round 16 LtCmdr Reid - Though, I Walk Through the Valley of Death, Don't Fo

[Blueheart]

Though, I Walk Through the Valley of Death, Don't Follow Me, I'm Lost

((Surgical Suite- deck 4, USS GEMINI))

::Reid was waiting for his surgical team to get themselves transferred from the USS Wyoming, to the USS Gemini's sickbay during the middle of a battle with a Klingon K't'inga heavy battle cruiser. He realized it had taken him awhile to be tansferred, Why should it be any less time for his crew? It all started aboard the USS Wyoming, where he had been working triage, and then sent to surgery to mend the wounded casualties by patching them up, help stabilize them, storing them anywhere there was a little space, prior to them being shipped out. Then it happened: two severely critical casualties requiring more than a simple patch, a temporary fix, temporary storage, and transportation elsewhere were assigned to me. But, I am beginning to get ahead of myself. Let us stop here, and back up to the first stage of scrubbing up for Surgery.::

Reid took the opportunity to take a sonic shower aboard the USS Gemini. While in the shower, Reid had time to reflect on the events that he had been through for the past few days,. First, he was stationed abroad the USS Wyoming, which had rendezvoused wth the USS Gemini, and both Starfleet vessels then responded to a distress hail. The USS Hermmes had come under attack by a K't'inga class, a Klingon heavy battle cruiser. They had placed a distress signal they were under attack, and requested immediate help. When both vessels had reached the USS Hermmes, it had already been boarded by Klingon boarding parties, and the K't'inga cruiser had already caused major damage to the Hermmes ship systems, and havoc among the crew. The USS Wyoming had been attacked first. So, it had taken on more casualties, than the USS Gemini, at this point. So, the casualties started piling up, even more, amongst the Hermmes crew during the intense fighting within. Then the USS Gemini had sent a Marine SAR team abroad the USS Hermmes, to capture the marauding Klingon boarding parties. Soon the SAR team reported mass causualties among the USS Hermmes crew. Then the Gemini's boarding parties began to take on casualties trying to accomplish their mission. It wasn't long before the USS Gemini came under intensive bombardment from the Klingon K't'inga creating their own set of problems, and casualties. Reid had already started triage of the wounded, then transferred himself into a surgical suite, and went to work performing "meatball" surgery aboard the Wyoming.::

"Meatball" surgery consisted of patching the body from within through any required surgery that helped ensure the patient's survival, and stabilization. Once accomplished, the patient had a better chance to survive being transpoted to another medical facility. At that facility, the patient would undego more of the required surgery, further treatment, and necessary care to facilitate the patient's healing process, and recovery.

::While waiting for the next set of wounded casualties, He had been summoned to the Captain's ready room. Once their, his life was about to undergo a drastic change. Starfleet Command gave him orders to permanently serve aboard the USS Gemini, as a surgeon. He had been transferred before, but this was the first time he was transferred during a battle. Due to the battle raging on between the three Starfleet vessels, and the Klingon K't'inga, further casualties kept occurring. Reid tried to report for duty aboard the USS Gemini, but could not find anyone with authority, who would be able to take his orders. He finally settled for a tired Gemini Doctor, who had sat down briefly to get a moment's rest. She sent him to triage immediately, and then he reported to surgery to continue more "meatball" surgery. Two severely injured Starfleet officers came in, and Reid was ordered to handle their cases. Reid found out his request for his surgical team to be given orders for the USS Gemini was granted. So, while waiting, he went and personally checked on the two severely injured patients, and had them start being prepped for surgery, and kept watch until the team came aboard. Meanwhile, he was now, himself, preparing himself for surgery, an had started with a sonic shower.

When he came out, he was met by a nurse, who came into the locker room while he was changing into scrubs. He turned around and there was the nurse standing there waiting for him. Reid thought to himself, oO Good thing I have my scrub trousers on Oo. He started to say something, and realized he didn't have a scrub shirt on. He immediately scrambled around through his things looking for his scrub shirt. Meanwhile, the nurse tried to hold it in, but eventually broke out laughing at the comedy before her. Reid stood up slowly realized he'd been had. Especially, when the nurse brought out a scrub shirt from behind her back. He reached for the scrub shirt, and said::

Reid: "Excuse me, nurse". ::Reid reached out and took the scrub shirt, and quickly threw it over his head, and slid it down to waist. He then tugged at it to straightened it out:: "And you are"?

Nurse: PO 2C Benntiere, Surgical Nurse Specialist. Doctor. Thinking oO Oh boy, now I'm in for it. Oo

Reid: Just how long have you been standing there? Meanwhile, Reid had a strange thought, oO Why do all surgical people have a sense of humor? I experienced it on the USS Wyoming, and it looks like there is going to be few pranksters here Oo :: Reid knew that different people had their little quirks. Everyone dealt with their assignments many different ways. ::

Nurse: Long enough! ::long pause:: Remember, you invited me to join your surgical team today. I am just reporting in as ordered.

Reid: ::putting his hand on the sore spot on his head.:: Ouch! All right, consider yourself reporting as ordered. Go find the chief surgical nurse, PO 1C Bothenet.

Benntiere: Aye, Dr. Reid! ::She turned, and walked out of the Dr's lounge.::

::as Reid straightened up, he looked around to see if anyone else heard the nurse's snide remark, "long enough." The remark made him blush, as he thought, oO Ok! Just how much did she see? Oo. Reid walked out the door, and went over to Lt. Applewood's biobed. He type in the patient's chart code, looked at data on her monitor, and shut off the overhead sensor cluster. He was checking just how much her hypovolemic pressure had dropped. At that precise instant he heard a voice say from behind him::

Knightling: The patient's pressure has not dropped significant enough to warrant any treatment at this time.

Reid: ::turning Reid said:: Thank you doctor Knightling. You know I check everything myself just as a secondary precaution.

::Then he heard another voice off to his left. He turned to his left, and saw Dr. Treadway, and his entire surgical team. Inside Reid was ecstatic, but on the outside, he remained emotionless. After all he had a reputation to uphold.

Treadway: Lt. Vetonia Treadway, and team, reporting as ordered Cmdr. Reid.

::Reid was glad to see her once more. He looked behind her, and saw his whole team waiting for orders. Reid began to speak::

Reid: It is good to see you all once more. ::pause:: I need you all to scrub up, and change into fresh scrubs for surgery. Prepare the suite for a double surgery, and on the duo tables set up support frames onto both tables. I will explain later. Also, someone test the overhead sensor clusters, establish stasis force fields, and the decontamination fields over the patients; until we are ready to do surgery. Two of you med tech's will report to the morgue, and see if you can be of assistance. That means you 2Classmans Ped, and Pod. 1Classman Posh, I need you to assist overseeing the establishment of the different fields on the patients biobeds. Test them now, to make sure everything works. During surgery,would not be the best time to discover faulty fields.

1Classman Posh: Aye, Dr. Reid.

::Posh left to perform the testing of all fields. Then he went to complete other duties before surgery got underway. Ped, and Pod didn't say anything. They just followed their orders, and went to the morgue to assist the already busy Gemini crew.::

Lt. Treadway, I need you to go over to triage, and see if you can assist somehow. If they don't need you come back and prep yourself for surgery.

Treadway: Aye Doctor Reid. ::she dismissed herself, and walked over to the triage area.::

Reid: The rest of you,who have not received any orders, just start performing your normal duties for surgery preparations like lyou always perform. Dismissed!

::Reid heard an assortment of different responses with ayes, and they all headed to their assignments. Reid turned around and checked the neural calipers report for both patients. Another vital sign measured during surgery. oO This is not good.Oo thought Reid, oO It indicates the patient's vital signs have dropped to serious levels. But, they counterindicate the neural caliper readings. Anymore readings like this, and we'll have to operate immediately, or we will lose these patientsOo. Reid turned to head back into the surgical suite, looked up, and saw an unfamiliar officer walking towards him, Dr. Brooke Zandra he presumed. Reid was going to wait for her, but then she suddenly changed direction. Reid contemplated briefly oO After all the wounded, dead, and dying I have seen today, I can truly say, "Though, I walk through the valley of death" Oo, Reid had to stop a moment, and recompiled his thought pattern. With Dr. Zandra coming towards him, then abruptly changing directuon, it gave him inspiration. Reid could honesty think, oO "Though I Walk Through the Valley Of Death, Don't Follow Me, I'm Lost". Oo

::Part II::

::When everything was in order, and ready for surgery to Reid's expectations, he called his team together, and began to give the team pertinent information on the two new cases.::

Reid: I have called you here to relay news pertaining to our surgery cases. We have been reassigned new emergency surgical cases. We will not be doing our usual "meatball surgery" this time. I will let Doctor Treadway explain. Doctor Treadway you're up!

Treadway: Surgical team staff, We have just received new emergency cases of two casualties from the USS HERMMES. One, a male ensign, and the second is a female Lieutenant. Both have received wounds the from the fighting, and also have sustained further injuries from being tortured. I suspect they both have internal bleeding as the result of torture. They both are in critical condition, and it could go either way for the Lieutenant, as it appears she has sustained more severe injuries than the Ensign. Neural Caliper testing showed how serious the internal wounds have affected their different biological systems. For now, they have been placed in a state of induced comas, and administered hypocoagulants to slow any internal bleeding.

PO 1C Bothernet: I never liked Klingons, as most of you know they killed my parents.

Reid: Alright, team, we will leave our personal feelings at the door. When we go through those doors, and work at the surgical tables there will be no time for emotions.

Bothernet: Sorry, sir, I didn't mean it, the way it sounded like.

Reid: That's all right nurse Bothernet. I, too, lost my father during the Battle of Wolf, in the Klingon Civil War. Now, I suggest no more interruptions until I finish the briefing. I will answer any questions at the proper time. For now, you will all conduct yourselves in a professional status. Now, you are all dismissed. Report to your stations, and see they are ready once the surgery begins. Nurse Bothenet, give the team their surgical assignments.

Bothenet: Listen up for your assignment. PO 1C Trusk, you are the surgical nurse anesthesiologist. PO 3Cs Posh & PO 2C Cogshell, the surgery med tech's, PO 1C Bothenet, the chief surgical nurse, PO 2C Benntiere the assistant surgical nurse, 1st Classman medic Tep, will cross type & match blood type, will provide the dextrose, saline, and lactate ringers IVs, and provide any necessary lab tests & results during surgery. Team, dis-missed!

:: All the team members responded with their proper Ayes, and left for their different stations to get them ready for the duo surgery procedure.::

Reid: Doctor Treaway, you will come with me to check on the Lieutenant. What is her name again?

Treadway: ::pulling up her medical tricorder, and pressing a few well placed buttons:: Her name is Margot Applewood, Lt, Communications, USS Hermmes. She is middle aged, her last physical has her in a great phyisue. She is married, and the mother of two children. Her family is quartered on Starbase 118. :pause: Do you want her current testing, and results, Doctor?

Reid: No, Doctor, you can send the results of all testing to her biobed overhead sensory cluster, and then to the surgical monitors. We can review them during the actual surgeries. I'd prefer to run our own tests, then compare the two results. By the way Doctor, has anyone run a second neural caliper test on them both to establish a comparison baseline.

Treadway: Evidently, she was scheduled for one, but she took a turn for the worst. So, no second neural caliper testing was done. That, is when I placed her into a state of induced coma. It has slowed down all her life forces; inclusive of bleeding.

Reid: Send one neural caliper test program when we get into surgery, and run the test immediately. Now, tell me about this young ensign. What is his name, and background?

Treadway: ::rerouting the data, the Medical tricorder once more delivered the Ensign's data:: His name is Jhanon T'Lar, he is a young male,half Bajoran, and half terran, in his early twenties, Ensign, Engineering, recently transferred to the USS HERMMES. It also says he was having a relationship with a young Ensign from Astrophysics. Her name is Erma Hines, and is currently listed as MIA.
As with the Lt's scan results, I will send his to the biobed overhead sensory clusters and then to the surgery monitors. Also, do you want to run a neural Caliper test as well?

Reid: Affirmative! Send the test scans to their biobeds, and run a second set of scans and tests for the team's review. Then, set up a final third program, run the Neural Caliper test on the Ensign, and I will run the final test on Lt. Applewood. Then send the test results to the surgical suite monitors, and we shall review the test data during surgery. To save time, you take the Ensign T'Lar, and I will take Lt. Applewood to expedite matters.

::they both went to the their perspective assignments, and begin running all tests, and scans; inclusive of the Neural Calipers scans. When they had finished all the tests, and scans, they returned together, and compared all data reports on the two patients.::

Reid: I was afraid of this. All data relays internal injuries, and bleeding to different biological systems, but they both are registering hypoglycemic shock. Worse yet, the injuries are indicative of having been sustained by different types of torture. Lt. Applewood's torture seemed more severe than Ensign T'lar's. oO If only the age differences. were reversed Oo, thought Reid, oO then the Lt.'s ability for survival would be a better gamble. As it is the Ensign has a better chance of pulling through Oo. "Inform Dr. Knightling he will assist as cardiologist, and assist me as a neurologist. I will act as the neurologist, and provide the brain surgery, You will be the Nephrologist,Urologist, and assist me In orthopedics for the rib cage restoration only. Both caseloads will then be turned over to Dr. Zandra,and Dr. Whale, who will treat any burns, suture any lacerations, repair any remaining fractuded, and treat all confusions, and bruising. Please make a list of these assignments, notify the surgeons involvement in their perspective surgical duties. Have chief surgical nurse, Bothenet to set a final schedule for all enlisted medical team staff.

Treadway: Aye, Doctor Reid. Right away.

Reid: The next step is to take Lt. Applewood out of her state of induced coma, and if she shows signs she can survive the surgery, have the med techs take her into the prepping area. You stay with her, and monitor her vital signs while they prep her. Afterwards, you then go scrub, change into surgical scrubs, and join the team in the surgical suite. The med techs can transport her into the suite when we are ready. Notify all the surgeons, we will have a short meeting to put us all on the same page before we actually begin the surgery. Let us get 'er done!

::Dr. Treadway went to comply with her orders. Reid headed into the scrubbing room, where he headed to the food replicator, ordered Irish Breakfast Tea, and a cinnamon scone. He had a few minutes to snack before he had to rescrub, and then change into clean scrubs himself. Then his fight with death would begin once again. He personally didn't like to lose.::

::Act III::

While Lt. Applewood was being prepped surgery, the three Docors were in conference discussing the upcoming procedures. All of them were standing around the replicator. The scene reminded REID of office personnel on break, congregating around the old water cooler, discussing the work day's events. Reid had estimated the surgery would last anywhere from 12 to 36 hours. Reid knew Ensign T'Lar would lose more opportunity to a full recovery, and rehabilitation, if he had to wait his turn for surgery. Since all three surgeons were going to have to wait or risk getting in each other's way, Reid had developed an earlier unique plan. Instead of wasting time prolonging the surgery, Reid informed the surgeons they were all going to practice a quick run through, after he informed them of his plan.::

Reid: Gentlemen, I propose we all operate on both patients, to facilitate any healing process, rehab, and recovery, at the same time, in the same suite. Each of us would be operating on different areas of both patients, without getting into each other's way. This would allow us to perform our particular surgical skills, and expertise, while also creating opportunities to help each other out as indicated, where needed at a particular moment. What are your opinions on the issue?

Knightling: It could just work at that, and each of us can have independent mobility when treating the different wounds on both patients at the same time.

Treadway: It would also allow each of us to perform our skills at some point when individuality nessistates specialized surgery on specific organs, or body parts. The other two can provide cover any general surgery abandoned for any specialized surgical opportunity, at a given notice.

Knightling: It also permits us to finish up a technique on one patient, then hop across to the other patient, and repeat any necessary surgery on the other, if needed. This gives us greater latitude, mobility, and freedom to act either independently, or together on their wounds, and repair any internal organsy that may have been damaged.

Reid: Suffice to say it is going to be a great undertaking in of itself. Doctors, we are all tired from all the emergency surgeries we performed ever since this battle started, but I believe in all of you. ::Reid paused for a moment to gather his thoughts:: Doctors, after going through all the test results, amount of injuries found, and medications necessary for the healing process, one would feel we are ready. But, we need to address another issue facing us. Therefore, I have asked Dr. Zandra to join us in the surgery briefing. At the moment, she is scrubbing up for surgery, and putting on fresh scrubs. She will join us shortly. Then, I will start the briefing.

::Posh, and Cogshell, the two supporting medic came into the surgery suite, and notified Doctor Reid, the patient Lt. Applewood was prepped, and ready to be brought into the suite. At that time, Reid informed them to also prep Ensign T'lar for surgery as well. Reid informed them only of the plan for this team of Surgeons to perform duo surgery procedures. Then Reid gave them two additional orders, one to get Ensign T'Lar prepped for surgery, and to have him ready within the next thirty minutes, as the plan was to start both surgeries, at that time. Also, would one of them go and inform Dr. Zandra to finish scrubbing, and meet the surgeons in the surgical suite within 15 minutes. That would be the exact time, the surgery briefing for the doctors would begin. Reid then dismissed the two med tech's, and they left the suite. Reid headed back to the surgery table, and began to review the surgical plan one final time. He picked up the padd contain the plans, and began to read the concepts of the plan. Reid also reviewed Bajoran physiology, concerning Ensign T'Lar, half Bajoran, and half terran.::

((Timeslip - 15 minutes ahead))

:Reid had been going through all of the plans, and even renewed reading all of the medical tests and scans. He set down the padd and had to rub his eyes to clear his vision. He heard the sound of the turbodoors emit their tell tale swish sound, when they opened, and When they closed. He removed his hands from his tired eyes. After all, he was feeling exhausted from having been doing surgery from the moment the Klingons started the recent fiasco causing many casualties that required his trained surgical skills, and years of experience. He felt every muscle, even a few that he hardly used. The only reprieve for rest, came when he had transferred to the Gemini. And that was a very short reprieve at that. In the back of his mind, Reid was fearful he would soon pass his exhaustion point, and move into the fatigue realm. Reid thought oO I am going to have to increase my workouts,marathon style, as if I were going mountaineering.Oo. He turned to see Dr. Zandra walking towards him once again. This time she stayed for the briefing, as she went over to the replicator. Their, she met Dr. Reid who was ordering something to drink.::

::Part IV::

Zandra, and Reid had finished their drinks, and as they were wrapping up their conversation, Reid looked at his wrist chronometer. He noted 14 minutes had passed, so he politely excused himself, and walked to the front of the suite. Where he grabbed his padd, and began the briefing::

Reid: Doctors, please gather round, and find a seat wherever you can. I will start the briefing, because the med tech's will soon be bringing both Ensign T'Lar, and Lt. Applewood. These are our two patients for this surgery. I am now giving you some background on them. They were both serving on the USS Hermmes, when the Klingons attacked their vessel. In the end, most of the ship's crew compliment either ended up wounded,dead,or dying. Though, there were a few survivors, these two were part of the luckiest survivors, if you can call them lucky, for what they have been through. They were rescued by an away team of Marines from the USS Gemini, on a SAR mission. Whom I understand the SAR team had suffered injuries as well. All survivors, Marines inclusive had suffered ranging from mild to major injuries. These two casualties are our main concern for the moment. I believe all the Marine personnel are being treated by the Gemini Doctors, as I speak. ::paused to clear his throat:: Tests have shone Lt. Applewood has suffered a trauma induced aneurysm on her brain, a tear to her spleen, causing excessive internal bleeding. I have used a hypocoagulant to control her internal bleeding. She had a multiple fractured ribs, some peripheral nerve damage to her extremities. She has also suffered burns, either from phasrer fire, or some other force, as well as, multiple contusions, lacerations, and bruises over the greater part of her body. She stands a 20% chance of survival from the operation. She had also many nails torn off her fingers and toes, and a few broken digits, on her left hand. There were also some filletinig done to her dermal skin layers on her extremities. But, we are not done writing her off, just yet. If, I have my way, this is one battle, I mean to see death lose, by keeping her alive. Tests have shone Ensign T'Lar is suffering from a fractured skull, a subderual hemotoma, fractured jaw, at the tempo-mandibular joint, and multiple fractures to the right humerous bone, left radial, and ulnar bones in the forearms, a damaged left midney, left tibia and fibular bones in the lower left leg, right torn Achilles tendon, torn lateral meniscus tear and medial meniscus tear in his right knee, and multiple lacerations, confusions, and bruises over 50% of his body. He is also going to need extensive dental work, Also, multiple digit fractures to fingers & toes. He is also missing multiple areas of dermal skin to the extremities; due to filleting type torture. Be advised most of these injuries were caused from extensive torture, not combat, by renegade Klingon mercenaries. Whatever information the Klingons got as a result of torture, May the infomation turn out to be false. It appears the two Starfleet officers paid dearly, as they were willing to be sacrificed, even die, to protect whatever they were guarding. They both have suffered Blunt Force Trauma, or NOT. Teeth pulling, nails removed, broken digits, skin filleting, and burns done in a 1-3" diameters, meaning controlled, on different areas of the extremities. To damage being committed internally, they have both been placed in a state of induced comas. That, doctors, wraps up the briefing. Are there any questions?

Treadway: Dr. Reid, there were other injuries suffered by these two officers?

Reid: Thank you for bringing up the question, doctor. As a result of imprisonment, and torture, both officers were also suffering from severe dehydration, and malnutrition. My guess the Klingons were not planning for these officers to survive the ordeal, or they would have provided food and water, and done less intrusive, and traumatic ways for getting the info. I believe the inflicted trauma was done for the Klingons sadistic pleasures, from ritual sacrifices.

Knightling: Dr. Reid, what test, and scans, were used to detect the injuries these two officers.

Reid: Those tests were a combination of Magnetic Resonance Imagining (MIR), CT scans, vital signs and neural calipers, biomolecular scans, angiography scans, CFS analysis, EEG & EKG scans, and multiple lab testing, such as urine analysis, Blood analysis, etc.
Please be advised these tests can be looked at on all the doctors monitors, and will be available throughout the multiple surgeries procedures.

These will be the assignments, since I have had to change them a second time. They are not written in stone. But, they are subject to change. Ben Trusk, PO 1C will be the nurse anesthesiologist, and he will handle the anesthesia. Pence Tep, 1st Classman medic - pathologist, Glenn Cogshell- PO 2C - hemotologist, Tep, and Cogshell will be the surgical Medics, Dr. D.A. Knightling - Cardiologist, Dr. Vetonia Treadway - Nephrologst, Urologist, and assistant orthopedics, and Dr. Reid, me - Neurologist, the brain, and orthopedics for the ribs only. We have a guest here today. She is PO 2C Benntiere, surgical nurse specialist. She will be working with our surgical nurse specialist, Bothenet. She has requested to join our surgical team, so today she is going through orientation the hard way, on the job training. She is formerly a survivor from the USS Hermmes. Nurse Bothenet, I would like you to note, Nurse Benntiere was offered some time alone, before the team tryout. She refused, citing she needed to get back to work immediately, to help her through grieving for the loss of her friends in the Hermmes medical department.

Bothenet: Aye, Dr. Reid, I will see it noted in her record.

Reid: Thank you, nurse. Let me finish up the job assignments. Where was I? Ah, yes, Dr. Zandra. ::Reid continued::

Dr. Brooke Zandra, since your primary focus is on contagious diseases, epidemiology, and also a general practitioner. You will be working with Dr. Shelley Whale, another general practitioner, who both will handle all fractures, except the ribs, suture all lacerations, and will deal with the contusions, and bruising. They both will treat all burns, with phisohex scrubbing, and use dermaline ointment to treat all burns. After the surgery is completed, they will see to the administration of Germyciillin, 600 units to start, an antibiotic that will be administered to both patients by Dr. Zandra, and Dr. Whale, after taking over Ensign T'lar, and Lt. Applewood cases. During this time they will also work to control the malnutrition, and dehydration suffered by both patients. Also, after the surgery is finished, both cases will be turned over to them, Surgeons please note, all three of us will be on standby, should something occur with the patients that requires our assistance.

::Reid had just finished the briefing, just as Trusk wheeled up the two anesthesia carts, and placed one each at the table heads, and hooked up the machines, monitors, and both Overhead Sensory Clusters to the biobed monitors. Cogshell uploaded the tests results and scans into the work place monitors of each doctor. Before dsimissing the doctors to allow them to go and scrub a final time, Reid said::

Reid: Doctors, I wish you success in all your endeavors around the tables today. You are all dismissed.

::Everyone left to go to the doctors locker room to scrub, and change into fresh scrubs. Meanwhile, the operating room came to life. All the team staff members came to life, as well. Instrument trays were set in each of the work places. Surgical Head nurse Debra Bothernet, Reid's chief nurse, and nurse Benntiere checked each of the trays for the full compliments, and checked to make sure each instrument was working properly. The instrument tray contained one Thrombic Modulator, medical recorder, laser scalpel with 4 laser settings, hyposprays unloaded, a dermal regenerator, and an osteogenic stimulator. A second tray was set up with any additional equipment needed by each Surgeon pertaining to his specialty assignment at each Surgeon Nurse's station, just off to the side of each surgeon. A third tray contained medicine in drug cartridges relevant to each Doctor's assignment. Next, Bothernet made sure the cardiac resuscitation cart was placed within easy reach of the two surgical tables, in case of cardiac arrest. Each surgeon's nurse was responsible for checking out all three trays at each of the different surgical stations prior to the beginning of the surgical procedures. Nurse Bothernet, and Nurse Bennitere the surgical nurses, each turned on, and checked each support frame to check if it was in operating condition, before it would be placed over the patient's chest, and trunk regions.

Trusk, the nurse anesthesiologist, was responsible to see the anesthesia cart was filled with different anesthetic gases, the anesthetic equipment, the oxygen tanks, the gas tanks were full, the anesthetic equipment accessories were operational, and readily available. All Trusk needed was Dr. Reid, the head Surgeon, to pick what anesthetic gas he wished to use. He would find that out when Dr. Reid asked for a specific gas to be used. The medic technicians, Posh, and Cogshell were to stand by, and be the runners, or "go-for" in case, the doctors and nurses needed anything; inclusive of food, and drink. Nurse Bothernet, the head surgical nurse, was to double check the overhead lighting system was set, and ready to be turned on when the surgeries started. THE last function of Benntiere, the surgical nurse, was to make sure an adequate amount of gloves, and masks were available in the doctor's, and the surgical nurse's sizes were available. The nurse then would help the surgeon don the gloves, and mask. Each nurse was then to assist a surgeon throughout the entire operation. When everything met the Head Nurse's approval, she would then have the med techs bring in both patients, and they were to lock down the air driven bio beds into their locking mechanisms. Then she would establish, and maintain the stasis field during the operation of any decontamination, and containment, to prevent the patients from getting infections. The surgeons, by this time, would be having the gloves, and masks help being donned by his surgical nurse. Then as Reid would say, let's get 'er done, and they would all concentrate on each of their own surgical tasks. The surgery would begin::

::Part V::

::The surgical procedure started with the nurse anesthesiologist, PO C1 Trusk, responsible for removing the patients from their induced comatose state. The N.A. used a combination of anesthezine, a general anesthesia, used by security, but due to the weakened state of the patients, it was the choice of gases. It was used in combination with Benzodiazepine, a sleep inducer gas. Throughout the procedure oxygen was delivered by an laryngeal mask designed to channel oxygen , or anaesthesia gas directly into the patients lungs. Induction of air, was then delivered by intubation of the airway to each patient. The pathologist, and the hematologist worked in combination of cross type and matching of plasma, using lactated ringers solution. Then later, the solutions would changed to normal saline, designated NS solution during the Urology surgery. Finally, dextrose, or D5W sugar solution is currently being used in combination with an NS solution for post surgical care. D5W or dextrose would help to feed the patient, until he, or she would begin a liquid diet. The NS, or normal saline would be used to piggyback any medication, be it pain control, or antibiotics, after surgery.

Multiple lab tests, and scans were continually taken, and read throughout the different procedures. The tests were read in conjunction to make the diagnoses of injuries, and dictated treatment to be used. They were reread often throughout the surgical procedures. They included, but not limited to: CSF (Cerebrospinal Fluids) analysis, CT scans(Computer Tomography) Imaging, MRI scans (Magnetic Resonance Imagining), BET scans(Body Emission Tomographic) Imagining, EEG (Electroencephalography) scan, EKG (Electrokardiography) scans, PO C3 Cogshell provided the Lab result tests which were performed throughout the different surgeries. They were Hematocrit, creatinine, oxygen input analysis, lymprocratic analysis, and variously blood draws, urinalysis testing, Myocardial enzyme balance, and neural calipers testing.

Dr. Reid began the first neurological procedure on Lt. Applewood. Lt. Applewood had suffered a cebrebral contusion to her occipital region from a blow to the back of her head, which was brought on by BFT, or Blunt Force Trauma. A Hypocoagulant was injected by hypospray directly into the carotid artery to slow blood circulation to the brain. An incision was made into the occipital region with an exoscapel setting. This made it easier to use when performing a craniotomy. Reid then removed a 2 inch section of the rear skull cap for direct access into the outermost menigeres layer between the duramater, and the arachnoid mater. A laser scalpel was used for further use on the cebrebral contusion, which was then separated from other veins, concurrent with the use of neural brain implants. A sonic mitagator was used for bundling the neuron firing sites on the nerve branches. The purpose was to separate the neurons in the brain at the site of the subdural hemotoma. The hemotoma was then removed by vaccuum suction, and any surrounding venous bleeding was then controlled by placing stent clippings on the venous ends. A brain pacemaker was then introduced to prevent seizures, and possibly a stroke later on. Reid would later make a note during transcription. It may be removed prior to the patient returning to active duty. The skull cap was then replaced after having been preserved in a normal saline, or NS solution. Microsutures were used to seal the skull cap back into place, and the original incision was closed using autosutures, which were similar to a anabolic protoplaser. A cortical stimulator, a device used to resuscitate comatose, or head injuries was then used to promote resuscitation as necessary. EEGs were the continued on a running basis throughout the remaining surgical procedures. Written orders were requested for use of a dermal regenerator during this ICU stay. Dr. Reid then used a dermal generator himself, to promote healing of the surrounding tissue at the surgical opening site. The underlying laceration, and torn epidermis meninges were repaired using microsutures. Reid the closed the surgical opening site with additional microsutures. He then used a dermal regenerator on the surrounding tissue at the site to facilitate the healing process.

Since, there were possible indications present to suggest possible hearing loss. Reid recommended Lt. Applewood should have physical and cognitive emotional testing performed by ship's counselor. Should the Lieutenant gain consciousness in ICU the symptoms can last up to 3 weeks. She could experience of feeling in a fog, amnesia, sudden mood swings, and an unstable, unsteady gait.

Dr.Reid, next performed the second neurological surgery procedure. Ensign T'Lar suffered a skull fractures caused by a blow to his forehead brought on by Blunt Force Trauma, or BFT. The fracture was a communitied fracture; having caused a depression to the forehead region. The skull had underlying lacerations, a tear into the epidermis meninges that ran through frontal lobe sinuses, and possibly the middle ear structure. The isomolecular scanner revealed a comminuted fracture of the forehead had splintered into several bone fragments. An incision was made into the cranium with a laser scalpel to prevent further bleeding. Bone fragments were removed by vacuum suction, and replaced by bioimplants, rebuilding the frontal cranial bone. Bleeding was stopped by the use of stent clippings placed on the ends of the veins that has been ruptured. A platinum coil was placed into the area of the congratulated blood which helped to dissolve the clots. The loose fragments of the clots,and any remaining bone fragments were removed by a vacuum suction process. Bioimplants were used to rebuild the forehead bone, thus removing the forehead decompression. Again, Reid used Microsutures to close the surgical opening. Followed by the use of a dermal regenerator to the surrounding skin tissue to facilitate the healing process. As for the middle ear, Reid recommended Ensign T'Lar would need to be seen by an ENT specialist, and an audiolgist for the hearing loss. Follow-up psychological care would with the ship's counselor is recommended.

Dr. D.A. Knightling performed the next, or third surgery procedure. Dr. Knightling saw
there were no significant signs of damage to the heart muscle. The damage was to the aorta of Ensign T'Lar. Once the surgical opening was made Dr. Knightling had the entire surgery team visually see the physiological differences of the Bajorans, which included a heart that is mirrored along a horizontal axis rather than the vertical axis seen in the Terran heart. The surgery team was then encouraged to visibly see the Bajoran aorta also laying along the horizontal axis. Rather than, along a vertical axis found in terrans.

Prior to the beginning of the Aorta repair, following medical protocol, Reid issued an order for blood transfusions. PO C3 Glenn Cogshell, and 1st Classman medic Pence Tep cross-typed and matched Ensign T'Lar's blood which turned out to be more human than Bajoran. Therefore, I ordered 2 units of whole blood, and to have a unit of matching Bajoran Blood on standby. It was to be used only in an emergency should Ensign T'Lar's body has a reaction towards human. Dr. Knightling used this 2 to 1 blood ratio a few times during the aortic repair surgery.

Dr Knightling saw by visible sight, that Ensign T'Lar's aorta had suffered torn lesions resulting from a blow to the upper left quadrant of the abdomen, brought on by
Blunt Force Trauma, or BFT. Dr. Knightling also pointed out the physical symptom of bruising at the site. To facilitate time, during the neurological surgery procedures, Reid removed a healthy specimen of two separate pieces of aortic tissues. The ascending aorta, containing the aorta arch which supplies 3 major arteries. The brachocelphalic artery supplies brain, and head, the left common carotid artery, and the left subclavian artery, which showed no signs of damage, or impairment. The aorta contained the coronary arteries which also branched off the ascending aorta. Here, he found indications of tearing of this 2 inch artery, which was full of tiny lesions, which impeded the flow of blood back to the heart. These had to be replaced or the Ensign would soon go into cardiac arrest. The descending aorta ends in the abdomen, where it branches into 2 common iliac arteries. Having noticed leakage from the branch itself, there were several lesions which slowly bled out into the abdomen. Thereby, significantly weakened the iliac arteries blood flow to lower extremities, which eventually could have resulted in paralysis. If not replaced, the branch would eventually rupture. Therefore, Reid who assisted in the surgery, elected to remove both damaged artery parts and placed healthy pieces from their aortic tissues into a Genotronic Replicator. It is a medical device to "grow" a new replacement organ parts at an accelerated rate. The use of a dermal laser scalpel sliced pieces of tissue off of the aorta. The new aortic tissue parts, of the coronary arteries, and the common iliac artery branches were completed and ready for transplant, when Knightling began the cardiology surgery. He opened the patient's chest cavity with a laser scalpel, and used surgical stent clippings to tie off the coronary arteries ends, and the iliac arteries branch. Then he removed the damaged parts, and a temporary pacemaker was attached to work the blood flow going throughout the body's natural circulatory system. Meanwhile, Reid diverted The blood, through a cooling filtration system to regulate slower blood circulation. The replacement parts were transplanted into the aorta remained attached to the horizontal axis with microsutures. A tear found in the aorta wall also necessitated repairing with microsutures. Meanwhile, a normal saline solution, or NS was run through the aorta to check for any leakage. Where any leaks were found, they were sealed by microsutures. The aorta showed no signs of leakage, so the blood was removed from the cooling filtration system, and rerouted through the new aortic implants. Showing no signs of leakage, Dr.Reid and Dr. Treadway decided to reconstruct the rib fractures, and stabilized the rib bones with bioimplants. Dr. Treadway closed the surgical opening site with Microsutures, used a dermal regenerator on the tissue surrounding the surgery opening site, to facilitate the healing process.

::Part VI::

::Suddenly, the surgery took an unexpected twist for Lt. Applewood. She went into cardiac arrest. PO 1C Trusk, Dr. Knightling, and Dr. Reid initiated Cardiopulmonary Resuscitation, or CPR protocols. Trusk incubated, and bagged the patient. After placing an motivated tracheal tube down Applewood's throat, he inserted it into her lung. He placed an oralpharyngeal mask over her nose and mouth. The he connected a compression bag to the mask, and began to squeeze the bag. This flooded her lungs with oxygen, so the air could oxygenate her body organs. Reid started the compressions to send the air, and Blood throughout her body. Reid would then use an osteogenic stimulator to jump start her heart. Knightling administered cardiac resuscitation drugs to aid the heart in regaining a sinus rhythm. Surgical nurses Bothenet, and Benntiere prepared the hyposprays as indicated by the CPR protocols, and handed them to Dr. Knightling. He then administered them as necessary, or prn, when indicated.

Lt. Applewood did suffer cardiac arrest, cessation of heartbeats during the surgical process, and Cardiopulmonary Resuscitation protocol was initiated. Knightling immediately grabbed a hyposprays loaded with 2cc of Imapedrezene, and administered it. Dr. Reid grabbed an osteogenic stimulator, and began compressions of the heart muscle.
Meanwhile, Trusk connected an oxygen line from the anesthesia cart to the compression bag. This facilitated administering a higher concentration of oxygen to the lungs when the bag was compressed. Knightling followed by administering 20cc of Hyperzene, a cardiac stimulant, and Reid followed by further compressions of the heart muscle with the osteogenic stimulator. Then Knightling administered 60cc of Imaprovaline, a drug which stimulates cardinal cell regeneration. Again, Reid followed with further compressions by an osteogenic stimulator, and Trusk administered more compressions of he bag. Introducing more highly oxygenated air volume to the lungs. At that point, Knightling consulted Dr. Reid,if he would make the call, because of the amount of damages suffered by Lt. Applewood's injuries. Dr. Reid refused to relent to the time of death, and called for the 2nd line of defense against the cessation of heartbeats. Knightling asked Reid if continuing with the 2nd line of medication was advisable. Knightling reasoned it could also cause further damage resulting in death. Dr. Reid stated that she was dead already, so trying could only help to resuscitate the patient. Dr. Reid, and Knightling readily concurred, so Knightling immediately grabbed a hypospray of Chlormydride, and injected a full dosage of 40cc. Meanwhile, Dr. Reid repeated the compressions with he osteogenic stimulator, and within 30 seconds of the last set of compressions, the patient's heart began to beat on its own. Knightling immediately administered 20cc more of Hyperzine, and the heart beat returned to a normal cardiac rhythm of 60 beats per minute; gradually the heart rate returned to 76 bets per minute, and from that point on maintained a normal sinus rhythm. After the successful resuscitation of Lt. Applewood using CPR Protocols. Reid, and Knightling returned to the business at hand. A Dak'tar, Klingon dagger that caused the damage
when stabbed into the spleen of Lt. Applewood. Reid had seen the tell-tale jagged tearing edge from the dagger, often used by a Klingon mercenaries. It was done for sadistic, and often ritual pleasure during torture. The tearing not meant to heal resulted in the damaged spleen, and was the cause of her excessive slow internal bleeding. She was nearly dead when she reached Reid. So, he administered a hypocoagulant to slow the bleeding process.

Before the spleen operation began Reid ordered a blood transfusion prior to surgery. Again PO 2C Cogshell, and medic 1st Classman Pence Tep performed another cross-type an match on Lt. Applewood's blood type. It turn out to be blood type "B", or BO positive, and had Cogshell, and Tep prepare 5 units of BO, or "B" positive blood. Two units were to be infused by a plasma inducer, one hour before scheduled surgery, and the remaining 3 units were to be placed on standby; for use only in the event of emergency bleeding during the splenectomy. Following Reid's prior order, Nurse Bothenet had already infused the BO, or "B" positive blood with a plasma inducer. Nurse Benntiere placed the remaining 3 units into the surgical refrigerator for storage. She then ordered PO 2C Cogshell to standby to prepare more BO, or "B" positive blood upon Dr. Reid's orders.

Having judged the spleen damage due to dark bruising at the site, and knowing the location of the spleen in the upper left quadrant of the abdomen, Reid made an incision. Using a laser scalpel on the site of the discolored bruise. Reid cut through the epidermis, and dermal layers, exposing the ribs. Using rib spreaders, Reid had Knightling pushed the lower ribs aside, being careful not to dislodge the floating rib. Reid could see a quantity of old blood, and mixed in were blood clots that had undergone the coagulation process. The risk of dislodging a clot was his next concern. If one clot were to break free, a thrombosis could occur, and easily lodge itself in the heart's coronary arteries, causing cessation of the heart muscle, inducing cardiac arrest.

By the use of vacuum suction, Reid was able to remove all the clots, all old blood, and plasmatic fluid which had caused the abdominal distention, and bruising. Now, that he was able to see the spleen, he visibly verified what the ultrasound test showed. A rupture in the wall of the spleen, and was approximately 3 cm in length. This would have ruled out a laparoscopic splenectomy, when detected by the laparoscopy instrument. This also verified Reid's call for an "open splenectomy." His next step was to locate the lower mesenteric artery followed by the superior mesenteric artery. Using stent clips, he closed off the superior mesenteric artery, stopping any remaining blood flow to the ruptured spleen. Then he located the inferior mesenteric vein, by following the superior mesenteric artery. Reid used stent clips on the inferior mesenteric artery, and stoped the flow of blood moving away from the spleen.

Using the laser scalpel once more, Reid severed both the superior mesenteric artery, and the superior mesenteric vein, separating then from the spleen. Observing for any leakage, he found none. So, now he dissected the ligments holding the spleen in place. Dr. Knightling then removed the spleen from Lt. Aplewood's body. Nurse Bothenet had prepared a place to set the spleen down, and he used it. Grabbing the tissue Mitagator, Knightling located an area that still had healthy issue. He sliced a few strips from the spleen, and had Nurse Bothernet place them in the Genotronic Regenerator. Then Nurse Bothernet packaged up the spleen, labeled it, and sent it to the boys in the lab. This way they could perform different tests on the spleen, and send back any analysis that would be requested during the surgery. While waiting for the spleen to finish the replication process, Knightling noticed 2 foci, called "accessory spleen". He informed Reid of his findings, so Reid allowed him to dissect them both with the laser scalpel. Reid wasn't above giving any surgeon who was that observant to practice removing anything he, or she found, that needed removing. Dr. Knightling did an excellent procedure under Reid's supervision of removing them. Nurse Benntiere prepared the specimens under the watchful eye of Nurse Bothenet. Benntiere then sent both foci to the lab for analysis as well. Eventually, the regenerated spleen was fully intact, and ready for transplant. Dr. Knightling gently removed the new spleen, and placed it where the old one once rested. Now, Reid began to reattach the ligaments with microsutures. Next, he reattached both the Superior Mesenteric Artery, and the Superior Mesenteric Vein with microsutures. After visually checking for any leakage he found no apparent leakage. Then began to reattach the Inferior Mesenteric Artery, and the Inferior Mesenteric Vein. When completed he released the stent clippings. As he released the stent clipping, he could almost hear a faint gurgling as the blood started to flow in and out of the new spleen. Reid discovered a tiny leak in the Inferior Mesenteric Vein, which he immediately closed with microsutures. Thinking it was best for the time being, Reid placed a temporary drain into the splenic area, which would allow any drainage to occur if necessary. Reid had Dr. Knightling close the surgical opening site with Microsutures around the drain. Knightling then covered the drainage tube with a small splenostomy bag. When nearly full the bag would be emptied into a measuring container to aid in recording the amount of fluid drainage. When there would be no more drainage of blood, the tubing, and bag would be removed. The drainage hole would then be sutures shut with Microsutures. A dermal generator would then be used to the tissue around the surrounding site. It would help to aid the facilitation of the healing process.

Prior to the briefing of the surgeons, Dr. Treadway noticed the abdominal distention in Ensign T'Lar. She ran multiple urinalysis testing, which indicted visual blood in the urine, and indisputably, through the use of ultrasound of the Kidney, she relayed her findings to Dr. Reid who concurred the need for Nephrological surgery transplant was indicated. The right kidney had been perforated, and was clinically unresponsive to urine output. Treadway had previously performed a biopsy of the ® kidney tissue, and placed the sample into a Genotronic Replicator. Due to the acceleration process, a new right kidney had been generated.

::Finale::

The last surgery of the day was a Nephroectomy, transplant of the right kidney, and Urologigal surgery was also indicated. Utilizing the catheterization procedure was indicated. Dr. Treadway used a sterile catheter, and induced it through the ureathra, and into the the patient's bladder during the procedure. A small incision was made a few inches below the patient's belly button; using an exoscalpel. She began reconstructive Nephrology, and urology. Using a procedure called retropubic suspension surgery which including pulling up the bladder neck, and sewing it into bone, or surrounding tissue with microsutures. Once the patient with the aid of the catheterization, Treadway was able to find a small tear in the ureathra, and successfully repaired it with microsutures. Using stent clippings, she clamped off the renal arteries, and renal veins of the the right kidney. Meanwhile, Dr. Reid had connected the patient to a dialaysis machine, The fluids in the kidney then went through a diffusion process, getting rid of wastes, followed by ultrafiltration, removing unwanted water from the blood, or hemodialysis. All this occurred during the transplant procedure. After Dr Treadwy extracted the damaged kidney, by cutting the two ureters, the renal arteries, and renal veins by laser scalpel, Reid removed the regenerated kidney from the Genotronic Replicator, and implanted the new right kidney into place. Reid held the kidney in place while Dr. Treadway using microsutures, reconnected the two ureters, tubing connecting kidney to the bladder, reconnected the renal arteries, and renal veins to the right kidney, She ordered the dialysis process discontinued. She then noticed a minor leak in one of the ureters tubing. This, she repaired using microsutures, and was successful in sealing the tubing. Ultimately, the incision site was closed using an exoscpel, and a dermal regenator to facilitate in the healing processes. Follow up care would require catheterization, to help aid the healing process. I & O (input/output) charting was ordered, the dialysis process was temporarily ordered until such time urinalysis indicated normal urine output without blood in the urine, as needed, until ordered discontinued. Treadway ordered 600 units of Generecillin piggyback with NS, or normal saline solution, to prevent infection in both transplant receipents.

::Meanwile, the surgery was finished Reid informed both Dr. Knightling, and Dr. Treadway, since the surgery ended at 1800 hours, there still remained another 14 hours until the start of the new day's morning shift. Both Doctors could work it out among themselves. He then called for volunteers, by appointing both Doctors to the following shift. Each Doctor would be on call for 5 hours, and sleep until they needed to do either an afternoon, or midnight shift before going on leave. Dr. Reid elected to take the remaining 2 hours, until the 0800 morning shift which Reid would also take. Treadway would then relieve Reid, at 1600 hours,for the afternoon shift, and Knightling would relieve Treadway at 0000 hours for the night shift. PO 1C Bothenet, would oversee the remaining surgical team, who would finish cleanup after the surgery. She would then make out a duty schedule based on seniority rights. All the shifts would have a skeleton crew comprised from the surgical team, and medical personnel from the Gemini. When each shift was finished that surgical crew would begin leave. The Gemini medical staff would take care of their own schedules.

Reid dismissed the three surgeons, and he, himself went into the Doctors lounge, and took a sonic shower. He put on fresh, clean scrubs, and decided while dressing, he would stop off at the Tin Star Lounge. He would stop in for a few minutes, grab a some supper, and tie on a couple of stiff drinks, before heading back to his quarters, and some badly needed sleep. He had to look in on both patients at 0600 hrs. He would check their progress in the ICU, or intensive Care Unit. Check with the nursing staff, and go over their nursing notes containing records of meds given, for pain control and antibiotics also given. Next, he would check the usage of IV infusion pump care, and delivery amounts of NS, or Normal Saline, and D5W, or dextrose usage through the night. Last, he would check on the status of their induced coma states. Based on all this pertaining data, more on vital life signs, recent lab reports pertaining to each transplant, Blood volume levels, chemical balance of other body fluids,and any other pertinent data pertaining to the two patients. Reid would then write out his Doctor orders for the day. All nursing staff, med tech's, Surgeon's, and physicians would see to it that every order of Reid's would be fulfilled. Then, at 0800 hours, Reid was scheduled to work the morning shift. He would oversee the skeleton crews needing any medical treatment, while the rest of the ship had gone on shore leave.
During the morning shift all of his surgical team, would come in throughout the shift, and complete their dictation of all procedures used during the duo surgery from yesterday. At 1600 hours, it would all end, and Reid started his leave then. For as long as the USS Gemini under went repairs, Reid would spend his leave with his family.
Yet, knew he would also be on standby medical duty, should an emergency occur during his watch. Treadway, and Knightling would also be on call for standby duty, as needed.::

LtCmdr Jerry Reid

Medical Officer

USS Gemini

Edited June 8, 2014 by Blueheart