58807.11-1830 - "Due Diligence"

"Due Diligence"

Lt. Tyzur, Chief Medical Officer, USS Vanguard
Dr. Kira Velas, Head of Medicine, Royal Medical Facility, Kachivar, Drokar

Stardate: 58807.11, 1830h
Location: USS Vanguard

***

Tyzur's communicator chirped. A young female communications officer said, "Dr. Tyzur, I hate to bother you, but there is a call coming in for you from the planet Drokar?"

Tyzur entered his quarters. His shift ended a couple of hours ago, but he'd lost track of time once again. He ordered a Risan mai-tai from the replicator. It's a drink that had helped him wind down during his recovery. He sat down on the sofa thinking the Starfleet standard issue one is a bit uncomfortable.

"Computer, add replacing the sofa with an armchair to my personal to-do list."

Only vague memories of his childhood remained, but he did remember the comfort his grandmother's armchair provided. He took a sip when his combadge chirped. An incoming call from Drokar? Lt. Cmdr. Lektar had indicated they had an isolationist attitude, so this call was a pleasant surprise.

"Thank you Ensign! Patch it through to my quarters."

Tyzur sat down at the display unit on his table and pressed the button to receive the call.

The screen lit up. A woman's face looked out at him. She looked very much like Shirik - inky black skin, pure white hair, and deep violet eyes - but she was a bit older. Her hair was up in a tight bun on the back of her head, and she wore a white medical smock. Around her neck was a choker of some sort of sparkly crystals, and similar sparkly things adorned her hair. For a long moment she said nothing, her gaze studying this alien before her, noting the metal on his face. 

Finally she spoke. "Mi sa tamkrill kira velas, lub am rakiv ni'tam ni'sirob."

She watched him expectantly.

Ah. The Drokari language must not be in the Federation database.

"One moment. Computer, run the universal translator's new language initialiser. If it fails, run a level 5 diagnostic."

The universal translator usually picks a new language up very quickly. It can take a bit longer if no language with a common root is on record, Tzyur speculates.

The computer responded, "Language unknown. Running diagnostic."

The woman's eyes lit up and she nodded with a frown, holding up one finger. She then turned and murmured something softly to someone offscreen, then looked down at her console and tapped in some commands. She looked back up once more. "Can you understand me now?" she asked. "I forgot that you creatures do not speak a proper language." Her expression suggested she should expect nothing more of him.

"I am Dr. Kira Velas, head of the Royal Medical Center on Drokar. I am told that you need some information."

Tyzur would have to navigate the conversation carefully. Physician to physician, that was the common ground he hoped to find.

"Thank you for speaking with me, Dr. Velas. I appreciate that your government has limited contact with the Federation. I'm Lieutenant Tyzur, Chief Medical Officer aboard the Federation starship Vanguard."

"I appreciate that your world values its privacy, and I have no wish to intrude upon it. My purpose is purely medical. I am responsible for the care of a Rennari patient, and our knowledge of your people's physiology is understandably limited."

Every instinct urged him to ask a dozen questions immediately, but medicine had taught him that trust was often built before the first answer was ever given.

"Before I ask anything further, I'd like to know what information you're comfortable discussing. If there are credentials or authorizations you require, I'll gladly provide them."

"In reviewing the literature available to us, it became apparent how little we actually know about Rennari medicine. As a physician, I'd much rather learn from those with firsthand experience than rely on incomplete extrapolations."

He fell silent, resisting the temptation to fill the pause. If Dr. Velas was willing to entertain the conversation at all, she deserved the space to decide where its boundaries lay.

She seemed to be listening to every word he said, even as her gaze carefully watched his features as he spoke. One eyebrow rose slightly at his use of the word 'Rennari'. 

"As the head of the Queen's medical staff and this global Medical Center, I am authorized to discuss anything of a medical nature that I decide is pertinent." she said. "Your credentials have already been ascertained and accepted or we would not be speaking now." She paused for a moment to consider her words. "I am responsible for the health and well being of all members of the Royal House, Lektar. Including our First Princess, who is serving aboard your vessel. Your request for these records brings me some concern, as none of your doctors before have requested it. Is there something wrong with the Princess that requires more information from us?"

Of course they knew. He'd requested medical information about the only Rennari serving in Starfleet. Expecting the Queen's physician not to draw the connection had been wishful thinking. Tyzur inclined his head slightly.

“I understand your concern, Doctor. If our positions were reversed, I suspect I’d ask the same question. However, I hope you'll understand that I can't discuss the medical condition of any patient under my care without her consent. That's a professional obligation I wouldn't set aside, regardless of rank or title."

He let the words settle before continuing.

“My request shouldn't be interpreted as evidence of a crisis. Rather, it reflects my realization that our medical database contains remarkably little baseline information about Rennari physiology. I'd rather obtain reliable information before I need it in an emergency than discover our assumptions are wrong while someone is on my biobed."

He offered a faint, apologetic smile.

"What I'm hoping to obtain isn't Princess Shirik's medical records. I have no wish to intrude upon her privacy. Rather, if your government permits it, I'd be grateful for any standard medical references your physicians consider appropriate for treating Rennari patients. Anatomy, physiology, pharmacology, emergency medicine, anything intended to educate a competent physician unfamiliar with your species." 

She considered his words. "The First Princess is also my patient, as she has been since birth. We too have a code of privacy with our patients, but in this instance I consider it a professional consultation between two doctors treating the same patient. If there is something she needs treatment for, then I would have better information to know what exactly to send you that might help. General knowledge about our anatomy and common ailments may not do you much good should she have contracted some sort of space ailment or specific known disease of our people." 

She paused. "You must understand that our medical knowledge of Rennari physiology is also considered sensitive information. We do not share it freely with outsiders. In medicine as in diplomacy, information flows both ways. I am prepared to provide you with comprehensive references that would make you an exceptionally well informed physician regarding our people, and our First Princess in particular. In return I would expect a professional consultation. Not her private records, simply your clinical assessment of her current condition and any concerns you may have."

"I believe that's a reasonable proposal, Dr. Velas. I appreciate that you're approaching this as a consultation between colleagues. I would extend the same professional courtesy were our roles reversed."

He folded his hands together.

"Clinically, Lieutenant Commander Lektar is stable. Her recovery from repeated severe trauma has been remarkable, and she has returned to a level of function that exceeds what I would ordinarily expect."

His brow furrowed slightly.

"My concerns stem less from her current condition than from the limits of Federation knowledge. Rennari physiology appears broadly Vulcanoid, but I know superficial similarities can conceal important differences. I'd particularly value your guidance on the long-term implications of the focklym infection, her prior demyelinating condition, and the reconstructed pulmonary tissue."

He paused briefly.

"One observation may be relevant to both of us as her physicians: Lieutenant Commander Lektar consistently minimizes her own condition. She is more inclined to carry on with her duties than seek medical attention. Admirable in an officer, perhaps, but less so in a patient."

She listened intently, and although her facial expression didn't change, her eyes showed a number of things. Surprise, concern and a bit of anger. "I was not aware of the extent of her injuries. Our records of her condition have not been... consistently updated. This changes the nature of my request considerably. I must request her medical file from you, so I can more thoroughly understand her condition and advise you appropriately. Our people are quite resilient, and also quite private. Her reticence to seek aid is not unusual here, and such major injuries as you describe are rarely seen among members of the Royal House."

She paused once more. "A demyelinating condition is no small matter, as I'm sure you're aware. Are her symptoms causing problems? Are they getting worse? And this focklym infection, I will need more information about that as well to better advise you. I am aware of my people's superficial similarities with Vulcans and their kin, but there are significant physiological differences between us."

Tyzur listened without interruption, noting the subtle shift in her demeanor. The concern in her voice was unmistakable.

"I understand your request, Dr. Velas, and I agree that a complete medical history would be valuable. However, Starfleet medical ethics require me to obtain Lieutenant Commander Lektar's consent before releasing her medical record whenever circumstances permit. She is stable, so there is no emergency that would justify overriding that principle."

He re-adjusted his seating position.

"I will speak with her at the earliest opportunity. If she consents, I'll provide whatever information is necessary to support your consultation."

His expression became more thoughtful.

"To answer your immediate questions: the demyelinating condition is not currently progressing. From my examinations, she has recovered well and exhibits no significant neurological deficits attributable to it. My concern is whether there are long-term consequences unique to Rennari physiology that we should be monitoring."

"As for the focklym infection, it occurred years before I became her physician. My understanding from the record is that it caused irreversible pulmonary damage requiring reconstruction of both lungs. She presently has excellent respiratory function, but I cannot say with confidence whether that reflects complete recovery or successful adaptation."

He rested his hands on the desk.

"If there are specific findings, laboratory studies, or imaging you would like obtained while I await her consent, I'd be happy to arrange them."

She looked shocked for just a moment. "Reconstruction of... That is major damage. I would appreciate any information about her case that you can offer, Dr. I will need to look them over and perhaps consult with some specialists here." She paused. "The Princess is known to be stubborn, and a bit paranoid. It would not surprise me if she refused your request, even if is it in her best interest medically to agree. She may not fully comprehend the severity of what she's experienced and will continue to, she has no medical knowledge and as a Princess would normally have been protected from any such harm. I will appreciate any materials you can provide."

Tyzur considered her words for a moment before nodding.

"I understand your concern, Doctor. If our positions were reversed, I would want the same information. But I won't circumvent Lieutenant Commander Lektar's autonomy, even for what I believe are good reasons. She is stable and capable of making that decision herself, and maintaining her trust in her physicians requires that we respect it."

He paused.

"That is not a lack of trust in you. Quite the opposite. I will tell her that I spoke with the physician who has cared for her since birth, and that you wish to consult as a colleague. If she consents, I will provide a detailed medical summary with the information most relevant to your assessment."

He glanced briefly at the data console.

"In the meantime, I'll send what information I can share without violating her privacy, including my general observations of her recovery and current condition. Perhaps that will give your specialists a place to begin."

Tyzur offered a small, respectful nod.

"I appreciate your willingness to assist, Doctor. I know this is an unusual request, and I hope this can be the beginning of a productive exchange between our medical communities."

She gave a faint half-smile at his optimism. "Please send what you can. My colleages and I will look over it and see what we can do to aid you. Please contact me again when you have an answer." She paused, then added, "Good luck. I look forward to conversing with you in more depth about many things." 

"Thank you for your assistance. And Doctor... I too look forward to that conversation. Until then, stay well. Tyzur out.'

As the call ended, Tyzur smiled to himself. Collaborating with physicians of unkown species is the kind of exploration he signed up for.

"Computer, add arranging an appointment with Lt  Cmdr. Lektar to my to-do list."

The computer chirped. "Acknowledged."