Measured in Heartbeats

The day at the hospital started as chaotically as ever. Doctors, nurses, and volunteers hurried through the narrow corridors of the temporary clinic—once a government office building—now cracked and reeking of antiseptic. Machines beeped in cluttered harmony. Children cried. People waited, wheezing in corners, some holding bloodied rags to their skin like badges of survival.

The building was never meant for this. But after the last earthquake split the city’s only real hospital down the middle, we adapted. Crumbling walls, unreliable power, no elevator. Still, it was standing—and in this region, that counted for something.

I checked over a young patient, five years old at most. Knees raw from a fall. Skin sallow. Hair like dry straw. Yet she didn’t make a sound as I cleaned her cuts. Her eyes stayed locked on mine, unblinking.

“You like sweets?” I asked in halting Arabic, offering a gentle smile. She perked up immediately. A nod. Hesitant, but eager.

Her name was Sama. Hope. She was small enough to cradle with one arm.

“Be brave, and I’ll give you one,” I said, touching my hand to my chest as I spoke to help her understand. When I showed her the candy tucked in my pocket, she lit up as if I’d handed her the moon.

A quiet laugh left me before I could stop it. Even after three years working with the Global Mercy Initiative, I never got used to how children here showed more courage than they ever should have to.

Somewhere far away, on the other side of the world, I had grown up in a safe, rainy European suburb—my mother telling me stories in Arabic about a land she fled and a father I never met. I started university at sixteen, driven more by compulsion than ambition. Medicine came easily. Surgery made sense. But it wasn’t until I stepped off that plane in this country I’d only known in stories that I realised knowledge means nothing until it meets need.

Sama was finishing her candy and licking her fingers when the floor rolled beneath us like a wave.

First, a tremor.

Then the lights blinked once.

Then chaos.

The walls rattled. Metal trays clanged to the floor. I grabbed Sama instantly and threw us beneath the exam table. Above us, I heard something fall—sharp, heavy, glass? People screamed. In the hallway, someone shouted in three different languages. Children were sobbing.

The desk trembled above our heads. Dust fell in sheets. My heart slammed against my ribs, but I held Sama close, whispered to her in both tongues—nonsense syllables. “You’re safe, little one. We stay small, stay still. Just like the jackal in the rocks.” She didn’t understand the words, but she curled into me, trusting.

When the shaking stopped, silence cracked the room like a wound.

I eased out from under the table, gagging as fine dust coated my lungs. My mask helped filter the worst of it—until I looked down and saw Sama gasping in my lap, her eyes wild, her breath shallow.

No spare masks. No oxygen. No clean air. I didn’t hesitate. I slipped mine off and placed it gently over her mouth and nose. My lungs burned instantly, but she breathed easier.

I wrapped my arm around her and pulled my scrub top over my nose. Chairs lay toppled. The old ventilation unit had fallen straight through the ceiling. Somewhere in the distance, I thought I heard a low rumble—not from the earth, but from engines.

Sama clutched my hand.

And just like that, I remembered why I came here. Not for prestige. Not for redemption. But for this. For her.

I adjusted the mask over Sama’s face and lifted her gently into my arms. Her fingers clutched the collar of my scrubs, and I whispered in her ear—soft words, soothing tones—anything to keep her from looking around.

But even I couldn’t shield her from the rumble that followed.

The far wing of the building groaned. I turned just in time to see it collapse inward with a deafening roar. Plaster and concrete crumbled. Dust exploded into the air. Someone screamed. Somewhere under that rubble, I knew, there had still been patients.

No time to think. I moved.

The hallway was already filling with smoke and choking dust, and visibility dropped to almost nothing. I found two nurses—one limping, one dragging a metal cart with supplies—and waved them to follow me. “We need to get out. Bring anyone who can move.”

I kicked open the side exit. Blinding sunlight greeted us, sharp and golden through the haze. Outside, there was shouting—volunteers and locals running toward the building, pulling back tiles and debris with bare hands.

I set Sama down next to a wide-eyed teenage volunteer and knelt in front of her. “You stay here, okay?” I touched her shoulder. “Stay with this nice girl. Keep your candy safe for me.”

She nodded solemnly.

I stood. And I ran back in.

It was the kind of choice I no longer thought twice about.

Inside, I found two more survivors under a fallen ceiling beam. With help, we pried it off. A woman staggered out barefoot, blood streaming down one temple. I took her arm and guided her to the exit, her breaths ragged and shallow.

I pushed through the hallway, lungs still burning from dust and adrenaline. The air inside clung thick to my skin, and everything reeked of antiseptic, smoke, and fear. Somewhere behind me, someone yelled for gauze. Another shouted back something about blood type.

I made my way to the administrative office—if Reinhart was still around, he’d be directing everything from there.

But the room was empty.

The desk chair was still spinning slowly, like someone had just left. A canvas satchel lay half-zipped on the floor, medical files scattered like fallen leaves. A passport peeked out from a side pouch. There was a protein bar open on the desk, untouched.

My eyes locked on a note taped hastily to the clipboard rack.

Temporarily relocating to secure communications centre. Trust the team. Will coordinate from off-site. —DR

I read it twice.

So he ran.

Not with ceremony. Not with warning. Just gone.

The building shifted—another groan of twisted steel and splintered concrete. A tremor, or maybe just settling. I didn’t care anymore. I folded the note once, cleanly, and slid it into my pocket.

Then I turned on my heel, rolled up my sleeves, and walked back outside.

There were lives still waiting.

By the time I stepped into the sunlight again, the courtyard had transformed into a battlefield of a different kind.

Patients and staff lined the cracked pavement. A child lay unconscious on a tarp while someone performed chest compressions—blood-stained blankets. A man held a pressure bandage to his leg, teeth bared in pain. The volunteer beside Sama wept quietly as she tried to clean a toddler’s scraped hands.

More people were flooding in—some from nearby buildings, others helped by neighbours and relatives. One man arrived cradling his wife, his shirt soaked red. A woman clutched her own broken arm and refused a stretcher, pointing instead to a boy collapsed near the rubble.

I snapped into motion.

“Triage tags?” I called out. Someone thrust a satchel into my hands. I dropped to my knees and began checking pulses, marking foreheads with colours. Red—immediate. Yellow—delayed. Black... My chest tightened every time I reached for that one.

A field medic jogged over from across the lot. “Dr. Markovic!” he shouted, breathless. “We’ve got injuries two blocks out—collapsed housing. They’re starting to carry people here.”

I wiped sweat from my brow with a dusty sleeve. “How many?”

“Don’t know. Maybe dozens. Maybe more.”

“Set up a secondary triage zone. Get tarps, shade, and clean water. I’ll help stabilise as many as I can.”

He nodded and sprinted off.

The ground still trembled faintly under my feet, but this time, it wasn’t an earthquake—it was adrenaline. I could feel it in my spine, in the heat baking off the pavement, in the throb of my temple where dust had embedded itself into my pores.

I looked over my shoulder. Sama was sitting quietly, a smear of candy on her cheek, the volunteer’s hand still tightly wrapped around hers.

Good. She was still here. Still breathing.

And so was I.

I turned back to the chaos, bent to another patient, and got to work.

~

The courtyard was overflowing now—wounded sprawled on makeshift tarps, volunteers running between them with water, gauze, and what little morphine remained. Nadia worked her way through them with shaking hands and aching shoulders, barely pausing to breathe.

“We’re almost out of enalapril,” one medic panted, cradling an elderly man’s chest. “His pressure’s tanking.”

Nadia stiffened. That wasn’t just a missing item—that was a death sentence for patients with heart failure. Her voice came out hoarse. “I saw a box in the second-floor supply cabinet. Locked case. Left corner.”

The medic blinked at her. “That wing’s unstable.”

“I know.”

Before he could argue, she was already sprinting.

Inside, the air was heavier than before, thick with dust and that unsettling quiet buildings take on before they fail. Ceiling tiles hung at odd angles. A cracked support beam oozed fine grit onto the stairs as she ascended.

On the second floor, light slanted through a jagged hole in the wall. She reached the cabinet, smashed the lock with a piece of broken piping, and gathered what she could—enalapril vials, bandages, antibiotics, syringes. She wrapped them in a spare scrub top and tied it tight like a sling.

Just as she turned to go, a sound stopped her.

A breath.

Ragged. Wet. Human.

Nadia scanned the hall and spotted a man partially buried beneath a section of collapsed ceiling. One leg was pinned at an unnatural angle by a fallen doorframe, rebar jutting near his thigh. Blood smeared the wall behind him.

“Hey,” she whispered, kneeling beside him. “You’re going to be okay. Stay with me.”

His eyelids fluttered. Barely conscious. Pulse: thready.

She set down the supplies and braced herself. Three tries. That’s what it took to free his leg—gritting her teeth, lifting debris inch by inch, then yanking when the pressure shifted. He screamed weakly. She slipped her arm around his waist and hauled him upright.

Every step was agony—for both of them. The building groaned above them, complaining like an old ship in a storm. Dust rained from hairline cracks. Somewhere nearby, glass shattered.

Her grip faltered under his weight. Her knee buckled.

Then—

A flashlight beam. A voice. “Hey! Over here!”

A soldier burst through a hanging doorway—sleeves rolled, rifle slung across his back. He didn’t hesitate. In three strides, he was beside them, looping the man’s other arm over his shoulder.

“Let’s move,” he said. No name. No rank. Just a shared urgency.

Together, they limped down the collapsing corridor—one step at a time—until the sunlight finally cut through the smoke again.

They emerged coughing, bloodied, but standing. The soldier shouted for a stretcher. Medics rushed forward. Nadia sagged to her knees, still clutching the bundle of medicine as if it were gold.

Someone tried to take it from her. “Careful,” she rasped, voice dry as gravel. “Top vial’s cracked. Don’t jostle it.”

And then, for the first time in hours, she closed her eyes, if just for a moment.

***

Hours later, with the injured stabilised and the worst of the chaos tamped down, Nadia crossed the camp with her clipboard pressed to her chest. Her expression was tight, focused, only breaking when she passed a cluster of tents and caught sight of a figure standing off to the side.

The soldier from the collapsing building.

He was leaning against a supply truck, sleeves rolled, one arm bandaged, a cup of something steaming in his hand. Their eyes met across the space, just for a beat.

His gaze lingered. Curious. Measured.

Nadia gave a barely perceptible nod and kept walking.

Behind her, he tilted his head slightly, watching her fade into the tent shadows.

He didn’t say anything. Not yet. But something about the way she moved, the way the others moved around her—that settled in the back of his mind like a puzzle missing just one piece.