The hospital smelled of antiseptic and money. St. Jude's Medical Center was private, exclusive, and expensive.

Karly slipped past the volunteer desk while the receptionist was on the phone. She knew the layout. She had worked here as a resident in another life.

She took the stairs to the fourth floor. Neurosurgery.

Dr. Vance's office was at the end of the hall. The door was open.

Karly knocked on the frame.

Dr. Vance looked up. He was a silver fox, handsome in a way that suggested he knew it.

"This isn't pediatrics," he said, eyeing her uniform. "Are you lost?"

"I'm Gus Lowe's daughter," Karly said, stepping inside. "I'm here to discuss his surgery."

Vance laughed. A short, bark of a sound. "Gus Lowe? The man whose insurance was declined three times? The surgery is cancelled."

"I can pay you," Karly said. "Not in cash. In value."

Vance raised an eyebrow. "Value?"

"I know you're working on the cortical mapping project," Karly said quickly. "I know you're stuck on the temporal lobe interface. I can show you how to bypass the signal noise."

Vance froze. "How do you know about that? That research is unpublished."

"I read," Karly said. "I can fix your algorithm. In exchange for my father's surgery."

Vance stared at her. For a second, she saw curiosity.

Then, he opened his desk drawer. He pulled out a piece of paper.

"Your brother was here this morning," Vance said. His voice was cold now.

Karly's heart sank.

"He signed a waiver refusing treatment on your father's behalf," Vance said. "And he warned me that his sister is a pathological liar with a drug problem who might try to scam the hospital for pain meds."

"He's lying," Karly said. "He wants the disability check."

"Get out," Vance said. He reached for the phone. "Or I call security."

"Dr. Vance, listen to me. The compression on his optic nerve is-"

"Security," Vance said into the receiver. "I have an intruder in my office."

Karly grit her teeth. She turned and walked out.

Defeat tasted like ash. Hakeem was always one step ahead. He was thorough in his greed.

She walked down the hallway, her fists clenched.

Hakeem was leaning against the wall near the elevators, flirting with a young nurse. He'd clearly talked his way past the floor's reception desk, likely spinning a sob story about his poor, blind father and his 'troubled' sister.

He saw Karly and pushed off the wall. A smug grin spread across his face.

"Told you," he whispered as she passed. "Dad's better off blind. We get the check. You don't have to worry about bills."

Karly stopped. She looked at his throat. She knew exactly where to punch to collapse his windpipe.

Not here, she reminded herself. Cameras.

She pushed past him toward the restrooms. She needed cold water on her face. She needed to think.

She pushed open the restroom door.

A woman was screaming.

Not a horror movie scream. A primal, terrified sound.

A young mother was shaking an infant. The baby was blue. Silent.

"Help! Someone help!"

A nurse rushed in from the hall. "Code Blue! Pediatric airway!"

The nurse grabbed an oxygen mask from the wall unit. She tried to force it over the baby's face.

"No!" Karly shouted.

The nurse ignored her. She squeezed the bag.

Karly saw the baby's chest fail to rise. The air pressure was pushing the obstruction further down.

"Stop!" Karly lunged. "It's a complete blockage! You're killing her!"

Dr. Vance appeared in the doorway.

"What is going on here?" he bellowed. "Security! Get that girl out of here!"

The nurse shoved the mask harder against the tiny face.

The baby went from blue to gray. The struggle in the tiny limbs ceased.

Limp.

Karly's vision tunneled.

She didn't see a baby. She saw a patient. She saw an airway that needed to be opened now.

She body-checked the nurse.

The woman went flying, crashing into the paper towel dispenser.

"You crazy bitch!" the mother shrieked, clawing at Karly.

Karly shoved the mother back with one arm, snatching the baby with the other.

"Hold her down!" Karly ordered. The command in her voice was absolute. It was the voice of a Chief Resident.

The mother froze, stunned by the authority.

Karly flipped the baby over her arm. Whack. Back blow.

Nothing.

Whack.

Dr. Vance grabbed Karly's shoulder. "Let go of the child! You are assaulting a patient!"

Karly spun. Her eyes were wild, terrifying.

"She's dead in ten seconds unless I cut!" she roared at Vance. "Give me a scalpel!"

Vance recoiled. "You're insane."

Hakeem was in the doorway now, holding up his phone. Filming. "Look at her! She's killing that baby!"

No time.

Karly reached into her sleeve. She pulled out the utility knife from her desk.

The mother screamed. "She has a knife!"

Karly flicked open the lighter Hakeem had been using at the quarry. The flame licked the steel blade, turning it orange for a split second. A crude sterilization, but better than nothing.

Karly pinned the baby to the changing table. She hyperextended the neck.

She felt for the landmarks. Thyroid cartilage. Cricoid cartilage. The membrane between them.

A space smaller than a fingernail.

"Don't do it!" Vance shouted, lunging forward.

Karly sliced.

A vertical incision. Precise. One centimeter.

Blood welled up, dark and terrifying.

The mother fainted, crumpling to the floor.

Karly didn't look. She grabbed a suction straw from a juice box on the counter-trash left by someone else. She jammed it into the hole.

She put her mouth over the straw and sucked.

Metallic taste. Blood. And something sweet.

She spat onto the floor. A bloody lump of hard candy.

She put her ear to the straw.

Silence.

One second.

Two seconds.

Vance was reaching for her arm.

Then-

A sound. A wet, wheezing gasp.

Then a cry. Thin, weak, but unmistakable.

The baby's chest heaved. Pink color flooded back into the gray cheeks.

Karly slumped against the sink. The utility knife clattered to the floor.

The cry grew louder. It bounced off the tiled walls, a siren of life.

Karly wiped her mouth with the back of her hand. It came away red.

Dr. Vance stood frozen. His hand was still outstretched, inches from Karly's shoulder. He looked at the baby. He looked at the crude incision.

It was perfect. Dead center. No damage to the vocal cords. No nicked arteries.

"My god," Vance whispered.

Nurses swarmed in. They pushed Karly aside, tending to the baby, putting a proper oxygen mask over the face.

Security guards burst through the door. "Where is she?"

Hakeem stepped forward, phone still raised. "Her! My sister! She stabbed the kid! I got it all on video!"

The guards grabbed Karly's arms. They wrenched them behind her back.

"Get off me," Karly said. She was too tired to fight.

"Take her to the station," the head guard said.

"Stop."

Dr. Vance's voice cut through the chaos.

He walked over to the guards. "Release her."

"But Doctor, she-"

"She just performed a textbook cricothyrotomy with a utility knife," Vance said. He looked at Karly with a mixture of horror and awe. "She saved that child's life. The nurse was bagging a complete obstruction. She would have killed the patient."

The nurse in the corner went pale.

Hakeem's jaw dropped. "What? No, she's crazy! Look at the knife!"

Vance turned on Hakeem. "You. Get out of my hospital. If I see you here again, I'll have you arrested for interfering with a medical emergency."

Hakeem lowered the phone. He looked at Karly. She was covered in blood, hair messy, wearing a cheap uniform.

But she was smiling. A cold, shark-like smile.

"Delete the video, Hakeem," Karly said softly. "Or I tell the cops why you were really here."

Hakeem scrambled backward and ran.

"Come with me," Vance said to Karly.

In his office, Vance poured her a glass of water. His hands were shaking slightly.

"Who taught you that?" he asked. "That wasn't luck. You knew the anatomy."

"I watch videos," Karly lied. "I have a photographic memory."

Vance studied her. He didn't believe her. But he couldn't deny what he saw.

"You're wasted in high school," he muttered.

"My father," Karly said. "Surgery. Tomorrow."

Vance nodded. "I'll do it. Pro bono. I'll write it off as a teaching case."

"And the waiver my brother signed?"

Vance picked up the paper Hakeem had given him. He crumpled it into a ball and tossed it in the trash.

"What waiver?"

Karly stood up. "Thank you, Doctor."

She walked to the door.

"Wait," Vance said. "What's your name?"

"Karly."

"Karly. If you ever want a recommendation for med school... come find me."

Karly didn't look back. "I won't need it."