ALDE Chapter 4: Medical Intervention 101

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Leeda gently set Paladin down on the surgical table, nodding her thanks to Teagan as the woman left, though it was unnoticed and probably unneeded. They had managed to recover the basic systems, and there was a minimal medical database in place, basic gross trauma indicators and reaction variables. Plenty enough to provide assistance during the surgery. She grimaced as she took the room in, making a solemn vow to come back here and clean every exposed surface as soon as viably possible. Everything was grimy, and until the filtration systems were up and running at 100 percent, dust would be clouding the air every time somebody moved in the surgical bay. She took a few precious moments looking about, and finally just took off her outer jacket, hoping sadly she'd be able to recover it, and used it to wipe down the table around Paladin, the surfaces of the medical equipment, and the scanning and stasis arches that slid over the talbe, as best she could. She wasn't worried about bacterium, the steralizing field would take care of anything that could concievably cause infection, but grit in the wounds would cause problems just by being there, creating an autoimmune reaction which might compromise recovery.

After everything was wiped down as best she could, and she'd turned on the sterile fields and got the filtration running, she went back to Paladin, checking his vitals again. He was doing well, under the circumstances; Morgan had been spot on with his theory of cauterization, and the wounds themselves were seeping, but not bleeding significantly. As she'd assumed, shock would be the worst danger Paladin would face, what with the burning, the wounds themselves, and the pain of the injuries.

She wasted another few moments searching out a box she could stand on; she could have just levitated, without too much problem, but it would have been a drain on her systems and she couldn't afford to be anything less than perfectly alert, given the situation. She grabbed a laser scalpel from the bay of tools, still housed in their packaging, thankfully, and used it to carefully cut off the remains of the pilot's jacket and shirt. She carefully peeled the fabric away from the holes in his upper right chest and low on his left side, frowning as she spotted burned fragments in the wound that didn't come away with the bulk of the clothing. She'd have to pick those fragments out by hand, for the same reason she'd taken the time to wipe down the dust and grit in the room.

She finished stripping his torso and threw the rags in the corner, away from the surgical field. She double checked her perperations, made sure everything was within reach, took a shaky breath and turned on the stasis field. Tracking lights came on in the arches, illuminating the patient and indicating that the field was active and functioning properly. She reached over and tapped a few of the keys, getting readouts on his specific vitals. His temperature was low, but not dangerously so. His oxygen levels were good, definitely enough to sustain him through the operation, and since she'd already determined that excessive bleeding wasn't going to be a problem, she turned away, satisfied that he wasn't going to die on the table. "Computer, is voice command functioning in the medical bay?" She inquired to the empty room. "Affirmative function. Medical Bay is receiving properly, standby for orders." She slowly blew out a relieved sigh. Though it probably wasn't essential to Paladin's survival, it was reassuring to Leeda that the medical equipment would respond to verbal commands, since she might not always have a hand free to type out commands physically. "Alright. Give me a diagnostic rundown of exactly what we have in the way of medicine and subroutines concerning scenario response. I want to know how much of this I'm going to have to manage on my own." The last part was muttered under her breath as she began to clean the wounds, debriding the seared tissue that obviously wouldn't recover. She listened as the computer began to list off the various compounds it was capable of creating and the response vectors it had in its database. The list was woefully short, the absolute basic antibiotic and analgesic medicines and saline, to help with the blood loss. Nothing in the way of nano-reconstructive compounds, other than the growth simulators that would allow the wound to heal in a fraction of the time it would have taken without. Which all meant that she'd have to stitch up the wound by hand, to ensure the tissue healed properly. She grimaced; it wouldn't be an easy job. The wound down by Paladin's ribs was more of a glancing shot, probably a miss due to his body torquing about from the shot to his shoulder, and would be easy to stitch; it was linear, slicing cleanly through the muscle and leaving a straight path from front to back.

The circular punch of the blast to his shoulder would be much trickier. Almost perfectly round, it had seared away the flesh in its path, leaving a void that would be hard to close without distortion of the surrounding muscle and skin. She shook her head; she'd have to close it as best she could, and accept that it would be imperfect until she could go back and reconstruct the area. There would be puckering at the skin, definitely, and a severe restriction in the movement of that right shoulder and arm, as muscle pulled against muscle at the repair site. She decided that he'd have to have his arm bound immobile at least for a day, to allow the muscles to bond. Any stretching of the area might tear the sutures.

She pushed her hair back off her forehead again, wishing she'd thought to bring something to restrain the wild curls, and bent over Paladin, taking up the needle and filament and beginning the repair.

*-*-*

The surgery had gone well; no unforseen complications, and the equipment had functioned as well as she could have hoped. The wound was sutured satisfactorily, and she was confident that as long as Paladin kept the arm immobile, it would heal without incident. Of course, there was still the task of getting him back to 100% function, but that would have to wait until she could see how the nerves were reacting, how extensive the damage was, beyond the purely muscular.

She had laid him out in one of the sickbay beds, under thankfully clean sheets, some of the ones she'd ordered and had sent to the ship. His color was good and his pain medication seemed to be at good levels, though she made a note to ask him about it when he regained consciousness.

Which was apparently sooner rather than later; she heard him shift, and saw his eyes fluttering beneath the lids. She stepped up on the stool by his bedside and placed a hand on his free wrist, monitoring his pulse as she called his name softly.

A soft groan emanated from Paladins throat that sounded raspy and dry, his tongue flicked out to lick dry lips in futility as he said, "Where did that torpedo go?"

Leeda giggled slightly, but kept her hand on his wrist, monitoring the changes to his pulse as he returned to consciousness. "Welcome back," She smiled brightly.

Paladin blinked hard, his green eyes roaming around the unfamiliar confines of sick bay, confusion reigning supreme. "Dr. Paayt? What happened, where the devil are we?" Then he remembered aout the Mercs, and the fight... "Is everyone else alright?"

"Willa took a grenade, but got no worse than a bloody nose from it," she replied, letting go of his wrist. "Morgan looks and smells terrible, but he's okay too. "And I think you're fit to be up and around too, as long as you don't use that arm. We're going to have to do some therapy on it to get it to work right again. Sorry about that. I just don't have all the surgical tools I need on board yet to do a better job. And I'm babbling," she suddenly looked self conscious. "Sorry. Your in your sick bay, uh, Captain. And your crew is all over the ship like busy little worker bees, getting it ready to leave."

The sudden sound of air tools rattling through the hull emphasized her point.

Paladin nodded with relief, as the news of the others was given to him, and began to sit up, when he heard the news about his arm. "What do you mean 'get it to work right'"? He asked. "I'm a pilot, I kinda need that arm."

She hopped down from the box she was standing on to give him room. "Oh it'll be alright," she assured him. "But I couldn't rejen the tissue the laser burned away. We don't have one of those yet. And I don't have much in the way of rejen drugs or sutures yet either -- " She had to stop as more tools vibrated the entire ship making hearing anything impossible. "You're gonna have a scar where I sewed you up," she continued after the noise had stopped. "And your body's gonna have to do the healing work the old fashioned way. That means once the muscles have healed, you're going to have to do some range of motion exercises to get full use of your arm back. Otherwise you'll only be able to lift your arm about -- " She raise her arm to about shoulder height -- "this much." There was another bout of noise from the tools. "Stay on your pills and give it a month and you'll be fine," she finished brightly.

A month, that just about figures. Paladin pushed him self onto his feet, and began looking around the med bay. He caught sight of Eckhart laying on a neighboring bed, and walked over to look down at him.

"Is this one of the Mercs who attacked us? Have you already operated on him? If not, this med bay is closed, till its cleaned, and stocked properly. Did anyone think about taking me to the Infirmary on the Station Proper? I cant say what its like now, but when it was in service, these things had full hospital ranked medical facilities."

Leeda looked up at him, her hands stuffed into the font of her medical smock "I thought about it," she admitted. "For about a half a second. You know what they use for doctors on a mining station?" She asked sweetlly. "They're the ones who can't cut it in medical school. Assuming that, in about twelve hours when an operating room finally come open to stick you in, the half-trained med tech whose carving on you doesn't chop your arm off entirely, you'd still be months in post-op recovery just to maybe get enough use of your arm back to fly again some day.

"Not while your my patient, Captain. Now get out of my sick bay. You've got work to do and I have another patient to attend to." And with that she spun around and turned her attention to Ekhart.

"I didn't mean to sound ungrateful for your efforts, Doctor." Paladin began, "No one has made me Captain of this Vessel, unless it was decided while I was out, and if you're not going to treat me like a Captain, then don't call me that. You can call me Paladin, Hey you, or shit-head, for all I care. I'm sure that those half trained interns would be more than happy to let you work on me, and I'm fairly sure that Anastus would have opened a surgical suite before we got there."

"I'm also strongly suggesting that you at least ask about that before you cut on that man." He said, as he turned to go.

There was a part of medicine that couldn't be taught. This Leeda had learned in her final year in medical school. An accomplished Doctor of Xenobilogy and professor in her own right, she still found the pronouncement by her senior psychology professor, Doctor Milz, to be as curious as it was highly accurate. It was not for lack of trying, the professor had assured the all all but graduated students in his class -- but because it had to be experienced to be understood.

Independence was was part of the survival instinct of nearly every sentient race -- though there were exceptions, the Myri being the most notable example of sentient symbiosis. But in those races where independence as an essential part of the specie's success, the illusion of control of one's environment was an important part of the individual makeup, and also therefore, of the individual's ego. And the more powerful the individual, the more important that illusion of control was to that individual's perception of self empowerment. While the individual coping mechanisms were unique to each individual -- within the species norms -- they were as essential to healing as the surgery and the medications. Indeed, they could increase the healing time and the chance of full recovery by as much as 30%.

Leeda had never been face to face with such a powerful individual as Paladin. Not as his doctor. Not as one who had to assist him in his attempts to regain his sense of control over his environment after having had it completely shattered in an instant. But thanks to Professor Milz, and thanks to her work in her first field of choice, she understood what was driving Paladin's outbursts. She had deliberately driven him to the point of reaction. And in so doing he'd touched those emotions that made him feel first powerless, and in reaction once again at least the possibility that he might once again regain control. That was the beginning of healing. Now, hard as it was to see a powerful individual who was so embattled walk out of her sick bay, she knew that, for him to heal, she had to let him go and face the world that he felt had stripped him of his power. If she was lucky, Professor Milz had assured his class, he would be back.

"Let me explain what's about to happen, Colonel Ekhart, isn't it?" She turned her attention to her next patient...

Paladin heard her, as the hatch slid shut behind him, and shook his head. She was going to operate in an ambulance, in the parking lot of a hospital. Sometimes, people refused to listen to sense when they heard it. That seemed truer in direct proportion to how smart or educated they were.

Not my problem He thought as he swayed down the corridor towards the cargo hold.




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