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The gangster busting into my room.

Me giving up the ghost on handling everything myself and trying to call Hyena.

Getting backhanded and kicked in the stomach so hard I threw up the burger I ate for dinner the previous night.

The look on Tito’s face as he stood over me, cursing in Spanish—ugly and full of evil intent.

He was going to hurt me. I might not understand Spanish, but I knew his resolve like the medical procedures I’ve been committing to memory for my upcoming boards.

He was going to hurt me. And there was no time for Hyena or anyone else to get here before he did. I was completely and utterly alone.

All hope was lost…

Until I suddenly remembered the switchblade he'd pulled out on me.

New plan.

I made a desperate show of pretending to be more hurt than I actually was. Lolling my head to the side like I was on the verge of passing out. You’d think that and me being half-covered in my own vomit would be enough to disgust my aunt’s boyfriend out of trying to do anything else, but no…

He just laughed and crawled on top of me, his crazed eyes shining with delight that taking me against my will would be so easy.

Abject fear rolled over me in waves, but I refused to let it overwhelm me.

I worked the current problem like I was back in my Emergency Department rotation. Triaged my situation with the new plan as my main focus.

Which was simple but risky.

If I got any part of it wrong, he’d hit me again. And if that happened, I doubted I’d be able to keep it together enough to fight him off.

Strangely, it all came down to four pockets. I had to choose the right one on my attacker’s baggy jeans.

Back or sides? Right or left? If I chose wrong, I sensed I wouldn’t get another chance.

I ignored the hands pulling down my scrubs, and I reconstructed the scene from when he grabbed my wrist. Which hand had the switchblade been in? Not the right, as I would have assumed, considering that ninety percent of the U.S. population is right-handed.

It had been in his left. So, he’d keep the switchblade in his left pocket for easiest access. But the side pocket or the left back pocket?

Time stood still as I went in for the reach....

But when my fingers connected with the deadly metal object in his left back pocket, time sped up to ten times its normal speed.

One moment the switchblade was a target reached, and the next it was sticking out the side of my attacker’s neck.

No more menacing Spanish. He couldn’t even scream—just gurgle blood as he rolled off me with the weapon jammed into his throat.

I always think before I act. Always. It’s the thing that sets me apart from the other members of my lowlife family. I don’t even sit down for breakfast without a plan for how it will affect the rest of my day.

My favorite Frosted Flakes are fine for mornings when I only have shifts at the roadhouse. But that much sugar could crash me during rounds, so it’s off-brand multigrain squares and almond milk for me on hospital days.

However, most people aren’t like me. And my aunt’s boyfriend just panics.

While I’m yanking the pillowcase off my pillow to try to save him with arterial embolization, he desperately claws at the switchblade’s handle and pulls it out of his neck.

Basically, the worst possible thing you can do with a knife injury.

Blood sprays everywhere, and a few seconds later…he’s gone.

He’s just gone. There’s nothing I can do to save him. He’s bled out.

I’ve killed a man.

Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm….

The Hippocratic Oath is long AF, and that’s the part hospital shows usually condense down to “Do No Harm.”

But I’d done harm. I killed somebody—in self-defense, but still… When the police found out, it would be a job not to get arrested and money I didn’t have to hire the kind of lawyer who could keep me out of jail. And as for those boards I thought I’d be studying for in between making tons of tips at the roadhouse…

That was all done. My five-year plan lay as dead as the man on the floor.

There were people at the bedroom door. Deep male voices yelling that I killed Tito. My aunt screaming about all the blood.

My mind collapsed. Tried to boot back up to make a new plan, but then collapsed again.

Ruins. I tried so hard to do better, to crawl out of the circumstances I’d been dealt when I totally lost the parent lottery. But I killed somebody, and there was no plan that could fix that.

There came the sound of distant pops.