Jessica had just finished the final stroke in the bottom-right corner of her employment form. The ballpoint pen hadn't even left the cheap printer paper, and the last syllable of Yang Ming's "You start work now" still hung in the air.
The clinic's weather-beaten roller shutter took a brutal physical blow.
A series of shrill metallic screeches scraped across their eardrums as the bottom track was kicked out of shape. Dust and flakes of plaster showered from the ceiling, swirling in the glow of the incandescent lights.
The people outside had no patience to wait for a response. Two pairs of thick arms hooked into the gap beneath the shutter and forced it upward against the warped track.
The bearings let out an agonized grinding noise. Blinding morning light, carrying Hell's Kitchen's distinctive sour stench, sliced straight into the dim interior.
Two burly men covered in blood staggered through the doorway.
Their leather jackets had been slashed to ribbons, and tattoos of Cyrillic letters and Orthodox crosses covered their exposed arms. Those were the marks of the Russian mafia. Between them, they supported a shriveled old man.
The old man's feet dragged along the floor, his soles leaving two long muddy streaks across the dusty concrete. His face had turned a horrifying blue-purple, and the veins in his neck bulged, their walls stretched to the limit by the blood inside, ready to burst at any moment.
There were no screams, no groans. The old man's mouth gaped, a hissing sound leaking from deep in his throat like air escaping a broken bellows. Every futile attempt to inhale came with a grotesquely uneven movement of his chest-one side bulged high while the other remained completely collapsed.
The strong smell of rust mingled with the rank stink of incontinence, filling the entire clinic unchecked.
Jessica had spent years on the streets. She had broken thugs' ribs and thrown protection racketeers into dumpsters. Faced with these two vicious-looking Russians, her first response wasn't fear but an instinctive tightening of her muscles.
She slid her right leg half a step back, lowered her center of gravity, and curled her fingers around the heavy, rusty iron wrench at the edge of the triage desk. If either of them dared draw a gun, she was confident she could smash the bald one's jaw in half a second.
But Yang Ming's response was even more single-minded.
He barely raised his eyelids. His gaze passed over the two burly men and fixed directly on the dying old man's chest.
Asymmetric chest movement.
Pink foam spilling from the corners of his mouth.
The trachea visibly displaced to the left.
Irregular swelling in the subcutaneous tissue.
Visual examination complete. Less than a second.
No stethoscope was needed, no X-ray. This was no ordinary fluid buildup in the lungs or asthma attack. A blunt-force blow to the chest had caused a broken rib end to puncture the visceral pleura, letting air in but not out.
Tension pneumothorax, complicated by severe pleural effusion.
High-pressure air and the steadily accumulating blood were compressing the old man's lung into a sheet of paper. The displaced mediastinum was pressing on his heart. In another hundred and twenty seconds at most, acute oxygen deprivation and cardiopulmonary failure would turn this body into a corpse.
"Lay him flat on the operating table! Strip off his shirt!"
Yang Ming's voice was dry and his tone level, yet it carried a pressure that allowed no disobedience.
These two burly Russians normally killed people in the streets without batting an eye. Now, facing this Asian doctor in a yellowed white coat, they couldn't summon even the thought of arguing.
They hurriedly lifted the old man onto the stainless-steel multipurpose operating table and roughly tore open his blood-soaked wool sweater.
Buttons flew off, striking the tiles and bouncing.
The old man's shriveled chest lay fully exposed beneath the surgical light's pallid glow. His right chest wall bulged high, and they could even see traces of air bubbles moving beneath the skin.
Yang Ming turned and walked to the sink in the corner.
He opened the faucet all the way, letting cold water wash over his knuckles. Squeezing out a generous dollop of povidone-iodine hand wash, he scrubbed from his fingertips to his elbows. A surgical scrub, a sterile surgical gown, latex gloves. There wasn't a single unnecessary pause in the sequence.
He turned his head, locking his gaze on Jessica, who still stood behind the triage desk gripping the wrench in a defensive stance.
"Go to Instrument Cabinet Number Two!"
Yang Ming issued his first live-action order.
Jessica froze for half a second. Fighting was her specialty, and finding lost cats and dogs was familiar territory, but faced with this life-or-death emergency, her brain-accustomed to solving problems with her fists-briefly crashed.
She looked at the old man convulsing on the operating table, his eyes already beginning to roll back, then at Yang Ming's utterly emotionless black eyes.
Five thousand dollars.
The words flashed through her mind. Jessica dropped the wrench and rushed to the row of glass instrument cabinets against the wall.
She pulled open the cabinet door, and a strong smell of disinfectant hit her in the face.
Inside, scalpels, hemostats, puncture needles, and drainage tubes of every size were packed into rows.
The stainless-steel instruments gleamed coldly under the lights. To someone who had never received professional medical training, this was no different from confronting a tangle of bomb wires.
She reached out, her fingertips hovering over several rows of needles of varying lengths. Cold sweat had already soaked the back of her clothes.
The bald Russian beside her was so frantic his eyes had turned red. He grabbed the collar of Jessica's leather jacket and sprayed spit across her face. "Hurry up! Can't you see Boss Ivan's dying? If he dies here, both of you are going to the grave with him today!"
Jessica was already wound tight, and the sudden yank ignited her anger.
She caught the bald man's wrist, pressed her thumb precisely against the sensitive spot at his radial styloid, and tightened her fingers. Strength far beyond that of an ordinary person poured out without restraint.
The bald man's vicious expression twisted in pain, and a distorted scream tore from his throat. He felt as though a hydraulic press were crushing his wrist, the sharp grinding of his bones magnified in his ears.
"Let go," Jessica said hoarsely, the menace in her eyes even more frightening than the Russian's. "Don't get in the way while I'm getting the tools."
The bald man sucked in sharp breaths of pain and stumbled backward, staring at Jessica as though he'd seen a ghost. This woman looked thin enough to snap in half. How was she stronger than a Siberian brown bear?
"Take a deep breath, shut your mouth, and read the labels!"
Yang Ming had already reached the operating table. His left hand pressed against the old man's displaced trachea, holding it in place. The little incident hadn't disturbed his voice in the slightest. It remained as steady as an emotionless metronome.
"There's a color code beneath each instrument. I'll give you a name, and you find the matching label and bring it to me." Yang Ming raised his eyes, his gaze piercing through the surgical light's beam straight at Jessica.
"Get one wrong, and this old man dies right in front of you. And you can forget that five-thousand-dollar salary."
Jessica clenched her teeth and forced her gaze away from the cold metal instruments to the labels below. Red, blue, yellow, green.
"Large-bore puncture needle. Red label section, second row, third from the left." Yang Ming gave her the first set of coordinates.
Jessica's ability to track moving objects far exceeded that of an ordinary person. Her gaze swept across the row, and her fingers closed precisely around the thick needle in its sterile sealed plastic pouch. She turned and slapped it into Yang Ming's open palm.
"Sterile drainage tube with a one-way valve. Blue label section, bottom shelf, right side."
"Large hemostat. Yellow label section."
"Lidocaine local anesthetic. Green label section."
The orders came one after another. Jessica's movements rapidly shifted from awkward to fluid.