Vital Strike

In surgery, you need to be quick, precise and decisive with your scalpel.
A small delay could mean your patient bleeds to death.
You were attacked once, and in desperation, you grabbed a scalpel and realized all your surgery experience can be easily translated to the opposite: whacking dudes.
From that day and onwards, you carry a scalpel hidden in your sleeve.
If the following conditions are met:

• Someone is struggling with you at really close quarters, and
• Your hands are free, or near the place you want to hit.

You can roll Agility & Healing, with the proper difficulty modifier associated with making a Precision Strike to a small target (+4), but with a +2 bonus to your roll result:

• You stick your scalpel in a place not covered by armor.
• You do not need to roll damage, your enemy is now Shaken and gets 1 wound level of damage.
• Independent of the accumulated wounds, you can select between these 2 options:
  • Artery: Your enemy is now Bleeding out.
  • Vital point: The wound you inflict hits the lungs, a tendon, an eye , ear, or something similar. It causes an Injury of your choosing, related with the place you struck.

That will teach'em not to mess with a doc!

You lose the scalpel after your attack, it breaks or gets stuck in your enemy, or both. You cannot perform this attack again, unless you have spare scalpels.
You cannot perform this attack more than once in a fight, since it relies on the element of surprise.