Chapter 18
eighteen
. . .
The hospital always pulsated differently at night.
Softer hisses, gentle breaths and stagnant beeps, all under control, monitored while lights flickered faintly, painting everything in monotonous shades of white and gray.
Outside though, the streets of Salerno, Italy were still wet from rain, scooters cutting through puddles, the air heavy with an ocean breeze.
The late shift at Healing Heart Medicare, a private hospital that boasted polished floors and quiet corridors to the chaos that sometimes crashed through its emergency doors, felt almost like a normal workplace tonight instead of a front line.
At thirty-one, as a sixth-year neurosurgery resident, I lived in the strange in-between where I carried the weight of authority without yet wearing the title of Chief.
Junior residents deferred to me not just for my skill, but because of my relation to Dr. Carlo, the CEO of the hospital, aware my name opened doors that experience alone couldn’t, a privilege that embarrassed me even as I wielded it to save lives.
I remained grateful though, for the fortune of being adopted by Dr Carlo rather than arrogant about the power it gave me.
Interns watched me too, for cues before they spoke, knowing my word held merit.
Trauma consults came to my phone first before they filtered upward, my time barely mine as it belonged to scans lighting up with bleeds, to pagers that shattered whatever hour I'd managed to claim as rest, to the unspoken expectation that when something catastrophic rolled in, I would already have the plan.
Tonight was quieter than usual, and the stillness pressed against my instincts to not be fooled by it.
After spending the last four hours in surgery assisting Dr Carlo, the CEO and a world-renowned neurosurgeon, whose precision bordered on art, I welcomed the rare lull.
One day, I told myself, I’d command an operating room the way he did, steady and unquestioned.
For now, I leaned against the counter outside the nurses’ station and sipped coffee strong enough to wake the dead, letting the bitterness settle on my tongue.
Across from me, Brandi flipped through a patient’s chart before rubbing her abdomen in dramatic protest. “I swear, if I have to eat any more of those bland chicken wraps, I’ll committee a crime just to get prison food.”
“You wouldn’t last a day in prison,” I teased, stretching the stiffness from my neck. “You’d organize everyone’s meds even if they didn’t want it, clean the cells, and turn the inmates into a book club.”
“Damn right, even killers need stories,” she shot back, grinning.
At twenty-eight, a second-year surgical resident with encyclopedic knowledge of every pill in the pharmacy, an avid reader, Brandi carried her chaos in color-coded neatness.
I laughed, a rare, unguarded sound that only surfaced when the world wasn’t actively bleeding. “I think it’s—”
The overhead speakers crackled, slicing through the quiet:
“Incidente con diverse vittime, autostrada Salerno-Reggio Calabria. Collisione a catena. Venti o più feriti, diversi in condizioni critiche!” Incident with multiple victims on the Salerno–Reggio Calabria highway. Chain collision. Twenty or more injured, several in critical condition.
The respite exploded, my mug hit the counter hard, sloshing coffee. Brandi and I locked eyes, the usual look that said: here we go again.
“All trauma bays checked and tripled checked. Now!” I called out as several nurses and doctors appeared without being summoned, hands already reaching for gowns and gloves.
The floor snapped into motion. Stretchers locked into place, monitors blinked awake, supply carts clattered open. The stillness fractured beneath the rising howl of sirens from the coast, growing sharper with every passing second.
“Get cardiothoracic, ortho, and pediatrics on standby. Check our blood supply,” I ordered, keeping my tone measured. “And call Naples, tell them to dispatch their ambulances. We’ll need backup.”
“On it.” One of the nurses was already sprinting down the corridor.
“Let’s move people, this is not a drill!” I pulled my hair into a tight ponytail and snapped gloves into place. “Dr. Patel, you’re on triage.”
“Got it.” He pivoted toward the doors.
I drew in one controlled breath and scanned the room, watching the shift settle over the team like muscle memory, calm on the surface, haste beneath.
“Alright,” I said evenly despite the thunder in my chest. “Stabilize. Prioritize. Keep them breathing.”
Another deep breath before I moved to the doors and watched the flashes of pink light up the narrow city streets before the first ambulance screeched into the entrance, red lights strobing against the glass. And just like that, the hospital tipped from readiness into impact.
“Where do you want us?” Brandi came up behind me with Trixie, a nurse and close friend.
“By my side.”
“You got this,” Brandi leaned in to whisper.
I squeezed her hand a second before the first ambulance swerved into a bay, the back doors flying open.
“What do we have?” Dr. Patel asked as another ambulance screeched into a bay.
“Thirty-four-year-old, unrestrained passenger, GCS six,” the EMT shouted, sliding out a half-conscious man with blood slicked hair.
“I got this one, Dr. Patel.” I stepped in, gesturing for him to move to the next ambulance.
The patient’s pulse fluttered, fading. I took the gurney at a run.
“Let’s intubate now. Lucas you’re with me!
” The new intern with two nurses quickly helped get the patient set up.
“Tube in, good seal, bag him and get him up to OR,” I instructed.
“Pressure’s dropping!” nurse one announced.
“Push another line,” I tipped my chin at nurse two. “You got this, Lucas?”
At his nod, I rushed out of the ward, hearing another ambulance blast to a stop outside and Dr. Patel nodded for me to check it.
“Teenage male, abdominal trauma, seatbelt sign, hypotensive,” the EMT rattled on, sliding out the young boy.
“Trauma two!” I directed, voice hoarse.
Brandi was already there, eyes on the patient. “I’ve got this one. Go.”
The hallway quickly filled with stretches, rushing medical staff, noises layered over each other. Cries, orders, the dreaded flatline beep that made your stomach clench and more sirens.
A young nurse stumbled past me, face pale, eyes watery. I caught her arm. “Breathe, they need your expertise not your fear. Okay?”
“Yes, doctor.” She swallowed her panic and hurried away.
“Doctor Sharma, I need you,” Dr. Patel shouted, his voice cutting through the din of the emergency bay as he gestured to the medic leaning over the patient on the gurney, hands pumping rhythmically against her chest.
“Thirty-six-year-old female, crush injuries, severed artery, massive blood loss,” the medic rattled off as I steered the gurney toward Trauma three, my eyes already scanning the damage.
“Got a tourniquet on her left leg. Tried to intubate but couldn’t get her jaw open. She lost her pulse on the ride.”
“Get her on the monitor and hook up the rapid infuser,” I snapped, the command sharp enough to cut through the panic as a nurse rushed in. “I need five units of O-neg and push another round of epi.”
“Epi’s in, twice already. Still no pulse. She’s in V-fib,” the medic reported, hands pounding her chest.
“Stop compressions, checking rhythm.” I waited for the medic to step back before I leaned over the patient.
The monitor screamed its flatline as I cut swiftly into her neck, performing a cricothyrotomy with one practiced motion to secure the airway.
“Cordis in the right groin. Add a left femoral line, we’re going to flood her with blood,” I instructed without looking up, my hands moving on instinct as the lines went in quickly and the blood began to flow.
“Charge to one-twenty.” I listened as the defibrillator powered up with a rising whine that tightened the air in the room.
“Clear.” My eyes locked on the monitor, waiting for the spike that would tell me we’d won.
A quick jolt and her body arched violently.
“Nothing,” the nurse said, voice tight.
“Charging to two hundred,” I ordered. “Clear!”
Another brutal jolt. A beat.
“I’ve got a pulse!” the nurse said suddenly, leaning over the monitor. “Sinus tach—one twelve.”
A breath I didn’t realize I’d been holding escaped. “She’s back. Get a BP, keep giving her blood and get her to the OR.” I stepped away, removing my gloves.
“Yes, doctor,” the nurse replied.
I walked out into the crazy storm of more rolling gurneys, adrenaline burning through me, my heartbeat faster than my thoughts.
Behind me the double doors slammed open, another wave.
A child, this time, barely six or seven, her small hand clenched around a blood teddy, her white dress now stained red.
“Stomach laceration, left femur fraction,” the medic reported.
“Mommy,” she whispered, trembling.
I froze for half a second, emotion threatening to override my professionalism before I took a deep breath and knelt. “Hey, I’m Dr. Sharma. You’re safe now, okay. We’ve got you.”
Her pupils were blown, her breathing shallow. “Treatment six, peds trauma, stat!” I hailed one of the passing nurses.
“On it, doctor.”
Heart still heavy, I let them steer her away, my attention quickly pulled.
Someone pressed gauze into my hand, another yelled for suction, another screamed in pain.
The voices didn’t stop, nor did my pounding heart.
Yet through it all, I kept moving, because stopping meant death and I was never one to give in, that quickly, not even to the Lord of Hell either.
Outside the sirens finally faded. But inside, my pulse still raced, alive, electric and powered with the kind of passion that only came from holding the line between life and death in my hands.