-No mistakes - 1000
-Operation complete before 5 jolts - 500
-Inflammation remained below 3 - 300
-Completed with 210 left - 200
After the hard bomb mission you get a slight breather with this operation which isn't quite as hard. It still might present a few problems though. We're operating on a plane here so there's gonna be turbulence every now and then. When there is, you can't do ANYTHING or it will result in a miss. That's right, nothing. Not even things that have nothing to do with the patient like filling up the syringe. Or even trying to activate the Healing Touch. Every turbulence will be telegraphed ahead of time, and when these signals start, you have a few seconds before the big jolts start.
Anyway, get inside the patient. We're going to be looking for places where fluids are concentrated and make incisions with the scalpel, drain the fluid, and repair the incision area with the gel. You can find these spots with the ultrasound, but to get COOLs on them you'll have to make the incision without its help. Considering the locations are random, trying to find the spots by randomly picking with the scalpel is too difficult. The good news is that you can get nothing but GOODs throughout the entire operation and still get the XS. So we're going to be using the ultrasound.
First of all, I recommend that you don't use the Healing Touch, since all of the spots don't spawn on the lung immediately. They actually get added after each jolt. So if you use the Healing Touch and find all of the spots in the lung quickly, you may be stuck with nothing to do for a long time while waiting for the turbulence.
Basically, what we want to do is find and treat 3 spots before each turbulence. Obviously this isn't always possible. It depends on how quickly you can find each one. You need a tiny bit of luck so that your ultrasounds find the spots quickly. Not too much though. The ideal situation is this: you quickly find and treat all 3 spots before the turbulence starts, and you use the time you have before it actually starts to inject stabilizer. Like I said, this isn't always possible, but don't worry. Even if you only find two of them just keep going. There are 13 that you have to take care of in all, and you have to treat them before the 5th jolt to get the XS. This means that you'll be working in 5 rounds. Therefore, you can get away with only finding 2 spots on 2 of the rounds.
Unlike in most other operations, here you'll want to treat each fluid accumulation completely before moving on to the next one. The reason being that the patient's vitals drop too quickly when the incision holes are left open, especially during turbulence.
In fact, vitals will drop very quickly throughout the entire operation as you make your incisions. As I said before, the ideal situation is that you find and treat 3 spots quickly and use the remaining time to raise vitals. However, if after finding 2 spots you use the ultrasound 2-3 times and seem to be unable to find the third one, I'd recommend giving it up for that round and just raising vitals before the jolt. Of course, once vitals are critical, raise them a little no matter what.
You must make sure that you've finished before the 5th jolt. Otherwise you will not get the XS. If you do this, you'll be finished with the lung before the time limit, but it's very likely that it'll be very close, so make sure that you look at the time when you're closing up the patient. You need to be done before it goes below 3:30. It's also possible that the patient's vitals are very low at this point. Your priority is hitting that time bonus, so if you see that the time is about to go below 3:30, forget about raising vitals and just end the operation. Generally speaking, the lowest you'll want to go is 3:35 before going for the bandage. So if the time is above this, raise vitals as much as you can until it reaches this point. If you can't raise vitals at all, don't worry, as you could still get the XS even if the patient's vitals are very low. You could also activate the Healing Touch when you're closing up so that you have plenty of time to max vitals. It's up to you.
As an aside, notice how Angie gets mad when the people in the plane applaud you for saving the patient. What a bitch. Just further proof of my theory that she doesn't want you to succeed.