Cockpit Surgery

[Jaiysa t'Tamarak 0]

((Thanks to Kansas Kenickie as well.))

 

Hypercoagulin has the bleeding stemmed; anesthezine should help with the pain and keep her unconscious and immobile. But she is still weakening...something has opened internally. Pah...

 

Jaiysa rounded on the yyaio standing at her elbow. "How long until we reach your ship?"

 

The Vulcan woman's maddeningly calm expression did not shift at Jaiysa's abrupt address. "With the fuel intake problems we are experiencing, it is likely we will not arrive at the Manticore for twelve hours."

 

"This woman will be dead in twelve hours," Jaiysa said bluntly. "She has a good portion of the console behind you buried in her torso and appears to have opened internal bleeding. She needs to be taken to a fully equipped medical bay, and very soon."

 

The Vulcan looked back at her impassively. "So what do you suggest, Doctor?"

 

Jaiysa's jaw clenched and she stared down at the still body of the lloann'na medical officer. There was no question that the situation could not have been less ideal for exploratory surgery, and there was also to be considered the fact that her standing with this crew was of an uncertain enough nature that to have this woman die under her fingers might easily have repercussions on her own safety. But there was also no question that without surgical treatment, the Federation doctor would die, and that to leave her to her own devices was to reject an opportunity which Jaiysa had sought and been denied too many times in her life.

 

"It's honorable...to heal..." the woman had whispered even as she fell under the barrage of shrapnel.

 

I know...of all people I know...and it is all I have left...

 

"I need to get her onto her back," she said, eyeing the Vulcan again, wondering if the Federation officers would even trust her to operate, reaching out to unbuckle the straps which were holding the medical officer still in her seat.

 

The Vulcan stepped forward, steadying the injured officer by the shoulder. "Have you ascertained that Dr. Chalice's injuries are not such as to preclude movement? If her spinal column has been compromised, such action would be inadvis--"

 

Jaiysa cut her off curtly. "I am quite aware of the dangers, rekkhai, and have already done the necessary scans; the fact that the projectiles missed any vital organs initially is indicative of a level of good luck I've never personally been able to claim but her spine is indeed intact."

 

"You will need to provide a sterile environment for the surgery; these are not ideal conditions for such an activity," the yyaio continued, still appearing infuriatingly unruffled by the situation. Simple for her; she would not have her fingers in a chest cavity up to the wrist in a few moments.

 

Jaiysa shot her a withering look. "Fvadt! I could sterilize the entire cockpit and this ship would still come nowhere near 'ideal' conditions! Now, if you have nothing else to do but state the blindingly obvious, perhaps you can assist me in moving her -- silently."

 

She slid her arms around Chalice's shoulders and waited as the Vulcan scientist reached for her legs, and they very carefully began to maneuver the body off of the seat it had occupied and onto a clear space at the rear of the cramped shuttle. Blood spurted from one of the half-closed wounds over Jaiysa's hand as the medical officer's frame shifted unavoidably with the movement, and she muttered an unintelligible curse regarding worn-out scoutships and consoles unable to take the strain of use.

 

Her body was riddled with holes and she was still conscious. She could feel a strange warmth caressing most of her body, from the torso down. Vil's hand went to her thigh, touching whatever was happening to her, feeling her energy draining quickly. She pulled something out of her trousers, which happened to be a hard metal piece of the console that had blown beside her. She looked at the metal for a moment, trying to figure out where she had gotten it from. It didn't register that she'd just been slammed with half of the metal and other bits of console plate when it blew.

 

"I'm going to need blood for transfusion," Jaiysa said crisply to the Vulcan as she pulled out a tricorder with one hand and administered another shot of coagulant with the other. "A-positive. See if there's any available among your human crew."

 

She could see a comment growing in the Vulcan's eyes and scowled. "Just -- go. I know perfectly well how little I have to work with, I do not need it stated categorically. Go!"

 

The Vulcan turned and moved out into the cockpit. Jaiysa shook her head and looked back at her prostrate medical compatriot, then shut her eyes for a minute. Even if the yyaio managed to find a matching donor among the crew -- unlikely enough -- there would not be time to obtain enough of a transfusion to be of use without draining the donor dry. This was going to require very, very delicate work and a lot of hypercoagulin.

 

She cleaned her hands and disinfected as much of the surrounding area, then looked down and noticed Chalice's eyes fluttering. Quickly she loaded a hypospray of anesthezine and let it hiss into her neck. I've got quite enough to deal with without you contributing.

 

*******

 

In the end, an IV had to be jerry-rigged. The Vulcan, T'Prise, found one of the security officers, the female, to have the appropriate blood type, and they had managed to retrieve and sterilize some tubing and sample bags from the scoutship's scientific stores. Jaiysa now had approximately three hundred milliliters of blood to work with; not as much as she would have liked, but as much as she could afford to draw from a woman still working a tactical board at the front of the cockpit.

 

She hung her bag of blood from the bulkhead, sterilized another syringe, and inserted it into Chalice's arm, then placed a clamp on her length of tubing and stretched it from bag to syringe. She took a moment to survey the situation, the small area of decking sterilized and cleaned as best she could, the cramped bulkheads around her on two sides, the Vulcan woman kneeling across from her with the Federation medkit. Not exactly up to Ra'tleihfi hospital standards...or even Echo Facility's...pah...

 

She reached back into her store of tools and retrieved the small laser scalpel. "Kholairlh-a deleth t'selm*..." she muttered, and made the first incision.

 

Gradually the noise of the cockpit, the engineers trying to solve the fuel problems, the scientists talking, all faded to the back of her mind as she focused on the movement of her fingers. Vividly red blood spattered with each cut, the laser slicing through first skin, then muscle. She saw nothing around her but the movement of that laser, spreading the muscle of the chest and stomach apart and finding the colorful array of organs that was a human's thoracic cavity.

 

"Spreaders..." she murmured, reaching over to adjust the clamp on the IV drip. "Rekkhai...put your hands here and here and...pull. Hard."

 

Thankfully, the Vulcan felt no need to comment on this instruction, but obediently placed her hands onto the ribs Jaiysa indicated and pulled. The bones creaked, the sound sharp in Jaiysa's ears, and shifted under the pressure, then spread, revealing the inside of the ribcage.

 

It was full of blood which certainly was not all supposed to be there. Jaiysa's dark eyes scanned the interstices of the cavity and lit on a large piece of shrapnel nestled between the heart and lungs, which had shifted and lodged itself in the chest wall.

 

"There's my blood loss..." she muttered, opening the IV and reaching forward to carefully begin extraction of the large metal shard. Even as she began maneuvering it slowly out of its new home in Chalice's flesh, her scope of focus began to widen, taking in more small bits of metal throughout the cavity. Her eyes widened slightly. Fvadt...it's going to be a long day...

 

Suddenly she caught sight of something which made her blood-slicked fingers slip from the metal piece they were extracting. Under the heart, below the lungs, embedded in the flesh of Chalice's back along her spinal column and up along the sides of several other major organs, were a variety of alien-looking metallic implants entirely unrelated to the numerous shrapnel pieces calling for Jaiysa's attention. They looked as if they were supposed to be there, in an eerie sort of way, by the way they lined up in orderly fashion, and they had an oddly familiar look to them which Jaiysa could not place.

 

One of the implants, located around the middle of the spine, seemed to have come dislodged in the earlier excitement and was lying half-ripped from Chalice's flesh, pooled in blood which was slowly sinking into the maze of circuitry visible on its outer casing.

 

"Fvah dha'nia Kholairlh-a nahi?*" Jaiysa muttered, reaching for it and beginning to slowly tug it free.

 

"Is something the matter, Doctor?" T'Prise queried, sounding calm and unworried.

 

"Yes. More than I expected, as a matter of fact," Jaiysa responded without looking up, angling her arm back in the cavity to allow T'Prise to see past her hand.

 

The Vulcan peered down curiously and gazed at the implants silently for a moment before returning her stoic gaze to Jaiysa. No hint of surprise showed in her face, only understanding and serenity. "I suggest you tend to the injuries which are more pressing and ignore what may seem out of place."

 

"This goes a little beyond 'out of place,'" Jaiysa muttered, twisting her hand against the implant to start removing it; it had to come out anyway, so the ripped flesh underneath it could heal, though she couldn't restrain a certain amount of curiosity as to what it was doing there in the first place. She spared half a second's glance up at her surgery compatriot, narrowing her pointed eyebrows at the Vulcan's distinct lack of outward bewilderment with this event. "I don't suppose this is standard issue for a lloann'na?"

 

The Vulcan stared back at t'Tamarak, unruffled and implacable for a moment. "It is hardly the time or the place to discuss Starfleet medical protocol. Please perform the necessary tasks to heal Dr. Chalice and I will see that the shrapnel and other pieces are properly addressed."

 

Jaiysa's expression of frustration grew, though her fingers continued maneuvering the small piece of metal from the flesh it was embedded in. It came crashing home to her again, in a way that had been blocked by the exercise of her medical abilities, that she was the outsider here, that as she distrusted them, so they had good reason to distrust her. Do the job...fvadt...ignore the things that could be far worse, if they are what I think they might be...pah... "Of course...rekkhai..." she muttered, hoping the Vulcan would keep her word and investigate appropriately.

 

The dislodged implant which she was extracting suddenly popped free from the chest wall, followed by a shower of warm blood over her fingers, cutting off the discussion and returning her attention sharply to the task at hand.

 

*****

 

The pull of the metal through her flesh made her wince and come to a semi-conscious state. Vilanne's eyes fluttered briefly while she subconsciously tried to put all of the pain out of her mind. She was being held down by one of the crew; all she knew was that she couldn't move and she wanted to sleep.

 

There wasn't enough energy for her to even open her eyes. The pain, however, was excruciating. No amount of hyposprays couldn't resolve the things going on in her body. The nanoprobes were working overtime, having been shocked into activity again. Dr. Chalice wasn't aware of what was truly happening, that surgery was being performed on her in this archaic fashion, and she had never been aware of any of the implants. Her engrams had been exchanged - she had no idea - she only knew that she wanted to scream.

 

She couldn't move her arms, she wanted to grab her chest and hold it. The pain felt like someone was pulling her insides out, breaking her ribs, or even ... well, she couldn't figure it out... she couldn't think... she just felt everything, but couldn't even part her lips to scream. Tears were breaking through the closed slits in her eyes. She could feel them drop into her ears. She used that as something to focus on as she tried to tell herself to lift her legs and move her body, move a finger, blink, or move anything.

 

Years ago, Starfleet Medical had removed most of her blood and flushed it of foreign bodies. They had completed numerous different tests and removed all objects from the exterior of her body. The internal components were removed, where possible, but those attached to the central nervous system were nearly impossible to strip, the way they were intertwined. They had, however, had the technology to put them into an "Off" position. The jolt that Vilanne experienced, however, was enough to re-activate what was left in her blood.

 

"Are you awake again?" she heard the Romulan doctor mutter with annoyance, and then the hiss again of a hypospray by her ear.

 

****

 

Two hours later Jaiysa let the last piece of shrapnel fall into the small pile which had collected beside her. She glanced at the makeshift IV drip and let out a long breath, seeing that the dark red liquid within had not yet completely drained; her care had paid off. Chalice was still breathing, her heart still beat heavily against the back of Jaiysa's hand in the thoracic cavity, and her skin, though deathly pale, was not cold.

 

"Autosuture..." Jaiysa muttered tiredly, taking up the oft-used tool to seal the last gash in Chalice's innards.

 

"The task is complete?" asked T'Prise.

 

Jaiysa finally allowed her eyes to flick sideways from the wound she had opened two hours before. The Vulcan scientist looked as unperturbed as ever, and alert considering that she had been keeping her arms in the same strained spreader position for the past hundred and twenty minutes.

 

Jaiysa sighed. "The task is complete," she confirmed. "All that remains is to close the--" She stopped, then eyed the open cavity for a moment longer, her gaze roving over the remaining implants still buried in scattered places among Chalice's internal organs.

 

No...nothing to be done about them now. Should we happen to return safely to the lloann'na ship...we can investigate further. Sew her up, or you'll do more harm than good, and you've done enough of that in your life.

 

"All that remains is to close the thoracic cavity," she finished, looking back up again at the yyaio for a moment. "Release your grip."

 

She watched with no small feeling of relief as the strained ribs slid back into place, and began running the autosuture over the major incision, watching through tired eyes as the skin and muscle began to reknit.

 

"Would you term the operation to be a success, Doctor?"

 

"Well...she'll live," Jaiysa said, leaning one elbow on her knee, taking care to keep the blood from dripping onto her clothes. "The next few days may not be the most pleasant of her life but the internal bleeding is sewn up. As makeshift surgery goes, it could have gone much worse."

 

T'Prise raised an eyebrow at the Romulan's words but did not deign to comment on the sarcastic bent of her tone. "You did what you could in a difficult situation, doctor, no one will fault you if the work was less than flawless."

 

Jaiysa grunted. "They'll think what they think. I did what needed to be done. That's all that matters." The autosuture finished its work and Jaiysa ran a finger carefully over the closed incision, then reached into the pile of shrapnel next to her and retrieved the small blood-slicked implant from near the bottom. "I should like to know more about this, however..."

 

 

*Kholairlh-a deleth t'selm. -- Elements protect her.

*Fvah dha'nia Kholairlh-a nahi? -- What in the Elements' name?