JP: Lt. Cmdr. Elizabeth Snow and Lt. Solok - De Retour Sur Tes Pieds Part I & II

[Serala]

I really enjoyed reading this sim. It's a wonderful read about a surgical procedure being done to restore mobility for one of Astraeus' nurses who was left paralyzed following the previous mission. Well written by @Elizabeth Snow & @Solok. I am posting both parts here for continuity.

Part I

((Surgical Suite 1, Deck 12, USS Astraeus))

After slipping into her surgical scrubs and sterilizing, Elizabeth stood next to her best friend as the woman drifted off to sleep. When the Antosian woke up, she’d be a different person than what she had been during the days after the accident. oO If she wakes up. Oo 

She sighed. There was still that fear of ending her best friend's life lingering in the back of her mind. The constant battle. oO She will wake up. Oo Elizabeth was determined not to let that fear become a reality. 

Solok stood at the foot of the surgical bed, dressed in standard-issue Starfleet scrubs. He was aware of the personal connection between the CMO and the patient, and although this was typically reason enough to seek out another physician, planetside, Solok knew altogether too well from his own experience how differently things played out in Starfleet. He had operated often on colleagues – on friends – in the past. It was, quite simply, part of the job.

Stenner: She’s fully out, Doctors, and her vitals are stable. 

Solok nodded acknowledgement of the nurse’s report, then turned to Snow. He was there to assist his superior, as best he could.

Solok: Shall we proceed, Doctor?

Elizabeth looked at Doctor Solok and she nodded. oO You’ve got this. Oo She took a deep breath before speaking. 

Snow: Let’s begin.

Solok: Mister Stenner, remain vigilant in your observation of the patient’s – ::he glanced very briefly at Snow:: – of Nurse Avae’s vitals.

Stenner: ::nodding:: Yes, Sir. 

As Stenner kept an eye on Wyla’s vitals, Elizabeth tapped a few buttons on the cover that was slid in place on the biobed covering her back.

Snow: Separating the ventral and dorsal roots. 

Solok looked over at Stenner, then to the readout of Avae’s vitals over the surgical bed, and then back to Snow.

Solok: Heart rate and respiration remain within acceptable parameters.

It wasn’t an easy task to be done and took all of Elizabeth’s concentration. If she didn’t get the right area she could do more damage than good; setting them back a ways. 

Snow: Separation complete. ::beat:: Doctor Solok, go ahead and sever the brainstem. 

Solok, standing on the opposite side of Avae’s unconscious body, leaned forward with a look of utmost seriousness on his face. He was almost always expressionless, by non-Vulcan standards, at least. But this was something else: not the absence of expression, but the expression of absolute focus.

He had never severed a brainstem before. The medical ramifications of the act were, of course, profound. But in practice, it was a relatively simple procedure.

Solok: Brainstem is severed.

Once the brainstem was severed she heard Stenner call out.

Stenner: Placing the Cerebral Cortex on life support now. Primary brain dysfunction in four hours. Vitals holding within normal parameters. 

oO Good. Stay with us, Wyla. Oo They moved the cover out of the way and Elizabeth took the exoscalpel from Stenner.

Snow: Making the incision. 

Solok watched Snow as carefully as she appeared to be watching Avae. Part of his job in the operating room was to insure that Snow remained up to the task. But she was clearly a skilled surgeon, and the Vulcan saw nothing to make him reconsider his assessment.

Solok: A masterful cut, Doctor. Although I am puzzled as to why you opted to make the incision by hand. Would not a computer-operated scalpel have been more reliably precise?

Elizabeth looked at Solok and smiled. Sure she could have used the computer to do it for her, but some things she just liked doing herself. 

Snow: Thanks. I could have, but I guess I’m a little old fashioned sometimes and prefer to do things myself once in a while. 

Solok nodded.

Solok: I understand. I am of a similar opinion, when I must treat my slug.

It showed just how Vulcan he really was, that he was the only one in the room – or in the tales that were told of this moment, later on – who did not understand why what he had said could be construed as unusual or humorous in any way.

Elizabeth smiled and heard a slight chuckle come from Stenner. She had to say she has never heard that one before. 

Snow: Slug?

They were interrupted – mercifully, perhaps – by Stenner.

Stenner: Blood pressure seems to be falling, Doctors. Slowly, steadily – but falling.

Solok turned back to Snow.

Solok: Standard medical protocols would indicate treatment with Laporazine until blood pressure could be stabilized. But this would require at least temporary cessation of the procedure. ::Pause.:: How do you wish to proceed?

oO Slow and steady wins the race, right? Oo Though she wasn’t thrilled at pausing the procedure, it was something that had to be done. Hopefully, they wouldn’t encounter any more hiccups as they progressed, but the way Wyla’s immune system was going to react to the new spine was another concern at the back of her mind. 

Snow: ::nods:: Administer the Leporazine. Fifteen ccs.

Solok: Mister Stenner.

At Solok’s order, the man prepared a hypo with the required drug. Solok watched Avae’s blood pressure continue to drop, but did nothing to rush Stenner’s work. Better slower and accurate than faster and –

Stenner: Fifteen ccs Leporazine, Doctor.

Solok took the hypo from the nurse, pressed it against Avae’s neck, and administered the drug. All three of them seemed to be staring at the data monitor, watching her blood pressure, almost willing it to stabilize and rise. Time passed. Eventually, Stenner was the one to speak first – almost elatedly, but certainly with relief.

Stenner: Blood pressure is stable, Doctors. Stable, and rising to normal levels.

Solok turned to Snow.

Solok: We shall be able to proceed shortly, Doctor. Once Nurse Avae’s vitals are within acceptable parameters. If you wish to use this time in some other way, I will remain here to observe the patient and can alert you when she is ready to continue.

Snow: Thanks, Doctor, but I’ll remain. 

Sickbay would be just fine and if they needed her, they knew where to find her. She wasn’t leaving Wyla’s side unless there was a very great reason to do so. 

((Time Skip – 20 minutes later))

Now that they had Wyla’s blood pressure under control. Elizabeth and Solok carefully removed Wyla’s spine and placed it, carefully, inside the genetronic replicator and she activated the scan. As she waited, she looked back at the woman laying on the table. This was one procedure she never thought she would be doing. Especially not on her best friend, but here they both were. Now they were approaching the part that concerned Elizabeth the most. She said a silent prayer to the four deities that the woman's body wouldn’t reject the new spine.  oO Please stay with me. Oo 

Solok: Fascinating.

Solok’s description caused Elizabeth’s head to snap towards him with a look of bewilderment. Wyla was lying on the table with her spine removed. Of course she knew that Solok and Wyla weren’t close like she and Wyla were, but what could he possibly find fascinating about any of it?

Snow: Hardly. 

Solok: I do not wish to offend, Doctor Snow; I am aware the patient is a friend of yours, and of course, a colleague to us all. ::Pause.:: But this procedure, despite being entirely unorthodox, is a remarkable thing to observe. Simply from a scientific perspective. How does it work?

Although not technically an emotion, wonder was something Solok strove to keep from inflecting his voice.

Snow: Well, the genetronic replicator scans the object placed inside. Then, once the scans are complete, it replicates the object and then it’s grown into a replica after it is placed inside the body. 

Solok: A complete replication of biological material. A perfect substitution. It is an elegant solution to an ancient medical problem – perhaps the most ancient medical problem, that the body sometimes fails beyond our ability to repair it. ::Pause.:: Apparently, there are many developments with which I must become familiar, outside of my own specialty.

 

Part II
((Surgical Suite 1, Deck 12, USS Astraeus))

{{Time Skip}}

The beeping of the machine caught her attention. Now that the scans were done she hit the button to start the next phase. 

Stenner: Two hours and a half until primary brain dysfunction.

Snow: Mr. Stenner, go ahead and inject her with twenty-five ccs cervaline. 

Solok: You anticipate rejection?

Snow: I have taken that into consideration. Hopefully, the injection will help her body to accept the new spine. But I am prepared for it if her immune system decides to get aggressive with us. 

Solok: A logical course of action, Doctor. And what is our recourse to be, should her immune system reject the new spine?

Snow: We’ll have to get aggressive with immunosuppression. 

There were, he thought, only two real options: even more radical immunosuppression than would be produced by the cervaline, or to find some alternative to the new spine. But it did not seem Avae had many other options than this one, if the goal to be achieved was restoration of ordinary movement.

Solok: Understood. I am prepared to assist, whatever the outcome.

Snow: ::nods:: Thirty more minutes and then we can begin the implantation. 

Solok nodded. He turned to Stenner.

Solok: How are the patient’s vitals, Mister Stenner?

Stenner: She’s stable, Doctor. Doing fine.

The Vulcan turned back to Snow.

Solok: How long do you wish to wait before determining whether cervaline therapy will be a viable solution? Not having performed a transplant of this magnitude, I am uncertain as to how we should proceed. With less significant internal tissue grafts, it is customary to readminister cervaline approximately every four hours. But this is no simple tissue graft.

Snow: We should know once the growth process begins whether or not the body is willing to accept it. At least we have a head start in suppressing the immune system if it does decide to reject it. If that happens, we can administer the cervaline in smaller doses every couple hours.

Solok: A perfectly rational plan of action, Doctor. Let us proceed.

{{Time Skip - 30 minutes}}

Solok: Any time you are ready, Doctor.

As Solok held the container, Elizabeth carefully took the noodle looking spine of the container with her instruments and placed it inside. After it was adjusted into its place, they carefully slid the cover back into place. 

Snow: Closing the incision. ::tapping a few buttons::

Solok looked to Snow and nodded.

After the computer closed the incision it was time to begin the growth process. Soon they would have the answer to whether or not the implant would be rejected or not. Of course she was praying that things would go off without a hitch. 

Snow: Ready to begin the growth process. Is everyone ready to proceed?

Solok: I am ready as ever.

Stenner: So am I, Doctor. What do we do?

Snow: Just keep monitoring her vitals and let me know the second something happens. 

Elizabeth tapped a few buttons on the cover and the growth process began. 

Solok faced Snow, prepared to assist.

Solok: I come to serve, Doctor Snow.

He paused, as there really was nothing more to say. As so often in complicated medical procedures, the team of highly trained, highly capable physicians just had to wait.

It wasn’t long after that Stenner called out what Elizabeth had felt was coming. 

Stenner: Showing signs of rejection and vitals are showing a slight drop but are still within normal parameters. 

Snow: ::nods:: How long has it been since the last Cervaline injection?

The Vulcan did not need to consult a chronometer, as he had a well developed chronological sense. He spoke evenly, dispassionately – matter-of-factly.

Solok: 22.543 minutes, Doctor.

Stenner: Should I terminate life support?

Snow: We’ll wait until her vitals are stabilized. 

The computer emitted a brief alert.

Solok: Mister Stenner?

Stenner: Her blood pressure is falling. Seventy over forty and falling.

Snow: Twenty ccs Laporazine. 

Solok prepared the hypo himself. He spoke as he pressed the hypo against the side of Nurse Avae’s throat.

Solok: Twenty ccs Laporazine, Doctor. Administering now.

{{Time Skip - 40 minutes}}

It had been a long battle trying to stabilize Wyla, but they had managed to finally get her stable and remove the woman from life support. It was the worst and slowest forty minutes for Elizabeth as she wasn’t sure whether Wyla was going to make it. Thankfully, the woman had and the Cervaline was now doing what it was meant to. 

Snow: Thank you, Mr. Stenner. Have her room prepped and ready. I’ll take over vitals. 

Elizabeth took Stenner’s place as he went to tend to the task she had given him. 

Solok: Commendable work, Doctor Snow. On Nurse Stenner’s part – and your own.

Snow: You did a great job, Doctor Solok. At least now her body is starting to slowly accept the new piece of it. Though we’ll need to keep her on round the clock supervision. I'd say with a few more treatments of Cervaline that she will be okay to begin physical therapy next week. Fingers crossed things continue to improve.

The Vulcan glanced from the CMO’s face to her hands, but did not see anything unusual about the placement of her fingers.

Solok: Continued improvement seems likely, with an at least 82.4% chance of full recovery. ::He paused.:: In sickbay, perhaps even more than in Engineering, the odds do not frequently climb higher than that.

That was true, but there were always those few cases that went above those odds. It might have been wishful thinking on her part, but Elizabeth felt certain that Wyla would be one of those cases. 

Snow: Sometimes people have a way of surprising you. ::smiles::

Solok nodded, then turned and departed the operating theater – leaving Snow to attend to her patient – but more than that, he surmised. She would be watching over her friend. Thinking on this, he prepared to resume his duties in sickbay – but also to contemplate the question, whether anyone might feel inclined to watch over his bedside were he in a situation comparable to Avae’s. He doubted it; it was, after all, most illogical.

Most illogical, indeed.

{{Time Skip - 20 Minutes}}

(( CMO’s Office, Sickbay, Deck 12, USS Astraeus ))

Now that they had gotten Wyla settled back in her room, Elizabeth sat at her desk to finish the report. She could rest a little easier now knowing that the worst of it was over and that her best friend was on the mend. Though Wyla still had some work to do before she was back in action, Elizabeth planned to be at her side every step of the way. 

 

==============
Lieutenant Commander Elizabeth Snow
Chief Medical Officer
USS Astraeus NCC-70652
D238803EH0

&

Lieutenant Solok
Medical Officer
USS Astraeus
R237908S10

[Elizabeth Snow]

I'm so happy you liked it! It was such a joy to write this piece with @Solok!!