Elena Rostov adjusted the angled earpieces of her Littmann cardiology stethoscope in her ear canals, pressing the cold stainless-steel diaphragm gently against the fourth intercostal space of Clara Vance’s ribs.
Through the rubber binaural tubing came the steady, rhythmic lub-dub of a nineteen-year-old human heart.
Seventy-two beats per minute. Regular sinus rhythm. The aortic valve closure had that sharp, crisp acoustic snap that told an experienced trauma nurse the myocardial tissue was well-perfused with oxygenated blood.
Elena slipped her penlight from her lapel, gently lifting Clara’s left eyelid.
The pupil constricted briskly from four millimeters to two millimeters. She checked the right eye. Perfectly consensual, equal and reactive to light.
Cranial nerves two and three were fully intact. Elena took a blunt wooden cotton-tipped applicator from her diagnostic kit and stroked the lateral border of Clara’s right sole. The great toe flexed downward in a classic plantar reflex -- a negative Babinski sign.
In emergency neurology, a negative Babinski reflex in a patient who had been comatose for six months was practically a medical miracle. It meant the upper motor neurons in the corticospinal tract had re-established communication with the peripheral nerves. The deep structural damage inflicted by the Shift Covenant was reversing itself hour by hour.
