The First Hours

BOOM...MMM!

The second explosion shook the very bowels of the earth.

The ground beneath Elena’s boots buckled slightly, and the gray limestone ceiling of the field cave creaked, showering down fine, murky flakes of powdery snow.

The shockwave from Whitfield’s scatter-shot artillery swept across the valley, carrying the pungent, acrid stench of black powder mingled with the freezing air of melting snow.

"Everyone, ready!"

Elena barked inside the shallow stone cave set along the northern edge of the camp.

Her ash-blonde hair, bound tight behind her neck, was already matted with sweat despite the bone-chilling drafts rolling through the cavern interior.

She no longer wore her snow-fox fur coat, dressed only in a fitted, short-sleeved deerskin tunic, her hands already tucked into strips of coarse gauze soaked in sterile distilled alcohol.

The roar of the cannons drew nearer.

And then... the first casualty was carried in.

A young Cheyenne warrior had been hurled aside by shrapnel, his left shoulder shredded, dark red blood spurting in thick jets across a dried buffalo hide rug.

"Yellow strip!" Elena commanded sharp and clear. "Pressure bandage on the vein! Move him to the right corner!"

Sarah and two Lakota women lunged forward immediately, their hands working frantic yet precise, executing exactly what she had drilled into them.

Outside the cave, hell officially opened its gates.

Thomas Whitfield’s blue-coats did not attack from a single direction.

They encircled the valley of Talon Ridge from three sides: cavalry drawn tight around the southern river bend, infantry advancing in long formation through Limestone Gorge, and scatter-shot cannons belching continuous fire from the eastern ridge.

From her vantage in the shallow cave, Elena could not see the entire battlefield.

Yet every brutal turn of the massacre rebounded off her eardrums in gruesome detail.

The deep, commanding roar of Grey Elk coordinating their lines: "Hold your bows! Wait until they step over the ice line!"

The wild, primal war cries of the Lakota warriors: "Hokahey!"

And then... CRACK! CRACK! CRACK!

The rapid, volleys of Springfield rifles fired by the blue-coats tore through the air, cutting short the fierce battle cries, turning the valley into a massive, churning slaughterhouse.

With every single volley that echoed, agonizing groans converged toward the field medical cave.

"Elena! This one!" Sarah shrieked, her voice trembling through tears.

Black Arrow and two horsemen hauled in an elderly Lakota warrior.

A piece of jagged artillery iron was embedded deep within his chest and abdomen; a length of his intestines was exposed, and dark blood gushed relentlessly, staining the white snow outside the cave entrance a deep crimson.

"Scalpel! Hemostatic clamps!"

Elena dropped to her knees upon the cold stone, her slender hands diving directly into the warm pool of blood.

The cardiothoracic surgeon's brilliant mind automatically engaged its mode of absolute, icy detachment.

There was no time for horror, no time for pity.

Using her compact titanium scalpel, she cut away the necrotic, torn tissue, her fingers pressing tight against the oozing main artery, using her scarce remaining dissolvable sutures to drive swift, precise stitches.

"Gauze! Alcohol!" she barked in short, razor-sharp commands.

"H-here!" Sarah offered the gauze strips with trembling hands.

Sweat mingled with dried blood splattered across Elena’s pale cheeks.

Five minutes. Exactly five minutes for an emergency field procedure to prolong a life.

"Done! Move him!" Elena slammed her palm onto the earth.

The Lakota warrior was carried off to the quarantine corner, his breathing wheezing yet the arterial bleeding halted.

Elena caught no breath to wipe her brow before a fresh case was hauled inside.

The rate of casualties accelerated at a suffocating pace.

Every five minutes, another severely wounded man was dragged into the station.

The shallow cave reeked of thick blood, pus, charred flesh from red-hot shrapnel, and the sharp bite of distilled alcohol.

The three strips of dyed cloth—red, yellow, and black—resting on the field table became the most ruthless verdicts of life and death.

Elena was forced to make triage decisions within a three-second observation window.

A young warrior had been struck through the skull by shrapnel, his pupils completely dilated, his chest heaving in final, agonal gasps.

Elena looked at the pleading eyes of his mother standing beside him.

Her heart constricted ruthlessly.

Reaching out her blood-soaked hand, she picked up the dark black cloth strip and bound it tightly around the young warrior's wrist.

"Elena..." Sarah choked out, tears streaming down her face. "He... he is still breathing!"

Elena did not look back.

She spun around, her voice cold as she suppressed the internal shattering:

"Black strip. Move him to the dark corner. Clear space for the next red strip!"

For the first time in her career as a surgeon, she deliberately abandoned a breathing life to race against time to save those who still held hope.

The icy logic of field medicine forged her mind into an unyielding block of stone.

Sarah’s face had turned paper-white.

The eighteen-year-old girl rinsed blood-drenched gauze in a bucket of freezing water, shivering as she watched corpses being carried outside.

Elena cast a single glance toward Sarah.

She saw the impending collapse looming within the young girl's dark eyes.

Yet Elena did not pause to comfort her.

"Sarah! Look at me!" Elena growled softly, driving her sharp, ash-gray gaze straight into the girl's eyes: "Hold that basin firm! We are their final line!"

Sarah gasped, swallowing her tears back down, nodding frantically as she returned to her task.

Just then...

The chaotic, frantic thunder of hooves erupted outside the cave entrance.

"Elena! Save... save him!"

Black Arrow’s gut-wrenching shout tore through the air as he dragged in a massive, severely wounded frame, his own leather armor shredded.

Running Deer.

The fierce warrior with the long scar across his cheek was hauled inside.

His left chest had been punctured by a rifle ball, fresh blood surging out in dark bubbles with every ragged, wheezing breath. He had drifted into unconsciousness, his usually ferocious face now pale as ash.

Simultaneously, two other warriors carried in an elderly Cheyenne chief whose legs had been blown apart by artillery shells, the femoral artery spurting blood recklessly.

The field medical post was completely overwhelmed.

Only a single space remained on the dry buffalo hide rug, and Elena was the only person with the strength to hold a scalpel.

On one side lay Grey Elk’s younger brother—the warrior who had gifted her the snow-fox fur coat only yesterday.

On the other lay the elderly Cheyenne chief, hovering on the precipice of death from acute blood loss.

Elena stood rooted in the blood-soaked cave, the titanium scalpel in her hand trembling slightly under the wavering oil light.

The professional instincts of a cardiothoracic surgeon fired inside Elena's mind at the speed of a high-voltage current.

The golden window to save a patient suffering from a tension pneumothorax like Running Deer was measured in minutes.

The Springfield rifle ball had punctured his left chest, and trapped air pressure inside his pleural cavity was compressing the lung tissue, shifting the mediastinum, and directly constricting the vena cava.

Without immediate decompression, his heart would cease beating from asphyxiation.

Meanwhile, the elderly Cheyenne chief’s femoral artery had been severed by an artillery blast—the volume of blood lost had already blackened a vast patch of snow. His carotid pulse beat faintly, so thready it was nearly unmeasurable.

Two lives. A brutal choice on the threshold of life and death.

Elena looked down at the red strip in her hand.

"Place Running Deer on the main mat!" she barked, her voice ringing hard as a steel hammer striking an operating table.

"Elena! What about the elder...!" Black Arrow shouted, his bloodshot eyes filled with desperate fury.

"Apply a tourniquet to his leg immediately!" Elena spun around, driving her razor-sharp ash-gray gaze into Black Arrow: "Use bison tendon to bind it tight three finger-breadths above the wound! Pour alcohol directly to stall the bleeding! I am handling this case first!"

The surgeon's cold logic had delivered a ruthless verdict: Running Deer's trauma carried a significantly higher probability of recovery if granted immediate field intervention.

Whereas the elder... the volume of blood lost had crossed the threshold of survival for an aging body; the risk of irreversible hemorrhagic shock was far too absolute without blood transfusions.

She was forced to choose the life with the higher probability of survival.

Elena lunged toward Running Deer.

She ripped open the blood-drenched deerskin shirt covering the warrior's chest.

His left chest was abnormally distended, the skin cyanotic, every breath whistling in a wet, laboring wheeze... like a compressed leather bellows.

"Sarah! Rubber drainage tube!" she commanded.

Sarah instantly pressed a pliable rubber tube into her palm—one of the few remaining pieces of emergency field equipment from her twenty-first-century kit.

Elena had no time for thorough sterilization. She poured half of her remaining distilled alcohol over the titanium scalpel blade.

Slice!

A clean, two-centimeter incision cut through the fourth intercostal space along Running Deer's mid-axillary line.

Trapped air mingled with dark blood hissed out with a violent Whsssh!, spraying directly onto Elena’s cheek and chest.

Running Deer jolted violently in his delirium, his large hands flailing in panic.

"Hold him down!" Elena barked.

Black Arrow and a warrior immediately pinned Running Deer’s broad shoulders flat against the cold stone.

Elena swiftly inserted the rubber tube into the pleural space, dropping the opposite end into a jar of cooled boiled water to create a crude one-way water-seal drainage system.

Air bubbles and dark blood surged furiously into the water jar.

Running Deer’s agonizing wheeze smoothed out.

The blue cyanosis on his lips gradually yielded to a faint, fragile flush. His chest began rising and falling in steady rhythm once more.

"Halfway done!" Elena exhaled a long breath, sweat mingled with fresh blood running down her chin and dripping onto the earth.

Without taking a single second to rest, Elena spun back toward the Cheyenne elder.

Yet... it was already too late.

Black Arrow’s bison-tendon tourniquet had been unable to stem the massive rupture of the femoral artery.

The elder had ceased breathing.

His cloudy eyes stared blankly at the gray limestone wall of the field cave, his hands limp upon the cold snow.

The cave sank into a bitter silence.

Black Arrow slumped his shoulders, dropping his head beside the body, choked sobs falling into the dark.

Elena stood motionless amidst the dark bloodstains.

The scalpel in her hand trembled slightly.

The helplessness of a trauma surgeon carved deep into her soul once more.

She had saved Grey Elk’s brother, yet had been forced to leave an elder behind beneath the ruthless black strip.

"Elena..." Sarah approached, offering a clean cloth soaked in warm water with trembling hands: "You... you did everything you could."

Elena squeezed her eyes shut, suppressing the surging wave inside her chest, before opening them slowly.

Her ash-gray eyes reclaimed their cold, steel-hard resolve.

"No time for tears," she wiped the bloodstain from her face, her voice rising firm: "Move the body outside! Prepare gauze for the next case!"

Outside, Thomas Whitfield’s artillery cannons roared without cease.

The valley of Talon Ridge was burning.

Thick plumes of black smoke spiraled into the snowy sky, carrying the screams of the massacre, the rapid volleys of rifle fire, and the cries of a battlefield devoid of mercy.

Amidst that hellish expanse, the small, shallow cave along the northern boundary stood firm—where the twenty-first-century surgeon and the native women fought for every final breath against death itself.

And that life-or-death battle had only just begun.