Night of a Thousand Stars

Posted on Sun Jan 30th, 2022 @ 1:17pm by Lieutenant Gunnar Arnason & Lieutenant Jai & Crewman Apprentice Liala Caerson

3,270 words; about a 16 minute read

Mission: Roll With It
Location: Haumea Medical Center
Timeline: MD -1
Tags: jai, gunnar

“Have you been to the Vulcan restaurant yet?”

The boy looked up from where his nose had been buried in the padd. Tucked into a chair that was larger than he was, the small Only had his legs folded into a lotus position as he’d been perusing one of the medical journals. Nothing particularly riveting. A case study on virus propagation in closed starship environments.

The large, faun brown eyes flicked up to see a young woman staring back at him. She was the newest member of the hospital staff.

Well, the newest before Jai had arrived. Crewman... Caerson if he remembered correctly.

Shifting around in his chair, the boy put his legs down as he leaned forward and turned the chair so that he was facing the crewman as he answered, “No. Have you?”

It was still an adjustment. He imagined it would be for a while still. Haumea was a small enough colony that people’s expectations were tempered by having heard of the hospital’s kid doctor, but it was clear that the staff were still getting used to the idea.

With the hospital running on minimal staff, perhaps it was just that there weren't a lot of people around to talk with. Cultures across the galaxy celebrated the passing of one year to the next. It seemed Haumea was no exception. So Jai had arranged for as many of the residents and assistants to be off as had been prudent. It was himself and Lieutenant Arnason, with a handful of interns and medical assistants.

If anything unexpected came up, there was always the Emergency Medical Holographic Program that could pitch in while people were recalled from celebrations. But, Jai didn’t have cause to think this would be any more or less difficult than any other night in the colony.

“It’s not really my thing,” Crewman Caerson admitted, giving the boy an almost apologetic look as she explained. “But I overheard someone say that you’re a vegetarian and it's probably the only vegetarian place in town.”

The Only cocked his head to one side. There was gossip about him? Already?

In retrospect, should he be surprised? “Most Buddhists are vegetarians,” the boy affirmed, before he tacked on the obligatory but to that generalization. “But I’m from Tibet. There’s not a lot that grows there, so we’re…” the child began, trailing off as his head bobbed side to side while he searched for the right word, “...a little more lax in our diet.”

“Oh,” the crewman uttered, as though now embarrassed for having said anything. “I just thought...”

“I appreciate the recommendation,” Jai stated brightly, turning the offer back to the young woman as he started to reply, “Maybe you’d try it with me some...”

“We’ve got incoming!”

The boy hopped out of the chair, barely making it from behind the nurses station as an ambulance shuttle came into view.

A pair of EMTs and a gurney sled followed through the doors shortly after.

“Male human, seventeen, passed out at a restaurant,” one of the techs supplied, as Jai came up to walk alongside the gurney.

“Let’s get him into room three.” The boy pulled a medical tricorder from out of his pocket, giving it the most cursory of glances before passing the tricorder off to Crewman Caerson. As the gurney was guided into the medical suite, the boy reached over to activate the bio monitors. “Cross type and BP,” Jai ordered, shifting his attention to the teen on the portable bio-bed. Opening the teen’s eyes, the boy peered at the pupils.

“AB negative,” Caerson reported from the other side of the gurney, before adding, “BP seventy over sixty and falling.”

“Start a CBC on him,” Jai ordered, leaning back from the bed to peer up at the vitals on the overhead display. Heartbeat high. Blood pressure falling. “He’s in trouble,” Jai uttered aloud, before turning and ordering, “Ten milliliters lectrazine.”

With a nod, the crewman turned to fetch the hypospray. While she did, Jai glanced back up at the monitors and said, “Computer, CMP scan and display.”

From the corner of his eye, a shadow told him Caerson was coming back his way. Holding out his hand, he felt the hypospray drop into his palm, even as his eyes never left the readout.

“Why are his potassium levels dropping?” the boy asked aloud, even as he turned and pressed the hypo against the side of the teen’s neck.

The boy’s brown eyes flicked upward, hoping to see a positive response.

Instead, the vitals triggered the alarm. “He’s going into arrhythmia,” Jai stated in a matter-of-fact tone.

Why? Jai was certain that he didn’t know. So, rather than rush in blind, the boy paused to take a breath.

Caerson was obviously caught up in the urgency of the alarm. Anxiously, the crewman asked, “What do we do now?”

Loss of consciousness. Glucose normal. Lipids all over the place. Potassium crashing... Drawing in another deep breath, Jai let it go slowly as he refocused his mind. “Two hundred milligrams metrazen,” the boy ordered calmly.

Keeping his eyes on the monitors, the boy reached out as the hypospray smacked into the palm of his hand. Pressing that against the teen’s neck, he passed the used hypo back and ordered, “Neural calipers.”

As the small device was exchanged for the hypo, Jai applied the calipers to the teen’s forehead. Without a neural enzyme pH workup, he was going in blind. But the alternative was full cardiac arrest, so there was no alternative.

Delicately calibrating the instrument, the boy glanced up at the monitors and then over at where Crewman Caerson was standing by the control for the calipers.

“Set the control at thirty,” the boy stated, keeping his attention fixed on the vitals as he ordered, “Activate.”

The readings jumped back into the normal range. “That’s it,” Jai said, holding up one hand as he continued, “Now back it down... slowly...”

The readings evened out, the blood pressure rising as the heartbeat fell into a normal rhythm.

“You did it,” Jai heard Caerson announce, even as the boy stepped back from the gurney and felt all of the adrenaline flow out of his body.

It was as though all the energy in him fell through the floor. Another deep breath. “Order a biospectral analysis, neural enzyme pH, and blood gas,” the boy remarked when he’d gathered his thoughts again.

Grabbing a padd, Crewman Caerson started the chart for their newest patient. “Yes, Doctor.”

“I think I’m going to take a walk,” Jai stated, as he started toward the exit from the suite. “Call me when he wakes up,” the boy added as he walked.

Caerson may have replied. Jai wasn’t sure. He’d been a doctor for almost a decade, but the life and death decisions – the moments where a single mistake could be unrecoverable – were still an experience beyond reckoning.

He still didn’t know what had caused the arrhythmia in the teen, or the strange lipid profile. Did the potassium levels have anything to do with the loss of consciousness? Maybe. Maybe not. All he knew was how few answers he’d had when he’d ordered the neural calipers.

He’d gambled.

He’d gambled and won, but it still remained true that Jai had risked a teenager’s life on a theory.

It seemed like that was a lot of what emergency medicine was. Ferengi gambled around the dabo table. Doctors did it around a bio-bed.

When he’d become a doctor, Jai had such noble visions of the profession. Did he now? He’d like to think so, but each day around the ER challenged his assumptions about what it was to be a doctor.

Sometimes the act of saving lives could even cause one to question the one they were living. Before he’d realized it, Jai had wound his way up to the rooftop deck of the hospital, gazing out over the colony.

As was his habit, he didn’t wear a uniform. He was there to do work and he dressed the part. A pair of scrubs made his indistinguishable from anyone else in the hospital, nurse, intern, or technician. The combadge was concealed under the lay of the medical coat he wore, hands in the pockets as he just stared out into the cityscape.

It was quite late. The fireworks were likely to start soon. At least being at the hospital meant that they ought to have a good view when they did.

Mug of coffee in hand, Gunnar was standing near the edge of the deck having timed his break to be able to see the fireworks. Most people here had families or significant others, and he'd had no problem working tonight to let them take off to enjoy the spectacle together but did want to be able to truthfully tell the t'Leiyas children that he hadn't missed the show. Imagining their eager faces, he did regret not being there with them. On the other hand, the last time he'd watched fireworks with them, they had persuaded a borderline pyromaniac engineer to share his homemade versions. That had been exciting in an entirely different way, though by some miracle no one had actually needed his services.

Hearing someone else come out, he looked around to see Jai. The Miran doctor was dressed much as he was, though Gunnar had discarded the medical coat on what, by his standards, was a warm night. "Come out to see the fireworks?" he asked, offering a smile.

The voice startled the small doctor. "Huh?" Jai chirped, looking up at Gunner, having not even realized the man was there.

The boy's mind was still in a million different places. Had the man asked him something? "Oh," Jai uttered, as realization started to seep in. Glancing around the rooftop, the boy took a fleeting glance at the view and then looked back over at the man. "No, I just wanted some fresh air."

Well, that wasn't true.

Glancing around again, the boy admitted, "To be honest, I don't even think I knew this was here." It was a great view though. "I guess I wasn't paying attention to where I was going," he added with a faint smile as he glanced back over to Gunnar.

"Issues with a patient," Gunnar said sympathetically, coming over. It wasn't really a question. After all, it didn't take a lot to read between the lines - tone, body language, it didn't matter that it was seemingly coming from a child, it was all too recognizable to someone who had been there any number of times. "Anything I can do to help?"

"hmmmm," the young monk mused a moment, before glancing back up at Gunnar. "Check in on the patient in room three?" he opined finally.

Then he paused. "Not now," he added, not wanting the request to come across as something more direct than had been intended. "Came in and almost crashed on the gurney," the boy explained, giving a slight shrug before he said. "Emergency medicine can be exhausting when the adrenaline stops."

Shifting back to the patient, the boy remarked, "I think he's through the crisis, but I'm not clear what the cause was. Or is," Jai admitted. "None of the individual symptoms he was displaying made sense to me, but maybe when you look at the scans, you'll see something that you recognize."

Gunnar had almost nodded and headed for room three, but the next words from the diminutive doctor sounded as though the patient was reasonably stable and it was the doctor who needed care, or at least someone to talk it out with. Emergency medicine did put you through the wringer, especially when the case hadn't been unresolved, leaving that lingering sense of waiting for the other shoe to drop, or worse, Damocles' sword to fall.

"I'm not a doctor, but I'll take a look," Gunnar replied, taking a sip from his mug. "I have seen a few odd emergencies since arriving - usually from someone deciding to try to cook or brew or smoke," his eyes shifted briefly upward at that last, as though casting a 'dear God, why?' at the universe's absent creator, "with some new native vegetation that they didn't bother to tox screen first. So far, no one has died of it, but we had a close call with the smoker - acute laryngeal paralysis, which we dealt with only to have the patient crash because he'd apparently managed to inhale enough to get it into his bloodstream." Gunnar frowned into his coffee. "That was long night."

"Precisely why I think you're the right person to review the scans," Jai commented. He was still going through the records and cases of the past year, let alone even beginning to familiarize himself with the allergens or vegetation unique to Haumea.

"Besides, in my experience, the nurses usually have more an idea of what's really going on," the boy added wryly. "I suspect half your job is getting the doctor out of their own head and actually looking at what's in front of them, rather than the sea of possibilities."

There was something you rarely heard from a MD. Gunnar's brows lifted slightly, though some of the reaction was directed at himself. Whatever he understood about Mirans intellectually, someone with hundreds of years of life experience in the body of a pre-teen was still going to take some getting used to. "I try to help however I can," he replied neutrally. It wasn't in any course catalogue or ever listed in a c.v., but there was an unacknowledged nursing specialty known as 'managing doctors'. Every nurse learned it to some extent, but Gunnar had once been considered something of an expert ...until he got a bit too close to one of the doctors he'd been managing. "But truth be told, nurses can wind up getting in their own heads too. We just... face lower expectations when it comes knowing exactly and instantly what's wrong and how to treat it."

The boy gave a soft laugh, a bemused smile flashing across his face as he looked out over the colony. "I definitely will not claim to know exactly or instantly what's wrong and how to treat it," Jai remarked lightly. Since it had been on his mind anyway, it seemed a good segway into what he'd been wrestling with. "In many ways, emergency medicine is like gambling. You don't have all the facts. You're guessing at what might be the right questions. Then you come up with a plan that's half-baked at best."

His instructors at the Academy might not have agreed with that. It was all about being a professional. The profession of medicine. The absolute adherence to the data, to the science. "I actually waited and put off my ER rotation until the very end of Starfleet Medical," the boy added, as he started to go into a bit of a story. "During my pediatric residency, there was a plasma fire that ignited the EPS grid of a Class Twelve super-freighter departing the Sol System," the boy shared, though in Gunnar had been on Earth around the time, he could well have remembered the incident from ten years before. "Too much theta radiation for transporters. We scambled interns and doctors out in runabouts."

He still remembered the look on the Vulcan intern's face. She hid it well, but the look in her eyes had spoken volumes before they'd beamed away to their respective locations. "I beamed into a section that was on the verge of collapse. Almost as soon as I'd arrived, the runabout started losing the signal and wanted to pull me out, but I'd already identified two people who were still alive. The only problem, their conditions aside, was that the fire had already spread to the deck above my position and the whole thing was about to come down. There was only time to pull one of them out, if I could even get one of them out."

The fundamental dilemma of emergency response. The oath to do no harm, and the realism of there not being time or resources to save everyone. So the doctor had to choose. "One had almost nothing left of his respiratory system, the other had internal bleeding that I thought could be manageable. so that was the patient I chose to save," Jai shared, as he continued. "The transport was messy, the internal damage was worse than I'd realized, and I couldn't get the bleeding under the control."

So ended the lesson. "The man I'd left behind died when the deck collapsed, and the one I'd opted to save bled out before we'd arrived at Lake Armstrong," Jai remarked somberly before he looked back at Gunnar and explained, "What I learned that day was, I can know a lot of things, but I'll never have all the right answers. And even if I did, sometimes the right decision, made for the right reasons, can still get you the wrong result."

"I remember news about that incident," Gunnar said quietly. He'd been at the hospital in Ísafjörður, one of his first rotations while working toward his NP, but things had been slow and everyone had been riveted to the news feed. At the time, the emergencies he'd seen had been mostly fishing accidents or tourists rushed in for various life-threatening idiocy. It seemed like a long time ago.

"I think I'd have made the same decision," his mouth turned wryly, thinking that if T'Ango were there she'd have added 'or gotten crushed trying to pull the other guy out too', "...but it's never easy. I've certainly been in the situation of doing what I thought was right and having it go completely wrong." He hesitated, after Jai had shared such a personal story he almost felt obligated to reciprocate, but the image that came to mind was Raeni cut nearly in half, Ilan coughing up blood... That wasn't something he wanted to talk about.

The boom startled him, nearly enough to slosh coffee. But he quickly realized it was okay. In fact, it was the perfect interruption.

"Look, the fireworks are starting."

A good distraction, for both of them perhaps, the Only thought. Jai's story had taken them down a depressing topic of conversation. But, that was the genesis of gallows humor. There was a lot about medicine that inspired hope, but just as much that brought about frustration. Even helplessness.

"Well, we may be working, but at least we've got a good view," the boy opined in a more wistful tone.

Gunnar watched the fireworks for a moment. What had Q'asa called them? 'A glory of controlled chaos'? It described the hospital in some ways too.

"We do," he agreed as bursts of gold and white and blue lit the sky, one forming a rough image of the Federation crest. Ieliene and Devora would probably be trying to work out how to make one that would look like a bird of prey. Hopefully Ali would step in, or at least provide safety guidance. Of course, they weren't the only kids would probably try to join in with show.

"I should probably get back," the NP said, turning to head back down. "I'll check on the patient in room 3."

 

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