Thursday morning the rain came down steady, not hard enough to be dramatic but enough to soak through everything. My shoes were wet before I even reached the hospital gates. Walked through puddles because avoiding them seemed pointless at this stage.

  Orthopaedics was on the fourth floor in a different building. Had to cross through this covered walkway that connected the old wing to the new one, except the walkway leaked in three places. Someone had put buckets to catch the drips but they'd overflowed. Stepped around them and kept going.

  The ward was different the moment I walked in. Internal Medicine had smelled like antiseptic but here it smelled like fresh plaster and metallic, maybe blood, maybe just the general smell of a specific ward. The sounds were harder too. Patients groaning when they tried to shift positions.

  Most beds had people in casts or these metal cage things bolted directly into their bones. External fixators, I remembered from textbooks. Looked medieval in person. One guy had his entire leg suspended in traction, pulleys and weights keeping the bone aligned while it healed. He was trying to reach a water cup on the bedside table, face twisted up in frustration and pain, but his setup made it impossible to move more than a few inches.

  Found the nurses' station at quarter to eight. Five other students were already there, clustered together with that lost look we all had.

  One of the girls tried flagging down a senior resident who walked past with a stack of charts. "Excuse me, we're the students for—"

  He didn't even slow down. "Wait there."

  So we waited. Stood against the wall trying to look like we had a purpose while nurses moved around us doing actual work. One nurse gave us this look as she passed, not hostile exactly but more like oh great, six more obstacles to work around. Fair enough, really.

  Seven-fifty came and went. Then eight. Then eight-fifteen. Nobody told us anything. We just stood there. The guy next to me kept checking his phone, probably wondering if we'd gotten the time wrong or if this was some kind of test.

  Finally at eight-thirty this man walked in and the energy in the ward shifted immediately. Tall, maybe late forties, gray coming in at his temples. His white coat looked like he'd actually ironed it, which already made him different from most doctors I'd seen. He moved fast, grabbed a bunch of charts from the trolley without breaking stride.

  One of the guys cleared his throat. "Dr. Pierce? We're the students assigned to—"

  Pierce glanced over, did a quick count with his eyes. "Six of you?"

  "Yes, sir."

  He looked annoyed already. "Too many. You three—" Pointed at three of us randomly. Me, one of the girls, and another guy. "Stay. Rest of you go to fracture clinic, ground floor. Observe there."

  The other three looked almost relieved as they left. Fracture clinic probably meant sitting in a corner for a few hours but at least you weren't in the direct line of fire.

  Pierce picked up his charts again. "Follow. Don't touch patients unless I explicitly tell you to. If I ask a question and you don't know the answer, say you don't know. Don't guess. Don't make up answers. I can tell and it wastes everyone's time."

  Then he just started walking. We scrambled to keep up, nearly running to match his pace. The girl, she introduced herself as Priella in a whisper as we walked—looked as nervous as I felt. The other guy, Dev, had his notebook out already, pen ready.

  Ward rounds with Pierce were nothing like rounds with Dr. Bennett. Bennett would stop at each bed, discuss the case, ask teaching questions, actually explain things. Pierce moved through the ward like he was doing a factory inspection. Quick check, brief instructions to nursing staff, next bed.

  First bed was an elderly woman, maybe seventy, who'd had a hip replacement three days ago. Pierce didn't introduce us, didn't explain what he was about to do. Just pulled back her blanket, she flinched, and examined the surgical site. His hands moved over the wound quickly, checking for redness, warmth, drainage. The woman's face was tight with discomfort but she didn't say anything.

  The System flickered on in my peripheral vision and I had to stop myself from visibly reacting.

  I tried to focus on what Pierce was actually doing instead of reading the System's play-by-play. He was palpating around the incision site now, watching the patient's face for pain response.

  Pierce turned to us suddenly. "Complications of hip replacement surgery. Name three."

  All three of us just stared. Dev opened his mouth first, probably figuring something was better than nothing. "Infection?"

  "Obviously." Pierce's tone was flat. "That's a complication of literally any surgery. I asked for complications specific to hip replacement."

  Silence. None of us knew. I mean, I sort of knew because the System had just listed them out but saying anything felt dangerous somehow.

  Pierce's seemed irritated. He looked at each of us like he was trying to figure out if we were stupid or just unprepared. "Dislocation. DVT. Nerve injury. This is basic. Read about it before tomorrow's rounds."

  He turned back to the patient without waiting for a response, said something to the nurse about continuing prophylactic anticoagulation, then moved to the next bed. We followed like ducklings, all of us probably making mental notes to actually read about hip replacements tonight.

  Unlawfully taken from Royal Road, this story should be reported if seen on Amazon.

  Dev muttered something under his breath as we walked. Couldn't make it out fully but it sounded like a complaint about being expected to know things we hadn't been taught yet.

  Next bed was a young guy, mid-twenties maybe, with his leg in this complex brace setup. Pierce went straight to the computer and pulled up X-rays. We all crowded behind him but the angle was wrong and the screen was small so mostly we just saw the back of Pierce's head.

  "What type of fracture fixation do you see here?"

  The three of us tried to crane our necks to actually see the X-ray. I caught a glimpse of something that looked like a metal rod running through the center of a bone but couldn't see details.

  The System was already analyzing what little I could see.

  Priella answered first. "Intramedullary nail?"

  "Correct. Why do we use intramedullary nailing for femur fractures instead of external plate fixation?"

  More silence. I knew this one. The System was currently displaying a whole comparison chart in my vision like I was watching an educational documentary.

  I hesitated. Knowing the answer felt like a trap somehow, but Pierce was waiting and the silence was stretching too long.

  "The nail is inside the bone so it shares the load along the bone's axis. Plates are on the outside so they have to bear more mechanical stress. Higher failure rates with plates in shaft fractures."

  Pierce's eyes narrowed slightly when he looked at me. Not quite suspicious but definitely evaluating. "You memorized that from somewhere this morning?"

  "No, sir. Just remembered it from when we studied fractures."

  "Mm." That sound didn't mean approval. It meant something closer to third years don't usually know biomechanics in any detail. He turned back to the X-ray. "The key is understanding load-sharing versus load-bearing. The nail works with the bone. The plate works instead of the bone, at least initially."

  He moved on to the next patient. But for the next three beds, he didn't ask me any questions. Directed everything at Priella and Dev. When they got things wrong, which they did, because we were all fumbling in the dark here, he'd sigh, explain briefly, then glance at me for a split second before moving on.

  The message was pretty clear: knowing the right answer didn't make you teacher's pet. It made you suspect. Like maybe you'd stayed up all night cramming to show off or something.

  Dev definitely picked up on it. I heard him mutter to Priella between beds, voice low but not quite low enough. "Some people try too hard."

  My face got hot but I kept my expression blank and just kept walking.

  We hit bed seven—construction worker with a compound tib-fib fracture. Compound meaning the bone had broken through the skin. He had an external fixator on, these metal rods literally piercing through his leg in four places, holding everything in alignment from the outside. Looked painful as hell.

  Pierce examined the pin sites where the metal rods entered the skin. Each one was a potential infection point.

  "Signs of pin tract infection?" he asked, not looking at any of us specifically.

  We all leaned in closer, trying to see. The System activated again.

  Priella spoke first. "There's maybe some redness?"

  "Maybe?" Pierce's voice had that dangerous patience to it. "Either there is redness or there isn't. Which is it?"

  "There is. There's redness, sir."

  "And what does that indicate?"

  Again same cycle but opening my mouth after the last question felt like volunteering to be the next target.

  Dev tried to help. "Inflammation?"

  "Inflammation from what cause?"

  "Um. Infection?"

  "You're guessing." Pierce pointed at the pin sites with one gloved finger, not touching. "This is a grade two pin tract infection. Common with external fixators. Requires daily pin care, dressing changes, possibly oral antibiotics depending on severity. You need to recognize this immediately in any patient with external fixation. It's the most common complication they develop. This is basic ward management."

  He stripped off his gloves, dropped them in the bin, and moved to the next bed without waiting to see if we were following.

  The System was learning my survival tactics and apparently documenting them. Great.

  We got through maybe twenty beds total. Pierce asked questions scattered throughout, we fumbled most of the answers, he corrected us with this carefully controlled disappointment that somehow felt worse than if he'd just yelled. By the time we finished my notebook was full of fragments I'd barely understood and my confidence was somewhere in the basement.

  Pierce stopped at the nurses' station to sign charts and write orders. The three of us stood nearby like we were waiting for permission to exist.

  He looked up after a minute. "You three will rotate through fracture clinic, ward work, and theatre over the next two weeks. Today—" He pointed at Priella and Dev. "Fracture clinic, ground floor. The registrar will teach you the Ottawa ankle rules and when imaging is actually necessary versus when patients just think they need an X-ray." Then he pointed at me. "Theatre. Knee replacement. Observation only, you'll be in the viewing gallery. Don't touch anything. Don't faint. Questions?"

  "No, sir," all three of us said at once.

  He walked away. Priella and Dev headed toward the stairs without saying anything to me, moving just fast enough that I couldn't really follow without obviously trying to catch up. Cool, so that's how this rotation was going to be.