Combat Medicine

From the Story Arc: The Charge of the Labcoat Brigade

Previous Story in the Arc: Net-Working by Krasnaya Zarya (Sunday, February 18, 2007)

Next Story in the Arc: Decision Theory by Krasniy Zakat (Monday, February 26, 2007)

(posted Monday, February 19, 2007)

Sunday Next

((Cowritten with Alyon))

Four nurses, three doctors, two stressed secretaries, one annoyed head of department... A countdown to a furor, if not full-blown rhetoric emergency for the Rabinovich family. The ten people who had suddenly found themselves on the wrong side of the Russian Jews' sharp tongues were slowly being beaten back in frustration under the onslaught. Not only were the pair full of their usual righteous indignation of people who knew they were in the right, but they had the extra annoyance of people who were, in their eyes, wasting their valuable time.

After all, they had done the work getting the treatment from Doctor Carter, even threw in some rigorous lab testing to ensure that it wasn't some trick. They'd had both Thanh Ha and Victoria take their turns examining the two compounds, which were just as helpful and dangerous as the microbiologist had explained previously. As far as the Rabinoviches had been concerned, once it had Thanh Ha's signature on the test results, it was out of their hands and into the hands of the CDC, if not directly into Crowne Memorial's eager grasp.

If only things had gone so smoothly...

Instead, what with the rest of the CCCP either sick or planning retaliatory actions against various denizens of the Rogue Isles, the pair found themselves the only champions of the artfully designed treatment. They had spent the last couple hours talking and haranguing their way up the chain, trying to find some ready soil amidst the nettles of bureaucracy.

For a place accustomed to dealing with mad scientists, you'd think they'd have more respect for a man in a lab coat shouting 'Eureka! I have a cure!' Alex sighed to himself as he listened to Sofia applying yet another verbal lashing to the Head of ICU.

"Look, Doctor," Sofia grated, "you and I both know the uselessness of FEMA in this situation, and the CDC won't pay attention to anything coming from 'persons of dubious intent', so let's not get into yet another wasteful discussion about 'getting clearance'."

"Indeed." Alex tapped the signed letter from Thanh Ha, detailing the laboratory experiments. "This is our clearance. An accomplished MD has thoroughly tested this cure, as well as an accomplished physicist and chemist."

"Tested on what?" The mostly bald and portly man asked pointedly. "Cultures? Maybe even mice? These are living, breathing, thinking human patients!"

"Not so living or breathing at the moment," Sofia noted coolly, "are they?"

"And we can't afford them getting any worse!" He pointed down the hall at the rooms holding the isolation pods. "Some of our patients are in very critical condition. Your cure involves a known toxic substance! How do you know what might happen in the case of someone like, say, Miss Frost?" He crossed his arms in annoyance. "She's on a heart/lung machine!"

"Ugh." Alex wrinkled his nose. He'd had more than his fair share of experience being on the receiving end of such esoteric medical devices, and generally had unpleasant memories of them - luckily, in a way, he had been completely unconscious during that stage of the radiation treatment.

"Definitely not breathing, then." Sofia was implacable. "I am obliged to the Hippocratic Oath as much as you are, sir, but I am quite convinced that he would call the regulations imposed on treatments the Devil, and run like hell. Since when has 'do no harm' become second to 'do not get sued'?"

"Look, Miss Whatever-You-Said-Your-Name-Was -"

"Rabinovich. Doctor Sofia Rabinovich," Alex said automatically. "Ph.D."

"Doctor Rabinovich," he continued, a little deflated. "I've said no, and that's final. Nothing you have said will change my mind, and if you do not desist, I will have to summon the authorities."

"Ahem." Alex pulled out his wallet and flipped through to his Hero Identification Card.

"I should have known..." the department head muttered, peering at the card carefully. He grumbled something barely audible under his nose, and withdrew said extension of his face back, glaring at the Rabinoviches.

"We were not pulling that Card on you. I want it on record that we were most assuredly not, until you absolutely refused to remove your proverbial head from the proverbial wall," Sofia grumbled and glared right back, making a far better job of it.

"Fine, how about a compromise," he ventured, starting to walk down the hall to the previously pointed out ICU rooms. "If you can get something - anything - from the CDC, FEMA, the American Heart Association, the American Dental Association, or any regulatory medical body that does not consist of a woman that spends her days arresting Hellions, then I will suggest your treatment as a 'highly experimental option'. The recipient's family - or whoever has the legal right - will have to sign off on the procedure."

His eyes narrowed. "And if it doesn't work, I get to skin you both."

"Only under one condition," Sofia snarled. "If it does work, I want a pound of flesh, straight from your heart!"

***********************************

Quiet reigned in the department for a blessed five minutes and the peering patients and nurse withdrew their heads back into the rooms where they rightfully belonged. Alex found he had to put a restraining hand on Sofia's arm, and trot her after the rapidly absconding head of department. The spouses sound themselves casting looks in both directions along the long corridor, and catching fleeting glances of turned backs, hidden smiles and smirks, and almost a thousand curious looks. Sofia glared; Alex smiled and waved. The looks subsided rapidly.

"Are you going to tell us who the relevant parties are," Sofia demanded sarcastically, "or are you going to make us search the paragon City archives?"

The Director glared at Sofia for a moment, and then waved his hand toward the door labeled 'ICU Lounge'. "Some creepy looking guy that calls himself Alyon is in there, and he is listed as having medical power of attorney." He turned to walk off. "Good luck dealing with him." he added sarcastically.

"I wonder what that's supposed to mean..." Alex gave Sofia an odd look and immediately headed for the lounge, papers, treatment, and wife in tow. The Lounge itself was a standard hospital affair, of the kind that Alex had grown far too used to over the years. The 'creepy looking guy' was one of the people sitting quietly in the room and not watching the television bolted to the corner. Not watching the television was a common pastime in hospitals, but this was slowly evolving into an art form.

"Excuse me, Mr. Alyon?" Alex asked as they approached the man, who appeared to be dressed as a country music singer or a construction worker, in jeans and cowboy boots, smoking a cigarette in the same hospital with people with overflowing lungs, which took some real nerve.. Alex wasn't sure which of the two the man looked more like… Regardless, very out of place for Rhode Island.

Alyon looked up at the new arrivals. "Yes?"

"I am Doctor Alexander Rabinovich, this is Doctor Sofia Rabinovich -"

"If you are here to bring me bad news, then kindly dispense with the pleasantries." Alyon crushed his cigarette savagely into the ashtray at his elbow and stood up, before Alex could finish the sentence. He blinked in slight confusion at the expression, and decided to just let Sofia handle it.

"I see what that doctor meant..." muttered Sofia softly under her breath, "Are you always this rude to people who are trying to be helpful?" she asked in a louder tone that was bland enough to set Alex's teeth on edge.

"Not always. My apologies." The man trailed a hand through his hair, then stared at it, probably registering ash smudges. "This has been one of the most trying weeks of my life and you both certainly do not deserve for me to take it out on you. Now, what did you wish to speak to me about?"

"As a matter of fact," Sofia shrugged, "this week hasn't precisely been all shiny for us... and we have jetlag. As such, we were about to try and convince you do to something moderately insane."

"Moderately insane?" Alyon crossed his arms and peered back and forth at the two. "Ok, you have my attention."

"Excellent." Alex grinned. Sofia had her way at getting people's attention when she wanted it. "Since you wish to keep pleasantries short - something I am always in agreement with - here is the 'deal', so to speak: I have procured and thoroughly tested a treatment for the plague affecting Miss Frost. It has yet to be used on a live patient, sadly, so it is, so to speak, highly experimental." He shrugged. "I am convinced it is not dangerous."

"Quite. And seeing as how Miss Frost's definition of 'alive' is somewhat tenuous..." Sofia froze in mid-sentence. "Like I've said, it has not been a good week. Too many fools, too little time. If you sign the forms we will proceed to try this treatment on your friend. It has been announced me," she noted sarcastically, seeing the slightly wary look in Alyon's eyes, "that if she dies, I and Alexander shall be flayed. If it is any comfort."

"'Announced me'?" Alex murmured. "Someone's tired... Even slipping into British accent."

"And you dropped the article. What's your point?"

"Regardless..." Alex turned his attention back to Alyon, eyebrows raised in silent query.

"You are not telling me something here. Even if the treatment is experimental, you would not need my permission, unless the Head of ICU does not think it would work..."

"The head of ICU does not think, period." Sofia interjected, voice dripping poison.

"I certainly do not disagree with your assessment of him, ma'am. However, I am in a delicate situation here. Abigail put me down on her JTF paperwork as medical power of attorney only because she had to put somebody down. We were the only two in the last training group and she wanted to get the paperwork over with. I really should not be making this decision."

"There is no one else to make it." Alex shook his head.

"The way it had been explained... to me," Sofia brought her accent and syntax under almost palpable control - they were both more tired than they looked, or allowed themselves to feel - and continued in a more normal voice, "the situation is critical. They can't leave her on the heart/lung forever, and they can't disconnect. They can't treat her, and they can't not treat her. We are, as you see, at a quandary. I'll grant you, she may die - although I am fairly certain she will not - but on the other hand..." Sofia flipped a hand weakly to demonstrate that nebulous 'other hand'.

Alyon looked pointedly at Sofia. "What are the percentages? Obviously, with no treatment her chances are zero."

"With the treatment?" Alex - to whom Sofia promptly tossed the metaphoric glove - tilted his head to one side and then the other, weighing the options. "Oh, I would put them quite high. Others would disagree with me, sadly, but for all the wrong reasons. I am convinced of a ninety percent chance, at a minimum." He paused. "That is, of eradicating the virus. She may still have tissue damage that needs repairing, but that is relatively minor work."

"So, if you were in my boots, and your companion here was in Abigail's you would do it?"

"I have a... phobia of comas," Sofia shifted uncomfortably. "Alexander has his instructions for that contingency."

Alex rolled his eyes. "Yes, well, you know I wouldn't pull the plug after just a week." He leveled a solid gaze on Alyon. "In a heartbeat."

"Then show me where to sign."

Sofia held up the sheaf of red-tape fuel. "Right here."




"Dammit! She's going insane on us!"

"Look at that pulse!"

"… 120… 130… 140…" someone was counting in a dead monotone.

Sofia couldn't block the noise out. She couldn't ignore it. Her own blood pressure, in sympathy to the woman lying prone on the hospital bed. She slid the needle of her syringe slowly out of Abigail Frost's intravenous.

Beep, beep, beep, beep…

The monitor was screeching, the doctors were screeching, the nurses were screeching… Sofia herself wanted to howl. She flipped her wrist to follow the time, and realized that she had no watch.

Sofia threw the empty syringe into the distant wall, and it fell, ricocheting from the paint, with a loud 'thunk' that was, nonetheless, almost inaudible to the rest of the people present in the room. Breathlessly, heart pounding, Sofia started counting the seconds under her breath. Twenty-one… twenty-two… twenty-three….

"You got her killed!"

"You're a maniac!"

"You're gonna face court for that!"

That wasn't going to work. There was too much noise, too many people yelling at the top f their functioning, healthy lungs. "Shut up!" she yelled, breaking for a moment through the commotion. "Alex, clock me!"

Alex dived for the nearest wristwatch. It happened to be one worn by the gaunt, grey haired doctor who was Opponent Number three on their prolonged track to this moment. He grabbed the man by his wrist and, as the annoyed doctor tried to pull away, raised a glowing fist to the man's eyes. "See this?" he muttered darkly, patience clearly at an end. "Stay right where you are." The doctor froze.

"How long?" Sofia pulled the second syringe out of her bag with one hand - the other was still on the intravenous, and broke the plastic wrap by pushing the needle directly through it.

"Seven minutes; this is a good time."

"Carter said as long as possible." Sofia muttered that while glancing at the ever-rising sparks on the monitor. Abigail was fighting for her life; one last-ditch effort. "Carter isn't here"

"Eight minutes." Alex released the hand of the doctor, which he had used as an inconvenient time-piece. Sofia slid the syringe quickly into the IV's juncture again. The monitor's beeping turned into a cacophonous ululating siren. The sound pierced Sofia's brain and dissolved in the sweeping waves of a migraine. The auras turned, in record time, into nausea, and the latter decided to evolve into a faint.

Behind Sofia's back the monitor was crying its piteous, mournful call.

***************************************************

The Director of King's Row ICU shuffled papers on his mahogany table absently. The door to the outer office banged suddenly, and a mere second later his own office door was shaken by a series of imperious knocks. Before he could say anything, it opened and he groaned at the sight of the woman looming - despite her small height and stature - on his threshold. .

"Good afternoon, Doctor," the blonde woman smiled evilly, a drawn out smirk. "Do you remember our discussion from earlier?"

"Yes…" the doctor mopped his brow, and tried to glare at the intruder with proper annoyance. The notion failed because of his uneasiness, and her ever-growing frightening smirk.

"You might wish to descend from your pedestal and look at the pertinent ICU. I have," she added, as the doctor almost bolted out of his chair, "procured a scalpel... And a set of very precise weights."




Abigail's spirit felt as if she were rising from the bottom of an immense pool of water. She had floated here for days, suspended between life and death, and now it was time to rejoin the living.

First, her ears began to register sounds again. The rhythmic beeping of a heart monitor. The whoosh of a ventilator. Footsteps. Muffled voices.

She became aware of her body again. Pain in her chest and arms. Numbing cold across her whole body. The straps around her wrists. The intubation tube down her throat.

Abigail tried to open her eyes and could not. A brief feeling of panic sent the heart rate monitor pinging faster. She heard a voice... felt a hand on her shoulder...

"Miss Frost?" The duty nurse said. "Everything is alright. You are alright. Please try to relax. Don't fight the ventilator. I will take the tape off of your eyes and then go get the doctor." The nurse gently removed the gauze pads.

Abigail blinked several times and squinted, trying to get the world to come into focus. She could see part of the ceiling, the bright lights overhead, and several tubes. She shifted slightly and stared at the multitude of IVs running down to her arm. How long... she wondered. How long have I been out? What happened to me? It was just a cough...

More footsteps, the light pitter-patter she now associated with the nurse, and heavier, slower steps. A silhouette blocked out the light overhead and she blinked several times at the change in lighting. "Miss Frost, I am Doctor Overton. If you can hear me, please blink your eyes twice." Abigail slowly blinked two times.

"Excellent!" Dr, Overton said. "I need to listen to your lungs for a moment." The nurse pulled the sheet back and Abigail shivered a bit from the cold. She braced for the icy touch of the stethoscope, and was pleasantly surprised that it was warm. Dr. Overton listened intently, moving the stethoscope every few breaths as the ventilator did its work. Finally, with a grunt of satisfaction, he pocketed the stethoscope.

"I want you to try something, Miss Frost. I am going to disconnect the ventilator, and I want you to try to take a breath on your own. Next cycle, try to hold your breath and I will unhook the ventilator. Once it is off, breathe out and try to breathe in as deeply as you can. If you understand me, blink." Abigail slowly closed her eyes and reopened them.

"Good, good. Here we go." Abigail held in the next breath and Dr. Overton quickly unhooked the ventilator from the mask. With a ragged whoosh, Abigail forced the air out of her lungs and drew in a breath. "Again, please" Dr. Overton said. Abigail forced the air out and drew in another deep breath. "Excellent."

"I think we can take you off of this thing now. Here is what I need you to do. I am going to remove the intubation tube. Take a deep breath and when I say to, exhale as hard as you can. Abigail blinked at him. "Here we go, take a deep breath. Very good, now, exhale hard." Dr. Overton deftly slipped the tube out as Abigail forced herself to empty her lungs. She gasped at the sensation of the tube coming out and drew several ragged breaths, desperately wishing the pain in her throat would go away.

"Very good, Miss Frost. You are quite the model patient." He listened to her lungs again as the nurse slipped an oxygen mask over Abigail's face. "Nurse, since she is awake now, I believe you can remove those restraints too.

Abigail tried to relax as Dr. Overton continued to listen to her lungs. She felt the restraints being removed, and relaxed a little more.

"You are doing incredibly well, Miss Frost, especially considering that you were on life support no more than 3 hours ago. In fact I would call your recovery borderline miraculous." Abigail tried to speak, but the best she could do was a hoarse wheezing.

"Please, do not try to talk yet." Dr. Overton cautioned her. He raised her bed a little, so that she was sitting up at an angle. "Is that a little more comfortable? Can you still breathe easily?" Abigail nodded. "Good. Please do not try to talk for a while, and I will have the nurse bring you some ice chips to suck on. They will help your throat feel better. Just do not chew them, let them melt on their own." Abigail nodded again.

"I will be back to check on you in about an hour. If you have any difficulty breathing, or feel lightheaded, please tell the nurse." He turned to the ER nurse, "Let her have all the ice she wants, and do not leave her unattended. Page me immediately if she has any difficulty breathing."

Dr. Overton grasped Abigail's hand and gently squeezed it. "You are doing remarkably well, Miss Frost. If you continue to progress at this rate, we will move you to a room tomorrow morning. If you can, please try to stay awake until I get back." Abigail nodded and mouthed the words "thank you".

The nurse pulled the blankets back up over Abigail and lifted the oxygen mask long enough to slip a piece of ice into her mouth. Abigail lay back and relished the feeling of the cool moisture trickling down her parched throat.

An hour later, Dr. Overton returned, reexamined her and left orders for her to sleep as much as she could. Abigail needed no encouragement to do just that and she promptly drifted off into a deep dreamless sleep.

The next morning, she was moved up to a private room, given some applesauce and tapioca pudding and told to drink as much water as she could stand. Dr. Overton visited her several times that morning, and delivered the best news she had heard since she had woken up. "If you keep progressing at this rate, Miss Frost, you will be out of here in a week."