Generally, Pines Memorial’s schedules were flexible and fair, and Molly had come to value the nurses’ intelligence and ability to stay cool under pressure. But, she thought, I can’t be angry at work every single day.

Molly had originally decided to make the career switch from occupational therapy to nursing after her mother had passed away. While in mourning, Molly received several letters from her mothers’ coworkers. The letters “talked about her being the best nurse they had ever known, how much fun she made work, and how much the patients and her coworkers respected her,” Molly remembered. Inspired, Molly became a nurse, too, at the age of 27—ten years ago. “I’m not that touchy-feely, but I truly love nursing. It’s a meaningful career, I’m good at it, and it’s flexible,” she said. “You can find work any time of day, any day of the year, which makes it mom-friendly.”

Molly had wanted to be a mom for as long as she could remember. After three years of trying to conceive with her police officer husband, Trey, she had finally scheduled an appointment at a fertility clinic. As an agency nurse, she would be able to arrange her schedule around her clinic appointments.

More experienced colleagues kept telling Molly that once she worked at several other hospitals, she would realize that Pines wasn’t that bad. “Will I find out from working at other places that that was really as good as it gets?” she wondered. Experiencing hospital life at various institutions was the best way Molly could discover whether anybody was treating both nurses and patients right.

She gave herself a year to find out.

LARA

  SOUTH GENERAL HOSPITAL, August

On her way to the staff locker room, Lara stopped in her tracks. The half-used vial of Dilaudid, a narcotic five to ten times more powerful than morphine, lay on a counter. It seemed to shimmer with energy and promise. You deserve it, coaxed a voice she remembered well. You’ve been working fourteen-hour days. Your mom just died. She died in your arms. It will make you feel better. It’s sitting right there. No one will know. You want it. Take it.

Lara had been a drug addict. It had started so innocently. Nine years ago, as a single 26-year-old nurse, Lara was chatting with the other nurses on the night shift about paying off school loans, when one of them said, “Did you know you can get four thousand dollars per egg if you donate them? We should all go together.”

“That’s kind of cool,” Lara had said. “I’m young, I’m healthy, and it’s easy money.”

The next morning, the four nurses went to a clinic for the screening process. Lara, with her blonde ringlets and fair skin, was the only donor selected. After the multi-week process of egg retrieval, the doctor handed her a check and a prescription for Percocet.

The pill was the first narcotic she had ever taken. Within minutes, she was simultaneously giddy and calm, suffused with warm happiness, the world’s best buzz. She couldn’t stop giggling. Nothing bugged her. Her insecurities—about her dating life and her skinny boy’s body, which was never fit enough for her standards—dissolved. The next day, she took another pill. She didn’t think twice about it. It was her prescription, it energized her, and there were no side effects.

At work she was chattier and also more mellow than usual, and she managed to stay cheerful even while dealing with ungrateful patients and tedious charting. She skipped lunch breaks. When she finished the pills, a girlfriend who didn’t need her prescription anymore offered the pills to Lara. Why not? Lara thought. That week, she took three pills at a time.

A few days after the bottle emptied, Lara started to feel sick. That afternoon at work, she remembered that she had morphine in her pocket, 1 milligram left over from a patient. Back then, hospitals weren’t as vigilant about counting the “waste”—the surplus drugs left over from patients’ prescribed doses. Nurses went home, shrugged off their scrubs, and dumped their pocket contents into the trash.

She fingered the vial, running her thumb along the smooth, cool glass. If the Percocet made me feel that good, maybe morphine will, too, she thought. She returned it to her pocket to use at home. There was no inner voice asking her what she was doing, no angel on her shoulder imploring for restraint. It was just a little shot in the arm to take the edge off the day. She would never actually take narcotics at work, she told herself.

For the next several months, Lara conveniently “forgot to waste” leftover narcotics. Instead, she brought them home and stashed the Percocet, morphine, or Dilaudid in her underwear drawer. In the beginning, the drugs popped into her mind only occasionally, an elated realization like finding a twenty-dollar bill at the bottom of a purse: Oh! I have extra narcs in my pocket! She brought home vials about twice a week. It was too easy. Even once her hospital began requiring nurses to dispose of the excess in front of a colleague, the drugs were there for the taking. “Hey, I’m wasting this milligram of Dilaudid,” Lara would say, and the nearest nurse would hardly look up as she scribbled a signature. No one bothered to watch whether Lara actually threw out the vial, a procedure intended to prevent exactly what Lara was doing.

Not only was she able to do her job while taking the drugs, but she also had more energy than she knew what to do with. She worked additional hours for overtime pay. She justified the drug use by telling herself that her increased energy made her a more productive nurse. “You’ve heard about soccer moms being able to do everything on Ritalin? That was me. I could work! I could do ten thousand things and no one suspected why.”

Within months, Lara’s tolerance increased and her main concern at the hospital became collecting more drugs to bring home. One milligram wasn’t enough to spark a buzz, and she felt fatigued if she tried to go more than a day without taking something. So she signed up to work every day—zero days off—to get access to the meds because she didn’t want to feel tired. She was often sick to her stomach, but didn’t make the connection between her stomachaches and the drugs.

If you had asked Lara before she donated eggs what she thought about people who took narcotics, she would have responded, “Why on earth would someone do that?” Now it did not occur to her that she had become one of those people. It didn’t even occur to her that she was doing drugs (as opposed to taking medicine), let alone stealing them.

Lara was a superstar nurse, energetic without being perky, unfailingly positive, and constantly volunteering to help other nurses. Nobody questioned her, nobody told her it wasn’t healthy to work seven days a week. There was always a need for more hands. She would call the nurse manager and ask nonchalantly, “Hey, can I come in for four hours this afternoon?” Nobody ever said no.

About a year after she took her first Percocet, the workday started to seem longer. Lara was eager to get home so that she could inject herself. The first time she shot up in a staff bathroom, a voice broke through her thoughts: “It’s getting bad if you can’t even wait to get home.” I have a hard job and it’s a long day, she told herself. If other people saw what I see at work, they’d need something to take the edge off, too. “You’ve crossed the line you drew for yourself.” I can stop at any time.

Lara took sixteen-hour shifts, sailing through them with midday bathroom breaks to insert an IV, eventually injecting up to 8 milligrams of Dilaudid at a time, an enormous dose, but, for Lara, just enough to keep her alert. Once, she put a heparin lock in her foot to give her quicker access to a vein. She wore it the entire workday, attending meetings and caring for patients. She told coworkers she was limping because she had dropped a weight on her toes.