Posted on Wed Aug 25th, 2021 @ 2:52pm by Lieutenant Jai
3,387 words; about a 17 minute read
Mission:
What Lies Ahead, Between, and Behind
Location: Sol System
Timeline: 2389
Tags: jai
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SOL SYSTEM
Eight Years Earlier...
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He changed into a dry uniform in the runabout.
Details were sketchy. And reports changed the understanding of the situation with each new burst of chatter over the open channels. From what the boy was able to glean, a civilian freighter had just departed McKinley Station, in orbit of Earth, when its warp core became unstable. A power surge had blown the EPS grid throughout the entire ship, virtually igniting the internal atmosphere.
The high levels of theta radiation were interfering with the long-range transporter sensors, so Starfleet had responded by launching rescue teams in shuttles in order to try and secure the warp core while also rescuing as many of the crew as possible.
In his mind, the boy was trying to calculate everything he'd need to know once he boarded that ship. Burns. Symptoms and treatment for radiation poisoning. Blunt force trauma. Lacerations. Internal and external bleeding...
Every facet of medicine had been a test, until now. None of the patients had been his. He'd always worked in the shadow of a surgeon. Always had someone he could turn to, someone who'd correct him if he were wrong.
As the boy finished packing his med kit, he looked up in time to see an object go passing by the front windows of the runabout.
It was a body.
The color drained from out of the youth's face, his head turning as he tried to prepare himself for the hellish sight to come. Taking a step forward, the boy stared ahead at his first glimpse of an industrial accident. The freighter Marseilles was listing on it's side. Atmospheric gases venting in colorful plumes from breaches which perforated the hull, revealing flickers of flames and fires which raged within.
Swallowing nervously, the youth felt his heart begin to race within his chest. He had heard the phrase, 'baptism by fire'... but there was really no need for karma to be so literal right now.
"Coming on on the first LZ," the co-pilot announced from the front of the craft.
Turning, the boy looked back at the other two doctors that were with him in the craft. To try and cover as much ground as possible, they were being inserted one by one into known 'safe' zones that the first responders from the Starfleet Corps of Engineers had identified for them. Their orders were to diagnose, triage, and identify any patients for emergency lifesaving transport.
In a purely objective, hypothetical, the young Miran understood that the lifesaving part of the triage process meant that there needed to be some plausible chance of success. That he couldn't become so bogged down by any one patient that others, with more treatable injuries, might be sacrificed. If that were to happen, then for all practical test essay purposes, it was understood that he would have to make a choice about who lived and who died. Otherwise, they might all die.
...the bitch of it was, there was no academic text, mathematical computation, or standard criteria by which to gauge the measure of a man. And so it wasn't something he'd ever been tested on.
They did these in the holodeck of course. But, no matter how realistic the illusion, it remained simply that. An illusion. Imitation of life. Nothing then could have prepared the young doctor for the sudden apprehension, dread, or anxiety which ran through him now like an arctic wind.
The two with him were equally adept at the academic side of medicine. A fellow lieutenant, who'd graduated in the group ahead of Jai's class. He'd been conducting a residency at the medical clinic on Luna's Lake Armstrong. The other was a Vulcan ensign still awaiting the completion of her student residency to apply for board certification.
Every part of the boy's mind was crying out against the prospect of being the first one on the transporter pad. Every rational fiber of his being, aside from the abject terror detracting from his reason, could conceive an excuse to not step on that transporter pad.
He stepped onto the pad, holding tight to the medical kit as he pivoted to look back at the occupants of the ambulance. He thought he should say something, but knew not what that should be. So instead he merely looked at his co-workers, and they looked back at him.
And he realized then, they were the same.
They were afraid.
...well, one was Vulcan. She probably wouldn't admit to that. So, let's just say that they were uncertain, and call it even. Swallowing, the boy found his voice as he meekly uttered, "Energize."
The experience of being deconstructed, piece by piece, down to the sub-atomic level and at speeds ten-fold faster than the speed of light was not something that could be described with any other frame of reference. When he stepped onto the transporter pad, he thought that he understood fear. Or pain. The universe was a great teacher. In moments of complacency, it placed people outside their comfort zone and removed the veil of their own ignorance.
He went numb as the runabout dissolved, watching the light fade away.
The light returned a moment later, violently ripping open his eyes as pain racked his senses. The same instant in which he'd opened his eyes, he squeezed them shut. Felt them water against the waves of dry heat that were slamming into him as though he were standing in front of a giant blow torch.
He could feel his skin begin to chafe, holding up his arms as he tried to shield his head and squint through the haze of fire and smoke. The smell was sickening, biting at his nostrils as he tried to breathe and gagged.
Human flesh. Burning, roasting human flesh.
Staggering for a moment, the boy fought to get his bearings. With one hand, he pulled the medical tricorder out from the holster on his hip. Orienting himself to the readings, the boy moved left down the corridor. The first person he came to was already dead.
The second was pinned beneath a collapsed duct or conduit of some kind. Whatever it was, he was alive. And in relatively good condition, so the duct must have provided some measure of shielding against the flash of the plasma fires. Kneeling down by the man, the boy continued to try and shield his face against the blasts of heat that rushed through the corridors, shouting over the roar of the fire. "SIR! CAN YOU HEAR ME!"
"I-I can't see," a voice answered, as the man's hand reached out toward Jai's voice.
The fingers were badly mangled. The pinky finger all but burned away. As the boy paused to assess the man, he was immediately presented with a challenge.
A metal rod was protruding from the ceiling to the floor -- and through the lower right quadrant of the man's torso. Impaling him and pinning him against the deck of the ship. In his mind, the boy was already imagining the internal anatomical structure. The compromise and damage to the large and small intestines. The arterial networks.
That would be a lot of bleeding to control.
"I see you," the boy answered, taking the man's hand for a brief, fleeting moment. "You'll be all right."
He'd been a doctor for all of fifteen minutes and he was already giving out false diagnosis.
Crab-walking, the boy crossed the corridor to the other side, kneeling over the badly burned body of a man. The side of his face that was facing toward Jai had been seared away, the fat and connective tissues rendered by the intense heat he'd been exposed to. "SIR, CAN YOU HEAR ME?" the boy shouted, kneeling over the man's head as he ran the tricorder over the man to try and diagnose... where to even begin.
Bleeding wasn't an issue, but the burns presented both external and internal issues. The unconscious patient was on the verge of respiratory collapse.
Looking up, the boy shielded his face as he snapped a look up and down the corridor. The tricorder identified these two as the only lifesigns in this section. Which meant it was time for Jai to be a doctor.
Final exam. A scenario-driven practical: You've responded to a plasma fire. There are two patients. The first is responsive, with third degree burns on twenty percent of his body, perforation of the lower abdominal cavity, internal and external bleeding, rupturing of the renal artery. The second patient is unresponsive. Smoke inhalation Low pulse. Low blood pressure. Plasma burns over forty percent of his body. Body temperature high. Probable heat stroke. Second, third-degree burns to the alveoli of the lungs.
Now, doctor, you can only focus enough attention to save one of them. So, for 100% of your final grade, who lives? And who dies?
Raising one arm, a knife-hand pressed against the boy's nose and forehead, the small Buddhist uttered a quiet prayer as he came to his conclusion. Returning to the side of the impaled man, the boy flipped open the med kit and set to work at trying to heal the wounds.
[ "Runabout Thames to Doctor Jai." ]
Holding a vial of between his teeth, the boy pulled a hypospray from out of the field kit and made some adjustments before slamming the vial into the base of the hypo. As he applied the pharmacological concoction to the patient with one hand, he tapped the badge with his other, so he could talk as he rummaged for the next instrument he would need. "I'm a little busy right now," the youth answered.
[ "You've got a collapsing plasma manifold just one deck above you. Are you ready for evac?" ]
Should he cut the dowel rod?
No, it might bring the ceiling or parts of it down on him. And he didn't have time to do a diagnostic on the state of the parts or wiring overhead. He had his hands full with the parts and wiring in the human body. The boy didn't answer the call as he fell into trying to plan or plot the plan of attack.
[ "Standby for transport." ]
They could beam the man out, but when he re-materialized, the sudden air gap would cause massive hemorrhaging. So he'd need to stop the arterial bleeding before they could move him. "I need a minute," the boy uttered in reply, even as a loud series of booms echoed somewhere overhead.
[ "You don't HAVE a minute, Doctor!" ]
As a practicing Buddhist, Jai made a conscious effort not to swear. Whenever he felt the urge or desire, he said a prayer instead. It was a practice he'd used a few times in his life, but had suddenly become a daily occurrence since he'd made the decision to change careers from veterinarian to medical doctor. Juggling a laser scalpel, diagnostic regenerator, and the tricorder, the boy tried fastidiously to try and isolate the main aortic pipeline that passed through the kidneys.
Except, the rod had shifted the internal arrangement some. And the kidney was in two sections, and the artery was hard to see with the bleeding. "Om mani padme hum," the Miran offered, clenching his teeth as the urgency from the pilot and the urgency for his patient slammed into him.
[ "NOW, Doctor." ]
He came close to letting a word slip. He felt the deck vibrate roughly as an eruption broke overhead. Kneeling over the man, the boy felt an intense heat on the back of his head a half-second before the numbing effect of the tricorder took hold. Om mani padme hum.
The sudden change in temperature made the runabout feel as cold as Siberia, the boy's return from out of the fire heralded by the sudden spout of blood which erupted from out of the hole in the man beneath him and painted both boy and transporter pad in a streak of red.
"KAKPA!"
For the first time in more than four hundred years, Jai swore.
If you believed that the boy whom the monks named Jay Prakas Gyatso was, indeed, the Thirteenth Reincarnation of the Gyalwa Lamapa, then this was the first time in all the lifetimes from Obaydullah Tenzin Gyalwa Lamapa to Jai that he'd ever uttered a word aloud. He'd thought about it. He could definitely confess to having thought about it, and probably not just in this lifetime, but he'd never said it.
He was from the Tibetan region of Earth Two, so... it was Tibetan. But there you go.
Pouncing onto the open wound, the boy pushed his hands to try and manually stem the crimson tide and control the bleeding.
This was exactly what he hadn't wanted to happen.
"Please..."
The voice was haggard. Tired. Turning his head, the boy found himself staring into the eyes of the burned and injured man.
"...don't let me die."
The words pierced through the small doctor like a knife. When he'd been a child, Jai had been afraid of letting people down.
...yes, he was still a child. But, when he was ACTUALLY ten and not a hundred or two or three hundred years old... Jai had been told that a group of the most learned and respected monks in his religion had determined that he was the reincarnation of their spiritual leader. Like the Dalai Lama of Earth. And Jai had been deeply afraid when he'd been old enough to understand the scope of responsibility. Except, no one died because of a religious text. When the Enterprise had come, three hundred years after Jai had been left the last survivor of the Gyalwa Lama school of Buddhism, none of his earlier fears had mattered because Jai was a spiritual leader to a dead people. That allowed him freedom to decide his own purpose, his own path in life. Something he'd been denied from the time he was six. So he studied animals. And, many decades later, became a conservationist and veterinarian. Like being a guru, being a veterinarian was a lot of responsibility. And people were very sad when Old Yeller died. But, the balance of life and death remained that of a family pet.
"I don't want to die."
The choices that had brought him to this point was a natural evolution of everything that Jai had been learning from the time he was a small boy. He'd cared for people's souls. He'd cared for the world around them. It was natural to want to also care for the health and well-being of those same people.
"No one's going to die," the boy said tersely, finding it shocking at how easily he could lie to a man's face like that.
It was eye-opening to realize that nothing had prepared him for this moment. The parliament of 'if'. If he could control the bleeding. If he could alleviate the respiratory distress. If he could get a plasma transfusion going...
A burst of blood shot up, nailing the boy in the eye as it squirted up from the wound. The dam having earlier been broken, a litany of colorful metaphors and euphemisms were strung in rapid fire stucco from a respectable cross-section of languages. For this kind of operation, he needed four more hands and two assistants. Instead, he was doing the best he could to juggle the various instruments he was wielding with as much precision as he could with the time constraints he was under.
With one eye, the boy was trying to monitor the state of the man's vitals. They were crashing. Bad. Risking the pause necessary to snatch a hand back to snare his med kit, the boy found the vial of cordrazine. Popping that into his mouth, he held it between his teeth as he grabbed the hypospray with the one, free hand and adjusted the setting. Facing the open end toward his face, the boy held firm with his teeth as he jammed the hypo back to load it in a non-traditional method that would have instantly failed him were this a graded evolution.
"Are we in range of Starfleet Medical yet?" the boy called out, yelling up to the cockpit as he pushed the drug into the man's carotid artery.
"Starfleet Medical's full."
There was so much wrong with that statement that the boy didn't even know where to begin. He couldn't even be afraid or disappointed, he was just angry. Irrationally, unreasonably pissed off for the situation and what it was. Even though no one could have predicted or foreseen this. Even on Earth, there was a limit to the number of hospital beds, or operating suites, or surgical bays. There were doubtless other emergencies taking place in the Sol System right now, in addition to a commercial super freighter having a major plasma fire.
"Starfleet Command is re-directing the Titan and Aventine to assist," the co-pilot announced from the front of the craft. "Luna's on the far side of Earth, but we've got a clear line of sight on McKin..."
"McKinley Station doesn't have trauma facilities," the boy snapped, more aggressively than he'd intended.
"Right. Luna it is," the pilot reported. A moment later, the boy heard, "Hang on, we're punching it to full impulse."
Even as he continued working, the boy found himself drowning in the tasks that quickly overwhelmed his ability to keep up.
"Lake Armstrong Med Center, this is USS Thames. We are inbound with a Code White. Repeat, we are inbound with a Code White..."
No heart beat. The cordrazine hadn't been effective, because the blood volume wasn't there. Cardiopulmonary resuscitation wasn't effective in cases where there was a traumatic loss of blood volume. Direct, reticular stimulation was an one option...
Before he'd realized it, the boy felt himself blinking out of existence. It had only barely registered before he'd temporarily blinked out of consciousness, coming to a second later covered in blood with a patient bleeding out onto the floor of a hospital operating suite. As orderlies and nurses in scrubs snapped into position, the boy rose up from the floor. "Male Human, age forty-three," the young doctor announced, as the man was moved to a surgical bed. As the walls of the robotic bed slid shut, Jai took position opposite a pale, blond man. "Cardiopulmonary failure. Perforated abdomen with rupturing to the renal arteries..."
"Christ, it's a mess in there," the man in the scrubs noted, interrupting the boy. Gray-blue eyes flickered up from the screens for a moment, "You're a doctor?"
The boy nodded. "Jai."
"Wilhelm Bagley," the surgeon supplied, looking back down for a moment as he made some adjustments to the controls for the surgical bed. "He's dead," the man uttered flatly.
The boy's head snapped up the moment those words had been uttered aloud, "But..."
"Mark the time," Bagley remarked, tugging off his gloves as he began moving toward the exit from the suite.
Ambling along on the man's heels, the boy was quick to protest. "Wait, direct neural resequencing," the young doctor opined. He was pulling that straight out of his ass. But it seemed like a half-way decent idea. If you were desperate enough. "We can use that with cortical stimulation..."
Bagley didn't break his stride. "He's lost too much blood," the surgeon quipped, exiting the surgical suite.
"But..."
Bagley paused. Planting one foot, the surgeon pivoted, towering over the smaller Miran as he repeated, "He's dead." Those words hung in the air for a long moment, before Bagley resumed his earlier pace. "Get over it. We have a more patients, and I could use you in OR-1."
Standing inside the door to the operating room, the uniformed child stood there. The dead man's blood drying on his hands. His skin was already turning red and blistering from the heat and pressures he'd encountered inside the Marseilles. He'd changed out of his 'wetting down' uniform into a dry one, only to have it become saturated with blood. He'd endured years and YEARS of training. Biology. Chemistry. Pharmacology. Internships. Residency.
And what had it all been for?
to be continued...