The Procedure

“You don’t need a hospital to save a life. Just pressure, patience, and the will not to flinch.”

The sight that greeted us at the campsite instantly sent a jolt of panic through me. My breath caught in my throat as my eyes locked onto a half-collapsed, military-looking tent—its once-taut fabric now crumpled and sagging like a wounded soldier left behind on the field. It slumped to one side, poles jutting at awkward angles, casting shadows that hinted at calamity.

"Oh my God!" I exclaimed, the words tumbling out before I could restrain them. My heart was already surging into overdrive, my legs carrying me forward, instinct overriding logic. The shape beneath the tent was indistinct, and in the charged silence, it might have been anything—anyone.

"He's not trapped under there, is he?" I blurted, anxiety sharpening my tone, ready to throw myself into the wreckage without hesitation.

Paul's response came unexpectedly—a chuckle, low and genuine, pulling me up short.

"Oh, no," he said, the edges of his voice curved with amusement. "He's in the fully built tent," he added, lifting a hand to gesture casually toward a second structure. My eyes followed his movement.

Relief surged through me like a sudden flood breaking a dam. "Thank God," I exhaled, the words escaping on a breath I hadn’t realised I was holding. The tight band of tension around my chest loosened, just enough for me to start thinking clearly again.

The tent Paul indicated stood proud and intact a short distance away. Unlike the sad mess of the collapsed canvas, this one was taut and steady—larger, too. The kind of tent meant for serious occupancy, easily able to shelter ten men if needed. Its utilitarian precision was reassuring, a solid reminder of structure and shelter in a world that otherwise felt untethered from the familiar.

"That one is just my attempt to put a tent up by myself," Paul admitted, his tone laced with self-deprecation. I glanced back at the slumped canvas, now more comedic than tragic, and could suddenly picture the struggle—the frustration of poles that wouldn’t cooperate, fabric that twisted itself the wrong way, the eventual surrender.

"Oh, I see," I replied, the heat of adrenaline already beginning to fade, replaced by a flicker of amusement. Now that the emergency had passed, my attention shifted forward, toward the real concern—Jamie. The tent may have been upright, but the man inside it, from what I’d heard, was not.

And so the urgency returned, quieter now, more focused.

Luke moved ahead of me and pulled back the tent flap with a practised sweep, holding it open with a small nod. His gesture felt ceremonial somehow, like stepping through a threshold not just of canvas but into something more intimate, more fragile. I crossed it with care.

Inside, the shift was immediate. The light dimmed, muting the harshness of the outside. The air was warmer, tinged with a faint, musty odour of sweat, fabric, and something sourer—fever. Sparse furnishings outlined the makeshift camp interior: a large mattress and folded blankets in the one wing, suitcases and bags and clothing strewn about the opposite wing.

The figure of a man lay still on a low mattress, flanked by two small Shih Tzus curled in undisturbed slumber. Their soft, rhythmic breathing lent the space an eerie calm—like the eye of a storm.

"Jamie?" Luke’s voice, usually crisp, was now cautious, almost reverent.

But there was no answer. No shift. Not even a flicker of acknowledgement.

My body moved before my mind could catch up. I dropped to my knees beside the mattress. What I saw made my breath hitch. Jamie’s bare chest was slick with sweat, his skin pale and clammy save for the angry bloom of an inflamed welt across his sternum. It was weeping a thin fluid, crusted at the edges, raw and livid. I could already feel the heat radiating from it. Infection had set in.

"He's not good. Not good at all," I said, the words escaping in a low murmur, half to myself, half to Luke and Paul. I could feel my brows knitting together, that familiar furrow of clinical concern etched deep between my eyes. Whatever had caused the wound, it had festered far too long.

I looked back at Luke, then over to Paul, needing context—urgency demanded not just treatment, but understanding. "What happened here?"

"A hot coal struck him in the middle of the night," Paul offered, his tone oddly casual.

The words landed like a stone dropped in my stomach. A hot coal? I blinked. For a moment, my mind snagged on the absurdity of it. Not a fall, not an animal attack, not even a fever rash—no, a rogue ember. It felt surreal, the explanation so mundane yet so wildly specific it begged disbelief. My eyes darted to the welt again, to the torn skin and the fevered flush rising beneath it.

How does a hot coal land squarely on someone’s chest in the dead of night? Was it an accident—or something else entirely?

I didn’t want to entertain the darker thought, but it crept in anyway, uninvited and unwelcome. Could someone have done this to him? The camp was remote, isolated. My gaze drifted to Paul. Was it guilt I saw flicker there—or just fatigue? The rational part of me reminded itself not to jump to conclusions. The doctor in me had learned not to let suspicion blur focus.

"It's a long story," Paul added, and though his voice held no defensiveness, it didn’t help. The ambiguity only made the silence louder.

"Later, then," I said, more firmly than I expected. I needed to focus. There would be time for stories, for interrogation if necessary. But first, I had to treat Jamie.

Right now, all that mattered was the man burning quietly beneath the blankets.

My hands moved instinctively, honed by years of experience—swift, precise, deliberate. As I pressed gently around the inflamed area, I could feel the unnatural heat radiating from his skin. The welt, now more clearly defined beneath the faint glow of the tent light, had begun to harden around the edges, while the centre remained disturbingly soft and weeping. My fingertips searched for tell-tale signs: increased swelling, irregular temperature, skin discolouration—each one a possible clue in the language of the body, trying to warn us before the worst set in.

“I need a cloth,” I said, the words cutting through the heavy silence, my tone carrying the clipped assurance of someone who could not afford doubt.

Paul reacted quickly, rifling through a battered suitcase. From it, he withdrew a neatly folded t-shirt, its cotton clean but clearly not intended for this purpose. “It’s clean. It’s all we have,” he said, his voice low, almost sheepish as he extended it towards me.

I accepted it, but my eyes shot to Luke. “Seriously?” I couldn’t help it—the exclamation burst from me with the force of my frustration. It wasn’t just the improvised bandage; it was everything—the lack of antiseptics, sterile tools, lighting, even running water. The gravity of our isolation settled heavier on my shoulders with every passing second.

Luke gave a helpless shrug, his face drawn tight with regret. “I’m sorry, Glenda.”

I nodded once, tightly, then turned my focus back to Jamie. The t-shirt would have to do. It was far from ideal, but when faced with necessity, medicine adapted. I folded the fabric into a rough square and began to dab at the wound, working carefully to clean away the crusted fluid. As I worked, the injury revealed itself in stark detail—the inflammation more aggressive than I had feared.

A low curse escaped me under my breath, unfiltered, driven by sheer exasperation. My hands did not pause.

“He has severe swelling in the upper left of the small gap between his pectoral muscles,” I said, my voice calm but weighted. I leaned closer, eyes narrowing as I examined the pulsing mound. “I need to relieve some of the pressure.”

The men answered with a simultaneous, “Okay,.”

I shifted, preparing to act. “Someone hold Jamie,” I instructed, anticipating what might follow. If he woke mid-procedure, even groggy, he could thrash, panic, worsen the injury—or worse, injure himself further.

“And take those dogs outside,” I added quickly, glancing toward the two Shih Tzus who had begun to stir. Their presence was too risky now, a potential distraction in a space that demanded complete focus.

As Luke instinctively moved forward to steady Jamie, Paul stopped him with a hand across his chest. “I think you had better take the dogs,” he said, his tone gentle but firm. Something passed between the brothers—understanding, agreement, a moment of wordless trust.

Luke hesitated only a second before kneeling to gather the dogs in his arms. His touch was careful, cradling the sleeping creatures as if reluctant to disturb them, but his eyes met mine with a look that needed no translation—anxiety, hope, faith. He gave a small nod before disappearing through the tent flap, the canvas rustling softly in his wake.

I was left in the tent with Paul and Jamie, the dim light casting long shadows across the canvas walls. A stillness settled over us, the kind that comes just before a difficult cut or a crucial decision. I drew in a deep breath, steadying the storm inside me. This wasn’t the clean, ordered world of sterile hospitals and stainless steel. This was Clivilius—raw, unforgiving, and far from anything I’d known.

But even here, I was still a doctor. And Jamie was still a patient in need of care.

Kneeling beside Jamie, my focus narrowed to the injury before me. The ambient murmur of wind against the tent canvas faded into insignificance, replaced by the rhythmic thrum of my own pulse. This wasn’t just an examination—it was a reckoning. Every detail mattered. In the absence of modern equipment, sterile gloves, and antiseptics, I had only my knowledge, my senses, and the sheer will to help.

The challenge of providing medical care in such rudimentary conditions was daunting, yes, but also grounding. It stripped medicine back to its essence—not machines or charts, but human connection, observation, intuition. In that makeshift shelter, surrounded by dust and desperation, I felt the raw core of my vocation. Do no harm. Alleviate suffering. Bring healing—however, wherever.

I reached for the swelling again. My fingertips pressed gently into the heated skin, careful, precise. The texture, the resistance beneath the surface, the way the inflamed tissue yielded ever so slightly—these were my instruments now. I closed my eyes, shutting out the visual noise to better interpret the tactile story his body was telling me. Beneath the pectoral muscles, the secondary swelling felt firmer, more localised. There was no blistering, no ruptured skin, no tell-tale signs of a burn.

This wasn’t from the burn.

That realisation narrowed the possibilities—abscess? Internal reaction? Lymphatic involvement?—but it also sent a cold ripple through my gut. An untreated secondary infection in this kind of environment could spiral quickly into sepsis. I pushed the thought down. Focus.

Paul knelt beside me, his presence steadying in its own way. The faint zip of the tent flap closing behind him felt like the sealing of a surgical theatre, though our surroundings couldn’t have been further from it. The muted light created long shadows, brushing our faces in soft streaks as I turned back to Jamie.

"Hold his shoulders down," I instructed, keeping my voice level. There was no room for uncertainty, no space for hesitation. This wasn’t a hospital ward—there were no nurses, no protocols to follow. It was me, my patient, and what little help I had.

Paul obeyed at once, reaching forward with a hesitancy born of both inexperience and concern. His arm brushed mine in the tight space—solid, warm, human. A reminder that we were not machines, that medicine was always a partnership, even here.

"It'd be best if you sit on his waist," I added, the words catching slightly in my throat. It sounded odd aloud, even clinical, but it was necessary. In a controlled setting, I would use restraints. Here, we had only our bodies to prevent him from jerking mid-procedure and worsening his condition.

"Lightly," I said quickly, watching him reposition himself. Paul’s movements were awkward, clearly unfamiliar with such close, deliberate contact, but he listened, adjusting his weight so that it anchored Jamie without crushing him. His face was drawn tight with concentration and worry, a mirror of the emotions I was forcing myself to keep in check.

"He's likely to try and move suddenly," I warned, glancing up at Paul. The last thing we needed was a flinch or convulsion at a critical moment. Even the semi-conscious could startle. I’d seen it happen too many times—uncoordinated, instinctual bursts of motion that shattered hours of careful work.

As my hands hovered once more above the wound, my pulse quickened. The next few minutes would require everything I had—skill, speed, and unshakable calm.

And there was no room for error.

With the t-shirt carefully spread around the small, ominous lump near Jamie's left pec, I took a moment to steady myself. My hands hovered briefly, my breath shallow, heart thudding hard against my ribs. This was no ordinary procedure. The task before me was delicate, fraught with uncertainty and risk, and it demanded every ounce of my focus. One misjudgement and I could cause irreparable damage. One moment of hesitation and Jamie’s life could slip further from our grasp.

I touched the surrounding flesh lightly, using the tips of my fingers like instruments, mapping the contours with experienced precision. Beneath the heat and swelling, I confirmed what I had feared: the long splinter, lodged beneath the skin, had begun pressing deeper. The seriousness of the situation wasn’t just clinical—it was visceral. I could feel it in the way Jamie’s chest resisted my touch, in the faint tremble of the skin stretched over trauma. The margin for error was almost nonexistent.

"You ready?" I asked Paul, my eyes never leaving the wound. My tone was calm, controlled—yet every nerve in my body hummed with apprehension.

"Ready," Paul's voice replied, but the audible gulp that followed betrayed the nerves he was trying to suppress. I didn't blame him. This wasn't what he'd signed up for, yet here he was, willingly playing assistant in a field surgery with stakes no less real than life or death.

I tilted my head slightly, a brief shadow of doubt flickering through me. Would Paul be firm enough when it mattered? Could he hold Jamie down if he started thrashing? I didn’t have the luxury to wonder for long. The window for hesitation was gone.

The thought of puncturing Jamie’s heart by mistake flickered again through my mind—a silent terror—but I pushed it aside. Fear was a luxury I couldn’t afford. The splinter posed its own mortal threat, inching ever closer to the heart with every movement, every breath. To do nothing was to surrender him to slow death. And that was not an option.

Drawing on years of instinct and hard-earned confidence, I pressed my fingertips firmly into Jamie's chest, angling the pressure just so. Beneath my hands, his body jolted as if struck by lightning. His back arched, a guttural scream ripped from his throat—raw, piercing, full of confused agony. His eyes flew open, wide with shock and terror, the whites stark against his flushed, feverish face.

“Jamie!” I hissed under my breath, trying to speak to him without losing my composure. But he was far beyond words now—driven purely by instinct, pain, and confusion.

Paul was ready, thank God. He surged forward, pressing Jamie’s shoulders back against the mattress, using his weight to pin him in place. The tension in the tent became suffocating—dense, electric. Every second counted.

Outside, the dog barked in sharp, panicked bursts, its cries amplifying the chaos. The whole world seemed to narrow to the din within this canvas chamber. A flurry of frantic noise and clashing needs—pain, panic, animals, commands.

"Jamie!" Luke's voice broke through from beyond the tent, filled with alarm. I heard the sharp rasp of the tent zip moving fast, climbing in a single, startled motion. My heart clenched. We couldn’t afford another body in here. Not now.

"Stay out!" I barked, the words leaving me in a tone more commanding than I’d ever used at the hospital. This was no longer a clinic. This was a battlefield.

But it was already too late.

The largest of the two Shih Tzus had darted past Luke’s legs and now stood beside me, trembling with agitation, letting out growls far too menacing for its size. It crept behind me, fur bristling, teeth bared—a tiny, furious sentinel.

“Get them the fuck out!” I shouted, the raw urgency stripping away any semblance of bedside manner. Every second the animal remained was another moment of distraction, another risk added to an already perilous equation.

Paul hesitated only a second, but it was enough. His weight shifted off Jamie as he instinctively turned to shield me from the growling dog. In that split moment, everything threatened to unravel.

"Don't you move," I snapped, my voice slicing through the clamour like a scalpel, sharp and unflinching. I threw Paul a hard look, all the weight of my authority behind it. He blinked, recognising the gravity of the situation, and without a word his attention returned to Jamie, repositioning himself, hands pressing down once more.

The dog was scooped up and carried out, and the flap sealed again.

Inside, it was just us.

Me. Paul. Jamie. And the still-burning silence of what had to come next.

Jamie’s scream—his second cry of raw agony—ripped through the tent, a terrible sound that clawed at the nerves. But I didn’t flinch. I couldn’t. My world had narrowed to a single point: the festering wound beneath my fingers and the treacherous splinter buried within. Every nerve in my body screamed for urgency, but I forced my movements to remain precise, deliberate. There was no room for mistakes.

From the edge of my awareness, I registered movement—Luke, responding to my earlier command, had managed to corral the small dog. Its yaps muffled briefly as he clasped it against his chest and ducked out through the tent flap, the canvas fluttering back into place and sealing us once more inside this makeshift operating theatre. The reprieve from chaos was immediate, like a pressure valve released.

Still kneeling over Jamie, I drew a steady breath through my nose—bad idea. The fetid odour rising from the wound was ripe and cloying, like rotting vegetation left too long in stagnant water. But I pushed the nausea aside. There was work yet to do.

"Hold him. It’s nearly there," I told Paul, the words crisp with focus. He adjusted his grip on Jamie’s shoulders, pinning him firmly, and I returned to the wound with unrelenting resolve. My fingers sank deeper into the hot, inflamed flesh, the texture beneath my touch a mixture of resistance and yielding. Each shift in pressure was met with a twitch of Jamie’s body, a jolt of pain that manifested in his shallow, erratic breaths.

I felt it then—a shift in texture, a change in density. My fingernails, blunted from years of use, found a ridge. With a careful angle, I edged beneath it, easing the foreign object upward with excruciating patience. Grey and yellow pus welled around the site, leaking from the split skin in warm, sickening rivulets. The infection was deep, but the appearance of that vile mess confirmed what I had hoped: I was close.

And then—I saw it. A jagged edge of black, breaking the surface like a perverse bloom.

"Last time," I murmured, barely above a breath. A warning to Paul, and a mantra to myself. I repositioned, braced my hands, and pressed one final time.

Jamie’s screech rose again, so piercing it almost didn’t sound human. It cracked through the tent like a lightning bolt, and for a moment I feared he might buck me off completely. But Paul held fast, every muscle in his frame rigid with the effort.

Then—pop.

The noise was subtle, wet, and utterly vile. The splinter—a grotesque shard—emerged fully from the wound in a tide of viscous, foul-smelling pus and blood. I held it aloft briefly, stunned by its size, the blackened wood glistening obscenely in the dim light. The stench hit me full force now, turning my stomach, but I refused to waver.

Suppressing the rising bile, I grabbed the already-stained t-shirt and began to wipe away the worst of the mess. My hands moved on autopilot, trained instincts guiding me even as my mind reeled. I turned to Paul, holding the splinter out with a grim look.

"I’m guessing nobody knew that was in there?" The question slipped from me, dry with disbelief, my tone hovering somewhere between accusation and exhaustion.

Paul shook his head slowly, eyes wide with something bordering on horror. "I certainly didn’t."

His answer wasn’t surprising, yet it still landed heavily. I glanced back at Jamie. The violent tremors had ceased. His face, still flushed with fever, was now slack with unconscious relief. His breathing, while shallow, had begun to even out—a blessed sign of stability.

But we weren’t done yet.

"I need some clean water," I said, straightening myself to full height. The urgency had dulled slightly, replaced now with the second phase of care: cleaning, disinfecting, dressing. A new battle, but one I welcomed compared to what had just passed.

Paul was already shifting off Jamie’s body, his limbs stiff from the pressure he’d maintained. "I'll get it," he replied without hesitation, his voice hoarse but determined.

As he moved to exit the tent, I was left in the quiet aftermath, the sticky remains of infection still clinging to my fingers, Jamie’s shallow breaths the only sound.

And beneath it all, the steady drumbeat of resolve. Whatever this world held, whatever came next—I was in it now, blood and all.

As I dabbed at the wound, watching yet another discharge of pus emerge—thicker now, tinged with a dark grey hue as it met the open air and oxidised—I felt the full weight of where we were press down on me. This was no hospital. There were no sterile instruments, no monitors beeping quietly in the background, no colleagues at my shoulder. Just dust, heat, tension, and the raw human instinct to survive. And yet, against the odds, we’d done something extraordinary. We’d intervened. We’d saved a life.

But Clivilius did not reward victories with peace.

Jamie’s eyes flickered open. Not with the dazed gratitude I might have hoped for—but with the grim, startled confusion of a man ripped from unconsciousness into pain. His eyes swept the tent, unfocused at first, until they locked on mine. What I saw in them wasn’t trust or understanding. It was fire—defensive, volatile, frightened.

"Who the fuck are you?" he growled, the snarl edged more with pain than true hostility, but it still sliced cleanly through the space between us.

I met his glare, holding my ground. "I’m a doctor," I said, evenly. The temptation to defend myself, to match his sharpness with my own, simmered beneath the surface. But professionalism had its own power. I let it speak for me.

"And she just saved your life," Luke said as he re-entered the tent. He looked directly at Jamie, willing him to understand the magnitude of what had just happened. "You should be grateful."

"Grateful! You expect me to be fucking grateful!?" Jamie exploded, his voice rising into a bitter crescendo. His chest heaved, face contorting with raw emotion. It wasn’t personal—I knew that. But in the cramped confines of that tent, his words felt like punches in the dark.

The tension, thick as the air after a storm, had a ripple effect. One of the dogs growled low and menacing, the sound cutting through the tent like a warning bell.

"Duke! Stop it!" Luke snapped, the sharpness of his voice failing to settle the animal or the man it guarded.

Jamie tried to sit up. It was a feeble attempt, born of wounded pride more than strength, and I instinctively reached for his shoulder, my hand firm but not forceful. “Easy,” I whispered, trying to meet his storm with calm. But everything was already unravelling.

Duke surged forward.

It happened in a flash—the bark, the sudden pain, his teeth clamping down on the soft flesh of my forearm. Hot, sharp, searing. A shock of violence that shattered the fragile order I’d fought to hold.

"Get off me!" I shouted, panic slicing through my voice as my free hand came down hard on the dog’s head. It wasn’t elegant or calculated—just a desperate move to protect myself.

He released, at last, with a reluctant snarl. I stumbled back a step, heart thudding, the pain in my arm burning like fire.

Luke was there in a heartbeat, lifting Duke into his arms with an apologetic urgency. "Oh, Glenda—"

"Back away, Luke," I snapped, voice like a crack of thunder. No time for apologies. No room for regret. My patience, frayed to the very edge by pain, exhaustion, and adrenaline, had reached its breaking point. I glared at him, sharp and unwavering.

Luke stopped cold, his expression softening in recognition of my limit. He nodded once.

"I’ll lock him out," he said quietly, and without another word, slipped through the tent flap, the dog still cradled in his arms.

In the sudden stillness that followed, the air hung heavy with more than just heat. The clash of pain, duty, fear, and instinct had left its mark. Jamie lay motionless, his face ashen, his breaths laboured. And I, arm throbbing and body tense, remained rooted beside the wounded man—knowing that physical healing was only half the battle we faced.

The rest... would take far longer.

Wiping away the lingering traces of Duke’s saliva from my arm, I winced—not from pain, but from the disquieting reminder of how close the bite had come to puncturing skin. The teeth marks were faint but visible, angry red imprints etched into the surface. The area was already beginning to warm, a sign that couldn’t be ignored. Relief coursed through me that the bite hadn’t broken the skin, but that comfort was fleeting. In a place like Clivilius, with no known ecosystem of pathogens and no guarantee of immunity, even a seemingly harmless graze could become something far worse.

Infection, here, wasn’t a risk—it was a promise if not properly treated.

Driven by instinct, I crossed the tent in search of anything that could function as antiseptic. Paul's suitcase, still slightly ajar from earlier, seemed the most likely candidate. I dropped to one knee beside it, lifting fabric items with brisk efficiency—shirts, socks, and a threadbare towel—each one examined, then tossed aside. The air inside the suitcase carried the musty scent of sweat, sun, and the dry, dusty earth. There were no alcohol wipes. No iodine. No medical kit. But I needed something—anything—clean.

The sound of Jamie’s voice cracked the air like a whip.

"It's your own fault, you know."

His tone hadn’t softened. If anything, it had hardened further, weaponised by discomfort and bruised pride. I paused for a beat, fingers stilling in the fabric, the sharpness of his words cutting through my concentration.

I didn’t turn to face him. Instead, I took a deep breath, let it out slowly through my nose, and rolled my eyes in silence. Of course he’d say something like that.

Over the years, I’d come to recognise a pattern in people like Jamie—the wounded, the scared, the proud. Pain had a way of curdling into aggression. Whether in the fluorescent haze of a triage bay or the dusty twilight of a foreign world, some patients met vulnerability with anger, wearing it like armour to shield themselves from helplessness.

I had seen worse.

And more importantly—I had learnt not to take it personally.

Treat the person without judgment. The words were etched in block capitals on the wall of the Royal Hobart Emergency Department, right above the double doors that led into the trauma unit. It was more than just a mantra; it was a way to survive the emotional fatigue that came from tending to people at their lowest—drunks, drug users, abuse victims, soldiers, mothers, prisoners, teenagers, CEOs. Grateful, abusive, stoic, sobbing—it didn’t matter. You treated them all the same. You showed up. You did the work.

That mental reset—that quiet moment of returning to first principles—helped centre me again.

Jamie was no different, I reminded myself. Not really. Just another man in pain, disoriented, terrified, and lashing out in the only way he knew how. And while his gratitude wasn’t required, my care was. That was the deal. That was always the deal.

My hand closed around what appeared to be a folded cotton undershirt. Not ideal, but it would do—at least to compress the area and reduce the risk of irritation. I’d clean it properly as soon as I could find boiled water or even strong liquor. Until then, the best I could offer was vigilance, empathy—and control over my own reaction.

Jamie was still glaring when I turned back to him, but I said nothing. Instead, I walked past him in silence, determined not to give his words a place to land.

The job wasn’t about being liked.

It was about being needed.