The first patient came through and I didn't even see their face. Just blood, so much blood. The paramedic was doing chest compressions while running which seemed physically impossible but he was doing it anyway.

  "Male, approximately 30! Bus rollover! Unresponsive at scene! GCS 3! Massive head trauma!"

  They rushed past me toward Trauma Bay 1. Dr. Hayes was already there, gloved hands ready. The second stretcher came in. Then a third. Then people walking in on their own which somehow felt worse because they were conscious and terrified and looking at us like we could fix this.

  A senior resident grabbed my shoulder. "You! Triage station 2! Green tags only unless I tell you otherwise!"

  I moved to the designated area. A nurse was already there, setting up supplies. She looked at me, saw my white coat and my deer-in-headlights expression.

  "Stay calm. Assess quick. Green tag means walking wounded; minor injuries, can wait. You're not treating, just sorting. Got it?"

  "Got it."

  The first patient reached my station. Middle-aged woman, conscious, holding her arm at an odd angle. Blood on her forehead from a scalp laceration but alert and talking.

  "My arm... I think it's broken."

  Before I could respond, the System activated. But this time it was different.

  What the hell is this? The System was giving me actual quests now like this was a video game. I didn't have time to process how absurd that was.

  The woman in front of me kept talking. I clipped a green tag to her shirt. "Sit in that area over there. Someone will see you as soon as possible."

  She nodded and moved away, cradling her arm.

  The next patient was a teenage boy, sixteen, walking but holding a blood-soaked cloth to his head. He was pale, swaying slightly.

  "Can you tell me your name?" I asked.

  "R-Rayan."

  "What happened?"

  "I hit my head on the window."

  His words were clear. He knew where he was. I checked his head, deep cut, lot of blood, but head wounds always bled a lot right? Green tag.

  "Sit with the others. Keep pressure on that wound."

  A man was carried in by two other passengers. He was conscious but his leg was bent at an unnatural angle mid-shin. Open fracture, I could see bone through torn flesh. I feel sick but forced myself to focus.

  Breathing: Normal rate, 20/minute.

  Radial pulse: Present, strong.

  Mental status: "It hurts! God, it hurts!"

  He was in pain but alert, following commands when I asked him to squeeze my hand. Not immediately life-threatening but needed urgent care. So, Yellow tag.

  The System was tracking each one. Numbers climbing. But then the flow of patients increased and I stopped paying attention to the quest notifications.

  A woman stumbled to my station, holding her chest, breathing fast and shallow. Her lips had a faint blue tinge.

  "Can't... breathe..."

  I grabbed her wrist. Pulse was rapid, weak, thready. Respiratory rate, I counted fast, 32 breaths per minute. Over 30. Red tag.

  "Need help here!" I shouted. A nurse appeared, saw the red tag, and immediately guided the woman toward the trauma bay.

  More patients. A child with a broken arm: green. An elderly man with chest pain and difficulty breathing: red. A woman with multiple lacerations but stable vitals: green. The rhythm started to click. Look, assess, decide, tag, next. Don't think too long, just trust the protocol.

  Another stretcher rushed past, someone doing CPR on a patient. That wasn't my area. That was for the trauma teams. A young woman approached, walking but holding her abdomen. "I'm pregnant," she said. "I felt something after the crash..."

  My brain short-circuited for a second. Pregnancy complicated everything. The System flickered.

  She was walking, talking, but abdominal trauma in pregnancy could deteriorate fast. Urgent but not immediate: Yellow tag.

  "Go to that section. Tell them you're pregnant. They'll get you to OB right away."

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  She nodded and moved quickly.

  I was getting faster. The decisions were becoming automatic. A man walked up holding his side. "Just some bruises I think—"

  I lifted his shirt. Massive bruising across his left flank. Dark purple, spreading.

  "Any pain?"

  "Yeah, it hurts when I breathe."

  I pressed gently on his abdomen. He winced but it wasn't rigid. Could be internal bleeding. Could be just muscular trauma. Not immediately critical but needed imaging. Yellow tag.

  The quest counter kept climbing as I worked. 10/15. 12/15. Patients kept coming but the initial wave was slowing down. The walking wounded were mostly through triage now.

  A middle-aged man approached, limping but stable. "My ankle—"

  Green tag. "Sit over there."

  Progress: 14/15

  An elderly woman was helped to my station by her daughter. "She's confused," the daughter said. "Since the crash. She keeps asking where we are."

  I knelt down to the woman's eye level. "Ma'am, can you tell me your name?"

  She looked at me with glassy eyes. "Where... where's my husband?"

  "What's your name?" I repeated.

  "I... I don't..."

  Her breathing was normal. Pulse was steady, but altered mental status after trauma was red flag. The System popped up.

  Red tag. "Get her to neuro assessment immediately," I told the daughter. A nurse appeared and guided them toward the trauma section.

  I stood there breathing hard, my hands shaking slightly. The initial wave had passed. The nurse at my station looked at me. "You did good. First time triaging?"

  "Ye..." Before I could respond, another announcement came over the speakers.

  "All available personnel to patient care areas. We need hands for bandaging, wound care, IV placement, basic procedures. Students included. Report to your nearest senior resident for assignment."

  I looked around. The ER had transformed into chaos. Every bay was full. Patients lined the hallways. Medical staff moved between them with urgency.

  Dr. Hayes appeared, blood on his scrubs, looking exhausted. "Third years! Listen up! We need you doing basic procedures. IV placement, wound cleaning, bandaging. You'll work under supervision but we need bodies. Who here has placed at least one successful IV?"

  I raised my hand with about half the others even though I'd only successfully done it twice.

  "Good. You—" He pointed at me and three others. "Follow Resident Chen. She'll assign you to patients who need lines."

  Dr. Chen was a second-year resident, twenty-eight, with her hair pulled back in a messy bun and coffee stains on her white coat. She looked at us like we were potentially useful or potentially disasters.

  "IV placement. You're placing peripheral lines for fluid resuscitation and medication access. I'll check your site selection and watch your first attempt. After that you're on your own but call me if you can't get it in two tries. We don't have time for you to practice on patients all day. Clear?"

  We nodded. She led us to a hallway where patients were waiting on stretchers. "These are yellow tags. Stable but need IV access for fluids or pain medication. Start here and work your way down." The System activated again, this time with something new.

  Twenty IVs. I'd placed maybe five total in my entire clinical rotation so far. Two successful, three failures.

  The first patient was a man in his forties with road rash all down his left arm. His right arm was available though. Dr. Chen stood next to me.

  "Show me your site selection."

  I examined his arm. The median cubital vein was visible in the antecubital fossa; that's the bend of the elbow, the easiest place. "Here," I pointed.

  "Good. That's your best option. Proceed."

  I opened the IV kit with shaking hands. Tourniquet first. Applied it above the elbow, not too tight. The vein engorged, became more prominent. Cleaned the site with alcohol swab. Circular motion, inside out. Held the catheter at a shallow angle: 15 degrees.

  The System flickered and suddenly my vision changed. Everything else faded slightly and the anatomy of the patient's arm became... transparent? No, not transparent, like I could see beneath the skin in real time.

  I could see the vein as a glowing blue line beneath the skin, its path, its depth, even the angle it traveled. The System was showing me a 3D model overlaid on reality.

  "You going to just stand there or actually stick him?" Dr. Chen's voice snapped me back.

  I positioned the needle. The System showed me the optimal entry angle in real-time, a small green cone indicating the trajectory I should follow. I pushed the needle in following that angle. Felt the pop as it entered the vein. Blood flash in the chamber. Advanced the catheter. Withdrew the needle and secured it with tape.

  "Good," Dr. Chen said. "Connect the IV line and flush."

  I did. The saline ran without resistance, no swelling at the site.

  The visualization faded. Dr. Chen moved to supervise another student. I was on my own now.

  Next patient, an elderly woman. Her veins were thin, fragile, barely visible even with the tourniquet. I tried the median cubital, couldn't see anything good. Checked her hand, found a vein on the back of her hand, small but visible. Then applied tourniquet to her forearm and prepped the site.

  This time I didn't activate the visualization. I needed to do this myself. Positioned the catheter. The angle felt wrong. So I adjusted, made it shallower. Pushed in slowly and felt for the pop. Missed. The catheter went under the vein, into the tissue. The site started swelling immediately.

  Fuck. I pulled out, applied pressure. The woman winced but didn't complain.

  "Sorry. I'm sorry. One more try."