpler and more effective bureaucracy than the American healthcare system of today.

Many centuries ago, Bruce had once been a young man trudging home under a full moon through a barren and windswept landscape. After staying too late at the inn playing dice, he had missed his ride home, and was miserably cold and buffeted by a frigid wind that clawed through his threadbare workman’s clothing. A carriage with four black horses had slowed next to him, and the footman gestured for him to climb in. Bruce had been overjoyed at the chance to ride the rest of the way in comfort and out of the wind, eagerly clambering up the step into the warm carriage. In the candle’s light, a slim young woman with pale skin and blood-red lips smiled at him. She leaned forward, beckoned him closer, and whispered “Want to hear a secret?” The pain from her bite had been searing, and when he awoke from death 3 days later with a ravenous thirst for blood, he was somewhat immortal *and* a vampire. Since that time, he had seen Lilith on many occasions, in many countries, and with many identities, but he had never seen her as engaged and energetic as she was as Dr. Kay Bengtson. Bruce now worked as her office manager at the clinic, and it fell to him to keep things running smoothly.

Wade Walker fancied himself a culture warrior, a sleuth, a shrewd street-wise political operator. His staff thought of him as a blowhard and a tightwad, but they valued their jobs in his media company, and so they took care to be all smiles and fawn congratulations to his face. Wade fancied himself a hard-hitting journalist who exposed healthcare providers for the corrupt, grasping, and crooked liars that he suspected them all to be. In truth, Wade was really a gifted grifter who knew how to make complex things seem nefarious, simple truths look like deception, and unguarded moments appear scurrilous. Wade made coin on mining outrage, and could make the most innocuous activity look so wicked that he could get his mostly aged audiences frothing and bellowing in rage. He was gifted at sucking them in and picking their pockets with merchandise, tickets to appearances, and sponsorships. Multitudes of pensioners had impoverished themselves and drained their savings by “investing” in his documentary video productions about child labor (an actual summer camp), illegal immigrant invasions (trucks of seasonal migrant workers), and his newest project about organ theft (actual oncology tissue samples).

Wade had infiltrated the regular protestors outside a women’s health clinic. He had thought the clinic was suspicious because he found no past record of the owners, and they seemed to do most of their work at night. He had an uncanny gift for sniffing out a good story but stepping carefully over it to grab hold of the most marketable but wrong one. The truth that they were all vampires with new identities would have blown up into an international story worth millions, but Wade was already clambering over that to find something lurid about sex, drugs, or abortion. He had already lined up two potential buyers and a flock of “investors” for his story before he set foot amongst the protestors or even had a story outline.

For two days, Wade just mingled with the protestors, got an idea of the mood and the things people were shouting about, and he watched who came to the clinic and who worked there. By the end of the second day, he had a list of potential topics and had identified the staff. The woman with the purple rinse, varicose veins, and the bullhorn was sure that the clinic was a front for sex traffickers. Wade thought it had a nice hook, but the plot seemed thin. The guy with the red nose and the dank jacket that smelled like mothballs was convinced the clinic was a drug cartel’s facility. Wade acknowledged that it was plausible; the place seemed busy enough. It just didn’t work as a storyline, though. The little band of religious protestors was where he struck gold. They had evidence, they assured him, that the clinic was aborting pregnancies and selling fetal cells, blood, and organs to wealthy country club types, foreigners, and big pharma. The story had a hook, legs, and promise.

Wade decided to run with the baby parts theme, and his most likely cover story was to be from a local career fair organization. He had already spotted his way in: Sarah was one of the nurses working at the facility, and she seemed easy to approach. It didn’t take long for Wade to smooth talk her into giving him an interview the next day on what it was like to be a nurse, what her job involved, and her career path. Supposedly, this would help young students at an orphanage to pick and plan their careers after high school. He planned to secretly tape the interviews of as many staff members as he could before they rumbled him, and then edit the footage until it looked like they were selling baby parts.

Wade came 10 minutes early for his interview, and while Sarah was fetching him coffee and letting her manager know, Wade was carefully positioning his briefcase with a hidden video camera and two microphones that he placed under the table. By the time Sarah got back with coffee, it was all set up, wired for sound, and rolling. The interview started very amiably with how Sarah became a nurse, some of the partying she had got up to as a student, and how she found the clinic job. Wade steered the conversation expertly toward her work, and when she was describing the various different services they offered for women’s health, Wade asked about testing and samples. Then he followed up to ask what they did with … he appeared to stumble, groping for an unfamiliar term. “Tissue?” suggested Sarah helpfully. Wade feigned confusion. “Kleenex?” Sarah laughed and made an “air quotes” sign, then explained the medical meaning of “tissue samples.” Wade grinned, knowing how he could edit that snippet to look like she was laughing about baby parts for sale. Hungry for more, he abruptly shifted the tone of the discussion and became more pointed about abortion, more demanding, aggressive. Sarah was startled, and it showed on her face in a way that he could edit to great effect. She didn’t like how this interview was turning out, and was afraid she had been trapped into talking loosely. She was so nervous that she started sweating, and tiny beads formed on her upper lip.

Bruce, or Bryonie, as he was called in his post-estrogen life, could smell anxiety or fear at a hundred paces and was instantly suspicious. There was something going on in the clinic, but he couldn’t quite tell where and why. At the sound of a little dog-whistle on a silver chain around his neck, a pair of bats swooped down from the high rafters above the office partitions, and listened attentively to his whispered instructions. The bats glided overhead, and one settled above the room where Sarah was fidgeting uncomfortably. It could hear the faint electronic hum of the secret camera, and silently swooped past the suitcase and spotted the reflection of the lights on the small lens. The bat flitted just outside Wade’s field of view, but got close enough to make the hairs on his arms rise when a wingtip brushed against his elbow. He swiveled around, a second too late to catch a glimpse of the bat as it sailed silently up and out of the room.

Bryonie listened intently and took in what the bat had to report. The bat didn’t know what a video camera was, but it certainly could identify that there was humming and whispering with a single eye. This was more than enough for Bryonie. She stepped into the room and smiled at Wade. “I’m sure I can be of more help in answering your questions. You will understand that our clinic staff have critical patient duties, and Sarah should attend to her patients.” Sarah left quickly, flicking Bryonie a glance that was both grateful and guilty. Bryonie surveyed Wade briefly and flashed him a broad smile. She knew a worm tongue when she saw one, and with centuries of experience dealing with the best of them, she was ready to see whether Wade was just an unwelcome pest or an actual threat. She smiled again at Wade. “Now, if you are comfortable with sharing, what would help you with your interest in our happy clinic?”

After 40 more minutes, a lot had been said, and Wade had found it hard to stay focused. The manager’s voice seemed to drone on, and although Wade tried hard to prod her to get something usable, he found it an uphill battle to stay focused. Her voice was husky and smooth, velvet on silk, and what she said seemed so reasonable, but he just couldn’t get his teeth into it. Normally able to coax unguarded admissions, or provoke irritated outbursts, this time Wade felt like he was drowning. His thoughts were slow and heavy; he struggled to break into the rising and falling words coming from Bryonie. “Just relax here for a moment. I think our leader, Dr. Bengtson, may wish to meet you.” Bryonie rose smoothly and left before Wade could object.

Without the soporific voice coaxing him into a catatonic state, Wade’s mind spun up again, and he was suddenly aware that he had been told nothing of use. That slippery manager had been double-talking him to sleep. The more he thought about it, the more incensed he became. There was definitely a secret here, and he was certain that this big block of a woman had been trying to pull the wool over his eyes. “Well, I’m wise to you now, you big faker!” he muttered to himself, half in irritation and half in grudging respect. He would be ready next time, and when this executive made her appearance, he would be ready for her and any clever tricks she might try.

Dr. Bengtson listened to the bat and Bryonie, and agreed with their take. This Wade person had obviously tricked his way in, and was doing some sort of reality TV expose on the clinic. She reflected that a lawsuit would just attract more attention, that bribery was unlikely under these circumstances, and that appealing to his better nature was a non-starter. That left limited options to dispose of him. He would make a lousy vampire, and who the heck wanted to be in his rancid company for several hundred years to come? They could turn him into a zombie slave, but that might be too complicated, and again, who would want to have him around? That left the simplest and most straightforward option. Simply drain him, twist his neck a bit, and send him away in a box.

Wade was startled out of his self-angering wind-up as Dr. Bengtson entered the room. He opened his mouth to start his attack, but somehow his voice didn’t obey him. The room felt suddenly cold and the air too close, and some part of his mind seemed to be screaming at him to run. Goosebumps rose on his arms and neck, and inexplicable anxiety welled up in his gut. The hairs on his neck rose in an instinctive reaction that he didn’t understand, and fear gripped his mind with steel talons. Gulping for air, Wade stared at her. Their eyes locked, and he couldn’t look away as she moved toward him in a fluid motion. Lilith crooked one elegant finger at Wade and leaned in close. “Want to hear a secret?”