The Battle

Posted on Fri May 24th, 2024 @ 3:24am by Lieutenant Xex Wang & Lieutenant JG Gwenwyn Marwol & Lieutenant Timmoz & LMH

Mission: Mean Green Queen
Location: Sickbay
Timeline: Mission Day 1 at 2050

[Sickbay]
[Immediately following 'Medic!']

Sickbay stood empty, eerily quiet, expectant. It felt like it was holding its breath. Only the duty nurse populated its vacant spaces, and her features were tense with anticipation. A frenzied emergency call from the CMO would do that to a person. Her eyes flickered around the brightly-lit area, which was as prepped as she could make it in the scant moments between Doctor Wang's call and the transporter tech's warning of impending transport. The surgical suite had already run through its sterilization and was just finishing its start-up procedures. All that was left was...

“Activate LMH,” she said, just as particles began to shimmer in the air.

"Please state the nature of the medical emer..." The LMH, whether through learned practice or some bit of programming that gave it the ability to know when to stop talking, cut off mid-statement, turning from where he had appeared to take in the quick materialization of of the incoming emergency.

The particles swiftly coalesced into a gurney with its patient, and both doctors Marwol and Wang. The former was obviously mid-procedure, trying to keep Timmoz's insides inside, while the latter was already directing the grav-gurney toward the surgical suite. A few pieces of unfamiliar tech adorned the edges of the gurney, as well as Xex's tricorder, which had been rigged to give them a running-- and quite dismal-- diagnostic of the Orion's condition.

Xex wasted no time. “Get Bravo shift in here now,” he ordered as they moved for the surgical suite, “and I want two-- no three liters of--” he paused, glancing down at his tricorder again, “type B-positive-plus blood about four minutes ago.” Looking up from Timmoz as they stepped into the suite, he searched out the LMH, and finding the man's calm, inscrutable features, he almost smiled. “Ah, LMH. Glad you could join us,” he said, and began a professionally calm run-down of Timmoz's condition, “Patient is in the extreme stages of hypoxic shock. It looks like whomever stabbed him managed to get him right through his lung and his heart is starving for oxygen as we speak. As you know, this is particularly tricky with the way his two-way heart functions, and this is my biggest concern. He has a lesser wound that, judging by his drop is blood-pressure, is also bleeding internally. Doctor Marwol,” he then said, looking up at Gwenwyn and waiting until he also looked up to meet his eyes. “We'll shift him on three. One, two, three.”

With the help of the gurney's transfer protocol and their own careful hands, Timmoz was decanted onto the surgical table. The table automatically lit up, and a more comprehensive diagnostic scan ran across his still, blood-spattered form and shimmered into the air above him, a ghostly replica of his outline with the affected systems highlighted within it.

The LMH took all of this in stride, shifting into position beside the surgical table and dropping into the patter of medical speech that only those seasoned medical professionals could claim. "Recommend 12 cc's of coagulant matched to type B-positive-plus blood to assist with the internal bleed before opening," he said in the calm reasoned tones of a lifeform who has seen many an emergency surgery which, in the case of the LMH, turned out to be at least somewhat true.

As much as a tool the LMH was, it was right. "Agreed. We'll have to stabilise him first though but let the biobed run her scans." Gwenwyn quipped This was so surreal, him near a real surgery after never thinking it would be possible again.

The nurse, who had followed them in, nodded to the LMH's recommendation-- seconded by Marwol-- and promptly turned to the bio-replication unit to begin inputting commands.

"Excellent thought," Xex said, retrieving a small silvery device that looked suspiciously like a laser scalpel. However, as he went to work, it was clear it was just for the removal of Timmoz's clothing, smoothly cutting away what fabric still clung to his green skin without causing further damage to the flesh beneath. He worked around Gwenwyn's hands, swiftly and methodically baring the Orion so that they could work more efficiently.

Hovering above Timmoz like a ghostly replica, the scan was nearly complete. Several areas in the back of his torso were highlighted, and the images of the affected organs enlarged so the doctors could more easily see the source of the damage that was indeed causing the internal bleeding Xex had suspected. The truly eye-catching portion of the diagnostic however, was Timmoz's lung, which had also been enlarged to show meticulous-- and rather terrifying-- detail. The site of the original stab was obvious as the system had highlighted it in lurid red: a large, messy laceration, as though the person had stabbed Timmoz, and then struggled to get his knife out, and had had to work it around in his lung, further traumatizing the delicate tissues. Blood had pooled in the lung, and the diagnostic had shaded an alarming amount of the organ, indicating the tissue death of the area, and probable catastrophic shut down of that entire half his pulmonary system.

The diagnostic chimed, indicating its initial protocols were complete.

A brief silence descended on the surgical suite, as they regarded the diagnostic, into which Xex breathed, "Fuck."

Then, as though to move past his oh-so-eloquent commentary, he was all motion. The last of Timmoz's clothes joined their fellows in a pile on the floor that a bustling figure-- perhaps one of the recalled Bravo watch-- collected before it could get under foot. "Gentlemen," Xex said as he moved around the operating table, getting a look at the ghostly diagnostic image floating above it from new angles. He was aware that he both needed as much information as he could gather, and needed to act as swiftly as possible. "I will defer to your considerable expertise in this, but I do believe that lung will have to come out," he finished grimly, knowing full well that one thing they did not have in inventory was a spare Orion lung.

"Agreed," Gwenwyn said with a breath of annoyance. He was thinking of a surgical dermal regenerator, it could easily fix it up but blood could leak through and there simply wasn't enough room to apply pressure and heal. "...Could he live without it?" Gweywn wasn't vested in Orion biology "He's in critical condition, it could take, I don't know how long until we get in range of Pathfinder Station..." There was a brief pause, a lightbulb moment. "We remove the injured part, cut it completely and transfuse it with blood. Sure he'll be hooked in a machine in a biobed but at least he'd be critically stable." It wasn't the best idea Gweywn had but it took 1st place. "His heart needs both lungs, giving him one would cause severe pain, creating stress and cardiac arrest." Explaining why, in his eyes removing it whole wasn't a good idea.

Xex hesitated over Gwenwyn's question, glancing automatically at the LMH. Although he was no expert, he was fairly certain that the two-way pulmonary system, while incredibly efficient, was not robust when it came to operating at less than full capacity. What he was entirely certain of however was that, "Pathfinder is not an option. Whatever must be done to save his life must be done here, aboard." His gaze returned inexorably to the grim diagnostic floating above Timmoz, his eyes riveted to the ghostly image as he took a few steps further back. "Computer," he directed, "run a simulation for outcomes of partial transplantation, run against the diagnostic of the patient and known Orion physiological specifics."

The computer chimed its acquiescence and said, "Working." A few beats later, the computer chimed again. "Known data sets are limited. Simulation is approximate in the extreme." Xex's jaw flexed, but he said, "Continue." The computer complied, its voice as calm and unruffled as ever. "Patient has a fifty-seven percent chance of survival with specified parameters. However, his chance of full recovery is only twenty-three percent. Additionally, the database has no known samples from which to begin the bio-regeneration."

Xex's glance darted back down to the still form on the table, his mind flicking through the options one after another, each one seemingly worse than the last. "You're right of course, Gwenwyn. It has to come out. Given that, our first challenge is to keep breathing for him while we make him a new lung. The second challenge will apparently be," and he paused, swallowing audibly in the face of the computer's pessimistic analysis, "making him a new lung. LMH? Any thoughts?"

While Xex and Marwol discussed the options, the LMH had, quite quickly, drawn on its unfortunate prior experience with missing organs many thanks to his earlier tenure aboard the Adelphi during which he and Commander t'Nai, then the Acting CMO, had been required to stabilize Commander Lenek after several of her organs had been removed by the Vidiians.

"A holographic lung," he offered and though the idea was offered in almost alarmingly calm tones, it was in earnest. "There is precedent for this," he continued before the two could ask the obvious question. "Voyager's EMH completed a procedure like this while in the Delta Quadrant and Commander t'Nai and I used a similar method to stabilize the XO on our last ship. Commander Lenek's biology is not a replica for the complicated elements of an Orion, but we may be able to duplicate a holographic example well enough to ameliorate the strain from the loss of the removed lung and then place Mr. Timmoz in stasis until we can solve the problem of growing him a new lung."

Xex's brows arched at the LMH's suggestion, but he waited patiently for him to finish before passing any judgement. By the time he'd explained himself, Xex's expression had shifted dramatically from skeptical to determined. "I'm not sure we really have any better options. It sounds like a more stable option than a partial removal, at any rate. If it can keep Timmoz alive long enough to give us even half a chance at generating a replacement, we have to try it." Nodding resolution as he made the decision, Xex said, "Gwenwyn, work with the LMH on extracting the lung and replacing it with the... holographic lung," he paused, stumbling over the unfamiliar idea, "and I will tackle the 'new lung' problem. Questions?"

Gwenwyn shook his head in the negative format, even he heard the Voyager story he was never a fan of the holographic lungs, it was untested with little results that had the patient lying still while his option at least gave the patient the ability to move his upper body. Xex was the Chief Medical Officer, he didn't want to argue with his experience.

Gwenwyn's tight-lipped headshake did not go unnoticed. Xex pinned him with a stare. "Gwenwyn, now is not the time tiptoe around. It may have escaped your notice, but I have never performed a lung transplant on an Orion before, and I am very much open to suggestions. However, we need to make a decision, and quickly. That dying lung is killing Timmoz while we deliberate. Do you think some combination of partial removal and the holographic replacement the LMH mentioned might be a better option?"

Perhaps because rather than in spite of its programming, the LMH interjected. "My suggestion is that the lung be removed and temporarily replaced by a holographic lung," he said pointedly. "In case there is some confusion. My experience with replacing organs this way is on a Cardassian physiology, but the principle should hold."

"Well, I haven't done surgery on a lung since my intern rotation..." Gwenwyn stated but he had done replacement surgery on stomachs and livers, general surgeons had the most organ loadout. This would be tricky, he was critical but stable for the most part. Was there enough time to take a crash course on Orion cardiology?

"Sounds like it's time, then," Xex said crisply. Perhaps most worryingly, his tone held not the slightest shred of irony. "As principle is all we have to go on at the moment," he continued with a nod toward the LMH, "let us hope it is enough to link Cardassian and Orion physiologies. We are agreed, then. We will remove the lung entirely and replace it temporarily with a holographic transplant. That and the stasis field should hopefully give us some breathing room," he seemed not to notice the unfortunate wording, "with which to begin to synthesize a long-term replacement for him." As though drawn by a magnet, Xex's gaze returned to Timmoz's face, which had taken on a sickly, grayish green pallor, its normally sardonic lines unnaturally slack. Xex's lips thinned into a hard line. Then, all at once, he seemed to gather himself.

Turning back to his two colleagues, he said, "I will leave the removal in your capable hands; I know Timmoz couldn't be in better ones. Collaborate however you think best for his outcomes." Xex did not come out and explicitly mention Gwenwyn's hand-- however questionable the young man's judgement might have been when it came to himself, Xex had no doubt it was solid when it came to his patients. He would involve himself however was best for Timmoz. Out here in the middle of the Delta quadrant, Xex had little attention to spare for the nitpicking of the Starfleet medical board. "I'll see what I can get started for the replacement," Xex explained of his own forward steps, his gaze straying to the main sickbay where the recalled Bravo shift was working to clear away the jetsam of their frenzied arrival with the borrowed gurney. Order would have to be restored.

"If there are no questions..." Xex said, already starting back out into main sickbay, "we had best get to work."

A post by:

Lieutenant Xex Wang, MD
Chief Medical Officer

Lieutenant (JG) Gwenwyn Marwol, MD
Assistant Chief Medical Officer

LMH
Long-term Medical Hologram