Chapter 92: Anterior Shoulder Dislocation

The moon, plump tonight like a luminescent bladder gameball amongst bleak skies, vomited ghastly green hues onto a decade-abandoned dirt path. Foreboding starbursts flickered in the night, revealing the corpses of massacred trees and an overgrown trail.

Praying the crawlers skittering through the emerald forest behind him couldn’t hear the trotting of his mount, the scout gripped his horse’s reins tighter. He urged Sally towards the beach, across forsaken sands, and closer to the collapsed heathen barrier on Malten’s coast. His eyes darted past Church rubble and towards the ocean.

They had to be lurking in those dark, azure depths.

The night of repentance had just begun, and judging by the heathen swarms roaming the wilderness and yesterday’s unprecedented heathen raid, which struck a day too early, an even more massive heathen raid would assault Malten today. Or so the guard captain said.

But that made little sense. The sorceresses, Celeste guide them, slaughtered an entire raid yesterday. Only one carapaced devil attacked every month, so another couldn’t appear to lead a second raid tonight. Right?

Still, although a raid couldn’t coalesce, the scout’s duty was to alert Malten whenever coastal heathen numbers exceeded hazardous limits. A duty he regarded with utmost importance. But not because he gave a shit about keeping his job. The scout only took this suicidal post because his family lived in the north-western district, which heathens typically besieged first. He vowed to be the aegis that defended his daughters, twelve and fourteen, who were probably gazing out the window, waiting for daddy to return home victorious.

And he had never failed them before. The scout always delivered the warning siren with haste, giving Malten’s sorceresses and knights ample time to prepare for war. Tonight would be no different.

The ocean stirred. A vast gray trunk, covered in heathen circuits burning blue in the abyss of night, rose from the murky depths.

Heart drumming in his ears, the scout’s hand shot to the hollow bull horn at his hip.

The flaps on the carrier devil’s back burst open, and two stone birds launched towards a blackened sky. They slithered under livid clouds towards Malten as the carrier devil submerged back into gloomy waters.

Two fliers. Not a big deal. The scout moved his hand away from the blowing horn. However, despite every reason to feel relief, he could not shake the sensation of being watched. Hunted.

The scout uttered a hasty laugh. Heathens didn’t stalk people, and even if they did, their gargantuan statures and blue circuits would reveal their silhouettes in the night. No reason to worry. Just his nerves acting up as usual.

Two hundred strides away, a crawling devil emerged from the ocean, brine dripping down its six long and sharp limbs. Oddly, the beast did not charge towards Malten. Stranger yet, the crawling devil pivoted, and its spherical core seemed to glare straight ahead.

Right at the scout.

He froze. That… that had never happened before. What was he supposed to do? The scout couldn’t abandon his post, but he had to do something! Hoping to frighten his adversary, he puffed out his chest and bared his teeth, gripping Sally’s reins in case the devil charged.

The crawler turned around and retreated further into the ocean until frantic waves swallowed it whole.

Ha! Pussy!

While the scout grinned in celebration, another crawler skittered onto the beach. And another. Then several more. They stampeded past the scout and towards Malten’s protectia enchanted walls. Eight of them! All at once!

The scout’s hand shot towards the medium-sized bull-horn at his hip. Should he sound the alarm? Could the knights and the holy bomb lobbers handle this many without regrouping?

Moments later, carrier devils dotted the ocean like miniature islands, flying devils soaring from their spines and into the sky, swarming in circles, layered screeches piercing the night.

At least fifteen heathens. Twenty. No—thirty! F-forty?

Dread sinking into his stomach the longer he watched on with glazed-over eyes, the scout grabbed for his blow horn, but pounding sand behind him sapped the vigor from his arms. His grip loosened, and the warning horn plopped onto the beach. He glanced back.

Crawlers encircled the scout in a wide arc, their sharp legs piercing and thwacking dirt and sand. They scuttled closer.

They didn’t leave to assault Malten!

They plotted to surround him!

Mind scrambling to make sense of the aberrant heathen behavior, the scout slammed his thighs into the horse’s flanks, and Sally galloped. With all direct routes to Malten blocked off, he circumvented the clustered crawling devils by riding towards the shore and around them. A mistake.

Flying devils soared in from the ocean.

He was surrounded.

“Sally! Go! Go!”

Although Sally sped up at his desperate plea, galloping faster than all but a noble’s warhorse, her pace could not outmatch that of a flying devil. Over a dozen gained on him. Every moment saw the gap cut short several strides.

The scout gritted his teeth. Where the fuck did he go wrong? He kept his distance, carried no enchantments, and couldn’t afford to cast spells let alone learn them! Why were the heathens targeting him?

Fliers soared overhead, dropping feathers from their wings.

As the scout swerved Sally to the left, stone projectiles dug into the dirt behind him. First volley dodged. A few more to go. If he reached the forest, the abandoned villages and leafy oaks would provide enough cover to flee!

Sally let out an ear-piercing shriek.

The scout looked back, and his heart dropped. A feather pierced the horse’s stifle, flesh above her hind leg melting away into a widening wound. Sally limped and shook to shake the scout off her back.

“I know it hurts, girl! Just a little further!”

The flying devils launched volley after volley.

“Sally! C’mon Sally! Stay with me!”

She huffed and brayed, but despite doubtlessly horrific pain, Sally recovered. Overwhelming joy coursed through the scout even as frigid winds pounded into his wide-open eyes and his head grew fuzzy from holding his breath. He rode through a deserted village, praising Zera for his good fortune.

But his relief was short-lived.

A deafening screech echoed from the coast. That of a carapaced devil.

The scout’s gut sank to his waist as the scattered crawlers and fliers that plagued Malten’s north-western territories began retreating towards the coast.

They were organizing.

A raid was coming!

A raid more horrific than the scout had ever seen!

He cursed himself for losing his blow horn—endangering his family—but swiftly resolved to reach Malten. He had to deliver the warning no matter the cost!

The booms and crackles of holy weaponry atop distant walls went silent as heathens vacated the forest. A glance back revealed that most of the crawlers and fliers hunting the scout had retreated, too, with only three beasts in pursuit. He would make it!

Two flying devils soared above, unleashing a barrage that made Sally utter a pitiful shriek. She collapsed.

The momentum of the fall flung the scout from her back and across a ravaged forest floor, his spine slamming into a split tree. He winced, and, scampering away, glanced back.

A crawling devil sliced its claw through Sally’s belly, both fliers circled above him, and beyond dark clouds hovered a sprawling blue silhouette. The scout squinted to make sense of the blurry figure until a violent fire burned into his calf. He screamed and fell, clawing at the stone feather burrowed in his leg, searing heat coursing throughout the limb.

Wielding rock hammers coated in blue blood, a gaggle of knights upon armored horses neared.

“Scout!” a voice much like Lord Valter’s said. “Can you walk?!”

“M-my Lord! There’s a massive raid gathering! At least forty! Mira and the guard captain must know!”

As a feather shattered against the armor of Valter’s warhorse, the young lord lifted his visor, revealing a handsome face mired only by a scar. “Meier, Wendler. Slaughter that crawler! I’ll deliver the warning!”

“Yes, my liege!”

Having fulfilled his duty, the scout’s vision blurred as he slipped into an endless slumber at Zera’s side, a hopefully long wait to see his family again, only for a steel gauntlet to grab his arm and shake him into consciousness.

“You’re not dead yet!” Valter said. “Stay awake and the holy ambulance shall cure you!”

A sorceress accompanying them, two men carrying a stretcher ran closer.

The Jade Surgeon’s servants.

A pained smirk spread across the scout’s face. Perhaps Zera had granted him another chance to embrace his daughters in this lifetime.

Ephemeral ‘stars’ fazed in and out of existence within the field hospital’s operating room tent. They illuminated random crevices with green light. A dozen would materialize every instant, appearing within a crate of surgical tools, under the operating table, or lodged halfway through a leather wall. Nowhere was off-limits. Not even a patient’s wound.

Like unreliable endoscopes, the phenomenon would occasionally brighten red flesh that heathen’s blood melted through recently—an injury resembling liquefactive necrosis from deep, alkali burns. Fortunately, this sorceress would sustain minimal scarring. Combat medics neutralized the corrosive liquid before it could consume her upper arm, and Dimitry was already suturing her skin. The wound would heal without issue.

But not everyone was so fortunate. As the supersonic crackling of rifles and black powder explosions grew frequent and severe, so did injuries. They had ever since the night of repentance began hours ago. Medical emergencies occurred in bursts, leaving Dimitry little time between surgeries. One patient inside usually meant another waited outside. And there was no one else who could do his job. Some nurses knew wound care basics, but they needed experience before they could work on their own.

So Dimitry worked swiftly. He surged from patient to patient like a busy evening at a trauma center. However, instead of treating endless car crash survivors, heart attacks, or penetrating bullet and knife injuries, he was the backbone of a people fighting for survival against stone beasts.

And he loved it.

This rush was one Dimitry longed for ever since cancer left him bedridden. For the first time in months, he was content. Joyful. Even while cutting the thread of his patient’s final suture, Dimitry couldn’t help but adorn a weary smile. “You’re almost done, madam Elze.”

“No need for formalities,” the sorceress said. “I’m already bashful for taking up the Jade Surgeon’s time with trivialities.”

“Don’t be. Even a small wound can be deadly. After you’re finished here, you can return to your squad. Stay safe out there.” Dimitry nodded at a freckle-faced nurse to finish the job.

Lili knelt to wrap Elze’s sutures with bandages. “Keep the stitches dry for two days, then come back in a week to—”

Her advice drowned in a mist of jumbled ramblings, shouts, and prayers when Dimitry stepped outside to scout his next patient. He was just in time.

From the gatehouse and through a terrified yet enthusiastic crowd that swelled to twice yesterday’s size, approached a man in rusted iron armor. Behind his gargantuan stature trailed a second paramedic, a stretcher, and the decorated knight lying on top. The leather bed Milk hauled lowered to the carved street floor.

Not seeing a heathen feather in the creases between the knight’s steel plating or dents from a crawler’s swipes, Dimitry crouched for closer examination. “What’s the issue?”

The paramedic, huffing after a doubtless frantic race through the western wilderness, shrugged. “He couldn’t get up when we found ‘im, but I think he hurt his hand.”

“It’s my shoulder,” the knight said. “It got fucked up when I smashed a crawling devil’s guts into a tree, and my damn horse spooked at a little heathen’s blood. Can you fix me?”

The flexed elbow of an externally rotated arm that pressed into the knight’s abdomen confirmed his condition. It was a telltale sign of an anterior shoulder dislocation. They often occurred when a raised and outwardly turned limb suffered a blow, just like a knight’s arm would when he slammed a massive, overhead rock hammer into a towering heathen’s core.

As the most common manifestation of shoulder dislocation, Dimitry encountered the injury many times. Although treatment was usually simple, there was potential for complications. Fractures in nearby bones could debilitate soldiers for life. They often resulted from high-velocity collisions, which included people riding their galloping horse into a stone adversary.

To confirm his diagnosis, Dimitry dropped his hand onto the patient’s steel vambraces. “I need to check something. This might hurt.”

“Get it over with.” The knight struggled to suppress his guarded, right-leaning posture.

Dimitry tugged his injured arm.

His eyes slammed shut. “Fuck!”

“You have a dislocated shoulder.” Dimitry pointed back at the operating room tent, which glowed green under a full moon and countless ‘stars’. “I’m bringing you inside for—”

“Don’t believe the surgeon’s lies!” a man holding a tattered scroll yelled. “He seeks to sully Zera’s—”

Others amongst the crowd swiftly silenced him.

“Looks like you don’t have it easy either,” the knight said as the paramedics carried him into the field hospital.

Dimitry shook his head. That wasn’t his first decrier, and he wouldn’t be the last. Their complaints became more frequent since the night began. As his supporters grew in number, so did the opposition. He shot a glance at his guards.

Leona nodded back to reassure him they would eliminate any threats, and Angelika scanned the sky for flying devils.

When he passed through the field hospital’s door flap, Dimitry discovered a knight lying on the operating table wearing only underclothes. His bevor, pauldrons, vambraces, plackart, breastplate, mail, and gambeson stood in a pile beside a satisfied Lili.

She smiled. “What next, mister Dimitry?”

Thrilled to have a nurse that took the initiative, he rinsed his hands in a bowl of ethanol-water. “Could you carefully take off his shirt? Try not to hurt him more than necessary.”

Lili guided the knight’s arm through his sleeve.

He yelped and pulled back. “Daughter of Jung, would you just cut my shirt off? The pain is unbearable.”

“As you wish, son of Schwarz.” She sliced away cloth scraps with scissors.

“You two know each other?” Dimitry pulled the patient’s arm, and a dimple appeared near their clavicle. A positive Sulcus sign. Along with a shoulder that lost its rounded appearance and an acromion that protruded like displaced bones did, they confirmed glenohumeral instability. The joint fully dislocated.

The knight grit his teeth. “Are you sure you know what you’re doing?”

“Of course he does,” Lili said. “To answer your question, Sir Schwarz and I met at a banquet once.”

“Sounds fun.” Dimitry checked for breaks in the skin—signs of humerus fragments and, therefore, open fractures. They would be challenging to treat with limited technology. Thankfully, there were none. At least none he could find. On Earth, he would have ordered X-rays or an MRI to determine the full extent of the damage, but a physical examination was his only option.

He continued to distract the knight with small talk while beginning a painful musculoskeletal exam. “I’m personally not one for banquets, but—”

“The Jade Surgeon is none other than the ancient evil!” someone yelled outside. “Her Royal Majesty must execute him at once if she wishes to rescue the souls of—”

His calls for murder ended with a wooden thud and a muffled cry.

Lili giggled. “You must have been really naughty before you came to Malten.”

Unlike her, Dimitry didn’t find the humor in his situation. “Sir Schwarz, tell me if you feel any pain.” He pressed into the knight’s clavicle, working through the supraspinatus tendon, subacromial space, scapula, chest, elbow, and forearm, wrist, and fingers. Although the patient begged for mercy several times, there weren’t any palpable step-offs, fractures, tendon tears, or ligament injuries.

Fear in his eyes, the knight glanced up from the operating table. “Perhaps the rumors are true. Maybe you are the devil.”

“Maybe I am.” Dimitry brushed a cotton ball against the patient’s deltoid, checking for axillary nerve injuries. They often accompanied dislocated shoulders. “Does the sensation feel normal, decreased, or is it completely absent?”

“Normal, I think.”

A good sign. “Extend your wrists and fingers.”

Sir Schwarz did.

The ease with which the knight mobilized his extremities made radial nerve injuries unlikely. Continuing his neuromuscular exam, Dimitry looked for hematomas and diminished pulses, then examined the skin’s color and temperature. Nothing seemed out of the ordinary.

All that remained was for Dimitry to decide on a course of treatment. “Have you ever dislocated your right shoulder before?”

“Don’t think so.”

Dimitry stroked his chin. Should he schedule surgery for the knight? Left alone, young men with physically demanding occupations like him were likely to have recurrent dislocations after the first. With each repeated injury, Bankart lesions and Hill-Sachs defects would appear or worsen, decreasing shoulder stability further. There would come a day when Sir Schwarz could no longer wield his weighty rock hammer without dislocating the ball-and-socket joint. He would be out of work, and Malten would lose yet another warrior.

Stabilization surgery, however, was not without its own risks. Inadequate equipment, untrained personnel, and a world containing unknown pathogens made open wounds lethal. Success wasn’t guaranteed.

Closed reduction was the best choice. Setting the joint back into place gave a chance for a full recovery without further intervention. Although the knight would have to rest for several months, it was better than suffering a botched operation or losing a limb to infection.

Dimitry stood by the patient’s side. “I’ll be fixing your shoulder now.”

Lili stepped closer, her eyes full of curiosity. “I saw it done before. Will you shove the bones back into place?”

Sir Schwarz hyperventilated.

“No,” Dimitry said. “Never force a joint into place. This is an anterior dislocation, and there are over a dozen methods for handling them. I’ll be using the external rotation technique.” He glanced at the knight. “Try not to worry too much. Your injury is still fresh, meaning your muscles haven’t tightened up yet. While it’ll still hurt, you won’t need sedatives. Ready?”

“Fuck.”

“Just lie flat on your back, take deep breaths, and relax. The calmer you are, the less pain there’ll be. I promise.”

Sir Schwarz squirmed before holding still. “I’m ready.”

Eager to learn all she could despite distant explosions and the amplifying shouting outside, Lili leaned in.

Dimitry flexed the knight’s forearm until the elbow was at ninety degrees. “No sudden movements, no matter what.” Supporting the arm, he externally rotated it away from the body. Whenever the patient’s face distorted and his muscles tightened, Dimitry paused to let his pain dissipate. Several yelps and grunts later, he felt the ball-and-socket joint snap into place. “We’re done.”

Unfurling his fist, Sir Schwarz’s eyes relaxed. “T-that’s it?”

“Yep.” Dimitry pressed the arm back to the patient’s stomach. “I’ll put on a sling, and you’ll let your shoulder heal for two months. Don’t do any heavy lifting or heathen killing.”

“As long as the Jade Surgeon wills it.” He smirked at Lili. “I’ll be in my Amphurt manor drinking wine and practicing offhand spear counters if anyone needs me.”

“So tough.” She smiled. “Bragging about your vacation while your peers fight against devils.”

Sir Schwarz’s flirtatious expression vanished.

Fitting the sling, Dimitry sighed. His romanticized image of a knight’s chivalry crumbled with every passing day. It didn’t matter. As long as patients listened to his orders, he couldn’t complain. “You’re all set.”

“Your skills are as the rumors say. My family will return for the armor and provide payment at a less chaotic opportunity. I hope that is well.”

“Not a problem. Just stay warm and try to take it easy on the wine—too much will slow down your shoulder’s healing.”

“Very well.” The shirtless knight bowed and left.

“Next!” Dimitry shouted.

No one entered.

Lili glanced at him, and he looked outside. There were no more patients waiting for him. A welcome respite after five in a row. He fell onto the operating table’s leather surface, using the opportunity to rest his aching feet and reflect.

And he lay there.

And he lay there.

Gradually, voltech rifles quit their supersonic roars, bombs no longer rocked the ground with shock waves, and the screaming of those assaulted by flying devils came to a halt.

Silence veiled the night.

An odd silence.

A discomforting silence.

Lili peeled back the tent’s leather flap, and confused whispers leaked in from the streets. “Mr. Dimitry, you need to see this.”

He examined the green spark bursting at the tip of his nose. “It’s still the night of repentance, right?”

She nodded. “But I’ve never seen it this quiet this early. Not even as a child in Einheart.”

“Is something going to happen?”

“I’m… I’m not sure.”

Dimitry jumped off the examination table and peeked outside.

Sorceresses conversed atop the western walls, the movements of their robed silhouettes slow and uneasy. Mounted knights trotted in through an unstable gatehouse gate and scoured the streets as if for a clue. Royal guards shot each other unsure glances.

“Did they mutate again?” a refugee’s whisper pierced the night.

Hushed voices deliberated throughout.

The franticness of the night vanished, taking on the form of anticipation instead.

Dimitry’s heart skipped a beat.

Lili poured herself a cup of distilled water and held it in a shaky hand.

A frantic horn resounded from atop the northwestern wall, signaling the start of a lethal night.

In response to the oncoming heathen raid, sorceresses rushed across battlements, knights returned to the battlefield, and refugees hid beneath metal awnings.

Dimitry marched outside and clapped, attracting over a hundred gazes. “The real deal is starting, and we’ve got a long night ahead of us. Let’s do what we’ve set out to do.”