Jessica's brain showed an astonishing ability to adapt under extreme pressure. Every turn, every handoff was exact.
There was no unnecessary chatter, no useless reassurance. The shabby Underground Clinic had become a set of precisely meshing gears.
Before death's scythe could fall, the lead surgeon and his hastily recruited rookie assistant completed their first collaboration, without any established rapport yet fitting together perfectly.
Yang Ming took the lidocaine and snapped off the ampoule's glass top with one hand. He drew the medication into a syringe and aimed the needle at the second intercostal space along the old man's right midclavicular line.
This was the ideal site for chest puncture. Inject, withdraw. The anesthetic needed time to work, but the old man had no time left.
Yang Ming tossed aside the syringe and gripped the thick puncture needle in his right hand. Its tip gleamed coldly beneath the surgical light.
Jessica stood beside him, keeping her breathing light. She watched his latex-gloved fingers hold the needle hub steady, without the slightest tremor.
His profile looked exceptionally cold under the light. Far from diminishing his professionalism, the dark circles beneath his eyes gave him the composure of someone who had spent years walking the line between life and death.
Yang Ming secured the skin at the puncture site with his left index and middle fingers.
His right hand pushed.
The needle pierced the epidermis, subcutaneous fat, and pectoralis major.
Avoiding the nerves and blood vessels along the lower edge of the rib, it passed precisely over the upper edge of the next rib and plunged perpendicularly into the pleural cavity.
The instant he felt it break through-
"Hiss-" An intensely sharp rush of escaping air rang out through the clinic.
High-pressure gas surged wildly from the end of the puncture needle, carrying a mass of dark red, bloody foam.
The old man's chest visibly sank.
Without pausing, Yang Ming swiftly attached a sterile drainage tube with a one-way valve to the end of the needle, connecting its other end to the negative-pressure drainage bottle beside the bed.
The blood and fluid accumulated in the chest flowed continuously through the transparent silicone tube into the glass bottle.
The fluid level rose rapidly.
Three hundred milliliters.
Five hundred milliliters.
Eight hundred milliliters.
As the pressure in the chest eased, the compressed lung regained room to expand.
The broken-bellows rasp in the old man's throat stopped. He greedily drew in a deep breath of air scented with disinfectant, and his chest began to rise and fall steadily.
The bluish discoloration visibly faded from his face, returning it to a normal human pallor. His displaced trachea slowly returned to the midline. The veins in his neck, which had looked ready to burst, finally subsided.
He had pulled through.
At the sight, the two burly Russians' legs went weak, and they nearly dropped to their knees. Their initial disdain for Yang Ming had turned into the fervor of men looking upon a god.
The bald brute haphazardly wiped the cold sweat from his face, so excited that he even burst into Cyrillic.
He frantically rummaged through the inside pocket of his leather jacket and pulled out two thick stacks of bloodstained Franklin bills. Holding them in both hands, he respectfully set them beside the battered employment form on the triage desk.
"Dr. Yang... this is your fee! If it isn't enough, we'll get more! Boss Ivan owes you his life!"
Yang Ming withdrew the puncture needle, covered the wound with sterile gauze, and secured it with medical tape. He stripped off his bloodstained latex gloves and casually tossed them into the yellow medical waste bin at his feet.
"He won't die." Yang Ming walked to the sink and turned on the tap again.
"Bring him in every day for a dressing change. The drainage tube needs to stay in for at least three days. No cigars, no drinking, and no fighting until then. If he won't listen, take him straight to the crematorium next time. Don't bring him here to dirty my floor."
"Yes, yes! We'll do exactly as you say!" The bald brute bowed repeatedly, then cautiously called his companion over. Together, they wheeled the operating bed out of the clinic with the still-semiconscious old man on it.
The rolling shutter was pulled down again.
Deathly silence returned to the clinic.
Only the occasional bubbling from the drainage bottle remained.
Water washed over the stainless steel sink.
Yang Ming raised his head, his gaze settling on the line of ghostly blue text at the edge of his vision that only he could see.
[Long-term teaching mission: A physician's legacy.] [Current progress: 5%]
The progress bar grudgingly crept forward a tiny fraction.
The emergency treatment had been harrowing, but by the system's standards, Jessica had merely served as a mechanical arm handing over instruments. She was still worlds away from "being capable of independently completing the preliminary preparations for routine surgery."
Yang Ming shut off the tap and pulled over a towel to dry his hands. He turned to look at Jessica, who was still standing dazed in front of the instrument cabinet.
Her breathing had not fully settled, and her chest rose and fell much more deeply than usual. Her gaze wandered between the bloody gauze, the drainage bottle full of dark red fluid, and the two stacks of cash on the triage desk.
Five thousand dollars.
All I did was fetch a few tools as instructed, and this dump made twenty thousand dollars? And that old man who already had one foot in the grave was actually saved with a few tubes and a needle?
Jessica's worldview took a small hit. Until now, her idea of doctors had been limited to the white coats in public hospitals who prescribed overpriced aspirin and told you to drink more warm water. These few minutes of firsthand experience had completely overturned that perception.
"You passed your first lesson." Yang Ming's voice interrupted her thoughts.
He walked to the triage desk, picked up the two stacks of bloodstained bills, casually pulled out a hundred, and tossed it onto the desk in front of Jessica.
"Go to the convenience store on the corner and buy two black coffees. Keep the change as your errand fee. When you get back, clean the blood off the floor, bag up the medical waste, and put it in the designated bin in the back alley."
Yang Ming opened a drawer, tossed the rest of the money inside, and locked it.
"Once you're done, we'll start learning human anatomy."
Jessica looked at the Franklin on the desk, then at the blood on the floor. She neither complained nor haggled. Grabbing the bill, she stuffed it into her jeans pocket, turned, and lifted the rolling shutter to leave.
Fifteen minutes later, Jessica returned to the clinic carrying two steaming black coffees. She put one on Yang Ming's desk, then found a mop and disinfectant in the storage room and began cleaning up the mess on the floor.
She worked briskly, clearly accustomed to this kind of manual labor. The disinfectant diluted the blood, and the mop scraped across the concrete with a soft swishing sound.
Yang Ming lifted his coffee and took a sip. The burnt bitterness of cheap beans spread through his mouth. Leaning back in his swivel chair, he watched Jessica work.
The girl's strength really was terrifying. Yang Ming had seen exactly what happened when she gripped the bald Russian's wrist.
If she had not deliberately held back, she would undoubtedly have crushed the brute's radius into a comminuted fracture on the spot.
Having a bodyguard and assistant like her in the clinic would certainly save him plenty of trouble when dealing with unreasonable gangsters or addicts who had overdosed.
But first, she had to catch up on basic medical knowledge.
"Wash your hands when you're done mopping." Yang Ming set down his coffee and took a thick hardcover book from the drawer. "Come here."
Jessica washed the mop and put it back, scrubbed her hands hard with soap, and walked over to the triage desk.
Yang Ming pushed the book toward her.
Netter's Atlas of Human Anatomy. Its cover was worn from use, its corners frayed.
"You used the colored labels to find the instruments earlier." Yang Ming tapped the cover with his finger.
"That's an idiot-proof design for morons. Starting today, you need to burn the position of every organ, every blood vessel, and every muscle in this atlas into your brain."
Jessica stared at the book, which was thicker than a brick, her brow tied in a knot.
She had spent most of her high school biology classes asleep or skipped them to work at a bar. Making her slog through a professional medical textbook now was even more torturous than sending her to the docks to haul sandbags.
"Do I really need to study it in that much detail?" Jessica tried to resist. "Isn't knowing how to hand you scalpels and hemostats enough?"
"No." Yang Ming rejected her suggestion flatly. He opened the atlas to the page showing the anatomy of the chest.
"That old man had tension pneumothorax. If the puncture needle had gone half an inch lower, it would have pierced an intercostal artery and caused massive bleeding. An inch to the left, and it would have gone straight into his heart."
Yang Ming pointed at the densely packed paths of blood vessels and nerves in the atlas.
"Surgery isn't fixing a car. A fraction of an inch can cost a life. As an assistant, you must know where the surgeon's blade will cut next. Only by anticipating the bleeding site can you put a hemostat in my hand before the blood spurts out."
Jessica felt dizzy looking at the interwoven red and blue lines in the atlas. But she did not argue again.
A base salary of five thousand dollars, plus daily tips for running errands-this job was far too tempting to pass up.
Besides, the skills this man had just demonstrated really were worth learning.
"Memorize the skeletal system first." Yang Ming pushed the book toward her. "All two hundred and six bones in the human body, their Latin and English names.
"I'll quiz you tomorrow morning."
Resigned to her fate, Jessica picked up the heavy atlas, sat at an empty table in the corner, and began memorizing it by rote.