“I don’t understand,” I murmured, looking over the room. “Where is everybody? Where are all my friends? My peers? My colleagues? Why is no one here?”

I was standing in the hall of a local funeral home, eyes on the group that had gathered to lay the great Dr. Kakos to rest. In the front row sat my husband and children, gently dabbing away at reds of their eyes. My parents, siblings, and extended family formed a supportive wall around them, supplying them with tissues while trying to manage their own tears. At a lectern, my brother acted as funeral officiant, reciting a lengthy speech about my life and career. Beside him, my casket lay open, my statue-like face peeking out from the white silk of my coffin.

It would have been a touching sight, if not for the fact that the bouquets in the hall severely outnumbered the guests. I’d never fantasized much about my own funeral, but the few times I did, I’d envisioned a much bigger crowd, a room brimming with people all present to mourn me. And yet, despite being large enough to seat hundreds, the hall was pathetically scarce.

Beside me stood the Reaper, his billowing robes black as ink, his hood covering his face and revealing only his bloody lips. His scythe towered above him, the blade gleaming in the artificial light of the room. When I’d awoken after death, the Reaper was the only one present, the only one who could see me, hear me, answer me.

“Unfortunately for you, Anastasia Kakos,” he said coolly, his voice deep and rich, “these are the only guests in attendance.”

“I can see that.” My own voice was frank with irritation. “But what I want to know is why. Why didn’t more people come? Why didn’t the department show up for me? My nurses? My fellow attendings? My research team? Not even my own residents?”

The Reaper scoffed. “You seem angry.”

“Well, forgive me for feeling a little disrespected,” I snapped at him. “I worked my butt off for years to get to where I was. My awesome grades, my insane research output, my groundbreaking clinical technique? I made so many breakthroughs throughout my career, and paved the way for so many new innovations! My department wouldn’t be what it is today if it weren’t for me. Hell, my specialty wouldn’t be what it is today without me! And yet, none of them could show up to even just honor me? Do they even care that I died?”

The Reaper sighed, his tone thick with disappointment. But before I could question his reaction, he thrust his scythe into the air, triggering a tornado of black mist that enveloped us. I shielded my eyes with my arms, and when I finally felt the winds settle several minutes later, I uncovered my face to see that we were now in a massive slate-grey cavern, stalactites and stalagmites encircling the dark tunnel. The Reaper and I were now a standing in the middle of a small canoe, sailing along a river made not of water, but of old and worn-down objects, pieces of trash all bumping into each other as they flowed down the path.

“What…what is this place?” I asked taking in the unusual surroundings. “Where are we?”

“Purgatory,” announced the Reaper. “And this particular river…well, it goes by many names in throughout the cultures of the earth. But for your sake, we’ll call it the River of Dreams.”

I stared out into the current of rusting trinkets and broken objects. “‘Dreams’?”

“People are not the only things that die,” the Reaper said grimly. “Dreams die too. And when they do, this river is where they end up. It’s a river full of failure, regret, and insurmountable obstacles. A painful reminder of all the desires one never got to achieve in life.”

A lump formed in my throat as I scanned the river and noticed an unused baby crib, layered with dust and surrounded by a cloud of pregnancy tests, each and every one negative.

I swallowed hard.

“But I achieved all my dreams and goals,” I said to the Reaper. “So why did you bring me here?”

“You’re not here to see your broken dreams, Anastasia. You're to see the broken dreams of others…dreams that you are personally responsible for killing.”

I recoiled in shock, watching as the Reaper thrust out his scythe and diverted our boat towards a smaller side stream. As we took the detour, the river morphed from the broken dreams of the general public, to the specific dreams of aspiring doctors. My heart hammered as I took in the sight of pitiful MCAT scores, medical school rejections, failed board exams and the NRMP email informing students that they hadn’t matched.

Then, I spotted a familiar name on a pile of job rejection letters somewhere off to my left. It was the name of one of my fellows. My professional relationship with her had started off well enough…until last year, when she’d stood up to me one day in defense of some medical student I’d snapped at. They’re trying their best, she’d said to me. You don’t need to treat them like that.

I didn’t like being talked back to, so I’d retaliated by reaching out to all the department chairs of the attending positions she’d applied to, covertly feeding them with exaggerations and half-truths about my fellow, all in an effort to convince them not to hire her. And if this rejection pile was any indication, my plan had worked, and the fellow would be jobless for the next year.

When I turned to my right, I noticed a picture frame of me and a classmate from medical school, posing in our scrubs. We were so happy to be done with board exams, and we’d dreamed of building our careers together, until we’d found out in fourth year that she’d made AOA and I didn’t. Jealousy had overcome me, and one day, I stopped answering her calls and responding to her texts. I silently abandoned my position as her maid-of-honor, and didn’t show up to her wedding…or any of her other important moments, for that matter. Her residency graduation, her house-warming party, her three baby showers, and then her final breaths in hospice as she  lay dying from Stage IV kidney cancer…I’d missed them all.

Hence the hideous crack of the frame’s glass, right down the middle.

My eyes caught next on an obituary…an obituary for one of my own interns. I gasped in horror as I recognized the black-and-white photo of his face, next to his death certificate and funeral pamphlet. The last time I’d seen him was a week before my death, refusing his repeated requests for time-off to take care of his mental health. Stop being such a baby, I’d told him. You’re a resident now. Every doctor before you handled the schedule no problem, and if you can’t, maybe it’s time to admit that you don’t have what it takes to be a physician.

And now here I was, staring at the aftermath of my words. His cause of death? A self-inflicted gunshot wound to the head.

I couldn’t take it anymore.

My knees buckled and I collapsed into the canoe, overwhelmed by the horrifying truth of everything I was seeing. The Reaper stood still beside me.

“So convinced that you’d lived a life of honor,” he stated. “Blinded by the gold of your awards to the type of person you really were. Look at the real impact of your life, the words and actions you demonstrated to others. You wondered why no one outside of your family could be bothered with your funeral? Well…now you know.”

I buried my hands in my palms and began to weep bitterly. My cries were drowned out by the roar of the river, and the Reaper finally lifted his hood to reveal his dark eyes, eyes that now looked upon me with pity…and condemnation.