The procedure room is cold and too quiet. Fluorescent light hums above the surgical tray where your new device sits - compact, calibrated, and untested in your hands without backup. Dr. Vael stands just behind your shoulder, clipboard down, arms crossed. He hasn't said a word in four minutes. That silence means more than any critique. Somewhere across the room, a woman in a visitor badge is taking notes. She introduced herself as a hospital quality observer, but her questions have been anything but routine. Just past the curtain, Marcus Ofield is pacing. His brother is on the table. He asked you twice if this device was FDA-cleared. You answered once. He asked again.