Elena Rostov tuned out the shrieking metal of Magistrate Silt’s chest tabulator.
In a crowded trauma bay with four gunshot wounds on the gurneys and monitors chiming across three different frequencies, a good charge nurse learned to hear only what mattered. The rest of the world was just background noise.
If an emergency room nurse let panic enter her ears, someone died on the table. When the alarms went wild and the floor grew slick with blood, survival came down to a single question: what are the patient’s vitals doing right now?
Right now, what mattered was the girl under the wool blanket.
Elena kept the stainless-steel binaural earpieces of her Littmann Cardiology IV stethoscope sealed tightly in her ears. The heavy rubber tubing was cold against her neck, but the acoustic chamber was shielded against external vibration. Her left hand held the heavy dual-frequency chestpiece, warming the cold metal rim against her palm for two seconds before she slid it beneath the folds of Clara’s hospital gown.
The cold metal met the skin over Clara’s fourth intercostal space, just medial to the left midclavicular line.
At first, there was only the thin, sluggish rustle of hypothermic blood flow. At ninety-four degrees Fahrenheit, the human heart didn’t beat with crisp authority. It thumped with a wet, struggling cadence, dragging itself through thickened plasma like an exhausted swimmer treading cold harbor water.
