The Lighthouse

In the months they were together she mapped his body with a surgeon's knowledge and a lover's touch.


The serratus anterior originates on the surface of the upper eight ribs at the side of the chest and inserts along the entire anterior length of the medial border of the scapula.

Bones, muscles, ligaments ...  the machinery of the human body, her expertise, her specialty, the one thing she can always rely on. She knew every joint and every hollow of his body, from textbooks, from a thousand operations, before the first time she lay down beside him.

Discovered them anew, in the miracle of Michael Mitcheson stretched out beside her.

The levator scapulae arises from the transverse processes of the first four cervical vertebrae and inserts into the vertebral border of the scapula.

"You have a beautiful sternocleido mastoid."

"A what-which-now?" Mitch asked, grinning.

"Here." Nerila ran her fingers along the muscle. "From the medial portion of your clavicle to the mastoid process of your temporal bone."

"That's a fancy way of saying neck, then?"  He wrapped his arms around her and rolled them over, bent his head to kiss her throat. "You have a beautiful stern-cled-mast-thingie too, sweetheart."

She giggled. "That's my hyoid bone."

"And a very pretty hyoid bone it is."

"Like you care what it's called!"  She tangled her fingers in his hair, her other hand flat against the smooth plane of his left latissimus dorsi. 

"Like you care if I care..." 

The pectoralis minor arises from the third, fourth, and fifth ribs, near their cartilage and inserts into the medial border and upper surface of the coracoid process of the scapula.

"From the pectoralis minor to the biceps brachii ... " Her fingers found the small nub of bone on the hollow of his shoulder. "That's your coracoid process.  We call it the Surgeon's Lighthouse."

"Why?" He turned his head to grin at her. "It flashes on and off in the dark?"

She smiled back. "A lot of nerves and blood vessels in there. This little bone tells us where they are, if there isn't time for a scan. Shows us where to cut, to be safe."

"Keeps you off the rocks?"

"Exactly." Nerila traced the fragile wing of his clavicle with one finger.  For whole moments of time she could forget that body beside her, warm and strong and by a process no science could explain containing a mind and soul unlike any other, was as fragile and as vulnerable to steel and blast-caps as any other bleeding on her table. "Exactly."

On the lateral angle of the scapula is a shallow pyriform, articular surface, the glenoid cavity, which is directed lateral and forward and articulates with the head of the humerus.

She is up to her elbows in blood, which makes it an ordinary day for her, now.

No scans, no fancy equipment. Those who can, go to station medical. Even here, in the heart of the Syndicate, there's quality medical care - for those who can afford it.

Who can afford to answer the questions that come with it.

Who want doctors who can afford to answer questions themselves.

Nerila has no scans, no machines. She has scalpels and sutures and bandages. She has a table scrubbed with disinfectant in a dingy back-room that's as clean as she can make it.

She has two steady hands and a knowledge of the human body that no scanner could match.

There is blood everywhere, sharp red arterial blood pumping from the jagged hole in the shoulder of the man sprawled on her table. His friends are standing by the door, big men with hard faces, and Nerila is under no illusion that her life depends on how well she does here.

There's too much blood to see the bleeder, and she has no med-tech to suction out the wound.  She feels for it with fingers slippery with blood, knowing where it has to be, the dorsal scapular artery just where it emerges from the superior angle of the scapula ... there.


She pinches with two fingers, follows along them with a clamp.

The bleeding stops.

Now her time is measured in seconds, before she has to choose between saving this man's life and saving his arm.  The round is still in the wound, she can tell.  No way to get a grip on it with forceps - she'll have to cut.

There's a lot that can go wrong for her patient, if she cuts into the mess of nerves and blood vessels in his shoulder, without a scan to guide the knife.

There's a lot that can go wrong for her personally, right now, if she doesn't do what the men by the door want and fix him up, fast.

Nerila puts her thumb in the hollow of his shoulder, by the wound, finds the hook of bone that she knows will be there, measures by eye from the Surgeon's Lighthouse.

Cuts.

The flesh parts beneath her blade.

Her hands are steady, and fast, but her eyes don't see a bloody wound, ragged flesh, clean incisions.

She has relearned her anatomy, and every body on her table is the same body, now.

Nerila cuts, stitches, bandages.  Takes the money and the threats designed to keep her mouth shut. Scrubs blood from the table and from beneath her nails.

Afterimages linger on the inside of her eyelids, even though she knows the table is as empty as her bed.

The coracoid process, a small hook-like structure on the lateral edge of the superior anterior portion of the scapula ... serves to stabilize the shoulder joint ... palpable in the deltopectoral groove between the deltoid and pectoralis major muscles.

In her dreams, she traces the spot, leans over to press her lips to it.

The lighthouse that used to keep her from the rocks.