Page 1 of Vital Signs
Ohio winters always sucked,but tonight was different. Sharper. The kind of cold that didn't just chill my skin, but reached inside and wrapped around my vital organs, squeezing until breathing became a struggle.
I trudged along the frozen path near the Hocking River, each step harder than the last. The university lights twinkled in the distance. Christmas decorations still hung in windows, though the campus was empty for winter break.
Something twisted inside my chest, iron bands tightening around my ribs. My heart stuttered, skipped, raced. Skipped again. Like missing a stair in the dark.
Dr. Wright had said the increased dosage was safe. Dr. Wright said a lot of things.
Another wave of nausea hit, and I doubled over. My knees hit the snow first, then my palms. Even through my worn gloves, the icy ground burned my skin.
"Just... make it back," I gasped, forcing myself upright.
The homeless encampment lay less than a quarter mile ahead. It was just a few tents clustered beneath the bridge, sheltered from the worst of the wind. Athens PD didn't care much about the encampment as long as it stayed out of sight of the university patrons.
I struggled to my feet and leaned against a tree. Something was seriously wrong. My vision blurred. My left arm had gone numb ten minutes ago, and now my heart skipped every third beat, racing too fast then stuttering. The air tasted metallic. Sweat drenched my clothes despite the freezing temperature.
The brutal December cold normally kept most people indoors, but tonight it might kill me before the drug interactions did. Wright had doubled all my meds. Said it was—what did he say? Couldn't remember. Didn't matter.
"Come on, Tyler," I muttered. "You've handled worse."
I fumbled through my coat pockets, searching for my pill bottles. I was supposed to take one for chest pains. Which one? Which was which? The labels swam, letters bleeding together. I couldn’t remember what to take, only how much each trial paid. NervEase—$45. AdrenaCore—$50. NeuroPath-5—$50.
In six months and I'd have enough for a security deposit. Another year of trials and I could afford top surgery. The math had seemed so simple. Dr. Wright made it sound safe.
I stumbled forward, legs growing heavier with each step. The moonlight cast blue shadows across the snow, making the path look underwater. Maybe it was. Maybe I was drowning in air.
Another spasm gripped my chest.
The money had seemed worth the risk. Barely enough to survive on, but still better than nothing with no healthcare. No different from what everyone in the county faced since the factories closed, since the opioid epidemic transformed neighbors into statistics, since healthcare became something only the university staff enjoyed.
When they rejected me for the fourth drug trial because of my T levels, I'd lied. Checked "no" on all the medication questions, knowing the screening blood tests were looking for opioids and recreational drugs, not hormone therapy.
Sam from camp had done the same thing. And Sam stopped coming to trials three weeks ago. Dr. Wright said he'd dropped out, moved away. But Sam wouldn't have left without telling someone. Without collecting his final payment.
NeuroPath-5's $50 weekly would make the difference between affording top surgery next year or never.
Being a lab rat was the closest in my adult life I'd come to actual medical care.
I dropped to my knees again, unable to stand as dizziness washed over me. A bottle of pills scattered across the snow. I lunged forward, trying to scoop them back up with numb fingers, but they sank into the white powder. My hand trembled as I watched the small white tablets dissolve at the edges, disappearing before I could reach them.
I fumbled to pull out my phone. No signal. Dammit. I considered crawling back toward the university grounds where someone might find me, but pride kept me moving toward the encampment instead.
Hunter used to be a nurse. He'd know what to do. Dammit, I should've listened to him when he said I shouldn't do another trial. I should've done a lot of things.
Another step. Another. The path blurred.
I thought of my parents' faces when I'd told them who I really was. The disgust. The immediate ultimatum. The door closing forever. It'd been nine years ago, but the wound still ached alongside tonight's newfound pain.
I'd found a different kind of family under the bridge. People who called me Tyler without hesitation. People who corrected others who tried to use my deadname or wrong pronouns.People who pooled resources and protected each other. Calvin, who shared his last can of beans when I hadn't eaten in two days. The elderly woman everyone called Mama Rose, who somehow kept a tiny garden alive in coffee cans, growing herbs to season our bland meals.
The university lights floated now, detached from the ground. Beautiful and unreachable. The campus had been my dream once, back when I believed education might lift me out of poverty. Before I understood how the system worked. Before I recognized that some doors remained closed regardless of how hard I knocked.
The Christmas lights blurred into meaningless streaks of color. Peace on Earth. Goodwill toward men. I thought of the photo on Dr. Wright’s desk. The smiling woman, the two kids and their dog. He'd be home with them now, warm and safe.
I tried to take another step, but my legs gave out. The snow broke my fall. Soft. When did the snow get soft?
The cold didn't hurt anymore. I knew that was bad, but I couldn't remember why.
Stars shone through the branches. My breathing came in gasps. Short. Fast. Getting shorter. There was a clawing, crushing pressure in my chest that felt like an elephant was stepping on my ribs.
