I woke myself up with a panic attack.

Startled, I pressed my hand to chest, willing myself to control my hyperventilation and racing emotions.

My girlfriend, awoken by my panic, rubbed her hand down the length of my back in a soothing motion.

She rested her head on my shoulder, kissing my cheek. "Another bad dream?"

All I could do was nod in response, letting out a shaky breath. "They're getting worse, Ava."

She resumed rubbing my back. "Have you considered going to see the psychic I told you about, the one who interprets dreams?"

I pushed myself up out of bed, taking a few gulps of the glass of water that was resting on my nightstand. "I don't need some quack that claims to be a doctor telling me about my nightmares."

Ava sighed, clearly exhausted with this argument. "Fine, Jacob."

I bent down and kissed her cheek. "I love you."

A smile replaced her annoyed expression. "I love you too, you stubborn ass."

I used my morning shower to wash away the intricate details of my reoccurring nightmare.

My nightmare didn't happen every night, but when it came it left me haunted for several days after. It always started off the same, me with a knife. I was a serial killer in my dreams, each nightmare hunting down a different victim. Each victim only had one thing in common, they were always female.

I didn't know why my subconscious had chosen to manifest the way that it had. My girlfriend believed it was from working too many long hours in the Emergency Room, and I was reliving the blood and the gore through my dreams.

Her theory made sense. The dreams only came after long and difficult shifts, one in which I'd witness a multitude of deaths.

Lives I couldn't save had always haunted me.

Once I was freshly showered and dressed for my shift, I met Ava out in the kitchen, where she'd brewed some coffee and was making breakfast.

I bent down to kiss her once again. "Sorry for waking you up like that."

She shook her head. "I know that your nightmares take a toll on you. No need to apologize for them."

We flipped on the news, half-watching the weather reports and the local updates.

That is, until a picture of a dead body flashed across the screen.

I let out a loud yelp, my eyes wide as I stared at the young girl on the screen.

"That's her," I whispered, my eyes fixated on the picture. "That's the girl from my dream last night."

Ava let out a small sigh, sitting next to me. "Why don't you take a few days off, Jacob?"

I didn't acknowledge her question, watching the news report with vigor. I listened as the newscaster reported that this had been the fourth unsolved murder, and that the police had no leads to work off of.

"The assumption so far is that the murderer must have some kind of medical training," the reporter said. "The way that the murders have been committed, each is done with delicacy and precision. No one with an untrained eye would be able to-"

The television shut off.

I glanced toward Ava, my eyes wide. "I'm killing people."

She kneeled down in front of me. "Jacob, are you hearing voices again?"

She didn't understand. How could she? "No, okay? Just listen to me. I killed that girl last night in my dream."

I know it'd been her. She had the same blonde hair, the same tanned skin. She'd even been wearing the same color shirt as what'd been shown on the report.

"Jacob, there are a lot of blonde, tanned girls in the state of California," Ava said. "I think you should go and see your psychiatrist again, okay?"

I slowly nodded, and she ran her hand down the side of my cheek. "It's okay, Jacob. You're okay."

I let her lead me back to the bedroom, and she slipped my lab coat off of my shoulders. "Take the day and relax, okay?"

My body felt numb as I nodded in response, and I let her take my shoes off before slipping underneath the covers.

"I'm going to call your doctor now. Just rest."

~*~

"Frequent flier in Room 12," Nurse Wilma said, handing me a file. "Complains of stomach pains, right side.

"Positive suitcase sign?" I asked, glancing at the name.

Rebecca Weston. Everyone knew Rebecca in the ER, as she was here once a week. She was usually fucked up on something, whether it be pills or alcohol. And she always insisted that she stay a night to ensure that her chief complaint was resolved before she returned back to work.

Work for Rebecca Weston was on the corner of Lincoln and Memorial Street, where she went home with a different someone every night. Prostitution, as they call it here.

"Positive suitcase sign," Nurse Wilma said. "Good luck."

I finished my coffee before picking up her file, heading toward her room.

Rebecca was seated on the bed, her hospital gown already on.

"Evening, Rebecca."

She nodded in response. "Dr. Ripling."

I flipped open her chart. "Right side abdominal pain, is that your chief complaint?"

"Yes, right where the appendix is. I looked up the symptoms online, and I believe I'm suffering from a ruptured appendix. I'm looking for immediate surgery."

I raised my eyebrows at her. "You believe that your appendix has already ruptured?"

"According to Web MD."

My least favorite website. "Let me take a look for you."

She laid back, resting her hand on her stomach. "I mean, even if it's still there, is there any harm in taking it out?"

I began feeling around her abdomen. "No, but insurance doesn't cover unnecessary surgery."

I already knew she didn't have insurance before she opened her mouth. "And neither does the hospital," I added.

"If it's a potential risk, I don't see why not."

She hadn't even noticed that I was pressing on the direct location of the appendix. "Any pain so far?"

Her eyes immediately snapped toward my hand. "Yes!"

I pulled my hand away, locating her chart again. "Some symptoms of appendicitis would be a low grade fever, nausea, vomiting-"

"-diarrhea and loss of appetite," she finished. "I made sure what I was suffering from before coming here today."

"Well your temperature is at 98.4," I said, glancing up at her. "And you reported having eaten pizza just a few hours ago."

"I had to eat," she defended. "I was working."

I placed her file down on the bed. "At this time I don't see any signs of Appendicitis."

"Check again!"

I stepped out into the hallway, calling for a nurse. I was greeted by Nurse Tracey.

"Can you get Rebecca SFU, 50 Dose?"

Nurse Tracey smiled. "Of course."

"What's that going to do?" Rebecca asked me. "What are you giving to me?"

"Something to help with the pain," I said. "And I'll be back in a bit to check on you."

"What's my diagnosis then?"

I exchanged glances with Nurse Tracey. "I'll reassess in a bit, okay? Nurse Tracey will get your medication ready."

"So?" Nurse Wilma asked me, as I headed back to my desk.

"She's a dying swan in there; we'll have her out in a couple of hours."

"You really think she'll go home?"

I signed off on her discharge, closing her file. "She won't have a choice."

~*~

"How is the new medication working?" Ava asked me, as I poured ketchup onto my microwaved hot dog.

"I think I'm doing okay," I said, glancing in her direction. "I haven't had a nightmare in a couple of weeks now."

She rose up and kissed my cheek. "Good. I hate to see you suffering." She took a swig of my soda. "I'm going to shower, feel free to join."

I smiled at her. "Let me eat the first piece of actual food I've had in 36-hours. And then I'll be right there."

She sashayed out of the kitchen, winking at me over her shoulder.

I was starving, but not enough to miss that kind of an opportunity.

Two knocks came on the front door as I took my first bite.

Wiping my mouth with a nearby napkin, I took my hot dog with me to the front door.

Whoever it was couldn't be more important than my food.

Standing on the doorstep were two police officers, both of which I knew.

"Hey, Doc," Tanner said, with a slight grimace.

"Sorry to show up like this," his partner, Drew, said. "But we have to ask you a few questions."

I stepped aside, gesturing inside of my house. "Come on in, boys. Can I get you anything to eat? Anything to drink?"

They both declined with a shake of their head.

We went into the kitchen, and I sat across from them at the kitchen island. "I hope you don't mind if I eat, I just got off my shift."

Tanner shook his head. "Not a problem."

I took another bite of my hot dog. "So what is this about, boys?"

Usually the police would drop by if a patient of mine were to go missing after visiting the Emergency Room, or something of that nature. I was one of the last people to speak or hear from them, and so I'd have to go through the usual questioning.

It didn't happen often, the last time it'd been a criminal who'd faked an illness to come to my ER. I'd helped the police track him down, as he'd stolen a good deal of Dilaudid and I knew where the biggest Black Market for that was.

Being an ER doctor had its perks.

Drew nodded. "Do you know someone by the name of Rebecca Weston?"

I chuckled at that. "Sure do."

Tanner and Drew exchanged looks.

"Doc, when's the last time you saw Rebecca?" Tanner asked me.

I used the napkin to wipe my mouth again. "She was in my ER late last night. I discharged her, forced her to head home."

"Did you know that she turned up dead today?" Drew asked me.

I practically spat out my hot dog. "Excuse me?"

Drew nodded. "The same type of murder we've been seeing here lately, a clean cut down the center. But um... well this one was a bit different."

I raised an eyebrow. "How so?"

Drew glanced toward Tanner.

"Well, you see, Doc," Tanner said, with a slight grimace, "she was missing her organs."

"Excuse me?"

Tanner nodded. "Most of the organs were still at the crime scene, all but one. Her appendix."

Her appendix. Rebecca's killer had taken the very organ she'd come into the ER complaining about.

And the only person who'd seen her that night was me.

I stood up, my head aching. "I'm sorry, this is a lot for me to, uh..."

"Comprehend?" Drew suggested. "We know, Doc. We're sorry to have to bring you into this."

I massaged my temples as I headed over to the refrigerator, helping myself to some cold water. "She'd been disemboweled?"

Both of the boys nodded.

"And her appendix...?"

"We don't know where it is," Tanner said. "This is the fifth murder in the same kind of fashion."

"Did Rebecca say anything to you before she left?" Drew asked me. "Anything about where she was headed? Did she mention any names?"

I sat back down, letting out a long sigh as I tried to recollect the memory. "She was reluctant to leave; I eventually had to call Security to take her out. She's a regular in the ER, always complaining of something or another. But we just didn't have the room to take her in, we had patients filing in."

"A lot of homeless people have been taking shelter," Tanner informed me. "It seems like our killer targets them."

"Specifically prostitutes," Drew added. "But we can't rule out the homeless."

That would explain the rush last night. "She said she didn't have anywhere to go, and I offered to call a local shelter for her. But she cursed me out and stormed away."

Drew took note of that.

"Did she mention where she might be headed to?" Tanner asked me.

I shook my head in response. "I called the shelter anyway, hoping she might make her way there. But apparently she didn't."

"She was found in an apartment on the Upper East Side," Tanner said. "It's a vacant complex, known for housing the homeless. It seemed she'd been living there for quite some time, she'd even hung some pictures up on the walls."

Drew slid some of the pictures toward me. "Recognize anyone?"

I scanned the photos of her posing with a variety of people, and my eyes stopped on one in particular.

"This is Jackson," I said, pointing to him. "Jackson... His last name starts with a R. He's a Frequent Flier."

Tanner raised an eyebrow at me.

"Sorry, we use shorthand in the ER. He comes in often."

Drew jotted that down as well. "When's the last time that you saw him?"

"I wasn't on duty, but when I was closing files a few days ago I saw that he'd been in the ER," I said. "Complaining of chest pains, really just wanted some pain pills."

Tanner and Drew both stood up. "Thanks for your-"

"Are you coming or what?"

I turned to see my girlfriend standing in the kitchen doorway, naked.

"Oh my God!" she screamed, quickly turning and running.

Tanner and Drew both turned to look at me, wide-eyed.

"Well good afternoon to you boys then. Is that all that you needed?"

They both nodded, standing up. "Yeah... uh, thanks. Thanks for your... your, uh, help, Doctor Ripling."

I ushered them both out the door before seeking out Ava.

"That was so embarrassing!" she wailed, pressing her forehead into my chest. "Why were there police officers here?"

I stripped my shirt, tossing it toward my hamper. "Another murder, apparently I'm the last known person she spoke to."

Ava kissed my cheek. "I'm sorry, Jacob."

I slid my pants down, stepping out of them. "You know what I need right now?"

She raised an eyebrow at me in question.

"A nice, hot shower with my favorite girl."

~*~

Where am I?

A blinding headache throbbed against my temples, keeping me from focusing on my surroundings.

I could feel a cool, cement floor underneath my feet, signaling to me that I was barefoot.

Had I slept-walked again?

I reached up to press my fingers to my temple, and I felt a warm liquid drip down my face.

I forced my eyes open, and I was met by blurry vision.

After a few blinks, I managed to refocus my eyes.

I was standing in what seemed to be an abandoned warehouse. I glanced down at my attire, and I was indeed barefoot. And still wearing my pajamas.

And then I saw the blood.

My hands were soaked in blood, the red liquid dripping from my face.

I let out a startled scream, falling back a couple of steps.

Even my footprints had blood on them.

I began to wildly glance around, trying to determine where I was.

Had someone brought me here?

Was I in danger?

Had I sustained any injuries?

As I began to inspect the blood, I realized that it wasn't my own.

I had someone else's blood on my hands.

I don't know how long I stood there screaming for, the world blurring around me into one, big anxiety attack.

What was I doing here?

Who had I hurt?

Was this the first time?

Eventually, my body began to calm back down.

After all, the body can only panic for a maximum of 20 minutes.

My brain was running in overdrive, but I knew I had to formulate a plan.

First and foremost, I had to figure out where I was.

As I began to study my surroundings, I noticed the bloody knife lying a few feet away from me.

The same silver blade that I often saw in my nightmares.

I slowly picked it up, studying the black handle smeared with blood.

Was this my knife?

I placed the knife back down on the ground, slowly backing out of the warehouse.

Now I was standing next to a road.

I still didn't know where I was, and the landmarks that surrounded me didn't help much.

And then I saw two headlights coming down the road.

The car immediately stopped when it approached me, and a young boy stepped out. "Doctor Ripling?"

I squinted at him, my vision still slightly blurred. "Alexander?"

He wrapped an arm around me, ushering me toward his car. "What happened to you, Doctor?"

I don't know.

"I think we should go to the ER. You're covered in blood."

I glanced around us as he started driving. "Where are we?"

"You're less than a mile from the hospital," he said, casting me a worried glance. "I was out searching for my brother, he likes to play out in these woods while I'm getting ready for work."

His brother.

"John," I mumbled. "John Gill."

He nodded. "Don't worry about it, Doc. Let's just get you some help."

The ER team was swift in taking me back and assessing me for wounds.

"You don't seem to have sustained any major injuries," Doctor Coates said, as he studied my file. "I'm baffled, honestly."

I slowly sat up, making eye contact with him. "Answer me truthfully."

He rested my file down, slowly nodding.

"Coates, is this my blood?"

He slowly stood up, pushing the open door to the ER hospital room shut. "Excuse me?"

"Am I covered in somebody else's blood?"

"Ripling..." he trailed off, his eyes wide. "Do you think that you are?"

"I don't know." I began to tear up. "I don't know."

"Tell me what happened."

And so I did. I told him about the nightmares, about the similarities to the serial killer victims. And I told him about this morning, waking up in somewhere I don't remember being, covered in blood.

A lot of blood.

"Jacob, have you been taking your medication?"

I nodded. "It's getting worse, Coates. Everything is worse."

Silence passed between us, and then Coates stood up, placing my file on a table. "I'm going to get you some water," he said, quietly. "You're going to wash yourself off. Take the hospital gown and leave."

"What-"

"I'll shred the file," Coates continued. "There will be no evidence that you were here this morning."

"What are saying?"

"Leave," Coates whispered. "Call out and don't come back until all of this blows over."

"Alexander-"

Coates shook his head. "I'll deal with the Gill family. Just get the hell out of here."

He left and came back with a bucket of warm water and a washcloth. "Tell Ava that you're ill, that the medication isn't working. Do not leave your house, do you understand me?"

Tears built up in my eyes. "I can't do this, Coates."

"You can and you will, Ripling."

"But, why?"

He dunked the washcloth in the water, handing it to me. "Because you're a good person of unsound mind. And I won't let you go down for that."

A good person of unsound mind.

"If I'm killing people-"

"You're not," Coates interrupted. "You're hallucinating, understand?"

I slowly nodded. "Okay," I whispered.

"Go home, Ripling. And don't come back."

~*~

"The two police officers are here again," Ava said, resting her hand on my back. "What should I tell them?"

"Talk to my psychiatrist," I said, quietly. "I'm not well."

She kissed my cheek before leaving the bedroom again.

The officers were only gone a few hours before they came back with a warrant.

"I'm sorry, Jacob," Ava said. "I've done all that I can to get them to leave. They insist on talking to you."

I pushed myself up out of bed, a bit wobbly on my feet.

The new sedative medication made my days and nights blur into one. I could hardly think for myself anymore, my body a shell for a mind that was no longer there.

I let Ava lead me out to the kitchen, where Tanner and Drew were seated.

"Doctor," Tanner said, his eyes studying me.

I sat down in one of the chairs, Ava sitting next to me.

"He's not well," Ava said. "You've seen the note from his doctor."

Tanner nodded. "We have to ask him some questions. There's a serial killer on the loose and..."

Tanner and Drew exchanged glances.

"And what?" Ava challenged.

And I'm their number one suspect.

"They all seem to have one thing in common," Tanner said. "A connection to your boyfriend."

Ava ran her hand up and down my arm. "He's been through a lot."

"What do you need to know?" I asked, my voice hoarse. "Let's make this quick."

They two boys nodded. "Of course, Doctor."

Drew pulled out his notepad. "What were your whereabouts on the night of December 29th?"

I glanced toward Ava. "What is today?"

"That was six days ago," she said, quietly.

Six days ago. My brain was only working at half-capacity, my memories hazy.

"I, um... I don't remember."

Drew nodded.

"Were you with him?" Tanner asked Ava.

She shook her head. "I was at my mother's, doing some landscaping and gardening for her. She's been ill."

Drew took note of that as well.

"Do you remember being with anyone?" Tanner asked. "It's important, Doctor Ripling. If you don't have an alibi..."

The underlying message was clear.

"I don't know," I whispered. "I... I don't remember."

"He's ill," Ava said. "He's on very strong medication."

"What's ailing you?" Drew asked me.

"It's a flare up of my Schizophrenia," I said, pressing my fingers to my temple. "Hallucinations, voices, panic attacks."

Drew and Tanner exchanged glances.

"Doctor Ripley, when was the last time you spoke with Alexander Gill?"

Alexander Gill.

"I don't know," I said, my eyebrows pinching together as I tried to recollect the last I'd spoken with the Gill family. "His brother, John..."

Ava bowed her head.

"What happened?" I asked, glancing between her and the police officers. "Did something happen to John Gill?"

"He was found murdered," Drew said.

"And the last person reported at the site was you, Doctor Ripling," Tanner added. "Alexander said that he picked you up, soaked in blood."

My heart began to pound against my ribcage. "Did I kill John Gill?"

Ava's hand rested on my shoulder. "No, Jacob." She glanced toward the officers. "Call our lawyer if you want to speak with us again."

"Ava-" Drew started.

"Jacob is ill," Ava said, helping me to my feet. "And you putting these false ideations of murder in his head won't help him a bit."

"We're trying to help," Tanner said, quietly. "We just need an alibi."

"We don't believe Doctor Ripling would murder anyone," Drew added. "He saved my life. And I won't forget that."

"Coates," I murmured. "Call Garrett Coates."

Drew scribbled that down.

"Doctor Ripling, if we have to come back..." Tanner started, pain evident on his face.

"I understand," I said, quietly. "I'm sorry, boys, but I don't know the answer you're looking for."

"Take care, Doc," Drew said, standing up. "We'll do the best that we can."

Ava led me back to the room, coaxing me down onto the bed.

"Did I murder those people?" I whispered, as she ran her fingers through my hair.

"No, baby," she said, tears in her eyes. "You save lives."

That didn't mean that I wasn't capable of murder.

"And you loved John Gill," Ava added. "Like a son."

I'd raised the Gill boys as my own ever since their parents had died in my ER. A car crash, they were both dead upon arrival.

Young Alexander Gill had only been 22-years old, his brother six. And Alexander had assumed custody of his brother, enlisting the help of me to raise him.

John loved to run around the ER in a lab coat, helping me to assess patients and write reports while Alexander was at work.

The fact that he'd been murdered...

"You're getting worked up again, Jacob," Ava whispered. "Just relax. They'll find the killer, okay?"

"And what if it's me?"

She didn't answer.

~*~

"Where are we?" I asked, glancing around at my surroundings.

"My mother's."

I could see the garden from the window, the blooming flowers. "How is she?"

"She died, Jacob. A few weeks ago."

Weeks.

"How long have I been out?"

She rested her hand on mine. "You've been unwell."

"In what way?"

"Don't worry about it now. Would you like something to eat?"

I nodded, and she left the room.

I took in my surroundings while she was gone. I was in her mother's guest suite, wearing my silk pajamas.

I never wore my silk pajamas.

My skin was paper white, and I could see the veins running through my arms.

"What's wrong with me?" I asked, as Ava returned with soup.

"I told you," she said, her eyebrows furrowing together. "You've been unwell."

As an ER doctor, I should be able to diagnose myself. But my brain was scrambled, and I felt as though I could barely remember the conversation I'd had with Ava, let alone my medical training.

There was something very wrong with me.

"Don't worry," Ava said, bringing a spoonful of soup toward my mouth. "You always worry about things you can't control, Jacob. Just rest."

And so I did. I let her spoon-feed me soup, and then we curled up together, Ava turning on an older, romantic movie.

"Am I going to be okay?" I asked, glancing toward Ava.

Tears fell down her cheeks. "Of course, Jacob. I would never let anything happen to you."

"Something feels wrong, Ava. My mind..."

"You're sick, Jacob," she said, quietly. "But you'll get better soon. Everything will get better soon."

It was almost as though my head hit a brick wall, a headache splitting across my forehead.

Ava disappeared again, coming back with a wet cloth, which she laid across my forehead. "You're putting too much stress on yourself, Jacob. Rest."

"What are they calling me?" I asked.

She raised an eyebrow at me in question.

Vague memories began to dance across my vision, almost like a dream sequence.

"The media. The people. The murders."

She shook her head, signaling that she wasn't going to answer.

"What are they calling me?" I repeated, and she sighed.

"Jack the Ripper."

Jacob Ripling. Jack the Ripper. It was a clever name.

"I killed so many people."

Ava rested her forehead against mine, tears in her eyes. "Just rest, okay? Everything will be okay."

Nothing would ever be okay again. "There's something wrong with me."

She shook her head, running her fingers through my hair. "You're a good person, Jacob Ripling."

A good person of unsound mind.

---

Rachel Meinke (knightsrachel) is a writer from the sunshine state of Florida. She's currently a graduate of the University of Central Florida, looking to seek out her Masters in Fine Arts. In her free time, you can find her at the beach, at the closest amusement park, or at a used bookstore, browsing the bookshelves to add to her always growing compilation. She's a lover of animals, collector of candles, and has an addiction to sappy books and movies.