"Hello, this is resuscitation room 2 of the emergency department calling. We require an urgent consult for a patient with a pericardial thrombus and effusion. We've already performed… What do you mean you can't right now… You're in the OT already? But this is… Alright…"
A doctor was making a phone call in the resuscitation room of Southern Queen's Hospital's accident & emergency department, while his colleagues were busy trying to resuscitate an old man lying unconscious on the bed. The doctor finished the call and announced to the team.
"The on-call cardiothoracic surgeon is in the operating theater right now with another patient, he won't be down here for a while, thirty minutes is what I've heard. That's way too long for the patient to endure, we're doing the emergency thoracotomy here.
Surgical tools were assembled and the surgical site was hastily disinfected for emergency surgery. A wide incision was made on the left side of the patient's chest, revealing the yellowish-orange fat tissue and red muscles underneath. Scissors were used to cut through the muscles, through the pericardial sac surrounding the heart and blood flowed out. Suddenly, the vitals monitor began beeping loudly.
"Cardiac arrest," the doctor called out as he put both his hands inside the incision he had made. "I'm beginning cardiac massage, get the crash cart ready."
The doctor used his hands to rhythmically squeeze the heart, mimicking the pumping action of a heartbeat. After a few seconds of open cardiac massage, the regular rhythmic beeping of the bedside monitor returned, and the doctor withdrew his hands from the chest cavity and continued on with the procedure.
"Forceps."
A pair of forceps was used to lift a small blob of red from the patient's chest. One of the nurses asked the doctor.
"Will the patient be okay now, Noah?"
"Not quite yet, there's some blood oozing out of the left ventricle, there's likely a small rupture on the heart which was what caused the hemopericardium. Cardiothoracic surgery will have to fix that up soon. Cover the surgical site with a sterile drape while we wait for them to take our patient to the operating theater."
A few days later in the ICU, a student entered the unit to collect data for her thesis. As soon as she stepped in, she was met with a full code team surrounding a patient, resuscitation ongoing. An advanced practice nurse called out to a critical care doctor who had just arrived.
"Patient went into shock after open heart surgery, developed into cardiac arrest while you were on the way here. None of our labs shows anything useful, the cause is still unknown. Rhythm is asystole, we're already on our fifth round of adrenaline, I think I'm going to call it soon."
The flatline beep from the vitals monitor rang out as the resuscitation effort stopped, a nurse turned off the monitor, and only silence remained. Juliet Joyce, the doctoral student, broke the silence as she chatted with one of the nurses in the nurse station.
"This is crazy. This is what? Like the hundredth once-in-a-lifetime event I've seen just from occasionally walking around here this month? I swear all these crazy conditions can't be a coincidence. Three mass casualty incidents this week, multiple patients with extremely rare disorders, heck I've even seen a patient with the black death!"
Outside of the hospital, a woman was walking down the road leading to the entrance of the emergency department. A man in a suit with a crutch in his hand walked in front and stopped her.
"You are Camila, right? What are you doing outside the lab here at Southern Queen's Hospital? Anyhow, you don't look so good."
Camila stopped walking, her eyes locked with his for a moment, and she let out a small annoyed sigh before responding.
"Yes, yes. I'm Camila, what the hell do you want? What I'm doing here is none of your business."
The man chuckled with a smile on his face, tapping his crutch on the ground.
"Just starting some small talk with you. Anyway, haven't things been quite interesting as of late? With Haucon Island's death rate skyrocketing, one really does wonder how that happened. Anyways, you should take care of yourself before you become the next victim.
Camila pushed the man out of her way and continued walking towards the hospital's entrance to the accident and emergency department.
"If you're not going to get to the point, I'll be going, I have much better… things to do than to waste my time… chatting with you."
Even as Camila walked away, the man continued talking.
"This is the biggest crisis in the history of Haucon Island, you better not slip up, or else you will all succumb to the full horror of this new type of warfare."