I woke up at 5:14 AM. Hadn't set an alarm. Just opened my eyes in the dark and knew I wouldn't fall back asleep. Murin was still out, face pressed into his pillow, one arm hanging off the bed. I got up quietly, grabbed my phone and jacket, and left.

  The hostel was silent at this hour. Everyone still asleep. I walked down three flights of stairs, my footsteps echoing in the stairwell.

  Outside, the air was cold. Pre-dawn gray light that made everything look washed out and uncertain. I started walking without a destination. Ended up at the 24-hour convenience store two blocks over. The one that sold terrible coffee and stale pastries. Bought both. Sat on the curb outside drinking burnt coffee and eating a pastry, then started scrolling through my phone.

  Nothing from Mr. Santos. That was good. No news meant Akki was still stable, still waiting for the swelling to go down enough that the doctors would risk waking him up. I put the phone away and finished my terrible coffee.

  The sky was getting lighter. Early morning joggers started appearing. A guy walking his dog. The city waking up. I headed back to the hostel. Got to the room around 6:30. Murin was awake, sitting on his bed staring at his phone.

  "Where'd you go?" he asked.

  "Needed to clear my head."

  Then Murin said, "Surgery rotation starts today."

  I blinked. "What?"

  "Your surgery rotation. It starts today." His voice was flat.

  "Yeah. But I'm not seriously thinking about that. Should I skip?"

  He looked at me and his eyes were red-rimmed. "Skip it, then? Take a leave of absence? Sit in the ICU waiting room for weeks waiting for Akki to wake up?"

  "I don't know. Maybe?"

  "And then what? Fall behind? Have to repeat the year? Akki would kill you if he woke up and found out you'd fucked up your entire academic trajectory because of him." His voice cracked slightly on the last word.

  I didn't have an answer for that. He was right. Akki would absolutely give me shit for derailing my education. Would make terrible jokes about me being so dramatic. Would probably call me an idiot while secretly being touched that I cared that much. But Akki wasn't here to give shit to anyone.

  "We should eat something," Murin said after a long silence. "Before we go to the hospital."

  "I'm not hungry." I couldn't bring myself to say I'd eaten already.

  "Neither am I. We should eat anyway."

  I found it hard to leave him to eat alone. He always ate together with Akki or me or both. We went down to the mess hall. It was nearly empty this early, just a few unfortunate souls who'd drawn the 6 AM anatomy lab shift. We got rice porridge and tea and sat at our usual table. Murin pushed his food around with his spoon but didn't eat. I managed three bites before my stomach rebelled.

  "Did you sleep at all?" Murin asked.

  "A bit." I didn't mention the research binge or the System interrogation or the letter.

  We sat there not eating our breakfast. A group of first-years came in, loud and energetic in that way that only people who hadn't experienced real clinical rotations yet could be. One of them was talking about some party this weekend. Another was complaining about an assignment. I wanted to throw my bowl at them.

  "We should go," Murin said, standing up abruptly. I followed him back to our room.

  We got ready in silence. The routine was familiar enough that I didn't have to think about it. Shower, clothes, bag, phone, keys. Murin did the same. We moved around each other like we'd been doing this for years, which we had. At the door, I paused. Looked back at Akki's bed one more time.

  "He's going to be fine," Murin said. He didn't sound convinced.

  "Yeah."

  We weren't convincing each other. Just saying the words because not saying them felt worse.

  We parted at the main entrance. His Ophthalmology rotation was based in the main optic wing. I continued two more stops to the teaching hospital annex where the general surgery ward was located. Pushed through the door and found the nurse's station. A woman in scrubs looked up from her computer. "Can I help you?"

  "I'm Ashrahan. Third-year student. Starting surgery rotation today."

  She checked a list on her desk. "Right. You're with Dr. Okafor's team. They're doing rounds. Started about twenty minutes ago. You can catch up—they're probably around bed 8 by now." She pointed down the hallway. "Go."

  I went and found them at bed 11. A group of six people clustered around a patient's bed: two residents, two interns, one fourth-year student, and a tall man in his fifties with silver hair and wire-rimmed glasses who had to be Dr. Okafor. I approached quietly, stood at the back of the group.

  Stolen from its rightful place, this narrative is not meant to be on Amazon; report any sightings.

  Dr. Okafor was examining a middle-aged woman's abdomen, palpating carefully while asking her questions about her pain. His voice was calm, the kind that made you feel like everything was under control even if it wasn't.

  He finished the exam, pulled the woman's gown back down, smiled at her. "We'll get that sorted out. I'm going to have my team order another ultrasound, make sure we're not missing anything."

  "Thank you, doctor."

  He turned to the group. Noticed me immediately. "You're the new student?"

  "Yes, sir. Ashrahan."

  "You're late."

  "I'm sorry. I was told rounds started at seven."

  "Rounds start when I start them. Today that was 6:40." He looked me over. "You look terrible. Didn't sleep?"

  "Not much."

  "Personal issue or medical issue?"

  I hesitated. "Personal."

  "Will it interfere with your performance on this rotation?"

  "No, sir."

  "Good. We'll discuss it later. For now, stay quiet and pay attention." He turned back to the group. "Next patient."

  We moved to the next bed. Dr. Okafor introduced me to the team during the walk: Dr. Sarah Kimathi, senior resident; Dr. James Chen, junior resident; Dr. Anya Petrov and Dr. Marcus Williams, interns; and Kayla Thompson, fourth-year student.

  Kayla gave me a sympathetic look. "First day?"

  "Yeah."

  "You'll survive. Okafor's tough but fair. Don't bullshit him and you'll be fine."

  The next patient was a post-op appendectomy, day two. Young guy, nineteen, looking bored and uncomfortable. Dr. Okafor had Dr. Chen examine him, then asked questions.

  "Vital signs?"

  "Stable. Afebrile. No tachycardia."

  "Incision?"

  "Clean, dry, intact. No erythema or drainage."

  "Bowel sounds?"

  Dr. Chen hesitated. "I... didn't check."

  Dr. Okafor's expression didn't change. "Then check now."

  Dr. Chen pulled out his stethoscope, placed it on the patient's abdomen, listened. "Present. Normal."

  "Are you sure?"

  "Yes."

  "Because you said you didn't check, which means either you did check and forgot, or you didn't check and you're guessing now. Which is it?"

  Dr. Chen's face went red. "I didn't check the first time. I just checked now. Bowel sounds are present and normal."

  "Better." Dr. Okafor turned to the patient. "How are you feeling?"

  "Okay. But I'm hungry."

  "That's a good sign. We'll advance your diet today. Clear liquids first, then regular if you tolerate it." He made a note on his tablet. "Any questions?"

  "When can I go home?"

  "If you tolerate food and your pain is controlled, possibly tomorrow."

  The patient brightened. Dr. Okafor moved on to the next bed.

  We continued like this for ninety minutes. Twelve patients. Dr. Okafor examined each one, had the residents and students present their cases, corrected their exam techniques, adjusted management plans. He didn't yell or humiliate anyone. Just pointed out mistakes clearly and expected them to be corrected immediately.

  By the time we finished rounds, I had a notebook full of observations and my brain felt slightly less like it was drowning in anxiety about Akki.

  Before leaving, he pulled out a schedule. "You'll be assigned to Dr. Kimathi for the first week. She'll teach you the basics: how we round, how we write notes, how we manage post-op patients. You'll also scrub in on cases when available. We have two appendectomies and a hernia repair scheduled for today. You'll observe the appendectomies."

  He handed me the schedule. "Go find Dr. Kimathi. She's probably in the resident work room."

  I found her twenty minutes later, sitting at a computer terminal typing notes. She looked up when I walked in.

  "You're the new student. Ashrahan?"

  "Yes."

  "Good timing. I need you to go check on bed 14. Post-op day one cholecystectomy. Patient's complaining of nausea. Take a history, do an exam, and report back to me. Don't order anything yet. Just assess."

  "Got it."

  I went to bed 14. The patient was a woman in her forties, looking miserable. I introduced myself, took a focused history. Did my exam—checked her incision, listened to bowel sounds, palpated her abdomen gently. The System flickered on.

  I checked her vitals on the monitor. Normal. Asked about pain—she rated it 6/10. Asked about bowel movements—none since surgery. Reviewed her medication list on the chart—morphine every four hours.

  "I think I know what's causing this," I told her. "The nausea is probably from the pain medication. It's a common side effect. I'm going to talk to my resident about switching you to a different pain medication that might be easier on your stomach."

  "That would be great. I feel awful."

  I went back to Dr. Kimathi. Presented my findings. She listened, nodded. "Good assessment. What do you want to do about it?"

  "Switch from morphine to a different opioid. Maybe oxycodone. Add an anti-nausea medication. Ondansetron, four milligrams IV."

  "Why IV instead of oral?"

  "Because she's actively nauseous. Oral medication might not stay down."

  "Correct. Go write the orders. I'll cosign them."

  I wrote the orders in the computer system. She checked them, approved them. We moved on to the next task.

  The morning passed quickly. Around noon, Dr. Kimathi sent me to lunch. "You've got thirty minutes. The OR cases start at 1 PM. Be in the surgical lounge by 12:45 to change into scrubs."