"Alright everyone knows their jobs, everyone has prepared, and everyone remembers. This is going to take a while, probably longer than some of you have ever been up before, and it is going to take all of us to manage this operation correctly." All around him, clustered in a group in the operating suite stood no less than half a dozen surgeons, and other medical staff.

There was krill of course, head surgeon who would be performing the most important parts of the operation. Then they had a dedicated human anesthesiologist. Following him they had both a cardiac and pulmonary surgeon, both of them human. Dr. Katie was there as their dedicated general trauma surgeon. Following her they had a tesraki send by the company they had purchased the organs from, who was, as her credentials stated, an expert in the application of artificial skin grafts. There were a few others thrown into the mix, not to mention the veritable army of surgical staff on hold. It was a crowded room at this point, but everyone knew their place, and they had practiced for multiple days in a row to be able to get around without bumping into each other, and potentially, catastrophically bumping into the surgeon.

Krill looked around the room, bright surgical light brightening up the faces of his gowned and masked companions. There was nothing left to do, but begin.

"Empyrean, it is time to begin." He said, addressing the ship in a loud voice.

The empyrean had already moved their patient some time last night, and Adam lay on the surgical table, or perhaps the better description would be that he lay inside it. The missing part of his body, where his heart and left lung should be, were fused into the very fabric of the ship, as it was the Empyrean working to keep him alive, pumping hisbloodand infusing it with oxygen. The effect was like some sort of gruesome art installation.

BWhat remained of Adam had been sterilized and placed under drapes and blankets to stimulate the stability of his core body temperature, and his hair was hidden under a surgical cap. They had hooked him up to their own oxygen despite the empyrean doing most of the work. His face was rather pale, lips white in the stark lighting of the surgical suite.

Krill stood poised over the opening eager, and nervous, to assess the damage.

As he watched, the Empyrean began to pull herself out of the wound, drawing back from flesh like water flowing out at low tide. Behind her she left raw, gaping flesh still full to the brim with blood. This was a good sign that meant at least the tissue was alive. She drew back some more revealing shards of broken rib where the bones had been beyond repair and had to be removed, and then all at once she was gone, except for a network of gentle tendrils that kept him alive.

All of which they would have to replace one by one.

The wound was surprisingly bloodless which was a good thing, but it was strange to see an entire half of a chest cavity without its two most important organs, or its two resident organs as there wasn't much else in the left side of the chest cavity that was of note at this particular moment

The task itself was incredibly daunting, and looking at the wound even krill found himself lamenting all the work they had to do. There was so much of it, how could they hope to make this work? But he pushed those thoughts aside and began to give orders. They would need to fix the damage to the major vessels that had been left by the injury. Some of them would be prepared and others would be replaced entirely. They would replace the heart first and then the lungs and then the ribs. Following that they would replace major muscle and tissue groups reconstructing the area surrounding the opening

It was a lot of work, but they had structured it so they would all work in shifts preforming their specialty.

Of course there was a part of Krill that wanted to order them all out of his OR so he could do it himself, but he knew that even he wouldn't be able to last for the amount of time this would take. Besides he was here for one of the most important parts of the surgery.

And so he was right.

It dragged on for ages. Hours and hours passed by slowly when he wasn't doing the work, and fast when he was in, up to his elbows in Adam's chest cavity. Each vessel was repaired one by one until the moment of truth. It was time to place the heart. And so the container was brought over, open on the top and still full of the clear filmy fluid. One of the surgical attendants reached inside and withdrew the heart as a technician disconnected it from the false vessels.

The heart stopped beating.

They had to work quickly.

Krill had performed a couple of transplants before. People still needed organs while on arcadia, so he had even done several heart replacements. He worked together with the cardiac surgeon to attach their reconstructed major blood vessels. A few of the vessels had already been replaced with the artificial ones that came along with the heart, as they had been damaged too severely. Krill even took the opportunity to replace a few of the vessels he thought more prone to damage. As they did, the empyrean relinquished her hold, and all at once blood began flowing into the chambers of the heart, warm and wet.

This was the moment of truth.

Come on, come on.

Hearts often started with blood flow, but sometimes they needed a little push. The question was.

Was it too late?

Was the body too far gone for this to work?

The cardiac surgeon cupped his hand around the heart gently flexing his fingers, shaking the heart back and forth to dissipate any bubbles. He squeezed hard with his hand trying to facilitate a beat.

There was nothing.

"Lets get paddles, quickly." Krill said trying nt to let the stress enter his voice.

The cardiac surgeon leaned in using the small circular paddles directly on the outside of the heart, "Charging in three two.... one , clear."

The heart jiggled, and then went still.

"Chargain again, three two."

Krill held his breath, antenna going still as he waited, watched the heart jolt with electricity. Along the far wall the heart monitor was a still green line, long and thin and uninterrupted by either valleys or peaks. The asystolic tone was deafening to everyone in the room.

"Charging again three two one... clear."

Time seemed to slow, waiting.

Waiting still and silent.

And then the lights around the room flickered and shook gently. The group of them turned their hands upward in confusio bracing themselves against the ground their eyes wide with concern.

And then it came.

A short sharp beep.

They all turned towards the monitor where a single green peak and following valley appeared on the monitor before dying away.

They waited.

The room shook again, and the lights grew suddenly brighter.

They held onto each other, held on to their tools.

The monitor beeped again.

Krill ordered the lights be turned off for a moment.

Someone did as ordered, but as the room shook again the bulls still flickered. The beat came again, faster now. And then that sudden bump turned into a prolonged rumble that grew, and grew, and grew until Krill was worried it would ruin everything they had set out to do. People stumbled backwards into tables and walls, trying to hold themselves upright. The lights overhead burst on and grew brighter and brighter and brighter until something tripped, and they went dim again leaving behind only the steady beating pulse of the heart monitor.

Krill felt a sudden wave of relief and allowed himself a moment of triumph before returning his focus to the matter at hand. Several of the surgeons had to step out and scrub back in having fallen into each other and grabbed onto the walls, but soon enough they were back at it again. Overhead the heart beat happily away in its newfound home. Krill didn't like leaving it exposed to open air likes this, no matter how bacteria resistant it was, but still they had to keep working.

The cardiac surgeon traded places with the pulmonary surgeon, and together they worked on the lung. This moment was not nearly so gratifying as they wouldn't know it worked until Adam was taken off of bypass, but still they worked to connect all the major vessels.

There was another issue to consider.

Nerves.

Back in days past when doing a heart transplant there was no way to reconnect severed nerves to the heart. In patients who have not received heart transplants, the brain can communicate directly with the heart, telling it to either slow or speed up its beat depending on the situation, however, historically when a heart was removed it was severed from its connection with the brain. Now luckily the heart has its own electrical system and can operate independently, but when its connection with the brain is severed, it is forced to rely on hormonal cues in the blood to determine when to speed up and when to slow down, which makes its reaction time slower.

However over the past so many years, they had come a long way in the understanding of the nervous system. In this case specifically the vagus nerve. Of course, this wasn't hositrically, and using new techniques developed in perhaps, the last fifty to a hundred years, and even a few techniques that Krill himself had worked to create, they were able to, using a mixture of surgical and chemical cocktails containing stem cell regenerating agents, and adapted driven chemical compounds, they were able to recover the use of most of the nerves inside the chest cavity including those linking the heart and other organs.

When the lung was in place and nerve damage had been returned to functional, they began reconstruction of the surrounding tissue, including the pericardium and the pleura, Flexible artificial ribs were then attached to bone and socketed into place before they began reconstruction on the pectoral and upper abdominal muscles knitting the waiting sheets of fiber together with the other muscle and connective skeletal tissue sealing both the heart and lung behind a cage and a wall of fake muscle.

For a moment they sat there staring at an open chest and abdominal cavity that was simply muscle. Muscle of a strange blackish red color, both human and nonhuman. It was of course the Tesraki's turn to step in, and she did with utmost professionalism. What she brought with her was a strange looking spray bottle, which she used to coat the exposed muscle, and as she sprayed the strange misting liquid hardened and fizzed forming what seemed to krill seemed and unbroken layer of skin. He stared in awe as it closed seamlessly over the wound site, and when he looked closer, he could see the delicate pores found in human skin. He touched it gently with a gloved hand and it gave under his fingers just like skin, warming up as blood began to run through it.

Krill had seen a demonstration of the strange new technology.

It was the end of skin grafting as they understood it, driven primarily by adapted DNA and human stem cells placed into a fast acting mixture that was basically magic at this point, even to krill

They had discussed the next part at some length, though it had been sunny's final say.

She had been greatly amused when Krill came to her with the question.

Adam had lost the entirety of the left side of his chest.

So.... did she want them to replace his nipple?

When she had stopped laughing, manic from either exhaustion or worry she had sat there for a while, "If you don't replace it we could make fun of him. We could call him nippless which could be funny, but also.... He'd look kind of weird without one. They had already been informed that the replacement skin couldn't grow hair, which was also kind of funny, not that Adam had been particularly hairy to begin with, but still. Eventually Sunny's continual laughter had alerted everyone else, and the council of Morons i.e Sunny, Ramirez Maverick, Conn, and Celex who collectively determined that Adam had lost nipple privileges.

Also kay learned his new favorite word.

Nipple.

In the end the decision was probably a good thing since none of them had expertise in plastic surgery. Krill could do it of course, but he had never actually created fake nipples before so he would have liked to study up on the subject.

Despite that mild moment of amusement.

Now as the moment of truth.

He was closed up, and whole once again, laying there for all the world like he was simply sleeping.

A whopping nearly 47 hours.

They were all exhausted.

But it wasn't over just yet.

"Take him off bypass." Krill ordered.

The entire operating room held its collective breath, poised inward with worry, hope, and exhaustion as the empyrean withdrew, and the machines were finally shut off waiting with bated breath for that first gasp of air....