Stardate 58806.27-58807.10
"A New Life"
Lt. Tyzur - Chief Medical Officer
Lt. Cmdr. Shirik Lektar - Chief Operations Officer
EMH Mark VII
Location: Various, USS Vanguard
Stardate: 58807.03, 08h00
***
It was a quiet morning. Tyzur glanced at his final transfer authorisation while sipping coffee, a human beverage he had learned to appreciate during the intense shifts at his previous posting. He paused as he reached the line 'Assignment: Chief Medical Officer, USS Vanguard'. Not 'Resident Doctor', not 'Former Borg', but Chief Medical Officer. He read it several times before closing the PADD. It was the first posting that was entirely his choice. He remembered the parting words of his mentor, another El-Aurian physician. "You spent a century healing bodies because you were ordered to." A pause. "Now you get to heal people because you choose to."
Time to pack. Despite his age, Tyzur owned surprisingly little. The Borg collective had little room for personal affairs. His time at the academy and his position at Starbase 327 on the edge of a warzone left him with little time for a personal life. He gathered his Risian lute, a collection of science fiction novels from Betazoid, Vulcan, and Cardassian authors, a holopicture of his mentor, and replacement uniforms specially tailored around his cybernetic right arm. Tyzur glanced at the concealment glove he got during his academy days to make his implants less noticeable. He picked one up and considered packing it. Instead, he put it into the replicator for recycling. He was tired of pretending his arm wasn't there. He wasn't proud of it, but he wasn't ashamed of it either.
The corridors of the Utopia Planitia transit station were well-worn, providing a temporary home for countless Starfleet crews about to embark on their missions. Tyzur walked past an observation window, and spotted her. USS Vanguard. NCC-76381. She was small compared to other docked ships like the Intrepid and Sovereign classes. It would be an adjustment, living spaces on Borg cubes and starbases are massive.
The gray-haired Tellarite glanced up from the transporter console as Tyzur approached.
"Lieutenant Tyzur?"
"Yes."
His eyes flicked to the cybernetic arm, then back to the console.
"Hm."
He frowned at the readout.
"You're carrying... just under twelve kilograms of cybernetic hardware."
"Eleven-point-eight," Tyzur replied. "I maintain it myself."
One bushy eyebrow rose.
"You actually know the weight?"
"It helps when recalibrating the inertial compensators."
The Tellarite gave an approving grunt.
"I like officers who know their own maintenance."
He tapped a few more commands, then paused as another line of Tyzur's service record appeared.
"Starbase 327."
"Yes."
"That's a hard posting."
"It could be."
The Tellarite leaned back slightly.
"I've beamed more casualties off that station than I care to remember."
For a moment, his usual gruffness softened.
"They always said the doctors there were miracle workers."
He finished entering the transport coordinates.
"Don't prove them wrong."
It's about the closest thing a Tellarite gives to 'good luck'. Tyzur inclined his head.
"I'll do my best."
The Tellarite snorted.
"Good enough. Transport lock established. Vanguard transporter room one is ready to receive."
As he rematerialised, he was greeted by Lieutenant Commander Lektar, Chief Operations Officer.
Shirik stood at the console of Transporter Room 1. She'd looked over the personnel records of their new doctor, and wasn't overly thrilled to be meeting him. Why did they so seldom seem to get regular doctors on her postings? She let out a breath as they signaled the transport. "Ready." The familiar whine of the transporter filled the small room as the beam of light shimmered and coalesced into Tyzur. She nodded a greeting with a neutral expression. "Welcome aboard, doctor. Do you wish me to escort you to your quarters, or sickbay?"
Tyzur stepped off the platform.
"Thank you Commander! I'd like to get settled into sickbay first. Would you come in for a medical checkup? It's standard Starfleet procedure for a new crew, and in my experience things can go sideways very quickly."
One eyebrow went up. He hadn't even stepped off the pad yet and already was wanting to start on checkups? She managed not to frown. "Very well," she said, "This way." She led the way out of the room and to the turbolift not far away. She may as well get this over with, she thought.
He detected the unease in her. They had warned him that would happen after being liberated from the collective. Still, it wasn't going to stop him from doing his job. They followed the corridor and turned a couple of corners, and there was sickbay. It was a modest facility, but more than enough for a crew this size. Upon entering, Tyzur noticed the biobeds to the left. He gestured to one of them.
"Please take a seat."
He considered using the medical equipment in his cybernetic arm for the checkup, the scanner's resolution is 2.4% higher than that of standard medical tricorders after all. But since he had sensed some apprehension from the commander, he thought better of it. He had a quick look around the room and found where the medical tricorder was stored. He began the scan.
"I've read your medical record, you have quite the medical history. Everything seems to be in check, but we'll have to keep an eye on things. I haven't come across a Drokari before. I see similarities to Vulcan physiology, but there are differences. Any chance you could put me in touch with the Drokari so I can get a look at their medical texts? It would help me treat you more efficiently."
She hopped up onto the biobed. While he was retrieving his tricorder she took a moment to look him over, noting the cybernetic appendage. She filed it away for later but otherwise had no reaction to it.
At his request she almost smiled at the sheer absurdity. But he wouldn't know. "My people would not speak to you," she said. "I can attempt a request myself, but I'm not sure they would approve it."
It had been a while since he encountered an unfamiliar species. It was part of why he signed up for an exploratory mission. It would be exciting to figure out the differences from Vulcan physiology. But he wouldn't let his excitement show, that would be unprofessional.
"I see. Please do, it's worth a shot. Thank you for having your checkup so quickly, it can be a challenge to get the crew in sometimes. Let me know if there's anything I can do for you."
"Indeed," she nodded, hopping off the bed once more, glad it was over with a minimum of questions. "If you require any supplies or equipment, let me know. Cargo is still coming aboard."
"I've requested some cutting edge xenobiology equipment. Has that been approved? I'd like to upgrade Biolab 1 so we're ready to study any new life we'll encounter."
"I will certainly check on that and if not, I will see to it that it gets approved and delivered before launch. Is there anything else?"
"That's all, thank you!"
Tyzur sat down in his office chair and picked up a PADD, not sure how to end the conversation.
She nodded. "Let me know if you require anything else," she said, tapping on her PADD as she exited sickbay. With any luck, she wouldn't be back any time soon.
"Back in the Saddle"
Crewman Andrea Guilder - Nurse
Capt. Varissa sh'Orthamu - Commanding Officer
Lt. Tyzur - Chief Medical Officer
Location: Deck 2, Sickbay
Stardate: 58807.08, 19h07
***
Guilder beamed aboard with a throng of other crewmen, a swath of faces standing before the Head Nurse. Hands passed PADDs, and each was given their duty rosters. Day shift. Supplementary Intake Exams. There are always a couple of officers who slip through, either because their transfer overlaps with their examination, or because they conveniently forgot.
It was strange being aboard a Starfleet vessel again as a crewman rather than a passenger. Not too long ago, she was the one who had a tricorder, here, there, everywhere, while a ship's counselor nodded along to her accounting and a security officer showed her ships that she could not say were the ones that downed the Vivaldi. As she waved the tricorder over the officer, the results blinked onto its display. Nominal. The next. Nominal. And the next.
During a lull in the cavalcade of officers getting their pre-launch checkups, a certain Andorian slipped in for her own medical clearance after a particularly intense workout in the ship's gym. Varissa was still in a simple combination of Starfleet sports bra and workout shorts with a Federation-standard grey towel draped over her shoulders as she glanced around the sickbay. She had hoped to run into the CMO on her visit, but wasn't terribly certain she'd be able to pick him out of a crowd as of yet -- human males were fairly difficult for the Andorian to tell apart, embarrassingly. While her face didn't give any indication of urgency, her antennae told another story, bobbing in different directions to get a lay of the land.
The torrent of Officers eventually slowed to a meandering stream, then dried up. She was halfway through an internal communique with an Ensign regarding a pet tribble. "While your assurances that Fluffy has been both spayed and neutered is reassuring," she spoke as she typed, "this must be verified by medical staff. Please deliver Fluffy to Sick Bay to complete this at your earliest convenience." She hit send and noticed the Captain. She stood, straightened her uniform, and unwrinkled her pipless collar.
"Captain, pleasure to meet you. I am Nurse Guilder. I am happy to report that Intake Exams are expected to be completed on schedule. I'm afraid Dr. Tyzur has stepped out for a bit if you wanted to talk to him. Or is there anything else I can help you with?"
"Nurse Guilder, a pleasure." She hummed nodding along to Andrea's words. "Well, I suspect you'll be able to take care of the official business, though I was hoping to speak to our resident doctor... but that appears to need to wait until a later date. I'm here for my intake exam... and before you say it, I'm already aware of the mess in my left shoulder blade. That was actually what I wanted to discuss with Doc Tyzur. Well... that and to introduce myself."
"I can message him to let him know you're here; maybe that might speed things along. In the meantime, I can perform the exam." She said, indicating a nearby biobed. "Please, take a seat."
Rissa made her way to the nearest empty biobed and sat down, her antennae probing at every beep and bong from the various medical equipment in the sickbay. She was never one for lingering in medical facilities... too many bad memories tied up with people dying under scanning arrays.
"That sounds like an excellent idea, crewman! I'll, em... I'll let you take care of that. Did I need to change into a gown or anything for the checkup? I apologise for my casual attire, but I find the best thing to soothe an anxious mind is a stiff workout. That gym we have on board is going to be my favorite room on the ship. Have you had a chance to use it?"
(Crewmen have the lowest priority for recreational facilities,) she thought. "Ah, no, not yet." She waved the tricorder by her head, narrowly missing an antenna. "As for stripping down, that won't be necessary." (It hasn't been necessary since the 22nd century, not since the advent of the TR-100.) "I can get all I need from here." She said, holding the sensor up.
She had soon circled behind the Captain by this point, scanning as she walked, the display revealing all: an elevated level of lactic acid, a bit higher than the Human baseline for that level of exercise, but that was normal for Andorians. An elevated heart rate, no doubt related to the aforementioned anxiety, as to whether it came from outside of the Sick Bay or was a sign of Whitecoat Syndrome, who was to say? She wasn't the ship's counselor, or it could have come from the shoulder which the tricorder reported as...
...Torn. And healed poorly. And torn again. And healed again... poorly...
Presently, it was edging another tear... truth be told, it was likely one of the worst rotator cuff tears she'd ever seen. Most people with this much scar tissue would be hobbled in pain; what was Captain sh'Orthamu made of!?!
"Ah... you'll have to forgive me. I... don't tend to frequent the medbays. Or... get checkups. I... have a lot of painful memories wrapped up in these bright, sanitized facilities... heh..."
Varissa's antennae drooped as she went on. Heavy stuff, indeed.
"Er... but as a Captain, now, I have to set the bar for the crew, and I want everyone on my ship to be in tip-top shape! So... em... how bad is it?"
(Most people would be howling in pain at this point.) With the amount of damage done thus far, Guilder would suggest surgery. Put Captain Orthamu under general anesthetic, or local, though based on what was required, it'd be best to put her out. Pop that shoulder out, debride the material: scar tissue and what could not regenerate, and if needed, perform an acromioplasty. Next would come the regeneration of the muscle and tendon, but given the ample supply of biomimetic gel, there would be little concern for that. Then attach bio-mimetic anchors as a guide for cloned muscle; the technique was known colloquially as muscle stitching in some medical forums. The preparations for the surgery could be done in two hours; the surgery could be done in less than one. Unfortunately, as a Nurse, Guilder was unauthorized to perform such procedures. And given Orthamu's admitted history of using exercise as an emotional pressure valve, either Tyzur would have to perform the procedure, or she'd eventually tear it completely, condemning herself to the kind of months-long recovery medicine had largely eliminated centuries ago.
The former was preferable.
"I'm making the recommendation that you see Tyzur at your earliest convenience. It's close enough where I'd..." (No, you can't say that; you can't make suggestions, can't make formal diagnosis, you can't even give people analgesics unless you're given the go-ahead, you're not marooned.) "I'm going to run this up the ladder so this can be treated ASAP. In the meantime, I'm going to make the recommendation of a change, not a cessation, of exercise. Have you tried low-impact exercises? Swimming." She asked seemingly nonchalantly as she typed away on her PADD.
"That bad, eh?" She mumbled with a sigh, antennae now drooped down almost flat against her forehead. "I suspected, but... well... at least my instincts were right about having a visit with the Doc. Er... anything besides the shoulder blade holding me back?"
Varissa gave a halfhearted giggle, that last comment meant to be a half-hearted attempt at humor before shaking her head at the nurse's question about low-impact exercise.
"No... can't say I've ever tried it. I typically do a weightlifting regime, hardcore cardio, mountain climbing, contact sports, martial arts... weapons training..."
(I can't do what she needs, I can only kick this up the ladder.) "This shoulder shows extensive scar tissue. To a point where one could," she pauses, "could call it neglect, or abuse in other cases." She lets the accusation hang unanswered. "Of course," she says all too quickly, "perhaps we're all too busy in what is in front of us to care for what is behind us." (Is there a genetic precedent for this in the Andorian genome? Akin to the Scandinavian genome? Further research might be required.)
"I'm unauthorized to do what I... some would see as the necessary treatment; I am forwarding your readings to Dr. Tyzur presently."
"Oh... abuse. Deeeeefinitely abuse." She laughed, rolling her bad shoulder. She had to be in such pain! "I tore it initially back on Stardate 49366. Gosh... almost fifteen years! And, em... well, I just fought through it. Through the Dominion War... through rebuilding efforts... just managed to slip through the cracks and never address it on the Halifax, my previous vessel. Might've bribed a couple of the nurses to push me to the back of the checkup list once or twice. Guess it's time to pay the piper, though! Let Doc Tyzur know I'm at his mercy before we set off, would you?"
She got up from the medical bed and winced at that lingering pain.
"I'll... attempt to avoid those pesky workouts until he gets me tied down for whatever he needs to do. Thanks, Nurse Guilder. I appreciate you being frank with me."
Tyzur was having a coffee in the mess hall as he got a message from Nurse Guilder. He hadn't been sleeping well and needed some caffeine to get through the rest of the intake exams. The message contained scans of the captain's shoulder along with Guilder's tentative diagnosis. It needed medical attention fairly urgently, he thought, better rush back to sickbay and let the captain know. He turned a few corners and entered sickbay, spotting the pair near one of the biobeds. He approached and greeted the captain.
"Captain sh'Orthamu, a pleasure to meet you. I'm Doctor Tyzur. Nurse Guilder has informed me of your medical situation."
He turned towards Guilder.
"I'm impressed by your assessment, you were spot on."
He addressed the captain again.
"Captain, I'm afraid your shoulder is in bad shape. It needs surgery as soon as possible to avoid long-term complications. You must be in quite a bit of pain. Nurse Guilder, please prepare an analgesic hypospray."
A fresh wave of dread washed over the Captain as she sat back down on the med bed with a 'thump'. Clearly there was medical drama behind the forced smile and those antennae, now shot straight up with fresh fear.
"Ah... hey Doc. Nice to meet you officially. Guess I'll be going under the knife while we make our introductions... heh..."
She squirmed a bit as he asked about the pain and informed her about the surgery. This was a long time coming, but she'd put it off for so long she didn't remember a time she wasn't coping with the daily pain!
"Er... truth be told, I kinda just tuned the pain out. There are worse things than physical agony and I s'pose I was... ya know... putting this off to deal with that. I guess this means I'll be able to return to my regular exercise activities... sooner?"
The Andorian's reaction was all too familiar. The friendly smile Tyzur had been practicing in the mirror faded as he remembered how often he'd seen a fear response like that.
"Apologies for being so brash. My previous posting frequently required quick action. The plan is to regenerate your muscle and tendon during the surgery. In fact, exercise is prescribed as part of the recovery process in order to train the new muscle. The pain will be gone in a couple of days. Your muscles will be back to their nominal strength in a matter of weeks, and you'll be able to resume your regular exercise activities. I'm afraid if your shoulder goes untreated, things will get worse and your recovery may take months or even years."
Tyzur paused for a second and remembered his training. Now that the patient has been informed it's time to reassure her.
"It's a fairly standard type of surgery, and I've performed it thousands of times before. The surgery, including preparation takes about three hours and you'd be able to return to your quarters the same day. You'll be ready to take the Vanguard on her maiden voyage: new ship, new shoulder."
He lifted his cybernetic arm.
"We'd be able to arm wrestle in no time!"
Tyzur tried to use humour to lighten the mood but instantly regretted the attempt.
"Anyway, would you be willing to proceed with the surgery after your duty shift ends? That would give us time to wrap up the intake exams and prepare."
Before making her egress, Guilder handed a PADD with the Captain's results. The look in her eye could say a thousand things to a seasoned doctor. All of them saying, Good luck; it's bad.