The Art of Medicine

Posted on Tue 25th Mar, 2025 @ 12:21am by Lieutenant Commander Lanis Dhuro MD & Captain Gordon Francis & Lieutenant Victor Delling MD & Makila i'Hartelhai

2,892 words; about a 14 minute read

Mission: The Phoenix Gamble
Location: Main Infirmary, Deck 83

"Wherever the art of medicine is loved, there is also a love of humanity." --Hippocrates

OOC:

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Dhuro Lanis rubbed at his nasal ridges as he studied the scans from the IBEX's crew, deep in thought. Malnutrition was not really his area of expertise, save that he had grown up with it to some extent during the Occupation of Bajor. As a Starfleet physician, though, he had never seen cases of it this bad--and that was considering that the IBEX's crew could have been much worse off. He was seeing signs of vitamin B3 deficiency, a condition the humans called pellagra. Fortunately, it had not progressed to dementia in any of them. The pentaptych had scanned patches of dermatitis, though.

The medical exo-comps had begun to treat the IBEX's crew with high-absorption vitamins and nutrients, so Lanis expected them to recover within a few weeks. Their CO, Alex Richardson, was suffering the effects of sleep meds combined with stimulants to keep him awake when needed. Tapering him off of them was going to be a challenge.

Meanwhile on the transport Floribunda..

True smoke billowed from the grate that hid the EPS conduit.. It offered a sinister vibe, as the steam that usually escaped from the vent had given a more fanciful sort of impression. The good doctor had been assured that such things were normal for a transport of this age, and certain things just could not be upgraded without losing the charm of the ship.

The black fog was sharp in his nostrils, making him take shallower breaths and discomfort. Pulling the first emergency hatch that he could see, he removed a respirator and placed it over his nose. Victor did not trust that this noxious smoke didn't have additives that he probably shouldn't inhale.

Upon reaching the communal area where the passengers congregated, he found a small crowd of scared people being soothed and attended to by one of the staff members of the transport. He thought he remembered seeing the man behind the kitchen window and wondered just what had happened. From the foredeck he heard someone call out "isn't one of our passengers a doctor?".

Oh boy.

Victor did what doctors do. He straightened and breathed his anxiety away in a piss of air through his front teeth as he walked forward into the smoke that poured from the forward compartment.

It was pure carnage, one officer lay on the deck plating, his skin shiny with burns, his chest not rising. A fire burned merrily from the console and associated conduits next to him, giving Victor a pretty good idea of what had occurred. Though, the twisted wreck of a conduit above that hung, ripped from its findings caught his eye before the next set of injured parties made itself known to him.

Another pair of officers were against the bulkhead, one unconscious and slumped over onto the other with smouldering hair and bleeding dark blood from both nostrils. Soot stained everything as the fire belched black smoke into the air around them.

We don't have a lot of time if the fire suppression is not working. It was moments like this that Victor wished that they had a transporter of a size to transport a whole ship. Getting a signal lock wouldn't have been a problem but the rematerialization process might have been difficult. He saw the Captain standing in the center of a circle of relatively clean decking. She was faced away from him, but still on her feet.

"Have you declared an emergency, Captain?"

It was at that moment that the ship's auto mayday began to play, a muffled version of the automated one it was transmitting. The captain turned and sagged into the chair beside her. Grey of face and Victor briefly caught sight of a metallic shine at the level of her collar bone.

"Great" he muttered under his breath and walked to the nearest panel. Not knowing its makeup, he walked to the nearest dazed crew member who was on his feet and seemed only scalded. "Get a communication channel open to the Starbase. Use medical emergency frequency 191.".

In Starbase 109's medical dispatch room, a distress hail sounded. The dispatcher on duty blinked and took the call. "This is Starbase 109 Medical, responding to TS Floribunda. Please state the nature of your medical emergency."

"Explosion on the bridge. Fire suppression system offline. 1 DOA, 5 seriously injured, with burns, blunt force and shrapnel injuries visible. Possibility of smoke inhalation injuries exist for the entire transport's capacity of 35. Requesting trauma activation, mass casualty level 1." Victor's voice was calm as he spoke into the comm channel.

"Roger that. To confirm: That's an internal incendiary explosion with no fire suppression. 1 DOA, 5 injured from burns, blunt-force trauma and shrapnel lacerations, and smoke inhalation overall for 35 people. Mass casualty level 1. Correct? Over."

"That is correct."

"I copy. What is your distance from Starbase 109? And do you need tractor assistance, or is your ship flightworthy? Over."

"We appear to be moving, but I am uncertain as to our precise engine status. I am not an adept engineer I'm afraid". He and the single conscious officer noticed the change in condition of the captain at the same time. An expletive escaped his lips as he leapt forward as she passed into unconsciousness. He caught her and winced as the bones in her shoulder shifted when he grabbed. That did not bode well, with that piece of metal in her, he'd need scans and pronto. "I need assistance immediately, control.".

"I copy, sir." There was a sound of muffled conversation and then the dispatcher's voice returned. "Starbase 109 to TS Floribunda. Sensors show you're within transporter range. Prepare for emergency beam-out in 15 seconds. Clear a place for a fire team to beam to your location. Over."

"There is room, 4 feet to my right for a team to beam in." he responded as he counted down in his head from 15.

"I copy. Over and out," the dispatcher said and the connection ended.

He let out a breath when he hit 5, and the next thing he knew the fires on the bridge sparkled out of existence to be replaced by the cool silvery blue of a Starfleet sickbay. His patient, the captain of the Floribunda, was on the bed in front of him, and he slapped the scanner plate to activate the biobed.

"Who is in charge here at the moment?" he asked, loudly to no-one in particular.

"That would be me." A tallish, thin Bajoran male with gray hair and a scarred face moved swiftly toward the biobed as the doctor and his patient materialized. He wore Lt. Commander's pips. "Dhuro Lanis, acting CMO and Chief of Surgery. And you are Dr. ... ?" He began performing an external survey of injuries as the biobed performed its scans. "Airway is patent, breathing rapid and shallow. Circulation will fail if we don't get some blood into her." He shone a light into the captain's eyes.

"Victor Delling, CMO as of tomorrow." he chuckled, getting a good glance at the Bajoran. "Glad to have you."

Lanis' eyes widened. "Glad to have you," he said. "Come scrub in. Are you up to stabilizing her lung while I handle the subclavian bleed?"

"Fine by me."

A couple of nurses hurried past him. One began cutting away the captain's uniform to expose her wounds, while the other began rubbing the patient down with antiseptic solution, wiping away blood, and placing drapes.

"BP's dropping, 85 over 69," the second nurse said. "Pulse is 115." The Bajoran physician glanced at the biobed. "Computer, generate two one-liter bags of Ringer's solution on a stand." It materialized at the head-end of the bed on Victor's side, complete with Y-tubing.

Victor cannulated a vein with the expertise of a long time practitioner and the adhesive in the tube stuck it to her skin when he pressed it down. "Good idea that crystalloid." He wasn't sure they needed 2 litres, but he'd use it to infuse other things should they be necessary. He rather figured they would be necessary.

"Left pupil is 2mm larger than the right," Dhuro noted, "consistent with brain bleed shown on scan. Computer, call Dr. Nadras to OR-1." He went on. "Scattered contusions, burns, and small lacerations on her face, upper torso, and extremities. Collarbone is exposed. Scan shows fractures to scapula and collarbone with collapsed left lung and a lacerated left subclavian artery. What happened?" he asked Victor and held out his hand for a pair of forceps, which the scrub nurse handed him.

"Shrapnel from a 70-year-old refurbished EPS conduit explosion. There was a merrily burning fire and no suppression system active, when we came out and there will be between 5 and 35 patients from the transport. All of the bridge crew will be joining us here momentarily. There was one DOA on the bridge, directly from the explosion. If you chance to look just anterior to the clavicle you will see the metal fragment." Victor answered with a grin, for he'd only seen it as a flicker of silver rather than white in the wound.

"Computer, type and cross-match patient and generate 2 units whole blood, one of plasma and keep a cryo on cool. Also, start generating O-, for the other patients incoming."

The computer bleeped in an acknowledgement and the blood bank container began to glow as it did its job and generated the blood they would need. "Do we have a neurosurgeon?" he asked as the scan of her head came up on the screen with an enormous bleed in between the skull and the brain. Turning to the nurse that was circulating Victor met her eyes and spoke "Get me a manifest of the TS Floribunda, and account for the crew as they arrive. No one comes off that ship without being seen by one of our staff, understand?"

"Yes doctor!" the young woman said as she scurried off to follow his instructions.

"I already summoned her--Dr. Nadras," Lanis said. He began working at the patient's collarbone, using a pair of Crile forceps to carefully clamp the upper end of the severed artery. Only then did he remove the sliver of metal and drop it on a tray. He held out his hand again for a second pair of Criles and then swore under his breath in Bajoran as the slippery lower artery end eluded his forceps. He had to find it fast, lest it spasm and withdraw deeper into the patient's body. The scrub nurse provided suction, which enabled him to see the artery.

"Finally!" Lanis muttered. He grasped that end with the Criles and held out his hand. The scrub nurse passed him a vascular protoplaser, and Lanis began the delicate work of repairing the artery.

"Excellent." Victor muttered, having heard the neurosurgeon's name without knowing the context for the summoning. "I haven't done a thorough study of my staff yet, there's quite a number of you, it seems." A boyish grin touched his lips, as he took up a laser scalpel and counted down the ribs to 5. He pressed the button once, and precisely opened an incision the size of his tube, before sliding the tube in. This was ancient medicine, with modern technology. It only took moments for the lung to reinflate with the specialty tube, which would seal its own incision as the body healed through it and used its proteins to make the repairs.

"Huge starbase; large infirmary," Lanis said. "Its size stunned me, too, when I first arrived. Nice work on that lung."

"Hand her off to the neurosurgeon when they arrive, there's more work to be done" Victor spoke as the alarm sounded for the next patients being beamed in. Three men arrived on biobeds, all three unconscious. The beds activated immediately, showing vital signs and beginning an autoscan per the trauma protocols. "Pick your poison, Dr. Dhuro" he offered with a sweep of his arm.

"I'll take the nosebleed," Lanis said. This patient had clearly sustained a blow directly to his face, causing heavy trauma to his nose. More OR personnel had arrived, and the room was becoming crowded.

The double doors opened, and another doctor backed into the OR, this one a short, slender Andorian female, whose surgical cap matched her skin tone. It had extensions for her antennae that comically resembled rather bent rabbit ears. "What do we have?" She gazed at all the biobed screens in the operating theater and made a beeline for the captain's gurney. "Right; this one's mine. Let's get her shaved." She pointed to the correct area on the captain's cranium, and a scrub nurse began shaving and prepping the captain's skull.

"Welcome to the party, Nadras," Lanis said. "This gentleman is Dr. Victor Delling, who's to be our new CMO."

"Mm. Nice to meet you," Nadras said absently and tapped her foot while waiting for the scrub nurse to apply antiseptic solution to the now-shaved surgical area.

"Indeed" he nodded to the blue-skinned woman who clearly had everything under control, and moved on to scanning assessments of the first of the unconscious men. He flipped the readout up so that the doctors coming in could see. In the adjacent room, he could see that more people were being beamed over in batches of 5. They seemed to have less critical injuries, and were being managed by what could only be a triage nurse by the way she took control of the room. His eyes flicked from surgeon to surgeon to nurses and aides and he smiled softly, approval warming him to this new station.

Makila had been summoned from the doctors' library, where she had been reading a journal when the mass casualty alert had sounded. Ensuring her wild curls were out of the way, she slipped into her labcoat and jogged to the main sickbay. It was easy to find the influx of patients, by the noise...and she slipped past Dr. MacAran and into the area where the brief opening of the doors showed more patients. "Where do you need me, Dr. Dhuro?" she asked the senior that she recognized.

Lanis was tempted to reply, "Anywhere!" to Makila, but vagueness was never a good idea. He thought quickly. Though Makila's official field of study was xenobiology, she was also well experienced with assisting her father in the two clinics he ran. He pointed to a patient covered in diffuse burns over most of the front of his body. Lanis pointed. "That guy on the gurney by the wall, Makila. I think he's the worst of the second group they brought in. See me when this is all over; I've got someone to introduce you to."

"Of course sir." The half Romulan turned her attention to the man with the burns and winced at the raw, weeping wounds all over him. His burns were still evolving and while she scanned him with her own personal scanner that interfaced with the computer the woman placed two fingertips on the center of his forehead. Her brow furrowed, and she focused her scans before spraying the whole bed with a decontamination and disinfecting foam. "Get them out of their uniforms, it's causing the burns to increase their potency."

A couple of medical ensigns in their second year of internship hurried over to Makila's patient and began cutting away the officer's uniform. "This is going to be a mess to debride," one of them said under his breath, "I'm glad he's already sedated."

"I don't disagree." Makila answered quietly.

At his own patient's table, Lanis studied the scanner display. "Let's start on this guy's nose. Computer, I need an internal image of the patient's left nostril--normal spectrum lighting." He held out his hand for a cautery, which the scrub nurse placed in his palm. Someone else applied suction to the spurting artery deep inside and fed an optical fiber into the patient's nose. An image appeared onscreen. "We'll have to set the nose, next," Lanis muttered as he glanced at the monitor and carefully wended his cautery into the patient's nostril alongside the suction tubing.

"This one needs a full OR." Delling said quietly, looking up at the scrub nurse as he checked the OR schedule. "Let's go to 5. Dr Dhuro, do you need assistance with that one or can I take this patient out of the equation?"

Lanis flicked a glance back up at the bioscan display. "This one has scattered burns and lacerations. Facial trauma and smoke inhalation are the worst problems. I can handle him with a resident to assist. Do you need back-up with yours?"

"I do not believe so, but he needs a hypersterile OR. Baro-trauma, inhalation burns and carbon monoxide injury. Need an oxygen bubble, among other things. If you can handle this, I'll take him and get him stabilized and we can meet at the walkie talkie patients when we're done."

"Sounds good, Dr. Delling. I'll see you when you're done, sir. Makila, how're you doing?"

"Handled, sir. Will take time, but I have him well in hand".

"Excellent," Lanis said to her. "Let's get these people squared away, and then we can all meet in the lounge for coffee when we're done. Our new CMO has arrived and has already gotten busy."

END

 

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