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James nodded. “Let’s expose the bone carefully. The hematoma’s causing significant pressure—time is critical, but we don’t want to rush this part.”

He activated the craniotome, the high-pitched whir of the drill slicing through the quiet. With meticulous precision, he created a series of burr holes around the affected area.

“Bone flap removal,” James instructed. Elena helped him lift the segment of bone, revealing the dura beneath. It was taut, bulging slightly—a clear indication of the pressure buildup.

“There it is,” James said, his voice low but resolute. “Large subdural hematoma confirmed. Let’s evacuate it.”

“Rongeurs,” he requested.

The scrub nurse handed him the instrument without hesitation. James gently elevated the brain’s lining, and made a small incision, taking care not to damage the underlying brain tissue. Blood pooled immediately, dark and viscous.

“Suction on full,” he ordered.

“Full suction,” the surgical assistant confirmed, adjusting the settings.

Working methodically, James evacuated the hematoma, a slow but steady process. His movements were deft, almost surgical choreography. “Elena, keep the retraction stable. No shifts.”

“Understood,” Elena replied, holding the dura gently aside with a retractor.

“Pressure’s dropping,” the anesthesiologist called out, monitoring Ruth’s vitals. “BP stabilizing. Nice work, team.”

James didn’t glance up but responded with a curt, “Good. Let’s keep it steady.”

As the last remnants of the hematoma were removed, James irrigated the area with sterile saline, ensuring no clots or debris remained. The brain tissue beneath began to relax, the tension visibly decreasing.

“Looks good,” he said, inspecting the cavity with a loupe. “No active bleeding. Let’s close up.”

The team moved in unison, reattaching the bone flap with titanium plates and screws. James carefully sutured the layers of scalp back together, ensuring minimal scarring and hairloss.

“Final check,” he said, straightening. His back ached, but his focus was unbroken. “Vitals?”

“Stable.” The anesthesiologist wore a satisfied smile.

“Good job, everyone.” James stepped back from the table. “Mark, dress the wound. Elena, let’s update the family.”

He stripped off his gloves and exited the OR, his mind already shifting to the post-op plan for Ruth.

* * *

It wasquiet except for the steady hum of machines and the occasional soft shuffle of feet. Ruth stirred, her eyelids fluttering as the effects of anesthesia began to wear off. Her head throbbed dully, and her body felt heavy, but she forced herself to open her eyes.

“Ms. Everhart? Ruth?” a gentle voice called. “I’m Emme, one of the nurses. The surgery is all over.”

Ruth’s lips parted, her voice a hoarse whisper. “Where… where am I?”

“You’re in the recovery room,” Emme said softly. “You just came out of surgery. Everything went well. How are you feeling?”

Ruth’s breathing quickened. Her brow furrowed as she blinked repeatedly. “I… I can’t see.”

Emme’s professional calm faltered for a second. “It’s okay, Ruth. You’re still waking up. Sometimes it takes a little while for everything to feel normal.”

“No, no!” Ruth’s voice cracked, panic rising. Her hand trembled as it clutched the edges of the blanket. “I can’t see anything! It’s dark. Please—what’s wrong with me?”

Emme placed her hand on her shoulder. “I need you to take deep breaths for me. We’ll get the doctor here right away.”

Ruth’s world was dark. Not dim, not blurry—just black. Her breath hitched as panic slammed into her, fast and suffocating. She tried to move, to sit up, but something tugged at her—restraints? No. No, it was just the weight of the blankets, the soreness anchoring her in place. She reached out, her fingers grasping at nothing. Her chest tightened.

Where am I? Why can’t I see?