Edan didn’t hesitate.
He tossed aside the intake clipboard, tightened the strap on his stethoscope, and sprinted toward the trauma bay. Through the wide swing doors, nurses and techs were already prepping trauma carts—IVs, fluids, crash meds, ultrasound gel.
“Edan, with me,” Dr. Harper barked without turning. He was pulling on gloves, already in command.
“Level 1 trauma inbound. ETA two minutes. Motorcycle vs. sedan, no helmet. Patient’s unresponsive at the scene, GCS seven. They’re bagging en route.”
Edan’s pulse thundered.
[New Mission: Blunt Force Protocol]
Situation: Level 1 Trauma – Unresponsive patient
Objective: Assist with primary and secondary survey under trauma team
Bonus Objective: Identify one missed injury before imaging
Reward: +35 EXP, Unlock Emergency Medicine Crossover Branch
System Sync: 25%
GCS seven? That’s severe. His mind flashed through trauma protocols: ABCDE — Airway, Breathing, Circulation, Disability, Exposure. He repeated it mentally like a mantra as the trauma team assembled.
The ER doors burst open.
A gurney wheeled in fast, pushed by EMTs. On it lay a young male, early 30s, blood caked along his temple, neck in a hard cervical collar, chest rising and falling via bag-valve mask. His jeans were shredded, the right leg twisted unnaturally.
Patient: Unknown Male, approx. 30
HP: 44% – Critical
VitalSight Alert: Rapid systemic deterioration. Multi-trauma suspected.
“Airway’s patent, bagging ongoing,” the EMT said. “BP was 84 over 40 en route, pulse in the 140s, GCS dropped from 9 to 7. No obvious bleeding, but right femur looks fractured.”
Harper took over airway management. “Edan—primary survey, now.”
“Yes, sir.” Edan moved fast.
“Airway is being managed. Breathing—equal rise and fall? Breath sounds…”
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He listened.
Right side was muffled.
“Decreased breath sounds on the right,” Edan called out. “Possible pneumothorax.”
Harper nodded. “Needle decompression tray—now.”
A nurse handed it over. In one swift motion, Harper inserted a large-bore needle into the second intercostal space, mid-clavicular line.
A sharp hiss escaped.
The patient’s vitals ticked slightly upward.
HP: 44% → 48%
Status: Critical, Stabilizing
“Circulation—pulse fast but present,” Edan continued. “He’s pale, cold. Abdomen soft but distended. Could be internal bleeding.”
Harper looked at the trauma resident. “Get FAST scan started.”
The resident grabbed the portable ultrasound. Edan leaned in, watching the monitor.
Black fluid pooled around the liver edge.
[Clinical Awareness Activated]
Free fluid in Morison’s pouch—hemoperitoneum likely. Source unknown. OR consult needed stat.
“Positive FAST,” Edan said. “Likely intra-abdominal hemorrhage.”
Harper’s voice snapped like a whip. “Page surgery. This guy needs a lap before he codes.”
The trauma team moved like clockwork. As the surgical resident ran in, Edan scanned the body again during exposure—checking for missed injuries.
And then he saw it.
A subtle deformity at the base of the left arm. Not obvious—covered in blood and bruising—but clearly not aligned with the rest of the limb.
Posterior shoulder dislocation? No. Elbow fracture? No—it’s the wrist.
He pressed gently—unnatural movement at the forearm junction.
Distal radius/ulna fracture. Possibly open.
[Bonus Objective Complete: Missed Injury Identified]
+10 EXP
Early Detection Prevented Complication: Nerve entrapment avoided
The system pulsed again.
Mission Complete: Blunt Force Protocol
+35 EXP
+1 Skill Point
Emergency Medicine Crossover Tree Unlocked
Branch: Trauma Response
Perk Unlocked: Triage Reflex I –
Improves instinctual prioritization in multi-injury scenarios.
+5% to rapid decision accuracy in emergent settings
System Sync: 30%
Note: System fatigue threshold reached. Cooldown recommended.
Edan stepped back as the trauma team rolled the patient toward the OR, blood still dripping along the gurney wheels. His scrubs were streaked with sweat and adrenaline.
He didn’t even realize he was holding his breath until Harper clapped a hand on his shoulder.
“Didn’t freeze,” Harper muttered. “Didn’t guess. You saw what mattered. Go hydrate.”
Edan nodded, barely hearing it over the internal crash of everything that had just happened.
As he left the red zone and stepped back into the fluorescent-lit hallway, the noise faded behind him. A nurse passed him a water bottle. Another gave him a brief nod of acknowledgment.
Edan sat on a bench near the supply room and let out a long breath.
System Suggestion: Enter Rest Mode
Your cognitive stress threshold has peaked.
Mission Log will pause. Recommended: Skill Review, Tree Optimization, and Reflection.
Next Chapter: Skill Branch Expansion – Internal vs. Emergency Medicine Integration
For the first time since the system appeared, Edan let himself lean back and breathe.
I’m not just keeping up anymore… I’m changing the game.