《They are Smol》They are Smol Doctors at Large - Chapter 11: Correlation does not imply Causation
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They say time flies when you’re having fun. This “They”, whomever the them that “they” are, have apparently never worked a job that’s required 100% of your attention, willpower, or emotional reserve. Time does fly when you’re having fun, but time also flies when you’re defusing a bomb, wrangling 15 toddlers, de-poofing a MOTHER, piloting a spaceship through atmo, or - in the case of Tipo - working as a Nurses’ assistant at the Caring Touch Hospital and Clinic. The tiny-chompers who started the class were honest about the dropout rate from the beginning; a class of a couple hundred dwindled down to a couple dozen, and now that the demands included classes and licensing tests, more and more people were dropping out. The work was hard, the pay was low, and the ability to screw everything up was a very real danger that could cost lives. Those that still wanted to stay, but didn’t want the challenge, moved themselves to intake, or to back-office paperwork. For them, the work they were doing was good enough; close to the tiny-chompers and close to the action, but not responsible for anything serious. That wasn’t the work that Ngruzren was doing, no.
The work he was doing was the most rewarding thing Ngruzren-of-Arzgr had ever done in his life, outside of getting married and having children.
It had been three weeks since their first Code Grey, when the Jornissian JOHN DOE was… subdued by tiny-chomper medical technology. In that time there had been other tiny-chomper patients, but neither he nor any of Ngruzren’s classmates were allowed to help. Fetch things, sure, watch - oh absolutely - but not actually DO anything. The inverse seemed to be true whenever there was another species in the infirmary, and not just trauma patients: In the past few weeks Ngruzren had changed blood filters, found veins, cleaned fecal receptacles, performed no less than 4 assisted bathings, and had to deal with almost constant sexual harassment from his female Dorarizin patients when they were on certain medication… and sometimes when they were off of it.
On one paw, nice to know he’s still got it, even after his first batch of pups. On the other paw, he was now the record-holder for the most complaints about pre-surgical prep among his shift. His vict- eer, very outspoken patients somehow kept getting the largest needles, the coldest prep-gel and the loudest machines strapped to their beds which just-so-happened to have the comfort topper missing from the base mattress each time.
It was a mystery.
What wasn’t a mystery was the increasing camaraderie between his dwindling training group and the tiny-chomper medical staff. More and more often he was getting close-up training on how to set a broken tiny-chomper bone, or re-locate a jaw/joint/somehow ribs?/limb, or where the main veins were, or how to support the body when transferring beds - still nothing incredible, but, it was a start. Nothing he was allowed to do, but seeing the process so close was fascinating, and rewarding in a way as well. As he and his colleagues became closer to the tiny-chompers, more and more things started to spill out. Personal histories, philosophies, suggestions on what to order from the cafeteria, superstitions on what MEDIBOT did when he traveled to the basement morgue and the lights flickered - silly things like that. But the most interesting thing was something that slipped out from Laverne during a coffee break, as a complete aside to the conversation at-hand:
“[You’re practicing on people who can take it, because we tiny-chompers can’t.]” Nurse Laverne said, taking a bite out of her honey bun before continuing, “[If I miss a vein, there’s internal bruising - you’re strong enough that if you miss a vein, you pierce the muscle and hit bone.]”
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That gave him, at first, food for thought, and eventually strength. He pulled from that strength when he was asked to do a menial task, it made him focus when he was doing something as simple as sanding down scales for an outpatient procedure. ‘[You can take it. We can’t.]’. They were adults, yet needed to be handled like pups. Compound that with the fear and confusion of coming into a hospital, potentially against your will or knowledge… in Ngruzren’s mind, a thrashing Jornissian JOHN DOE was replaced with a thrashing tiny-chomper -
He paused, for a moment, at the foot of the bed he was calibrating, and sighed. That image was going to stay with him, no doubt, and he truly knew why no one was yet allowed to ‘really help’ when working on a tiny-chomper patient.
“[Something eating you up?]”
Ngruzren-of-Arzgr turned and gave a little smile - tiny-chomper style, not that of his kin - and shrugged. “{Not too much, no. Just having a thought about how… all this is weighing on me.}”
“[Weighing on you how so?]” Dr. Nick Silver said, fully stepping into the empty room from the hallway outside. “[It’s fine to let it get to you, but it’s not good to let it eat you up from the inside.]”
Ngruzren gave a bit of a dismissive wave. “{No, not that; I mean, it might be that eventually but I’m not feeling like the arbiter of souls here or that I’m out of my depth. More, just. You see people at their most fragile, and then you compound that with tiny-chomper biology and it’s…}”
Dr. Silver gave a wry smile. “[Unfortunate?]”
“{Intimidating.}” Ngruzren corrected.
“[Really?]”
“{Yes. Not in … well. Part of it is in awe, but not at what you can do but what you’ve done with the biology you’ve been given. I know I’ve messed up on some of my jobs - other nurses correct me and help - but then, if I were to be the only person in the room when a tiny-chomper needs help…}” Ngruzren let his sentence drift out, and silence settled over the room, between the two.
“[Good.]”
“{Really?}” Ngruzren said, tilting his head to the side.
“[Yes, very much so. Even when things become routine, you need to pay attention - doubly so for someone with your physique. It’s good that you’re aware of that, because often times too many people aren’t. Honestly, that’s the number one reason why the remaining people fai-]”
Bzzzzt
Dr. Silver looked at his smartwatch, mouthing out a little command of some sort. “[Well, we’re going to have to cut this short - I’ve got a Code Grey on a tiny-chomper-]”
“{Can I come?}”
Dr. Silver let out a small laugh. “[Ngruzren, I think so - after all, this is your job.]”
= = = = =
The trauma room that Tipo found himself in was close enough to what he had been training with to be familiar, but alien enough to be outright exotic. If push came to shove he was certain he could find his way around, but… for the most part there seemed to be a lot less automatic tools and machines and a lot more hands-on devices that were being pulled from sterilized pouches and laid out on the surrounding tables.
Dr. Silver began to put on his PPE, starting with his shoe booties. “What do we have coming in? Than mo?”
“Nothing I can tell - probably anaphylactic shock, given the symptoms. Uh… what’s coming in from HELO, ETA 5 minutes by the way - we got Male, Hispanic, Mid to late 20’s, BMI healthy, noooo previous major surgeries, aaaannnd not on any medication. Infrequent smoker, drinker - normal stuff. Presenting with what… no. Hold up.”
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“[What?]” Tipo asked, putting on his much larger PPE, as he had been trained to do. He wasn’t expecting to actually get in there and help, but he was the only non-human in the room, so…
Better safe than sorry.
Than mo hummed to himself, furrowing his brow. “It’s. Our patient was found unresponsive in his office, skin covered in possible hives. Diagnostic AI in the HELO is spitting out Anaphylactic shock symptoms - lethargy, inflamed mucous membranes, weak rapid pulse, and when he’s awake, confusion.”
“So we should get some antihistamines as well as adrenaline-”
“Yeah, Doc, but that’s not explaining the pneumonia in his lungs.”
Dr. Silver stopped his prep for a moment - just a moment - before continuing, snapping on his gloves. “That could be an underlying condition that’s being exacerbated by the shock-”
“In-flight DIAGDOC keeps giving me weird shit. It’s apparently finding tumors? Walnut sized, but it’s classifying them as foreign objects-”
AS if on cue the doors to the human medical wing’s trauma center opened up, the Jornissian EMT having to duck down just a fraction of a foot to clear the lowered ceiling. “[We got more personal data-]” There was an exchange of lanyards, and everyone’s PDAs were updated with the newest information. Tipo pulled up the updated file, and froze.
“[Juan?]”
The medical professionals could only spare a side glance as Juan Esteban was wheeled into the theater proper, breathing tube already intubated down his throat. When Tipo’s exclamation turned out to be one of surprise and not the traditional rattle-off-of-information, the EMT began the debriefing. “[-Yes. Juan Esteban, had been complaining of breathing difficulties for the past few days. Found unresponsive in his office by a coworker, we were called. He went from breathing heavily to not breathing at all-]”
“What’s been administered?” Dr. Silver said, turning on a few machines while Than mo slid an IV needle into Juan’s wrist, capping it in place with a multipurpose monitoring wristband.
“[Everything the diagnostic AI recommended.]” The Jornissian EMT responded, looking at the patient bed hard. “[But we stopped when it started to give us multiple, conflicting suggestions. Adrenaline and antihistamines were all that we gave him - and he should be breathing unassisted right now.]”
“Thank you - we’ve got it from here.”
“[I.. Yeah.]” The EMT said, before excusing himself. The two humans on call began to work on the patient, the mixed-species administrative staff doing their best to lean-in-and-eavesdrop-without-looking-like-they-were from outside the theater.
“[That’s… Juan, though.]”
“Do you know the patient, Tipo?” Dr. Silver said, looking back at his tag-along trainee. “And, I would like your help up here - I need you to start removing clothing from the patient-”
“[Oh! Right, just… yes. I know the patient.]” Tipo said, stepping up to the much smaller bed and beginning to undress the patient… his friend. “[We were the involved parties in Mothenacht-]”
“You’re fucking with me-” Than mo laughed, and when no one corrected him he leaned forward towards the much physically larger, yet now seeming somehow smaller Dorarizin nurse. “You’re not fucking with me. Oh man, what the hell was-”
“FOCUS, Than mo.” Interjected Dr. Silver, cutting away the last of Juan’s shirt. “Listen, Tipo, if you need to excuse yourself that’s fine.”
“[No, I’m here.]” Tipo said, successfully removing Juan’s pants, immediately providing him modesty with a sterile blanket. “[This is exactly what I want to do. He runs a farm with his family, and we’ve lost touch with each other over the years.]”
“Farm? Hm. At least it’s not a farm accident - that kind of stuff can be nasty to see. Is MEDIBOT en route?”
“Yep.” Than mo responded, pressing leads onto Juan’s chest and arms. “Woke James right the fuck up too for this, so he’ll bring him in and be on-call.”
With a grunt Tipo reached up, pulling down the task lighting/scanning arm that was in rest on the ceiling. Juan’s body was bathed with harsh white LED light, the leads on his torso syncing with the rest of the medical technology in the room. Rotating the nondescript plastic cylinders between the lights, Tipo found the proper selection and locked it in place, turning it on with an unspoken command. With a series of repetitive humming clicks (which Tipo secretly thought that only he could hear) Juan’s body opened up.
Digitally, of course.
“Good, good.” Dr. Silver murmured, the plastiglass HUD of his medical headset pouring through reams of information. “This… doesn’t look right at all. This can’t be cancerous - I’m not seeing anything that would look like traditional tumor metastasis.” On reflex, Dr. Silver leaned forward, the medical headset HUD kindly enlarging what he was looking at from the body positioning cue. “I… have never seen this. Those are foreign bodies, but are they growing in him?”
Tipo saw nothing but the confused look on the Doctor’s face, and attempted to read what he could from it. “[Is it bad? Is he going to be ok?]”
“Tipo.” Than mo said, flatly. “He just got here. Worst case we popsicle him until he’s back at central-”
“Than mo-” Warned Dr. Silver, and the nurse just shrugged. He reached up and patted Tipo’s much larger arm reassuringly. “We’ll do our best, but I don’t think he’s in mortal danger. We’ll have to get in there, of course, and he’ll be in the ICU for a while, but this looks like foreign bodies. Might have inhaled something and it started to grow from the inside-”
“[Yeah, but that doesn’t happen- the stories of swallowing a grit-pip and having the stone grow in your belly is… right?]” Tipo said, his smile and optimism slowly draining as he wasn’t corrected by the humans at hand.
“I mean… sort of? Plant seeds have been known to grow in lungs before.” Dr. Silver murmured, standing back up as he looked over the patient’s other vitals. “His heartbeat is still fucked, but we’ve got him wired so he won’t code blue unless we just ignore him for a few days. My guess is- I’m sorry can I help you?”
Tipo leaned back, letting out a disgruntled huff. During Dr. Silver’s musing, Tipo had continued to scrutinize the humans’ face for any sort of lie or misleading statement - his own father had been playing tricks on him since well before his pups arrived, and Tipo knew the joy of the fatherly prank. But, come on. Plants growing inside you if you eat too fast. That’s the trick. Slow down, chew your food. Tell the story to get the pups to listen.
“[Really.]”
“Yes. There have been documented instances of pine trees, peas, watermelon vines-”
Tipo held up his hand, his face screwed into something that may have been pain. “[Just… that’s enough. What do we need to do now?]”
“Well.” Dr. Silver mused, tilting his head from side to side in thought. “Make sure he’s stabilized, oxidize his blood directly if necessary, get him prepped for OR. We’ll try to keep it as non-invasive as possible - tracheal route - but if necessary we just cut him open and bacta him back. Then physio, but that’s not our problem at the moment. Excuse me!”
Dr. Silver leaned around Tipo, and all the other xenos administrative staff suddenly looked very busy. “Yes, inform processing we’re going to be using whatever OR is open - closest one. Can you also wake Laverne up for me?”
“[Oh! Sure thing, Doctor.]” The Karnakian administrative assistant said, working on her terminal with practiced ease. “[We have Human OR Theater #4 ready for you right now.]”
“Excellent! Alright, let’s just-”
“[Sir?]” The AA said, leaning forward slightly. “[What should we do about the second patient?]”
The three men around Juan’s bedside shared a glance with each other, before turning as one to face the back office. “I’m sorry - other patient?” Than mo said, shaking his head. “Someone came in with trauma from a MEDEVAC and you didn’t bring them in?”
“[Oh! No, no, unrelated case. Antony Markus, works at Lil Caesar’s Government Garb and Blade emporium. Decided to come in here… in his words, ‘cause central’s too far away and I got dice to play’. Complains of being very tired, developed a slight rash, noticed wheezing in the past few days.]”
The assistant looked up from her terminals into three very worried faces.
“[What?]”
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