All The Light We Cannot See (Part V)
Posted on Sun Oct 3rd, 2021 @ 12:17pm by Lieutenant Jai & Lieutenant Commander Sofia Nikedoros
2,195 words; about a 11 minute read
Mission:
What Lies Ahead, Between, and Behind
Location: Bajor
Timeline: 2392
Tags: jai
"Computer, results of last bone marrow synthesis?"
[ Analysis will take three hours, seventeen minutes, and twelve seconds to complete. ]
The small Only stepped up to the large display that dominated the far wall of the medical laboratory. The reflection of the disheveled Tibetan was captured by the sleek black surface, as the child’s brown eyes took in the rendered graphics of the blood pathology.
It wasn’t anemia, but Jai had very nearly made the same mistake as the Bajoran doctor who had overlooked the cause for the symptoms.
Mika had Orkett’s Disease. Of an advanced stage. Beyond what was traditional responsive to treatment, which was normally done using a bone marrow transplant from a compatible donor. Except they weren’t on Bajor. This was a Federation starship.
Fortunately, the ship’s diplomatic officer was of Bajoran descent. Except her blood type and Rh factors demonstrated a similar variety as in humans. Strictly speaking, she wasn’t the ideal donor. But she was as close to one as what Jai had to work with.
It didn’t leave them a lot of options. If they had any options to begin with. Even with slipstream drive, the voyage to Bajor was far from instantaneous. They were three days from the Bajoran System. And Jai’s diagnosis was pretty grim in term’s of Mika’s chances.
[ Analysis complete. Bone marrow synthesis failure. ]
Leaning forward, the boy propped himself against one of the lab tables. His hands were clenched into fists, a red-hot anger coursing through the monk's veins as they seemed to draw from a deep well of frustration. The veins were visible against his forehead as the boy glared up at the displayed simulation.
The blood chemistry was simply too different. They were compensating for virtually every component save the plasma. He should have expected that result.
Except, he’d hoped for something different.
Praying for a miracle. Once upon a time, that had been part of his profession as well. Forcing himself to relax, Jai forced his eyes away from the display. Pacing inside the lab, the boy ran a hand over his normally smooth head and was shocked to feel the stubble beneath his fingers.
He hadn’t left the lab in over sixteen hours. Closing his eyes, the boy leaned his head forward as he pinched the bridge of his nose and tried to find some small piece of mindfulness on which to focus his thoughts. He needed to rest soon, but he’d thought he might be getting close to a breakthrough.
Instead, he was back at square one. Sixteen hours of work and he had nothing to show for it. Opening his eyes, the boy let go the breath he’d been holding. Crossing his arms, he turned back to the display.
Sample non-viable. Projected rejection rate: 97.375%
The boy looked away again. “Computer...” he began, his mouth hanging agape as he trailed off. If a bone marrow transplant wasn’t going to be the answer, then what? Was he going to come up with a novel treatment to a disease he’d never even heard of before yesterday overnight? What about the next five minutes?
Dr. Sorenson didn't have to look at the display to know the results, the news was written in every millimeter of his ACMO's body language and his heart sank with it too. He had known as soon as they brought they girl in what the chances were - he'd seen enough hopeless cases, not of this disease but of others, left untreated too long. Still, he had hoped... "It was worth trying, but I think Ms. Cerin's bone marrow cannot be adapted for this," he said sadly.
“What about...” the boy began, his mind seemingly several steps behind where his mouth wanted it to be. Then, looking up at Martin, the boy asked, “What about using a genatronic replicator?”
Martin shook his head. "If that could work, it would be standard treatment."
He was thinking aloud now. Using it for what? “We could...” the child began, stalling there as his mind raced to fill in the blanks.
He was grasping for straws. And coming up empty.
The pain was visible on the Only's face, and Martin suspected some shadow of it was showing on his own. "Jai..."
[ Code White. Sickbay. Emergency medical team, Code White, Sickbay. ]
The pair broke into a run, barreling out from the laboratory and into the main sickbay. As Martin emerged through the doorway, a nurse called out from the biobed where the small Bajoran girl seemed dwarfed by its size. “Acute respiratory distress triggering cardiac arrest,” the nurse announced.
"Cardiostimulator," Martin ordered, the nurse handing him the instrument almost in the same instant. "20cc triox and push intraosseous."
Close behind the larger man, the small Only took up a post on the opposite side of the biobed. “Blood oxygenation levels have fallen below forty percent,” Jai announced flatly. She was in hypoxic shock. It was a common trait for advanced cases of Orkett’s Disease. It typically signaled the beginning of the end. “Her organs are starting to shut down,” the boy added dryly.
Frak, frak, frak Martin clenched his jaw keeping the curses to himself. "Life support - now! Get the holoprojectors in place." He hated using holo-organs overlaid on live ones - it was yet another stress on already fragile systems, but with the bioreadings showed cascading failures it was the only option for keeping her alive.
“There,” the nurse called from the foot of the bed. Overhead, on the biomonitor, the flatline started to return to a rhythm. “Pulse and respiration are normalizing.”
"She's on total life support." Martin expelled a somber breath. "It's all we can do for now."
Jai keyed a detailed scan of the cardiorespiratory system. He only needed to view the results for a split-second to realize what had happened. Or, rather, what wasn’t happening. “Blood oxygen transport in the lungs has ceased,” the boy stated, craning his head up to look at Martin. “Her blood can no longer hold oxygen.”
Dammit. "Brain activity?" Martin asked, bracing for the result. As it was, she'd need multiple transplants after they found a marrow donor, but if oxygen wasn't getting to her brain it wouldn't matter.
Switching monitors, the boy paused as he looked at the results. Leaning against the console, he took a breath before he finally said, “Her neurons are starting to de-polarize.”
Brain activity had ceased. She was entering brain death. Even on full life support, her brain wasn’t receiving oxygen. Once, Jai would have fought. And kept fighting, until Martin or another senior medical officer pulled him away.
Sometimes, he missed that part of himself. Instead, pushing himself away from the console, the boy craned his head back as he announced, “Computer, this is Doctor Jai. Enter time of death as of this stardate.”
It was the right call, but Martin knew how hard it had been to say the words, and how much of a toll these last days had been on Jai. "I’ll talk to her parents."
Jai simply gave a nod, watching as Martin slipped out of Sickbay before he allowed himself to look at the body of the girl on the biobed.
He turned around. He’d started to walk back toward the medical lab. Before he'd realized it, his foot lashed out. A sea of padds flew across the office as a medical cart flipped end over end.
===============
B A J O R
===============
It was raining.
The seasonal rains watered the fertile Kendra Valley that was known to host the planet's famed, picturesque and pastoral paradise. It hosted as well a national graveyard that had originally been dedicated to victims of the Cardassian Occupation and grown into a cemetery that rivaled only Arlington on Earth.
Mika was being buried next to her grandparents, the procession slowly making its way through the haze.
The rain slipped down the smooth skin of the boy’s freshly shaved scalp. Jai was numbly aware of the water seeping through the dark field jacket he wore over his uniform as he watched the child-sized coffin moving toward the freshly dug spot over which a Bajoran vedek stood arrayed in his Sunday finery.
If the rain bothered the ceremonial clad vedek, the man didn't show it. As the coffin arrived, the round-faced, burly figure of a priest smiled faintly as he intoned, "Torum and Midal were graced with a gift from the Prophets that we had the pleasure to know as Mika. Today we celebrate her time with them and with us..."
Looking down at feet for a moment, Jai struggled to collect his thoughts as his mind seemed to be everywhere except for where he was. Instead of thinking about Mika, he just thought about himself. Glancing up, the boy surveyed the forest of adults that arrayed the small ceremony. “This should have been preventable,” the boy uttered softly, under his breath.
It was the truth. There was a treatment for gods’ sake. A cure. If only it had been diagnosed in time.
"If it had been caught in time," Martin replied gently. "By someone else. The disease was late stage by the time you diagnosed it."
“Thirty-six deaths to Orkett’s Disease this year,” Jai noted in his usual detached calm. Then gave a quiet sigh as he amended, “Thirty-seven now.” It was a bitter truth to deal with. She had been his patient. His responsibility. And he’d wound up inheriting another doctor’s mistake. Another doctor’s misdiagnosis. One that Jai had very nearly agreed with. A mistake he’d nearly made himself. And what did it matter? In the end, a girl was dead. Someone that Jai couldn’t help. “Each case, the facts are the same. Hypoxia. Anemia. By the time the doctors realized the misdiagnosis, the disease has progressed beyond treatment.”
"I can speak to the Health Ministry, recommend they develop a profile to trigger a scan for Orketts," Martin offered. Planetary bureaus weren't always amenable to recommendations from Starfleet, often viewing them as interference, but he knew Izzy and between her and her grandmother he figured he had a couple aces up his sleeve there. "It may take time, but just raising awareness will help by putting it on more doctors' radar."
Clasping his hands in front of him, the boy remained quiet for a few minutes. When he broke the silence again, he said only, “I’m staying on Bajor.”
It wasn’t presented as a request. “I’ll resign my commission if I need to,” the boy remarked solemnly. “There has to be a better way to diagnose this disease. No one should die from something this... easily treatable.”
"I agree but..." That is not what I meant by raising awareness The CMO didn't say it. Instead he looked down at Jai sympathetically. "There is other work where you're needed."
The boy paused, craning his head to look up at Martin as he started to add, “I understand that our work on the Vesta is important but...”
He trailed off there. How could he explain it? It wasn’t about what was more important. It was about being in a position to make a difference. He couldn’t have saved Mika’s life, but there were other Bajoran children afflicted with her disease. If not now, tomorrow. Or the day after. Maybe, one day, it could be eliminated. But, until then, they could at least eliminate the misdiagnosis. Maybe not all, but some.
And, right now, that seemed a damn bit more important than sitting in the Vesta sickbay, wondering why the ship was at red alert this time. Or the next time. Or even the time after that.
Martin watched the emotions play on the boy's face. He knew that look - he'd seen it in the mirror years ago before he'd resigned from a hospital on earth to join Doctors Without Borders. It had been a response to loss, to a crisis of faith in what he was doing and why. As much as, rationally, he knew his job as CMO should be to talk Jai down, convince him to stay on Vesta he couldn't help but think of how he felt then when others had tried to talk him out of going.
And really, looking back and at where it had lead him, it had been for the best. "You are fine doctor, Jai. I want you to know that I'd much prefer to keep you," Martin said honestly. "I should probably be talking to you about your career and other options for supporting the work remotely..." he curled his lips in, then sighed. "But I understand. I'm not a religious person, but I do think there's such a thing as a calling. If you think this is yours, then Bajor will be the better for it. I'll talk to the Captain about arranging a transfer."
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