"Max," Jax’s voice cuts through the static. It is his "Combat Medic" voice. Low. Grounding. "Focus on my voice. Just the voice. Ignore the noise."
"She rebranded the plane while we were inside it," I whisper. "She is going to make the pilot wear a cravat."
"Help! Someone help him!"
The scream comes from the back of the Business cabin. It is high, shrill, and terrified.
I see Jax unbuckle his seatbelt immediately as he jumps up to help the passenger. I follow him, not because I want to, but because the algorithm of a medical emergency overrides the panic of a social one.
Across the aisle, Luke starts to rise, his golden retriever instincts kicking in. "I’ve got the advanced cardiac life support certification! I can assist!"
Preston puts a hand on Luke's chest and pushes him back into the seat.
"Sit down, Luke," Preston says calmly.
"But someone’s dying!" Luke argues, pointing down the aisle.
"Let them handle it," Preston says, watching us sprint toward the chaos. "Look at them. They’re vibrating. They need the distraction anyway. If they don't stab someone in the chest in the next thirty seconds, Max is going to try to organize the beverage cart by viscosity and Jax is going to try to hijack the plane."
We rush down the aisle to Row 12. A man in his sixties—expensive suit, flushed skin—is slumped over in his seat. He is clutching his chest, his mouth opening and closing like a fish on a dock. He is gasping, but no air is moving.
"I’m a doctor!" Jax announces, shoving a panicked flight attendant aside gently but firmly. "Max, get in here."
"Hypoxia," I say, my brain snapping into diagnostic mode. The world narrows down to the patient. The noise fades. "Look at the jugular distension. He’s not moving air."
"Panic attack?" the flight attendant asks, trembling. "Because of the lace documentary? I feel like I’m having one too."
"No," Jax says, ripping the man’s shirt open. Buttons fly across the cabin floor, pinging off the plastic tray tables. "Look at the trachea. It’s deviated to the left. The right side of his chest isn't moving."
I look. The man’s chest is asymmetrical. The right side is inflated and rigid, like a drum.
"Tension pneumothorax," I confirm. "His lung collapsed. Probably a bleb that popped from the pressure change. Air is trapped in the chest cavity. It’s crushing his heart. He’s going to arrest in less than two minutes."
"We need to decompress it," Jax says. "I need a tube. And something sharp."
"Steak knife!" Jax yells, grabbing a metal knife from a passing tray. "Airline grade. Serrated!"
"It’s dull as a spoon," I warn, testing the edge against my thumb. It doesn't even break the skin. "You can’t cut through intercostal muscle with this. I need a trocar. I need something rigid."
The man in the seat wheezes, his eyes rolling back.
"Jax," I say. The sensory overload is clawing at the edges of my vision again. The wailing of the passengers, the hum of the engine, the smell of fear. It is too much. I look at Jax’s hands. They are steady.
Jax looks at me. He sees the panic. He grabs my shoulder, squeezing hard. Deep pressure. It grounds me instantly.
"You are the best anatomical surgeon in the state," Jax says, his eyes locking onto mine. "I am the blunt instrument. You are the precision. Look at the cart. Find me a tool."
I force myself to look away from the dying man and scan the service cart. Napkins. Soda cans. A ballpoint pen.
The pen.
"The pen," I say, grabbing a heavy, metallic pen from the flight attendant’s pocket. "Unscrew it. Take the ink cartridge out. The casing is metal. It’s hollow."
"It’s a Montblanc," the attendant protests, clutching herpearls. "That cost two hundred dollars! It was a gift for ten years of service!"
"Put it on Catherine York’s tab!" Jax shouts. "She owns the airline now! She can buy you a factory!"
Jax smashes the pen against the armrest, shattering the top mechanism. He strips out the ink. He is left with a hollow, metal tube.
