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JP by Dr Milsap and Cmdr Saveron: Difficult Questions


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((ACMO’s Office, Sickbay, USS Constitution))

 

::It was one of those eternal laws that Sickbay was busy. On a ship the size of the Galaxy-class, there was always someone in need of a doctor’s attention, even if only for a checkup. It wasn’t only in times of crisis that people got sick or injured.::

 

::Patience was a virtue in such places, and having been on the other side of the bench, Saveron was content to wait until he could have a private word with T’Reshik’s treating physician.::

 

Saveron: Doctor Milsap. I am appreciative of your time.

 

:: Jerry stood to welcome the counsellor. ::

 

Milsap: No problem, Commander. Have a seat.

 

::He waited until Saveron was settled in and sat back down himself.::

 

Saveron: I wished to speak with you about Ensign T’Reshik; I understand that you are her treating physician.

 

Milsap: If you can call it that. ::There was a hint of regret in his tone.:: From what I’ve been able to find out about...her condition, there ain’t much I can do in the way of treatment.

 

::That earned him a faint, curious [...] of the head from the Counsellor.::

 

Saveron: At times it would appear that little has changed since the twenty-third century. ::He considered the situation carefully.:: What does Starfleet Medical know about the condition?

 

::He knew what Vulcan cultures knew of it of course, so he’d never bothered to look up what Starfleet’s Medical databases had to say about it. Now he was on the outside, looking in, and had no desire to offend the hard-working man sitting across from him.::

 

Milsap: I admit, I never encountered a Vulcan in pon farr before, so I don’t have any real experience. And all the cases I’ve researched, they didn’t often turn out so well.

 

Saveron: I have noted that has generally been the case. ::He acknowledged.:: I anticipate that the problem is two-fold; a cultural reticence on the subject, and a lack of personal planning, particularly amongst young Vulcans. ::Neither of which was easy to overcome.::

 

Milsap: ::nodding:: It does seem to be a touchy subject, which I can understand. Lots of young people from all species find it awkward to discuss sexuality with adults. Learning about pon farr is kinda like the Vulcan version of what humans call “the talk”. Except in this case, if you don’t have it, you might die.

 

::That was truer than Saveron would have liked.::

 

Saveron:  I believe that Terran culture speaks of a tall bird that puts it’s head in the sand to disagreeable situations? ::His tone was dry.:: What do you know about the underlying biology of the situation?

 

Milsap: ::He sat back in his chair.:: Well, it’s a neurochemical imbalance that, if left untreated can cause death within eight days. It can be alleviated with a telepathic mating bond, but that could also bring on the plak tow. Then the patient runs a high fever and becomes irrational and violent, sometimes even unable to speak. And that can be deadly too. ::pause:: It’s pretty nasty, honestly.

 

Saveron: Only if improperly managed. ::He revealed.:: Which is generally the only situation that Starfleet has cause to observe. ::But Jerry was obviously up on what happened in those situations.:: From that basis one would assume that you can deduce what the natural resolution would be.

 

::If he was serving as a Medical Officer then Saveron would simply have delivered a short lecture on the subject to fill Jerry in. But he wasn’t, he was the Counsellor and his job was to lead people to their own conclusions, especially when he suspected that the knowledge was there, but the cultural inhibitions were preventing the connection. And as a Vulcan he knew all about cultural inhibitions.::

 

Milsap: The natural resolution, so far as I can tell, is to either mate or fight someone, and T’Reshik don’t seem too keen on either of those.

 

Saveron: That is correct, whilst the latter does not always resolve the situation.

 

::After you fought someone, you claimed their mate, after all. It was only if you lost the fight that you lost the biological imperative. The patient’s recalcitrance didn’t help the situation.::

 

Milsap: She’s done a lot of research on the condition, as I’m sure you know, and she thinks she can control the situation with isolation and meditation, and so long as she’s not in immediate danger I was willing to let her try it. If nothing else, just not giving her an argument over it might help calm her down. Cadet Thyar was willing to work with her too.

 

Saveron: Indeed, she has an interesting background with regards to certain areas of Vulcan biology. ::’Interesting’ was one way of putting it.:: However resolution through meditation is generally only available to those who had achieved the kohlinahr. She is aware of this. Having spoken with her, it is apparent that her condition is progressing.

 

::More’s the pity. He would wish her every success in that endeavour, but he knew that such was extremely difficult; Saveron held no illusions regarding his own ability to achieve such.::

 

Milsap: Another option is medication, keep her sedated and hope she sleeps right through the whole thing. And if her condition worsens I plan to do just that. I’m fine with letting T’Reshik try to fix things her way, but not if I think it’ll wind up killing her.

 

Saveron: It will kill her regardless. The physiological stress, if allowed to continue, is generally terminal. Is it unlikely that it will spontaneously resolve, despite your excellent care.  ::He replied gravely. It the reason that such situations could be so dire.:: There are cultural mechanisms on Vulcan to manage such situations, but not here.

 

:: Jerry appreciated Saveron’s compliment, he just wished he believed he’d really earned it. Ever since he’d graduated medical school it was very rare he’d find a condition he didn’t know how to treat. Part of the reason he’d joined Starfleet was to expand his knowledge to encompass treatment of other races and learn how to handle conditions he’d never be exposed to on Earth. Sometimes dealing with alien sickness was different from curing human maladies, but with a little research he was able to learn what he needed to do. This pon farr situation was the first time he’d encountered an affliction with no real medical resolution, and he felt at a loss. He’d had to rely on the expertise of others and, while that may have been the best course of action for his patient, it gave him an unaccustomed and unwelcome feeling of powerlessness. ::

 

Milsap: I get the impression that T’Reshik is resolved to ride this thing out her own way, even if it does kill her.

 

::Saveron had received the same impression from T’Reshik herself.::

 

Saveron: Having spoken with her at Counsellor Taurek’s request, I believe that I have persuaded her to review her objections in light of a ‘live to fight another day’ perspective. ::He said at length.:: Her researches, if successful, would be revolutionary. But she must survive to continue them.

 

:: That news lit a spark of hope behind Jerry’s eyes. ::

 

Milsap: Well, that’s a start. What can we do to help her now?

 

Saveron: She has made a request that she be transferred by direct transport to her quarters. I would consider this reasonable, on the provision that Security sweep her quarters for weapons and medication, and lock her replicator and console down to civilian functions only. ::That way the damage that she could cause would be minimalised.:: She has agreed to these conditions, but you are the treating physician, and the decision lies with you.

 

:: As he listened, Jerry nodded thoughtfully. ::

 

Milsap: Sure, I’d go along with that. Sometimes just a change of scenery can do a patient good.

 

Saveron: I anticipate a relatively rapid resolution, once she has the privacy and comfort of her own quarters. ::His tone was dry.::

 

Milsap: But even in that circumstance, won’t we have the same problem? She’ll still be suffering the same symptoms.

 

::Unfortunately Doctor Milsap didn’t get the subtle hint. Even Saveron held a certain reticence on the subject, although years amongst aliens had cured him of some of it.::

 

Saveron: You are correct, and she will continue to suffer them until her condition is resolved.

 

::At least now it seemed that T’Reshik would entertain the idea of that resolution.::

 

Milsap: You mentioned Vulcan has ways to deal with this kinda thing. Is it possible we could reproduce them here?

 

Saveron: Indeed, entirely possible. ::He agreed.:: Given the evolutionary purpose of the drive, the resolution is straightforward and effective.

 

:: Jerry felt like he was missing something. He still wasn’t sure what the alternate treatment was. Unless, of course, Saveron wasn’t talking about an alternative. Jerry’s brow creased. ::

 

Milsap: Are we still talkin’ about mating?

 

Saveron: Affirmative. Whilst I am aware of T’Reshik’s previous recalcitrance, I would ask, has curative therapy been offered?

 

::His tone was one of polite enquiry, as though they were talking about a vial of analgesic.::

 

:: Curative therapy? He couldn’t be asking what Jerry thought he was asking, could he? Maybe to a Vulcan for which pon farr was a fact of life that kind of thing could be viewed clinically, but to a human from a tiny town in Louisiana the idea was a little more unusual. ::

 

Milsap: You mean did anyone offer to *mate* with her? Not as far as I know….

 

::The Vulcan raised a hand in a ‘wait’ gesture.::

 

Saveron: In fact I have done so. ::He said bluntly.:: However, it ill behooves a doctor to withhold lifesaving therapy. What I am interested to know is, had I not offered, would you?

 

:: Jerry opened his mouth to respond, then closed it and looked down in thought. It never occurred to Jerry to offer to mate with T’Reshik, for several reasons. Still, Saveron raised an interesting point. From a certain standpoint, it could definitely be viewed as a lifesaving procedure. But was a doctor really obliged to save a patient’s life at any cost? If not, where was it acceptable to draw the line? This conversation was raising some uncomfortable trains of thought in Jerry’s mind. ::

 

Milsap: That’s a hard question, Counsellor.

 

Saveron: I believe that it is the Counsellor’s prerogative to ask hard questions. ::He pointed out, a certain light in those grey eyes.:: It is important that we are all aware of our respective cultural inhibitions, and I trust you appreciate that I know that of which I speak.

 

::As he spoke his tone became dryer. After all, it was Vulcan cultural inhibitions that had landed T’Reshik in her current situation, and Saveron was hardly blind to the problem. First, solve thyself.::

 

Milsap: ::nodding:: I’m sure. As for your question,I think the short answer is no, I wouldn’t have offered.

 

Saveron: I would be as to your reasons.

 

Milsap: Chalk it up to those cultural inhibitions. Now I’m not saying I would have just let her die, of course. If mating turned out to be the only thing that would save her, and she was willing, we’d find her a suitable and willing partner somehow. But I wouldn’t ask anyone to go against their own beliefs to do it if they didn’t want to.

 

::The Vulcan considered Jerry’s words. They were perhaps indicative of the reason that such situations caused such difficulties, but cultural conditioning was something they all had, with it’s associated inhibitions.::

 

Saveron: It’s a complex question; what is the value of a life? ::He posed rhetorically.:: Is it to be placed above one’s inhibitions? One’s comfort? One’s culture? And what are the duties of a medical officer? Can one withhold lifesaving treatment on a cultural basis? ::After a moment he made a placating gesture.:: The subject interests me because this situation continues to present a problem within Starfleet. There is only one reliable treatment, but it’s application appears to be fraught with difficulties, including lack of awareness despite all professional good intentions. ::Jerry hadn’t even been certain of it.:: You will, I trust, tolerate my endeavours to remedy that.

 

Milsap: ::smiling:: Besides, the Academy never taught us about sex as medicine. If they had, I suspect we might have a few more doctors in Starfleet. ::He chuckled:: Heck, it might have even made my brother get into medicine!

 

::That earned Jerry a quirked brow accompanied by an amused light in the Vulcan’s eyes.::

 

Saveron: Perhaps we should suggest an addition to the curriculum?  

 

:: Jerry threw his head back and laughed, even though he was pretty sure Saveron hadn’t meant the comment as a joke. Pretty sure.::

 

Milsap: Good luck with that.

 

Saveron: I have nothing further at this junction. If you will permit T’Reshik’s transfer then I will arrange the rest. Assuming that she agrees to treatment.

 

::He decided not to mention the euthanasia option at this point.::

 

Milsap: ::nodding:: It makes sense to me, and as you have a lot more experience in the matter I think you’ll agree it’s logical to follow your recommendation. As soon as I get back to the office I’ll take care of the formalities.

 

A JP by

 

Lieutenant JG Jerome Milsap

Assistant Chief Medical Officer

USS Constitution-B

C239208JM01


And


Commander Saveron

Counsellor and Diplomatic Officer

USS Constitution-B

R238802S10

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