Page 3 of Mercy Written in Blood

Akiko's voice drew his attention back to the monitor. The heart rhythm was deteriorating.

"Prepare for thoracotomy," he said.

One of the junior doctors froze — only for a second, but Renji saw it.

"Doctor Yamada."

The young doctor looked at him.

"Open the thoracotomy tray."

"Yes, Doctor."

There was no time to reassure him. The patient's heart stopped.

"Pulseless," Aoi announced.

"Start compressions."

Hands moved into position. The trauma bay narrowed around Renji until there was nothing beyond the patient, the failing rhythm and the next necessary action. He had always found a strange kind of peace there — not in suffering, never that, but in the clarity of crisis. A body did not care about politics, wealth, status or pride; it did not lie about what it needed. It asked only that someone understand it quickly enough to keep it alive.

Renji cut through skin and muscle between the ribs.

"Rib spreader."

Metal opened the chest. The heart lay pale and motionless inside. Renji reached into the cavity and wrapped one hand around it. For a moment the room seemed to fall silent — not truly silent; the alarms still sounded, compressions had stopped, blood continued dripping onto the floor, and people breathed behind their masks waiting for instruction — but Renji heard something beneath all of it: a faint rhythm, not in the heart itself but deeper, a pattern lingering through tissue and blood.

He pressed his thumb against the ventricle.

"Internal cardiac massage."

His hand contracted once, twice, again.

"Adrenaline given," Aoi said.

"Cross-clamp."

The instrument was passed to him. Renji worked without looking away. The young man's blood felt cold through the gloves.

"Come on," Akiko whispered.

Renji compressed the heart again. There — a tremor, so slight nobody else would have felt it. He adjusted his grip. The heart twitched against his palm. The monitor produced a disorganised series of spikes.

"We have electrical activity," Aoi said.

"No pulse."

"Continue transfusion."

Renji massaged the heart in a steady rhythm. One of the blood bags emptied; another was connected. The twitch became a contraction, then another — weak, uncoordinated, alive.

"Pulse returning," Aoi said. "Carotid present."

"Pressure?"

"Fifty-eight over thirty."

"Better than zero."