Post Spotlight – Medical Report (Obsidian Command)
http://command.obsidianfleet.net/index.php/sim/viewpost/504
The post preceding this one showed the seven months pregnant Chief Medical Officer, Minka Mazur, going into pre-term labor and under distress. In the earlier post, Doctors from multiple ships arrive to try to address the emergency. In this post, “Medical Report” which follows after, Doctor Llywd takes the time to enter a detailed report of the earlier events. This masterfully designed post will have the best effect when patiently read through to the end…
Medical Report
Posted on 12 Mar 2023 @ 6:17pm by Admiral Zavareh Sepandiyar & Commander Thaddeus Zayne & Commander Kasra Turan, MD & Lieutenant Commander Ethan Walker, MD, Ph.D & Lieutenant Commander Hamish Pembroke MD & Lieutenant Commander Alwyn Llwyd (*)
Mission: M3 – Into the Deep
Location: Infirmary – Obsidian Command
Timeline: MD09 – 1322HRS
4154 words – 8.3 OF Standard Post Measure
With a heavy sigh, Doctor Alwyn Llwyd dropped into the chair of the Chief Medical Officer’s desk, and just sat there staring blankly at the terminal screen in front of him. His hair was still slightly damp from his post scrub shower, and his new uniform smelled like the replicator, but at least it was clean. The door was closed now and the office silent but for the occasional chirp of the main display on the large wall facing him that showed the statistics on all of the patients in the ward, of which there were very few at the moment. It seemed almost impossible to to fathom that there were other patients there. That there were others that were sick when he’d been laser focused on just one for the last twelve hours and change.
If there was one thing he knew he had an advantage of over his Starfleet trained counterparts, it was understanding that the galaxy threw major league curveballs that the whole of the Federation and Starfleet’s technological advancements and medical therapies just weren’t ready to deal with. So many of these Starfleet physicians had this chip on their soldier that what they knew and what Starfleet had access to simply made it so they were invincible when it came to taking care of their patients. That there was nothing that they couldn’t heal with the right time and attention.
That was rarely the case and he’d found that their dogmatic belief in that often caused a lapse in care that would have never happened in the Federation Medical Corps where he’d come up. He would have sacrificed digits to have access to the technology that Starfleet Physicians had collecting dust in storage. Just going through the equipment manifest on the Alexander was infuriating. How many lives could he have saved over the years with just a fraction of what they just had lying around. It was one of the hardest parts of his transition into the Starfleet branch of medicine.
It was evident in Doctor Panthal, who had managed to collect himself and attempted to assist in the care of Doctor Mazur but he’d ultimately had to remove him from the surgical bay lest he continue to drag their process down. Alwyn wasn’t a full time surgeon and neither was Turan or Walker though the former was far more experienced in it than the latter. So Panthal’s constant need to insist upon other therapies that were reliant on a technological fix instead of actual surgical repair and grated him to the point that he’d kicked him out of the bay. Walker seemed to have it to a degree as well, but was far more accepting of the realities that Alwyn was trying to communicate leaving him to ascertain that his reliance was more a function of his lack of experience. He may have been a medical Doctor, but he was more actively a Psychiatrist. He was only there because they lacked any further depth on the bench. Medical was the only under-staffed segment of the whole ship and the only other Doctor he would have thought to trust went with Captain DeHavilland on the Pathfinder. Of course, had she known that Doctor Mazur would be incapacitated, she most likely would have stayed.
Surgical procedure was always a delicate thing, even with the advancements that they had at their disposal, there was still the need to cut flesh and operate on the inside of a living being. That being being pregnant only compounded the issues and created complications that were very difficult to plan for as the focus had to be on both mother and child at the same time. But something they were all trained for, at least in theory. Thankfully, both he and Doctor Turan had worked in similar situations in the past though this one was more than a challenge for both their experiences.
With the surgery completed, Alwyn now had the exhausting task of documenting their every step in the process for the official report. Notes were always taken along the way, with the attending Nurse’s jotting them down as they made their orders. But it still had to be formalized for the patients medical record in case there was ever any need to go back and review the process and procedure. Exhausted from his efforts, Alwyn drew the terminal on the desk a little closer, bringing up the Nurse’s notes and then activating the reporting controls.
“Acting Chief Medical Officers report on patient Mazur, Minka,” he began.
His first task had been to stabilize both mother and child once he arrived, something Panthal should have had the foresight to do but had been overpowered by his nerves. It was something he’d have expected a physician to have worked out in residency. Alwyn had sedated the former but it was a temporary fix to try and bring her heart rate and stress level down so he could take better scans of her and the child to work out the proper procedure.
“It should be noted that Doctor Panthal was of little to no help during this process. He was nervous and clearly overwhelmed at the prospect of working on the Chief Medical Officer. Whether that was because he knew her, or was overwhelmed at the daunting task before him, I’m not sure. But it will be my recommendation that he is no longer the attending Physician alone again until a more senior Physician can ascertain his abilities,” Alwyn reported, talking to the log as conversationally as he could, as he was meant to.
Once Turan and Walker had arrived, they had scrubbed in to surgery as well and they had begun the process. Now that he’d sedated Minka, her body was starting to settle and they could get better scans on mom and baby, to develop their game plan on how they were going to treat her.
“The expectation in the initial scans was that surgery would be required to adjust the child and the orientation of the mother’s internal anatomy to continue to support the growth of the child. Continuing natural gestation was the goal,” he outlined further.
The problem really was that Doctor Mazur was such a petite individual, which made carrying the child at all, let alone to term, a difficult proposition for her anatomy. He of course knew that going in and had been working with Minka on her own therapeutic decisions. The only reason that he was even on Obsidian Command was because she was mostly immobile and needed a second set of qualified hands, especially with the Assistant Chief off station.
But it wasn’t impossible for a woman of her size to carry a child to term, she’d done it already. He knew it could be done, but as he told every mother-to-be that came across his threshold: every pregnancy was different. Minka was a testament to that with her last pregnancy being heavily laden with morning sickness and nausea whereas this one had been plagued by back pain, irritability (more so than normal) and an intolerance physically to stress factors. More complications that the last and far more significant, if he was honest. People like to write stress off as a simple function, but they failed to understand just how all encompassing the issues it created were.
“Our initial surgical procedure was to restore the child to a supportive gestational position and prevent any subsequent reorientation similar to the current one. Our initial surgery took approximately three hours to complete and was mostly the work of myself and Doctor Turan with Doctor Walker supporting as well as Nurse Kelly. All signs remained stable, though not as favorably strong as we would have hoped,” he continued narrating.
It was always a challenge to take two lives into account, and that was exactly what they were dealing with. Turan and he were focused on Minka while Walker and Kelly kept their attention on the child, often slowing the surgical process down to account for the child. But the results were positive, and they were making steady progress adjusting the child in the mothers womb and keeping the mother in stable health as well.
“The complications did not arise until we were completing the surgical procedure with the child. A sharp spike in both patients vitals at the point of completion suggest that there was a sudden clot or other similar constricting blockage that was either dislodged or inadvertently created and dislodged during surgery. The decision was quickly made that we could not continue to guarantee both patients safety if we left the child in the womb. Doctor Turan and I prepared to immediately deliver the child via cesarean,” he continued, now rolling the notes on the panel down so he could read on with what Kelly had written out.
Really his fear the whole time was that they’d have to remove the child, and in doing so create a situation where they would need additional care for it as Minka was still two months and a bit out from full term. Not that they couldn’t handle the needs of a premature birth, but it was without a doubt always better for the child to gestate completely in the womb rather than by artificial means if possible. Life was complicated and no matter the technology in play, the body was the best place to incubate new life. Bar none.
“During my initial assessment of Doctor Mazur, I asked Doctor Panthal to inquire if the Alexander was within transporter range, eager for the expertise of Doctor Pembroke as his surgical expertise is second to none. I also asked that he summon Doctor Turan. The station comm’s officer was unable to immediately raise the Alexander or Doctor Pembroke and so Doctor Panthal left an urgent message with the comm’s office and then summoned Doctor Turan with urgency. Doctor Turan took it upon himself, thankfully, to summon his colleague Doctor Walker. I would have not been able to handle this surgery and subsequent care without either of their support. Doctor Panthal would not have been sufficient and the collective experience of the rest of the Physician’s in this department would not have been either,” he continued.
Medical had been the least staffed of all the departments, only because it was so large and because the Chief and Assistant Chief were incapacitated or off-station. Had they had a ship-wide case of the Flu, or three-hundred crew with broken arms, even the aftermath of the battle for the station, they would have had the manpower for that. But this emergency required far more than any of that might. Not only expertise, but experience and a strong diagnostic mind.
“It’s my professional opinion that, until their refit is complete, that Doctor’s Turan and Walker be temporarily assigned to Obsidian Command’s infirmary as an additional resource to the Physicians already on staff,” he continued, diverting slightly from the actual report he was providing.
They definitely had something to add to the department and a bounty of experience in which they could help educate the younger physicians on staff. Turan had taught at the Academy for a long period and as such was especially suited for this kind of ongoing education. Residency as a Physician by no means prepared you for everything, but it was a solid foundation. But this had challenged the most seasoned of them; Doctor Panthal would have had no chance of success without him, Turan or Walker to assist.
“The child was the most in distress of the two patients, thus our focus was on a safe and complete removal from the womb. Doctor Turan and I completed this surgery while Doctor Walker and Nurse Kelly prepared the neonatal suite for the child,” he continued, speaking to the terminal like a counselor he was venting his day to. “The surgery took nearly two hours and we were thankfully supplemented halfway through by the arrival of Doctor Pembroke who had received our message,” he explained, the relief evident in his voice.
Hamish’s speciality was surgical procedure and there honestly wasn’t a better one in the Fleet. To have him on hand for the more finite parts of the procedure had been instrumental in safely delivering the child. Seeing what he had done had made it clear that both him and Kasra were outclassed by his very, very skilled surgical hands. Hamish may have been arrogant and stubbornly self-confident, but it wasn’t bluster. He was that skilled. Few had that gift.
“Given Doctor Pembroke’s surgical expertise, I relinquished the lead in the surgery to him. I have every confidence that the child survived this procedure because of Hamish’s expertise and steady hands. There were several complications along the way that I cannot with confidence say I could have completed as successfully,” he declared for the record. “There is no doubt in my mind the child is alive because of him. I cannot say it would be had we been without him.”
Over the course of his career he’d had to tell an unfair amount of mothers that their child had died in childbirth, or that they would soon thereafter. It was an unfortunate byproduct of his work in often inhospitable or conflict-ravaged sectors of space. The FMC didn’t operate on peaceful, stable worlds. They sought out the sick and uncared for, and the result was that there were far more casualties than most Physician experienced. Not for a lack of skill, but because they were late to the party, often arriving weeks and months after the conflict. Rarely had they been there in type to treat the sick and injured. So Alwyn had hardened his heart a long time ago to telling a mother their child was gone, and he’d re-cauterized that part of himself in preparation to tell Doctor Mazur the same, so was beyond thankful that Hamish had spared him that.
“At approximately zero seven oh five, the child was removed from the amniotic sack and placed into the incubator. The child was male, weighting approximately three point nine five pounds,” he declared formally for the record. “I am a part of the Alexander’s medical team, assigned here on OC at the Admiral’s request to support Doctor Mazur during her late term. As such, I have a familiarity with Doctor Pembroke that the other physician’s do not. So once the child was removed from his mother, Doctor Turan took the child into the secondary surgical suite with Doctor’s Walker and Panthal to continue the immediate post-natal care. I remained with Doctor Pembroke and Nurse Kelly to complete the necessary care of Doctor Mazur.”
Thankfully, Minka had been unconscious still and so the removal of the child from the surgical suite hadn’t caused her any more stress. Generally, the mother was awake for these procedures and simply unable to feel the procedure beneath the curtain, so to speak. But all things considered, they had kept her under anesthesia and now that the child was free they had readjusted that to more completely cover her singular needs.
“I am attaching the full medical scans and notes to this report, far too detailed to give verbally. These additional complications were our initial focus now that the child was safely removed and we began working our way through them. Our preliminary and subsequent analyses were that we were in for a long surgery,” he continued on, now detailing the specific processes that they had taken and approximately how long each had taken.
“Additional complications arose after the fourth hour, post-cesarian, significant enough that I summoned Doctor Turan to return to surgical suite to assist,” he went on still, leaning onto an arm as he spoke and rubbing the stress from his neck. For another half hour he outlined the finite procedures and processes, linking further scans, and tricorder readings for the record as was required in this sort of report.
Starfleet was nothing if not meticulous in its reporting standards for all manner of events, from the lowly Yeoman to Fleet Admiral’s. Everything had to be on the record, and audibly recorded for posterity though easily accessible in written form as needed. It suited him because he was the same way. Like any good scientist he kept copious notes and verbal logs of all his procedures and processes. He was so engrained in that habit that he kept a daily diary of sorts the same way. This process was natural to him, but even by his standards, he was digging deeper into the details so he had that on record while it was still fresh in his mind. Even a few hours from now the details would start to fade.
“This ends my report on patient Mazur, Minka,” Alwyn finished calmly, pressing the button to terminate the feed.
With a heavy sigh he sat back, blowing his exhaustion out slowly, puffing his cheeks as he did. He glanced at the ships time on the terminal and shook his head. It was nearly fourteen hundred hours. It had been just past oh-two-thirty when he’d been awoken to report to the infirmary, something he’d wished he’d known would be needed of him when he decided to stay up late reading. He was exhausted, body and soul, and desperately needed a nap but knew he wasn’t likely to anytime soon.
Long minutes passed in silence in the office, lost to his thoughts. He was thinking and rethinking about all that had happened. He was questioning and re-questioning each step along the way, trying to look at it all as if he were an outside Physician reviewing their work. Trying to see if they’d missed the obvious. If they’d been so engrossed in all the complications that they’d missed something simple. He was on what may have been his third full review of it all when he came to the sudden realization that reviewing this all again wasn’t going to help anything or anyone. It was like a bucket of cold water had been tossed on him and he couldn’t bear to stare at it any longer.
Feeling a wave of frustration mingled with exhaustion, he transferred his report to a data PaDD, deactivated the terminal and stood up. He didn’t trust himself not to dive right back into it, so he turned to leave, pausing as he rounded the desk to look at the plaque on the wall. It was a pair of ancient Earth revolvers pointing up at angles framing a central placard that read: First Prize – Minka Mazur. He gave it a rueful smile, then turned and left the office.
The infirmary beyond the office was back to its normal pace and if it weren’t for the sight of Doctor’s Turan and Pembroke on the far end of the infirmary, there wouldn’t have been anything to indicate anything was amiss. Alwyn padded tiredly over towards them.
“Where’s Doctor Walker?” He asked the pair of them, reaching their conversation at the end of the hall a moment before Nurse Kelly arrived, her golden curls damp and drawn tightly back in a bun, offering a data PaDD to Doctor Turan.
“He is with Ptolemy,” Kasra replied, taking the offered PaDD and consulting it distractedly.
Alwyn gave a nod, “I’m heading up,” he said simply, waving to the lift and heading that way. Hamish gave him an uncharacteristic pat on the back in reassurance as he went on his way.
Doctor Llwyd called the lift and when it arrived, ordered it to the CIC, riding the rest of the way in silence, arms clasped over his waist, PaDD in hand, head down. Once more the urge to go back over everything was nearly impossible to resist. Even as he did, different flashes of memories popped up that demanded his conscious mind to fight back the subconscious.
It was an internal battle that ignored all else, including the coming and goings of other officers moving in and out of the lift on the long trek up the station to the CIC. It was a place he’d never actually been before, but trusted himself to find his way. Thankfully, he didn’t have to fuss too much with that as there was armed security waiting for him at the top of the lift as soon as he stepped off.
“Excuse me, sir. State your business in the CIC,” the Starfleet security officer demanded, halting his further progress.
“I’m Doctor Llwyd, acting Chief Medical Officer. I need to speak with Admiral Sepandiyar,” he explained patiently.
The security officer looked past him at his fellow, who nodded. “He checks out,” the woman muttered.
“The Admiral’s on the CIC deck, at the moment. Probably at the main holo table,” the officer explained, gesturing to the stairs that led up to the main level.
“Thanks,” Alwyn replied, heading that way.
He climbed the narrow stairs up to the second level, and took a moment that would have normally been a moment of awe at the sight before him, to look around and find the spot the security officer had mentioned. He spotted what had to be it finally, and headed that way, threading through other terminals as he made his way across the expansive deck.
He’d never been up here before and had heard that it certainly was a sight to behold; they hadn’t been wrong. From here he could see the planet below and the vast majority of open space around and beyond. There were dozens upon dozens of terminals, each with a crewman manning them, going about their day as normal. None had any inkling of the night and morning they’d had in the infirmary.
The main holo table certainly lived up to its name as he approached. It was a huge apparatus currently alive with all manner of holographic representations. From ships to floating reports, to star charts and everything in between. There were a collection of officers and NCO’s about the table, and among them was Admiral Sepandiyar, standing at the head of the rectangular table on the far side from where Alwyn was approaching. He was listening to Commander Zayne, standing just to his left, give some kind of report. One that he stopped giving as Alwyn approached the table, clearly interrupting the confidentiality of it.
Both looked at him in surprise, along with the rest of the gathered staff. “Doctor Llwyd?” Zayne asked, surprised to see him. “This is a confidential meeting,” he explained.
“Sorry to interrupt, Commander. Admiral, could I have a word in private, sir?” Alwyn asked gently.
Zavareh shook his head slightly, “I’m afraid we do not have the luxury of time, Alwyn, this is very important,” he replied, indicating the floating holo’s. “Can it wait?”
“I’m afraid not, sir,” Llwyd answered, shaking his head this time.
“I can only spare a moment,” Sepandiyar sighed, waving for him to go on.
“You’re certain I can’t have a private moment?” Alwyn pressed, looking around at the others and hoping that the Admiral’s experience with him would move him to reconsider knowing he’d never asked this of him before.
Zavareh lifted his chin slightly, looking down through his glasses more clearly at Doctor Llwyd and gave an almost imperceptible nod, “Clear the table, we will reconvene shortly,” he ordered. At once, all of the assembled staff turned and left the table.
“Commander Zayne, you should probably stay as well,” Alwyn added somewhat suddenly. He had been so laser focused on the Admiral that he’d missed the obvious point that Thad was this stations First Officer. He had every need to be here as well.
“As you wish,” Thad replied, having turned to walk away but turning smoothly back.
Zavareh looked around, waiting for the last officer to get out of earshot and then turned his attention to Doctor Llwyd. “Doctor? I presume you’re here on some matter of significance?”
Doctor Llwyd nodded slowly and then offered the data PaDD in his hand to Commander Zayne who handed it to the Admiral. The elder man flicked it on, glancing briefly at it and then over at Alwyn with a confused shake of his head.
“I’m sorry, Admiral,” Alwyn answered emotionlessly, measuring his words slowly. “But it’s my duty report that as of twelve hundred and thirty-seven hours, Doctor Minka Mazur was pronounced dead of complications from childbirth.”