Open Wounds

Posted on Thu May 2nd, 2024 @ 4:20pm by 1st Lieutenant Kes Th’relnal & Lieutenant JG T'Mara
Edited on on Fri May 3rd, 2024 @ 2:10am

0 words; about a 1 minute read

Mission: Year One: Whispers in the Wind
Location: Med Bay
Timeline: MD37 - 1000 hours

Kes grumbled as he held the gauze against his side. The wound he'd sustained just wasn't healing. Or even closing properly. He'd woken up to stained sheets and a burning pain. His thoughts went to wonder what had been with the terrorist blade that had opened him up.

He walked into Sick Bay and looked around. "Medic..."

Kes moved the gauze to look at the wound on his side and saw that it was still oozing. "Damn stuff..."

T'Mara was uncertain how her new ‘life’ on a starship would go. She had taken what Klaus had said to her quite seriously. That the pacing might be challenging to adjust to. Her thoughts were turned internally in that vein as she walked out of what was now her office – a completely blank slate filled with shelving for displaying items she did not have in her possession. A ‘seabag,’ was all T’Mara arrived with. Were the empty shelves but a metaphor of a life with no connections? She did not desire to be reminded of that even at her place of industry…perhaps she could put some medical supplies on them for the interim?

She walked out of the space, considering what objects would make sense to place in her office—which nothing came to mind—and saw an Andorian standing near the entrance of sickbay holding his side.

If his stance wasn’t an over display that something was amiss, the subtle grey undertone of his blue skin did.

Her empty shelving immediately forgotten, T’Mara strode forward with a confidence borne of experience and engaged the—eyes glancing to his collar—Marine first lieutenant. As she got closer though, her olfactory senses registered a sour, off-putting scent…infection.

“Come with me, Lieutenant.” She said by way of greetings, gesturing to empty bio-bed near her.

Kes followed T'Mara and managed to get his frame on the bio-bed with only a wince and a muttered curse as the burning sting from the wound shot up his side. He rolled his eyes as his antenna seemed to wave around aimlessly. "Got stabbed during the last mission. It's not healing."

As she approached him, Kes move the gauze from his side and showed that the wound still seeped the azure blood, the skin around the wound was grey and inflamed.

T'Mara observed the erratic movements of his antennae and the intermittent nystagmus of his eyes with a growing sense of concern. As the Marine lieutenant removed the gauze, T’Mara’s eyes immediately sharpened on azure ooze and erythema and swelling of overt infection of the portion of the wound that was visible.

“What was the mechanism of this injury?” She did not wait for his answer before beginning removal of the layers of clothing obscuring details of this wound. Her hands unzipped his outer jacket, pulling the jacket open to further reveal the wound. It was a slashing wound which appeared to have compromised the mesentery and perhaps the posterior nerve bundles…these were concerning enough findings. That infection had set in…the injury was older than 12 hours. This Marine had some explaining to do.

"An Ushaan blade." Kes replied with a grimace. "Obviously not well maintained." He watched as T'Mara began to fuss over him and inspect the wound. He let out a sigh, and didn't want to distract her or know about the injury yet.

"Welcome to the Moore." He managed to chuckle. "Do I have the joy of being your first patient?"

T'Mara tilted her head in acknowledgement. "I come to serve." It was said reflexively; the proper Vulcan response to such a greeting. A quick snip with a pair of trauma 'shears'--and grabbing a hold with both hands and tearing apart--and the Andorian's under tunic had been pulled far from the wound. Calculating eyes took in the jagged discolored edges which was signs of tissue necrosis, the overt smell of infection along with purulent drainage...T'Mara paused her assessment to foam her hands and apply a pair of aseptic gloves. The laceration went quite deep posteriorly...

"Ah. The omentum has been disrupted..." She paused speaking as her fingers probed deeper. "Initial exam, the small intestines do not appear to be compromised. It appears the iliohypogastric nerve has been transected, however. Unfortunate...and yes, you are my first patient." T'Mara turned from him and ripped her gloves off and began pulling out small trays of equipment and hyposprays loaded with specific medications. She began the process of cleaning the skin around his wound in the first step of many to create a sterile field to repair the damage.

Kes winced as she probed the wound. "You know doc, before I let someone put their fingers inside me I usually get their name first. Maybe dinner, dancing as well depending on the setting. But a name would be nice." As she touched something that made his antenna straighten, he sucked in air.

"I'm Kes Th'relnal by the way. Just in case you need to fill out my toe tag."

T'Mara stopped her movements momentarily to look down at the Marine officer. "You are fortunate indeed then that what you have described is not the nature of our...relationship. I can assure you that this is not a courtship overture. It is a primary survey." She returned to the preparation, slipping on a sterile gown ones the materials were opened and ready to repair the damage she could. "I am Lieutenant T'Mara. I have been designated as the CMO of the Moore. I have been instructed that patients respond positively to words of assurance. You are in 'good' hands, First Lieutenant Kes Th'relnal."

She picked up a hypospray and placed it against the Andorian's neck and administered a powerful analgesic and broad-spectrum antibiotic to begin tackling the infection. She then moved to the gaping slash and began injecting the angry looking flesh with local anesthetics so that she could begin debridement and suturing. The nerve was going to be a problem. They didn't have the specialized equipment necessary to facilitate major nerve regeneration.

Kes chuckled. "I'm used to blue hands and less pointy ears, but I'm sure you'll suffice doc."

He paused for a moment as the numbing sensation began to wash away the burning. He gritted his teeth and sighed, not from the pain, but from the comment. "Sorry, I know comments like that would probably wash off your back without a second thought but I didn't mean anything by it. I do need to get used to a mixed crew again I guess."

The marine offered her a weakened smile. "You keep me in fighting shape and I'll get you a bottle of Ale, the good stuff too."

"It is not my intention to simply 'be good enough,' Lieutenant." T'Mara responded in a cool voice. It was illogical to allow his statement to affect her, but she was somewhat defensive about being considered...less. At least the deeply ingrained social mores of her people kept what was a moment of pain covered deep beneath the placid exterior firmly fixed into place.

She began to probe the wound, while watching the Th'relnal's face for any sign of discomfort. Upon seeing none, she picked up the exoscalpel and began to trim the jagged edges of the wound to remove the non-viable tissue and to create a more even line for when she closed the wound up. Andorians might pride themselves on battle scars, but T'Mara would ensure that it was a well-approximated one that healed well.

"Your offer is acknowledged, however, I have never ingested any such libations...it would be unfortunate for such an offering to go to waste." T'Mara was certain she had most likely erred in her response to him, but it wasn't often that anyone offered to give her anything, and it brought up uncertainty. She shook her head slightly in self-censure. Focus on what you are good at, Doctor.

"Then you can give it to your guests when you entertain." Kes replied without missing a beat. He could feel the pulling and pressure as T'Mara worked. It was unsettling, but not overly unpleasant or unexpected. The hypospray had done it's job to numb the pain. He got the sneaking suspicion that the good doctor didn't plan on doing much entertaining either, but that was besides the point. There was always an excuse to drink even if he had to visit her himself to drink it.

"Humour me doc, what's an accomplished Vulcan surgeon doing assigned to an old ship like this?" Kes looked up at the ceiling lights over him and moved his arms up to place his hands behind his head. He was going to be here a while, he might as well relax. "I get the impression you're not just some run of the mill scalpel jockey."

Her brow flicked up in a measure of personal amusement. T'Mara wasn't sure just how accomplished she was yet, considering this was the first day of her posting as Chief Medical Officer. Regardless, she wasn't going to argue with anyone against their opinion regarding her competency, especially since it was a positive opinion.

The debridement was performed in a satisfactory manner, and T'Mara reached for the autosuture device to begin closing. Focusing on Th'renal's wound gave her a moment to consider how to answer.

"I am here in the same capacity as you most likely are, Lieutenant. I was given orders. However, I believe my attending selected a ship like this due to its distance from the core. He was of the opinion that good doctors become better when challenged. As you are my 'first' patient and have almost managed to kill yourself with infection from an injury inflected days ago, I will postulate that my work here will involve more than required physicals."

"Just a day doc." Kes gritted his teeth as the pulling went from uncomfortable to a tinge of pain for a moment. "But next time I'll make sure you get a challenge, I'll rub dirt in it too." The discomfort returned in place of the pain and he relaxed once more.

"I agree with your attending, in principle." Kes continued. "Without the comfort of a safety net we're all forced to adapt and work with what we're given to find new solutions to problems. Speaking of problems, how am I looking doc? Will I live to get stabbed another day?"

T'Mara might have made a soft strangled sound at the Andorian's commend about rubbing dirt in it. "Please do not. Dirt is host to numerous vectors that can precipitate infection. And do not seek to test me in this. I am a believer in 'learning one's lesson.'" She moved along the wound to the posterior aspect of the injury. The nerve.

"I am uncertain whether I can successfully reattach the severed iliohypogastric nerve. Axonal contracture has already set in." She tilted her head so she could look the Marine in the eye. "Lieutenant Th'relnal, this injury could lead to persistent lower abdominal neuropathic discomfort. If that occurs, there are treatments that can be attempted restore neuronal function, but any meaningful improvement will take...time." T'Mara might be a competent surgeon, however, she had been told more than once that she had the bedside manner of a 'sledge hammer.'

The mirth disappeared from his face and Kes frowned. "What exactly does that mean doc? Layman's terms please." He'd been wounded before, he'd taken some pretty nasty scraps and he considered himself lucky to have made it this long without a serious injury. Now he wondered if his luck had run out.

T'Mara swallowed. This part of the job was never easy. "Uncertain. Every case is...unique. However, traumatic nerve damage can cause severe, unrelenting pain, a sensation of burning, tingling, or total loss of sensation in the part of the body affected by the severed nerve. Given the location...you could experience pain along the side of your lower left abdomen, down into your groin, and upper thigh. I can perform nerve blocks which can offer temporary periods of complete relief, and will also immediately begin axonal re-stimulation treatments to encourage nerve regeneration. In the interim, depending on the extent of your...discomfort, there are analgesics that can be administered that are tailored for neuropathic pain and could prove effective at managing your symptoms."

"Keep me in fighting shape." Kes said firmly. "Whatever that takes, we do it." Pain and discomfort were a part of life, until it caused him to hesitate or pull back. Then it would be the cause of not only his demise but possibly that of his team. Unacceptable.

He winced as he sat back up, looking down at her handiwork. It was clean and he felt relieved with that part at least. Kes sighed. This wasn't going to be the end for him. Far from it.

"Just keep me fighting doc. I need to keep fighting." There was a grim determination to his voice. Being a soldier wasn't just a career for him, it was his way of life and he was still too young or stubborn to give that up. "Come up with a plan. I'll follow it. Once we get somewhere with the proper outfit that you need to fix me up completely, we'll do it then."

"Understood. You must remember these 'fighting' words if what I have warned of comes to pass. However...what is, is..." Her voice trailed off as she focused on doing what she could to bolster up nerve repair before beginning to close the wound.

"How is it you came to have an injury sustained by a weapon of your homeworld?"

"A damn traitor." Kes spat angrily. He'd dropped off the unconscious opponent with the other terrorists and hadn't really cared enough to follow up on if the scum had lived or died. "I'm hoping he's in worse shape than I am."

He paused then and his antenna flexed forward. "You know what an Ushaan is?" Kes couldn't help but chuckle. "A surgeon and a scholar. I'm impressed doc."

T'Mara winced as she realized she shouldn't have done that. An Ushaan-tor was an Andorian miner's blade used in duels to the death as dictated by their Code of the Ushaan which was vast and gave fascinating insight into Andorian cultural mores. She recalled that once her father learned he was being reassigned to the Andorian embassy as Minister Counselor, everyone within the family unit had been required to learn about Andorian culture, societal structure, laws, and language. It was a fascinating species, and T'Mara had looked forward to relocating to Andor with a keen sense of anticipation. It was not meant to be. At least, here and now, the information she had learned was finally proving useful.

"There was a time once where I thought I would be living on Andor and I was required to study about your people and culture..." T'Mara's voice trailed off as she focused in an area of skin that was not approximating well. "You fought another Andorian, and a traitor. Most curious." There. Just enough truth to satisfy the inquiry, and a change of direction to move the conversation on.

"Yes..." Kes muttered. He shook his head. "He was one of the terrorists that set off the bombs."

"What do we have to do now to keep me together?" Kes asked, changing the subject once again. "Let's just focus on that for now and we can go from there."

T'Mara considered his words...an Andorian terrorist? Just what had she stepped into here? Regardless, there were times and places for such debriefings, and she supposed that 'interrogating' her patient for more details was less than professional.

"I do not have enough data to extrapolate a stratagem, Lieutenant. However, staying away from other pointy objects would be logical." She had reached the end of the lacerating wound with the auto-suture and leaned away from the Andorian to inspect her work. It looked far better than when the Marine first entered sick bay. The gaping edges were now well-approximated and the wound itself was sealed. She reached out and picked up a few pieces of antimicrobial impregnated gauze and layered it over her work and then covered that with the transparent covering which would keep water and debris away from the incision.

"You will need to return every 24 hours for antibiotic dosing and reassessment. The wound itself should be numbed until its time to return, so your discomfort for now should be minimal. If you notice any signs of complications, erythema, swelling, purulent drainage or if you start to feel malaise or start running a fever, these are also return precautions."

"So just to review; no dirt rubbing, come back right away if I do, and I should be numb for a day." Kes nodded. "Sounds good doc. And I'll bring the good stuff next time."

Kes slowly stood up and looked at his cut shirt and shrugged before removing it completely. It was cut and bloody now anyways so he'd have to get a new one. "Do you make house calls if needed?" He was still pale, looking a little more Aenar than he liked, but with the infection under control he figured he'd be back to his proper shade soon enough.

T'Mara's eyes quickly darted down his bare chest then back up to Th'relnal's own in an assessing manner. "If the cause is sufficient. Please do not overexert yourself, and no strenuous PT until you are cleared by me. Get some rest, Lieutenant Th'relnal. Your body is still combating a systemic infection. That is an order."

 

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