Not from anxiety—but from something sharper, something keener. A buzzing in his mind that wouldn’t stop. Jordan Miller was stable in the cardiac unit, the echo findings had impressed even the cardiology fellow, and Dr. Harper had told Edan to report to the A&E the next morning.
It was the closest thing to a compliment the man had ever given.
By 6:50 a.m., Edan was already outside the ER, clutching a lukewarm coffee and scrolling through his system interface.
[Mission Queue]
Crossroads of Care (Active)
Follow-Up: Jordan Miller (Deferred)
System Sync: 16%
EXP: 65/100
Skill Tree: Internal Medicine Path
? Pattern Recognition II (Unlocked)
? Clinical Awareness II (Available for upgrade)
Skill Points Available: 1
He hovered over the active mission.
[Mission: Crossroads of Care]
Location: Emergency Department (A&E)
Situation: Limited resources. Two walk-in patients present simultaneously with potentially serious conditions. Only one bed available in acute care zone.
Objective: Assess both patients. Prioritize based on clinical urgency and outcome potential.
Failure Penalty: Deterioration of non-prioritized patient (-5 System Sync)
Reward: +30 EXP, Unlock Ethical Judgment I
Edan swallowed. So this isn’t just medical skill—it’s triage. Judgment. Choosing who gets help first.
A chill ran up his spine. He entered through the sliding glass doors.
The A&E was already buzzing—gurneys lining the hallway, nurses on headsets, monitors beeping in a rhythm that matched the building tension in the air.
Dr. Harper stood by the charge nurse station, reviewing a printout.
“Wood,” he said. “You’re with me today. Welcome to the deep end.”
“Yes, sir,” Edan replied.
A nurse rushed over. “Two new walk-ins at once—both flagged for fast-track, but one might need resus.”
Dr. Harper looked at her. “Give me the rundown.”
She didn’t hesitate. “First is a 67-year-old male with COPD history, short of breath, increasing O2 requirement at home. Sat’s 90% on 4L. Wheezing but alert. He’s upright in triage now. Mr. Alan Porter.”
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“Second?”
“Twenty-five-year-old female, Lisa Tran. Severe abdominal pain, diaphoretic, tachycardic—HR in the 130s. Complains of lower right quadrant pain and nausea. BP is soft—90/56.”
Harper turned to Edan. “Only one resus bed left. You pick. I’ll support it—but you better explain it.”
[Mission Objective Triggered]
Assess both patients. Decide who enters the resus bay.
Outcome will affect system sync and patient prognosis.
Edan’s pulse spiked. Of course it’s not easy. They’re not giving me a textbook case. This is real.
Harper gestured. “You’ve got five minutes. Go.”
Patient One: Alan Porter
Edan moved fast to triage. Alan, a thin, grey-haired man with sunken cheeks, was puffing through shallow breaths.
“Mr. Porter, I’m Edan Wood, a medical student. I’ll be quick. Are you having trouble breathing right now?”
“Yeah,” Alan wheezed. “Been bad since last night. Can’t seem to catch my breath even with the home tank.”
Edan checked his oxygen—delivering 4L by nasal cannula. Sat at 89%. Pulse: 112.
Lungs: Wheezing, diffuse, diminished bases.
But he was conscious, speaking in full sentences—tight ones, but functional. He was sick, but not crashing.
Above his head, the system showed:
HP: 63% – Status: At Risk
Trend: Gradual Decline
Risk of Acute Exacerbation: Moderate
Patient Two: Lisa Tran
Edan sprinted to the adjacent bay. Lisa was curled on the exam table, clutching her right lower abdomen, pale and sweating.
She barely registered his entrance.
“Lisa? I’m Edan. I need to ask you some questions, okay?”
She nodded weakly.
“Pain started when?”
“This morning,” she whispered. “It got worse fast. It… it’s sharp… and I feel like I’m going to faint.”
He touched her wrist—thready pulse. Cap refill: sluggish. Abdomen: rigid in RLQ. Rebound positive.
The system interface snapped into warning mode.
HP: 55% → 53%
Status: Unstable
Suspected perforated viscus or ruptured ectopic pregnancy. Immediate stabilization required.
This isn’t appendicitis—it’s something worse. Edan felt a tremor in his gut. She’s bleeding internally. Maybe ruptured ectopic.
His mind clicked.
Decision Point
He returned to Harper, voice steady despite the pressure.
“Resus bay goes to Lisa Tran. She’s likely got intra-abdominal bleeding—hypotensive, tachycardic, signs of peritoneal irritation. Could be ruptured ectopic or GI perforation. She’s deteriorating fast.”
“And Alan Porter?”
“COPD exacerbation, but he’s protecting his airway, stable vitals on supplemental O2. Needs nebulizers and steroids, but not resus.”
Harper nodded. “You sure?”
“Yes.”
[Mission Update]
Choice Confirmed.
Routing Lisa Tran to Resus...
Outcome: Critical Intervention Window Preserved.
+30 EXP
+1 Skill Point
New Perk Unlocked: Ethical Judgment I
Description: Grants improved clinical triage instincts and confidence in resource-limited scenarios.
System Sync: 22%
Lisa was wheeled away by nurses and an ER resident. Alan was placed in high-acuity observation with respiratory treatments started.
Harper walked beside Edan down the hallway, expression unreadable.
“You made the right call.”
Edan exhaled slowly. “I wasn’t sure if—”
“You never will be. But you were fast, and you had evidence.”
He paused, then added, “That’s what separates good doctors from dangerous ones. Decisions made under pressure, grounded in logic.”
Later that day, while reviewing labs in the corner of the nurse’s station, Edan got a system ping.
New Mission Chain Unlocked: Foundations of Emergency Medicine
First Task: Handle a multi-trauma patient intake under supervision.
Optional Bonus: Achieve accurate injury prioritization within 3 minutes.
Reward: Skill Branch Access – Emergency Medicine Crossover Tree
Edan glanced up just as a trauma alert blared overhead and the red trauma bay lights began to flash.
He stood up from the monitor, heart racing again.
The game’s just getting started.