There's no more time. She's dying. Do it.

He reached for the scalpel and made a linear incision in the scalp, over the left temporal bone. Blood oozed out. He sponged away and cauterized the bleeders. With a retractor holding back the skin flap, he sliced deeper through the galea and reached the pericranium, which he scraped back, exposing the skull surface.

He picked up the Hudson brace drill. It was a mechanical device, powered by hand and almost antique looking, the sort of tool you might find in your grandfather's woodshop. First he used the perforator, a spade-shaped drill bit that dug just deeply into the bone to establish the hole. Then he changed to the rose bit, round-tipped, with multiedged burrs. He took a deep breath, positioned the bit, and began to drill deeper. Toward the brain. beads of sweat broke out on his forehead. He was drilling without CT confirmation, acting purely on his clinical judgment. He did even know if he was tapping the right spot.

A sudden gush of blood spilled out of the hole and splattered the surgical drapes.

A nurse handed him a basin. He withdrew the drill and watched as a steady stream of red drained out of the skull and gathered in a glistening pool in the basin. He'd tapped the right place.

With every trickle of blood, the pressure was easing from Debbie Haning's brain.

He released a deep breath, and the tension suddenly eased from his shoulders, leaving his muscles spent and aching.

"Get the bone wax ready," he said. Then he put down the drill and reached for the suction catheter.