The crisp morning air greeted Hermione as she stepped out the door heading to work. In the distant eastern sky, the faint glow of the nearing sunrise shone. The smell of clove from her neighbour’s Christmas wreath floated toward her. It was Christmas morning, half past seven and Hermione was on her way to work. Even though magic enabled her to travel without having to step outside, travelling large distances in a moment's notice, she preferred walking to St Mungo’s, where she worked as a healer for three years. The ten minute walk gave her the time to get in the right headspace before work and at the end of the day, the time to process all that had happened and leave the patients where they should stay, at the hospital, not in her head. After just 2 weeks of her Healer training, Hermione had realised the emotional tax her job was about to have on her and had quickly established the routine.
She walked past the Christmas decorations in the shops on her route, snorting at the fake snow in the shop windows. London was not a place where you got a white Christmas, even though the movies like to paint that picture.
The streets were deserted as she quickly neared her destination. No one was up at this time on Christmas day and she only met a pastor on his way to his morning service, greeting him cordially.
She took a left turn into a narrow alley, using her wand to open the staff entrance of St Mungo’s Hospital for Magical Maladies and Injuries. The corridor was swarming with arriving staff grabbing their uniform robes from the distribution system. With a touch of her wand to the cupboard the system selected her size of robes and handed her a clean set of lime green Healer's robes. She continued on to meet Padma Patil at the door of the Healer’s lounge.
“Happy Christmas, Padma. Glad to see we’ve got our toxicology specialist on call for all the yearly Yule family poisonings,” she greeted her colleague.
Padma sighed. “You’d think the whole ‘peace on earth’ thing” – she made air quotes with her fingers – “would make people be a bit more tolerant toward their fellow men.”
Hermione sniggered and opened her locker. Changing into her work robes, she put her stethoscope into one of the pockets. Her colleagues often mocked her for using the Muggle instrument, but actually auscultating lungs or heart herself, was a lot better than the automatic diagnostic spell that pulled its own conclusions on findings. Diagnostic spells were not infallible and the faint difference between the fine crackles of pneumonia and crepitations of heart failure was something she’d like to hear for herself. Besides, she was not specialised in Muggle conditions for nothing. She had taken part of her training in a Muggle hospital and it had been a good lesson not to rely on magic for everything.
Armed with cups of tea in their hands, Padma and she moved into the adjacent room set up for patient handover. Piles of charts came flying in through the opposite door, followed by Healer Hutchinson, who had been on the night shift. He had dark circles under his eyes and the red smudges on his robes told them enough about his past twelve hours.
“It’s eight o’clock, we’re starting, I don’t care if Healer Nott is late as always,” he growled, sitting down and sending the charts flying towards the Healers opposite him. Padma and Hermione exchanged a look, grabbed a pile of charts each and some parchment, ready to take notes.
“Ground floor, newly admitted is Mr Pennington after a broom racing accident, past medical history contains traumatic injury to almost any bone in his body, work-up now shows fractures of his left mandibula, clavicle, costae 3-8 on the left side and a spleen rupture. Bleeding has been controlled, mediwitches are setting the fractures at this very moment. If he remains stable, he can be released this morning.”
Healer Hutchinson droned on about the patients he admitted overnight, besides broom racing injuries, there was also a man who got into a fight with a venomous tentacula, a youngster who was apparently fed so many Canary Creams that he didn’t stop sprouting feathers; and a woman who couldn’t stop carolling.
“Well, that was it,” Hutchinson groused, standing up. “I hope you have a pleasant Christmas, upper management has had a ‘festive breakfast’ delivered in A&E to buy off their guilt for chilling at home.”
That was the moment the door flew open and Healer Theodore Nott burst in, still in his normal day clothes, brushing the soot of his recent Floo travel off of his shoulders. “Sorry, I’m late, I’ll spare you the excuses, but I don’t think you actually care anymore, do you?”
His colleague of the night shift brushed past him without saying a word and dropped him a pile of charts in his hands.
“The house elves wouldn’t let me go. Felt it would be a disgrace to spend Christmas working.”
“Of course you’d use your elves as an excuse when you just didn’t get out of bed in time,” Hermione griped and gave Theo a shove.
Padma dropped a few extra charts on top of the pile in Theo’s hands. “Here, you can make it up to us if you round on these patients,” she smiled slyly and grabbed Hermione by the arm, walking out the Healer’s lounge.
“I hope he’s brushed up on his Silencio, because I know that carolling lady, she can’t hold a tune to save her life,” she whispered in Hermione’s ear, erupting in giggles as they closed the door behind them.
~.~
A few hours later she had discharged Mr Pennington, whose bones had been mended. He had proceeded to tell her what good fun the Muggle substance cocaine was and that combined with the exhilaration of flying he’d had the best kick in ages. She’d rolled her eyes, given him a lecture on the dangers of drug abuse in combination with the altitude of flying and sent him on his way. They’d probably be seeing him again all too soon.
After finishing charting she went to the Emergency Department to help out with arriving trauma patients and other urgent care seeking patients. Padma was just helping a four-year-old boy being strangled by enchanted tinsel that Hermione recognised as a Weasley’s Wizard Wheezes product. The little fella was starting to look a little blue in the face while his mother was shouting at his father for getting those joke products into the house. With a few well placed severing charms Padma released the boy from his restraints, following it up with a diagnostic spell that showed everything was in order.
“Here you go buddy,” she smiled and shook his hand, pushing him towards his fighting parents, who had not even noticed that the subject of their argument had actually been freed and was doing fine. Their shouting match had attracted the attention of some other patients, who were looking around the curtains surrounding their stretchers, wondering what the commotion was.
“Why is it that whenever something goes wrong, I am always the one to blame?” shouted Mr Prescott, red in his face from anger. “You’ve got no sense of self reflection, you hypocritical b-” That was the point Padma waved her wand and silenced the both of them.
“I will not have this kind of language in my A&E,” she bristled, her eyes shooting daggers at the parents. “Your child is released and healthy and would like to celebrate Christmas as he’s supposed to, so if you could settle your differences and get into the holiday spirit for him?”
Mr and Mrs Prescott had the decency to look ashamed of their behaviour, apologised to their son and Padma and quickly left the premises. Hermione and Padma exchanged a look. While shaking her head, Padma started to dictate her quill to write her chart.
“Hermione, I’ve got a patient for you,” Hannah Abbott appeared from a patient room across the floor. “I think this is more Muggle medicine than anything magical.”
Hannah was one of the most reliable colleagues Hermione had, despite only having finished her mediwitch training last year, so she quickly made her way over to where Hannah was standing.
“In room number 9 is Mrs Figg, 89 years old, who just came in. Past medical history contains breast cancer, a hip fracture on the left and heart failure. She’s a squib, but has always had her medical care here. She’s come in today with a fever, erythema on her left arm and shortness of breath” Hannah relayed to her, handing her the chart for the current visit and files of previous visits.
“Her vital signs are not too good. She has a fever of 39.8, is tachycardic 125 beats per minute, I think it’s Afib, and she’s hypotensive. I already gave her some pressor potions, hoping it will get her blood pressure up. I felt unsure giving her any fluids with her history of heart failure and she currently has oedema up to her groin.”
“Good work, Hannah, thank you.” Hermione opened the files, first thing she saw being a Do Not Resuscitate Order, signed by Mrs Figg herself and her cardiac Healer.
“Did you see this?” she asked Hannah, while holding up the form.
“Yes, I did. To be honest, she looks like she won’t make it through the night, but just didn’t want to die alone at home. Please let me know if you need me to get the palliative potion set.”
Hannah gave another caring look through the window in the door, before she went off to fend for her other patients.
While flipping through the rest of the file, Hermione pushed open the door and looked up to find Mrs Figg on the bed. Her eyes were closed and she was very obviously working for her breathing. Her eyes fluttered open for just a moment to see who had entered the room and gave a sigh.
“Hello Mrs Figg, I’m Healer Granger, I’ll be attending to you today. Could you tell me what brought you here today?”
“The Knight Bus,” the old lady managed to say, a smirk lingering on her features. Hermione snorted and decided she liked her patient already.
“I don’t mean to be rude, Mrs Figg, but you don’t look like you are in the condition to be taking any means of public transportation, why didn’t you call an ambulance?”
“I may be a squib, Healer Granger, but those Muggle hospitals have always given me the creeps,” the elderly woman sighed, only able to say a few words between laboured breaths. “Please don’t send me away…”
“Of course I wouldn’t,” Hermione laid her hand on that of her patient’s, rubbing softly. “Why don’t you tell me what I can help you with.”
Mrs Figg told her that her cat Albus had scratched her last week – she showed the mark on her left arm – and how the wound had gotten redder and redder, and started to become infected. She had first waited to see how it would develop, but over the last night breathing had become harder and harder and she was unable to lay down in bed anymore without gasping for air. She had tried to get some sleep in her chair with her cats curled up around her, but to no avail. This morning she had realised she was not going to manage this on her own, had grabbed an overnight bag and summoned the Knight Bus.
“Are you on any diuretic medication or potions?” Hermione asked.
“Loads, but other than making me pee every other minute, I don’t feel they’re doing what they should. My feet are still so swollen I can hardly get them through the legs of my trousers.” It took Mrs Figg half a minute to be able to relay her story, her need for oxygen hindering her speech.
“It’s okay, I’m going to do some testing, you just lay back while I’m at it,” Hermione pulled out her wand and ran her routine diagnostic charms. There was indeed the infection on her patient's left arm, but the spell also revealed that apparently the cat scratch had brought a bacteria in her bloodstream, turning the local infection into a much more serious problem. With the vital signs Hannah had already taken, Mrs Figg met all the criteria for sepsis. Combined with the heart failure that had worsened under the infection, chances of her being able to get Mrs Figg back to functioning on her own at home were slim to none.
She sighed and took a seat next to the elderly woman, taking her hand.
“Mrs Figg, I’m sorry to say you really are very sick. The scratch caused a bacterial infection, which has now spread into your bloodstream. We call that blood poisoning in layman terms. As your heart already is your weak spot, it gets a new hit every time something else happens, and it’s not taken kindly to your body trying to fight the infection. Your heart is not able to pump the blood around properly and that causes fluids to accumulate in and around your lungs. That’s what causes your shortness of breath.”
She cast a look at Arabella Figg, who was looking increasingly uncomfortable with how hard she was working to keep herself properly oxygenated. Her nostrils widened with every breath, shoulders rising high. She had closed her eyes, but Hermione knew she had heard every word. The grip of their hands had tightened during her explanation.
“We could treat all of this, I could give you anti-microbial potions, diuretic potions to drive away all the excess fluid, give you extra oxygen, get your blood pressure up with extra potions and probably also some Muggle medication, but to be honest, I don’t know how much good it will do…”
She let her last words hang between them and thought she saw an almost imperceptible nod from the woman opposite her.
She hesitated a moment before continuing. “I saw you have already signed a do not resuscitate order.” This time the nod was more pronounced. Hermione took another moment to form her sentences right. “Am I wrong in assuming that maybe you did not so much come here for me to cure you, but more for us to care for you?”
The moment she spoke the words, she knew she had hit the bulls’ eye. A sole tear leaked out of the corner of Mrs Figg’s left eye, making its way down her cheek. She visibly relaxed, regardless of her remaining struggles to breathe.
“Oh child, thank you…” she sighed, opening her eyes just enough to look Hermione in the eye. “You managed to articulate this far better than I ever could.”
“Mrs Figg, I want to give you our palliative care regimen, it involves potions with the purpose of making you comfortable. They will not cure you, they will not fight the bacteria, they will not remove any fluid backing up in your lungs. What they will do is fight your symptoms, mainly the shortness of breath you’re experiencing. It will in the end mean you are going to die.”
Hermione stopped there for a moment, making sure her message was received loud and clear. Mrs Figg’s eyes were clearer than she had seen them this afternoon.
“I would first like to start with a potion that has almost the same ingredients as the Muggles use in morphine. If that’s not enough to make you comfortable, there are other potions to make you drowsy, so that you don’t have to suffer.”
“Please dear, there’s nothing you’re going to say that will make me change your mind. Just get them here so I can take them.” Mrs Figg squeezed Hermione’s hand again. “I’m 89, I’ve seen all there is to see, I’ve had a well enough life, now it’s time for me to take the next step. I’m not afraid.”
Her eyes had closed again, exhausted by the effort to explain her wishes. Her head dropped into the cushion, her grip lessening.
“Then I’ll be right back,” Hermione whispered. She made sure the blanket was pulled up properly and stood to exit the room. She found Hannah at the staff station in the middle of the ward, organising and resupplying the emergency potions in the crash cart. The Mediwitch looked up when she saw Hermione approaching.
“Could you give Mrs Figg a dose of Morpheum, 25 millilitres should be enough for now,” she asked her colleague with a knowing look.
Hannah didn’t say anything, just grabbed a flask of potion she had obviously already prepared and walked off towards room 9. Padma, who had watched the exchange from her desk, snorted. “You two should work in a hospice rather than a hospital,” she grinned.
“Palliative care is just as important as curative care,” Hermione shot back. “But jokes aside, I’d get bored if I wouldn’t be able to see some acute cases, it’s the combination of a big trauma mixed with some elaborate palliative cases that does it for me.”
“And all those patients should be very glad to have you,” Padma said, and gave Hermione a sideways hug. “Are you okay?” she asked, concerned.
“Yes, she’s a lovely lady, but very old with lots of comorbidities, so it’s okay. I’d feel worse if she’d wanted me to do everything to pull her through this.” She pulled back some loose strands of hair that had escaped her bun. “But thank you, I’m going to see if we need to get anyone in for her.”
Hermione entered Mrs Figg’s room again, at the moment Hannah was carefully feeding her patient her potions.
“Mrs Figg, is there anyone you would like us to reach for you? Someone that should know you’re here?” Hannah asked quietly after the elderly woman had finished the dose of Morpheum.
“Dear, who would you want to call?”
“Family, a friend? Anyone else you hold dear, or who holds you dear?” Hermione added, standing at the feet end of the bed.
“I don’t have any contact with my family anymore since reaching adulthood, being a Squib is a very good way to become estranged from your own brothers and sisters, especially when you’re born in the time that I was. I never married, and we can hardly ask my lovely Muggle neighbour to come here, can we?” Mrs Figg kept her eyes closed and despite her blunt choice of words, her tone was laced with a hidden pain.
“I understand,” Hannah sighed, but she couldn’t hide the sadness she felt for her patient, being all alone in the world. She worked at making sure the cushions and blanket were arranged properly, preventing any sort of pressure sores from occurring.
“Maybe…” Mrs Figg started, her eyes opening again, finding Hermione still standing at the end of her bed. “Yes, you are Hermione Granger, aren’t you?”
“I am, why?”
“Could you please ask Harry to come?” It seemed Mrs Figg felt a little ashamed to ask. Her eyes darted around the room, pertinently avoiding Hermione’s.
“I don’t wish to be rude, Mrs Figg, but do you mean Harry Potter?” Hermione asked, thoroughly confused. She knew Harry still enjoyed a lot of fame in the wizarding world, he was still thanked for saving the people from Voldemort in the streets, asked for photographs when shopping at Madam Malkin’s or given free dinner when going out to eat. But she had never had a patient ask him to come to their death bed, let alone on Christmas.
“Oh Merlin, I’m sorry, I didn’t explain very well, did I?” Mrs Figg panted, a smile gracing her lips. “I’m Harry’s old neighbour from Little Whinging, I used to sit him when the Dursleys had an outing they didn’t want him joining in on.” She had started fidgeting with her fingers, lacing and unlacing them.
“I know it’s probably a long shot, it’s Christmas!” she exclaimed. “But Harry was a very dear child back in the day, even though I must have bored him to death back then, he was always polite. We spoke once after the war, but never got in touch again.” She seemed to ponder her request. “Oh, forget I said anything, it was foolish…” she trailed off.
“No,” Hannah said decidedly. “Hermione is going to floo call Harry right now, and she’s going to ask him whether he is able to visit you.” She sent a pointed look to Hermione, who got the very clear message she was being dismissed. She grinned and touched Mrs Figg’s legs.
“I’ll talk to Harry, Ma’am, sorry for doubting you.”
Hermione left the room and made her way to an office on the other side of the ward where a fireplace was situated and she could call Harry in peace. Grabbing some floo powder she called, “12 Grimmauld Place,” and stuck her head in the green flames.
She bit through the uncomfortable feeling of having her head travel through the floo system with her knees still on the floor of St Mungo’s. In a matter of seconds the twisting feeling stopped and she recognised the familiar kitchen of Harry’s home.
“Hello?” she called, hoping someone was around to answer her call.
“Who is it?” She heard the croaking sound of Kreacher’s voice before he came into view. When Harry had moved in after the war, he had found Kreacher had done minimal, but obvious cleaning around the house. Not much more could be expected of the almost geriatric house elf, but Harry had nevertheless appreciated the sentiment and made peace with the creature. He kept him on, though he didn’t give him too many tasks, as his age was getting the better of him.
“Hello Kreacher, is Harry home?” she asked, giving him a smile. “And happy Christmas to you!”
“Merry Christmas to you too! I will gets him for you, Miss Granger,” Kreacher replied and disapparated with a crack. Half a minute later, Harry came walking into the kitchen.
“Merry Christmas, Hermione! I thought you were working,” he greeted his friend, sitting down in a chair in front of the fireplace.
“I am, which is actually why I’m calling on you,” she replied, earning her a confused look from Harry. “I just had Mrs Figg come into Accidents and Emergency.”
It took a split second for Harry to realise who they were talking about. A look of worry settled on his face.
“She’s dying, Harry,” Hermione broke the news quickly. “And she wants you to visit her, she hasn’t got anyone else.”
Harry had already risen to his feet halfway through her sentence, grabbing shoes that were standing next to the door. “Of course I’m coming, give me a moment to let Ginny know where I’m going.”
Hermione wasn’t surprised, this was the loyal and kind friend she knew and loved. Okay, and this was probably also a bit of that saving-people-complex that he’d always had. There might not be actual life saving involved this time, but making sure Mrs Figg didn’t die alone was at the same level in a way.
Harry hurried out the kitchen door, leaving the door open. Hermione heard him calling for his wife in the distance. A few minutes later he reappeared, Ginny trailing after him with little James in her arms.
“Hi Ginny, sorry for disturbing your Christmas,” she greeted the redhead.
Ginny waved with the hand that wasn’t keeping James up dismissively. “Don’t worry about it, this little one won’t notice one bit and I’m gonna take a nap to catch up on the sleep he cost me last night.” She stared adoringly at the two month old boy in her arms.
“Well, sorry again. I’ll see you soon,” Hermione responded. “I’ll pull out of the floo and you can come after me, Harry. Call out for Healer’s office A&E.”
She pulled back out of the Floo and stood, stretching her limbs after the uncomfortable position the floo call required.
Harry came stumbling out of the hearth soon after, brushing the soot off his shoulders. Then his gaze fell on his jumper, a classic Weasley jumper, green with a black H knitted in.
He chuckled awkwardly. “This is probably not the most appropriate attire, right?”
“She won’t mind at all, Harry. It’s your presence that matters, nothing else.”
She led him out of the room, across the ward to room 9. Hannah just came out the door and closed it behind her, careful not to let it slam closed.
“She’s taken a turn for the worse, she’s barely conscious anymore. I took the liberty of giving her five of morphine subcutaneously, she couldn’t swallow the potions anymore.”
Hermione thanked Hannah, while also being very grateful she had Hannah on this case, and opened the door for Harry to come in. She grabbed him a chair and put it next to the bed. He had hesitated and was still standing in front of the door, a forlorn look on his features.
“It’s okay Harry, just sit down, there’s no right or wrong in this,” she whispered and gave him a gentle push towards the chair. He took it and his hand wavered above the bed, before he touched Mrs Figg’s hand, which laid on her stomach, moving along with the rise and fall of her breath.
Hermione had noticed immediately upon entering that her patient was worsening over her stay. She had first wanted to admit her to a quieter ward, far away from the hectic A&E, but now saw that they probably wouldn’t have the time for that. She cast a non-verbal oxos, only to see that the oxygen saturation had dropped to dramatic levels. Mentally she was deliberating whether she felt her patient was comfortable enough or if she’d need more medication to make her so.
Upon Harry’s touch, Mrs Figg opened her eyes for only a moment, before they fluttered closed again, but it was apparently enough to notice her visitor, because her relieved sigh was significant.
“Thank you for coming,” she managed to pant, her words barely more than a whisper. Her lips had turned up the slightest bit. It was the most she could manage with the limited energy left, but a content smile it was. A sense of peace seemed to come over the older woman, as if she was finally ready to let go.
“I have… one question… for you.” Her words little more than gasps by this point.
“What is it?” Harry asked. He scooted his chair even closer to the bed and squeezed her hand softly.
“Will you take care of my cats?”
Harry and Hermione locked eyes and a grin was exchanged. They should have known the animals were the most important issue for the lady renowned for her cats.
“We will make sure they find the best new homes possible,” Hermione promised. “I think Molly and the Burrow would love a cat and perhaps Hagrid would like a feline to counter Mrs Norris.” Harry snorted, but nodded all the same.
A few minutes passed in silence, Mrs Figg’s laboured breathing being the only sound in the room, starting to become more and more irregular. As Hermione stepped out of the room to get some more morphine, she could swear she heard Harry whisper “thank you…” She cast a look over her shoulder to see he was not talking to her, and made sure to close the door quietly behind her.
She didn’t see Hannah around the work stations, so decided to grab the medication herself. The storage cupboard for Muggle medication was behind all the potions and other magical items, in an almost forgotten corner of the room. Most of her colleagues didn’t even know it was there, let alone know the indications and use of the Muggle medication, but she had insisted it be added after her training in Muggle hospitals. Over the years she had learned how dosages needed to be adjusted to the magic running in wixen’s systems and it had proven to be a welcome addition to what magical healing could provide. Were it not for the very conservative magical world, being very afraid of anything Muggle, she’d use it way more often. One day, Hermione hoped, one day people would realise that combining the best of both worlds would get them much further than retreating into one's own.
She grabbed a syringe and the morphine, making sure to get the right dosage and walked back to room 9. As soon as she opened the door she realised she’d taken the trip to storage in vain. Harry stood up as she walked in, a fresh track of tears on his cheeks and hugged her.
“It’s okay, she’s gone.”