American Medicine: I survived the death knell thanks to the devil.

Lynn raised his right hand.

The five fingers are straightened and joined together, with the fingertips slightly bent, like a living probe.

"Blood pressure 52," Brandon reported, his voice steady, but his pace faster than before.

The fingers probed into the chest cavity.

Bring your index and middle fingers together and insert them into the tear in the lung parenchyma along the trajectory of the ballistics.

The fingertip glides along the surface of the tissue.

Lung tissue, spongy. Bronchi walls, tubular induration. Pulmonary artery branches, thin-walled and pulsating.

The feel of each tissue under his fingertips was completely different.

Just like a blind person reading Braille, each raised dot represents information.

The fingers continued to penetrate deeper.

It bypasses the left upper lobe bronchus, avoids the pulmonary vein reflux branches, and advances towards the mediastinum.

Forty-eight.

Brandon reported it again.

This time, the word "blood pressure" was not added.

But everyone present knew what was falling.

Julian stood opposite, holding the hook with both hands to maintain the exposure of the field.

His gaze had been fixed on Victoria.

This is his habit.

Every time he performed surgery with Victoria, he would observe her technique, how she handled adhesions, the angles at which she used instruments, and her judgment of anatomical layers.

In his view, Victoria's surgical skills were the best in all surgical departments at the Metropolitan Hospital.

He wants to learn.

But now, his gaze has shifted.

Lynn's fingers moved through the pool of blood as if they had eyes.

Each time the fingertip touches a blood vessel, the finger will slightly change its path, detouring by no more than two millimeters.

Two millimeters.

In the mediastinum.

That tiny space was crammed with the thickest tubes in the human body, one next to the other.

The space left for his fingers to maneuver was almost zero, yet he was able to dodge with millimeter-level precision.

Julian's Adam's apple bobbed.

He had never seen such precision in anyone's hands, not even Victoria herself.

"Forty-four," Brandon counted for the third time.

The meaning is clear: You have less than a minute left.

When systolic blood pressure is below 40, the heart loses its ability to perfuse itself.

Myocardial ischemia, conduction system failure, ventricular fibrillation, cardiac arrest.

"Found it."

Lynn's index finger stopped at one position.

He closed his eyes so that he could focus entirely on the sensation of touch.

"The bullet was lodged in the lateral wall of a branch of the left upper pulmonary artery. The bullet did not penetrate the vessel wall, but the impact caused a longitudinal tear in the lateral wall, about 1.5 centimeters long. There is no need to remove the lung lobe; the lateral wall has been repaired sufficiently."

From finger insertion to positioning completion.

Twenty-seven seconds.

Victoria's breathing rhythm changed.

Using bare hands and blind probing, he located a bullet and a laceration within the mediastinum of a living body.

It only takes twenty-seven seconds.

How many things is this little boy hiding that she doesn't know about?

"Coolie clamps".

Lynn left his left fingertips inside his chest cavity as anchor points, and took the Cooley clamps with his right hand, sliding the curved jaws deep into the mediastinum along the spatial coordinates transmitted from his left hand.

Proximal clamping. The force is just enough to flatten the lumen and block blood flow without damaging the vascular endothelium.

"Forty-one." Brandon's voice tightened slightly for the first time.

Victoria had already placed the second pair of Cooley pliers at the edge of his field of vision.

He didn't need to say anything. She anticipated the next step.

Distal end, clamping.

The bleeding stopped. Like a river that had been cut off.

The surgical field became clear instantly.

The monitor's alarm tone changed—my blood pressure stopped dropping.

It barely held steady at 42.

The bleeding stop window was opened, but only a crack.

Speaker Dawson's circulation was sustained by norepinephrine and the last two units of type O blood.

Suturing must be completed within the safe time limit of vascular clamp occlusion; otherwise, distal ischemia and necrosis will occur.

"4-0 polypropylene line".

Deep in the mediastinum, on a pulmonary artery branch less than one centimeter in diameter, the operating space is so small that even the needle holder has difficulty rotating.

Lynn held the needle directly with her fingers.

First needle insertion.

"Forty-three." It rose a little. The blood transfusion is taking effect.

The second injection.

The third injection.

Victoria counted the stitches. The interval between each stitch had an error of no more than 0.2 millimeters.

Deep within the mediastinum, on the pulsating walls of blood vessels, a needle held by the fingers achieved a uniformity that even machines might not be able to replicate.

Fourth injection.

The fifth stitch.

"Loosen the distal clamp."

Blood flow has been restored. The sutures withstood the arterial pressure. There is no leakage.

"Loosen the proximal end clamp."

Still dry. Not a drop left.

The numbers on the monitor started to jump.

48

52

57

Like a drowning person finally grabbing a rope.

Lynn pulled his left hand out from the diaphragm, with a deformed copper-jacketed bullet between his index and middle fingers.

The bullet landed on the curved disc. Metal clashed, a crisp sound.

It was especially clear in the quiet trauma room.

Brandon stopped calling out numbers.

Because the numbers on the monitor give people peace of mind.

Blood pressure 78/46, heart rate 118, blood oxygen 94.

Close the chest.

Victoria cooperated to complete the subsequent steps, checking the surgical field, placing the chest drainage tube, removing the retractor, closing the intercostal sutures, and closing them layer by layer.

From opening the chest to closing the chest.

A total of nineteen minutes.

It was better than the expected twenty minutes.

……

Director Brandon peeked over from the bedside and glanced at the monitor.

Blood pressure 92/58, heart rate 102, blood oxygen 97.

Stable.

In his 27 years of clinical practice, he has performed anesthesia for at least 3,000 cardiothoracic surgeries.

He quietly lowered the pump rate of norepinephrine.

Julian put the hook back on the instrument table and took off his gloves.

The sound of the latex rolling is very soft.

He looked down at his palm.

Dry.

For nineteen minutes, he didn't break a sweat.

It's not because I'm not nervous.

It's because, in his role as the second assistant, there wasn't a single moment when he needed to fill in.

Lynn's every move was so precise that she didn't need a second assist to cover for her, and Victoria's coordination was so precise that she didn't need a second assist to fill in.

He said he needed an assistant, so here is one.

Julie held the hook the entire time to maintain exposure.

That's it.

Julian threw the gloves into the trash can.

He recalled the words he had said nineteen minutes earlier.

"Don't let her regret it."

That's backwards.

Victoria wasn't taking any risks from beginning to end. She simply realized one thing earlier than everyone else present.

The attending physician in the cardiology department leaned against the wall.

He was clutching the marker he had never used.

He had unconsciously unscrewed and put the pen cap back on more than ten times, and the clasp had become loose.

He went over his plan in his mind again and again.

First, perform a CT scan to clarify the relationship between the bullet trajectory and blood vessels. Adjust the operating room setup and initiate cardiopulmonary bypass.

The patient underwent a midline thoracotomy to fully expose the mediastinum. The surgeon was an attending cardiothoracic surgeon, accompanied by two senior resident physicians.

From CT appointment to being wheeled into the operating room to being draped and starting surgery, it can take as little as forty minutes.

Dawson didn't have forty minutes.

He knew from the beginning that there wasn't enough time.

That's why he asked for a CT scan first, not to delay, but because he didn't dare to operate blindly without images.

There's too much stuff in the mediastinum; exploring it blindly is like gambling with your life.

His line of thinking is correct; it's textbook correct.

But this intern skipped the imaging.

Blindly locate the position by hand in 27 seconds. Suture the mediastinum with a finger-held needle; no leakage after five stitches.

He skipped the 40-minute preparation process.

It wasn't because he was reckless, but because his hands were much faster than a CT scan.

The attending physician in the cardiology department put the marker back into his breast pocket.

The pen cap wasn't fastened properly, but he didn't notice.

The attending physician in the trauma department stood in the corner.

Fifteen minutes ago, he was the one blocking the cart.

I can't say a word now.

Chief of Staff Grant stood by the door.

His right hand was in his pocket, his thumb repeatedly rubbing the seam of his pants.

Dawson is alive.

His gaze fell on Lynn.

This Asian intern is taking off his gloves.

After undressing, without looking at anyone, I walked to the trauma bed, pulled the lowered bed rails back up, and fastened them.

Then I raised the head of the bed by fifteen degrees.

For patients with left lung injury, the postoperative position should be appropriately elevated to facilitate drainage and reduce pressure on the healthy side.

The chief of staff and the five chiefs of staff were all present.

The last thing he did was to change the bed; he didn't try to please anyone.

Grant adjusted his expression and walked to the bedside to check Dawson's complexion.

Then he straightened up and nodded to everyone present.

"Thank you all for your efforts in treating the patients. The Speaker's Office will formally send a letter to the hospital."

The tone was sincere, the wording was appropriate, and it was standard politician rhetoric.

But he paused for a moment.

His gaze shifted once between Lynn and Victoria.

"What is this doctor's name?" He looked at Lynn's name tag.

Lynn was tidying up the curved plates on the equipment table.

Victoria answered for him.

"Lynn, Emergency Surgery."

She did not specify Lynn's exact rank.

Grant nodded.

His subordinates wrote down Lynn's name.

The door to the trauma room was pushed open.

Harold Wilson, the president of Metropolitan Hospital, strode in.