Hmm. Even John noticed she was overly tired.
She hoped Tony didn't have anything serious. Even in the 'clean' environment
of Alpha, viral and bacterial germs still lingered in their human reservoirs
and could strike without warning. She'd find out soon enough.
Tony was one of her panel of regular patients, as was most of the Command
team, excepting John.
Once showered and dressed, she felt more like
her usual self. Clipping on her commlock, she decided she could put
off breakfast for a while. She checked her appearance one last time
in the mirror and then headed out to Medical Center to start her day.
~~~~~~~~
Helena approached Medical Center with the usual
small shiver of anticipation she had never outgrown despite practicing medicine
for twelve years. In a perverse way, she found she enjoyed the practice
of medicine more since Breakaway. The challenges were more intense,
her skills needed more than ever and, she chuckled ruefully to herself, no
fear of lawsuits. She and her fellow Alphan physicians held themselves
to a higher standard than could ever be imposed by an external source, and
that along with survival were sufficient motivators to avoid failure.
She pointed her commlock at the double doors to
Medical Center and entered her home away from home. She could feel the
worries and tension that came from living on their runaway moon recede that
little bit further as she prepared to concentrate on the physical well-being
of her charges.
Helena nodded to the nurses on duty and entered
her office where she took off her blue jacket and slipped on the sleeveless
white labcoat. She picked up her stethoscope and folded it and tucked
it in her pocket. Her favorite mentor had always hated it when she had
worn the thing draped around her neck. Dr. Shaw had said it reminded him too
much of a dog collar, but Helena knew that by the end of her day, the stethoscope
would most likely be draped around her neck just so. Smiling at the
memory and picking up the datapad with her morning's patients, she walked
out of her office and almost ran into the off going physician, JoAnne Rysdell.
"Good morning, ma'am."
Helena looked up. The twenty-nine year-old
American doctor was the youngest member of her medical staff. She had
been a medical student on a special tour at the time of Breakaway but was
now fully credentialed in general surgery and developing a nice touch for
the intricacies of internal medicine. She was inevitably formal in address,
the legacy of her military training.
"Good morning, JoAnne. Any new cases
overnight?"
"Only one. Jack Pearson came in around
0100 with an avulsion of his distal left radius after a fall in a late night
basketball game. I splinted the arm and grounded him until Dr. Spencer
rechecks it in a few days. He wasn't too happy with me, but I made sure
to add him to the injured list so he shouldn't be assigned outside."
Jack worked as part of the lunar surface maintenance team that kept Alpha's
exterior safe and repaired. That bone chip was in a bad place for someone
whose life depended on being fully physically able, especially with the damage
being in his dominant arm.
Helena nodded with satisfaction as she reviewed
the x-ray scans JoAnne had pulled up for her review.
"Good. Why don't you go now and get
some rest. Are you on again tonight?"
"Yes, ma'am. I'll see you then."
With a nod that was not quite a salute, JoAnne
turned and left. Helena smiled at the young woman's back. Was
she once so serious? Probably.
Glancing back down at her list she saw she had
about thirty-five minutes until her first patient at 0900, who no doubt would
be on time. Her morning was full with scheduled office visits and the
afternoon with routine physicals. Scanning the latter group's names,
she realized they were all pilots. A full day, then. At least
documentation was now kept to a reasonable minimum and not the endless forms
that had been required by the Lunar Commission—a small blessing and
significant time saver.
Every Alphan had a complete physical biannually.
On a whole, Alphans were a healthy lot by selection for lunar duty, the enforced
exercise regimen to minimize bone loss, and Alpha's lean diet. The virtual
absence of obesity minimized the complicating diseases of diabetes, high blood
pressure and heart disease. Still, diabetes and the rest could occur
at anytime, not to mention the risks inherent with deep space and the ever
present fear of radiation. Vigilance was vital.
Helena glanced at her staff's schedule.
Bob was assigned to research, Ben in the O.R. for a few minor cases and Ed
was on stand-by for walk-ins. Helena glanced up to determine who was
to be her nurse today and saw a dark-haired, sturdily built young woman setting
up trays in the minor procedures area. Ah, Mina. Good. The
nurses scheduled themselves unless there were conflicts that had to be brought
to Helena's attention, which was rare.
Normally, after rounding on any inpatients, she
would have a cup of coffee while she waited for her first patient, but today
that didn't interest her, and there was no one admitted that had to be rounded
upon. She thought to call John and touch base with him, but just then the
main doors opened and Shermeen Collins walked in holding her arm at an odd
angle. Helena walked toward the anxious appearing botanist and met her halfway.
No reason to summon Ed, she had time enough to handle this.
"Shermeen, good morning. What's wrong?"
Helena gestured the young, pregnant woman back
to an exam table and waited while she pushed up the sleeve on her right arm.
"My arm started hurting last night, and this
morning I found this. Is it serious?"
Helena took the arm and readily saw the red streak
ascending from a small, purplish and angry looking blister on the back of
Shermeen's right wrist. As she took a more thorough history, it became
apparent this was most likely from the roses Shermeen cultivated as a special
interest. There was a rare bacterium that could be found on the thorns
and, apparently, which had made it to the moon despite all decontamination
protocols. Reassurance was offered and an antibiotic selected taking
into consideration Shermeen's pregnancy.
As Helena concluded her dictated note of findings,
diagnosis and treatment, Shermeen walked back in.
"By the way, Dr. Russell, the last time I
took this medicine I puked for two days. Can we try something else?"
Helena smiled and selected an alternative antibiotic,
filled a bottle, amended her dictation and sent the young botanist on her
way with instructions to return in two days, earlier if it worsened.
Glancing at the chronometer, Helena saw it was
now 0850, and she had no doubt her first scheduled patient would be on time
unless an emergency in Command Center prevented it. In fact, Sandra
walked in five minutes early.
Sandra was now twenty-four weeks pregnant and
having the completely benign pregnancy Helena hoped for each woman who was
able to conceive. There was that mild genetic anomaly found on routine
chromosome analysis, but it seemed to be causing no complications. Of
course, only after delivery could cognitive evaluations take place.
In any case, Helena was not following the pregnancy itself, but keeping tabs
for any medical complications pregnancy could cause. Alpha had obviously
never been assigned an Obstetrician, and routine gynecological care had fallen
as much as possible to terrestrial physicians with only gynecologic surgical
emergencies being addressed on pre-Breakaway Alpha. That had changed
by necessity. Now, a nurse practitioner was evolving into Alpha's de
facto ObGyn and doing a fine job from Helena's perspective.
"Good morning, Sandra." Helena
smiled at the small, quiet woman and led the way back to an exam room.
Moreso than many of her patients, Sandra appreciated the privacy four walls
provided.
Making small talk as Sandra undressed, Helena
was pleased to see Sandra was finally gaining some needed weight and filling
out. Her patient denied any problems and the blood and urine tests looked
good. A quick ultrasound by Fiona, the nurse picking up OBGyn duties,
was reassuring to everyone present.
As Sandra dressed, the door chirped and slid open
to admit an orange-sleeved man.
"Am I in time for the picture show?"
"Your timing is off, Alan, but I suppose
we can call up a replay," Fiona teased as she called up the images of
the fetus flipping and flopping healthily. The ultrasound machines were
initially used to diagnose certain cardiac and abdominal abnormalities, but
Fiona had co-opted this unit for OB purposes and even had had specialized
probes made for just her needs.
Helena stood back by the door and felt an unprofessional
twinge of jealousy as she listened to Alan ask Fiona all the usual questions.
She and John had yet to be able to conceive a child either naturally or via
lab methods. The... whatever it was Magus had done to them was still
not completely understood despite ongoing research. John had finally,
reluctantly accepted the plan to have her conceive by artificial insemination
using donated sperm from the late Victor Bergman. Very soon she should
be able to tell if the first attempt had been successful. She worried
about time, or rather, the shortage of it. She had just turned forty-two
and was all too well aware that the risk of complications sky-rocketed after
age forty, to say nothing of the risks from all the unknown exposures from
living on Alpha itself. She was unconsciously running her fingers through
her hair in a nervous gesture when she looked over to see Sandra smiling a
gentle smile of understanding.
Sandra nudged Alan and not so subtly looked at
the door. Alan appeared to take the hint. Helena smiled at their
interaction. She had been one of the few unsurprised when Alan had seriously
started to court Sandra. She had had an intuition that this pair of
opposites would work quite well together, and by all evidence she had been
right.
Helena moved to close the appointment. "Unless
you have any problems, Sandra, I'll check you again in two weeks."
Sandra ducked her head in acknowledgement and
Helena started to walk out the door.
"Hey, by the way, Helena, could you check
my hand? I've got this funny, itchy feeling deep inside."
Helena put down her datapad and picked up Alan's
left hand. He had gashed it pretty severely in an Eagle accident approximately
three weeks prior, but she had been told the healing had progressed well.
She ran her fingers over the scar lightly and then more firmly. There
was a subtle lump that shouldn't be
there.
"Come with me, Alan." She led
Alan over to the minor procedures area and pulled out a scalpel kit.
"Sit. Lie back." She pointed
to the exam table and used a no-nonsense tone to hasten compliance.
She had worked on Alan too many times over the years and was well aware he
would most likely pass out at the sight of his own blood. Sandra stood
at his side and gently turned his pale face away from the sight of Helena
preparing to re-open the wound.
"Do I want to know, Helena?" Alan
had closed his eyes.
"I believe a suture has worked its way to
the surface. I can have it out in a moment." By the time
she finished the explanation she was done and was applying pressure to stop
the minimal bleeding.
"You survived, Alan." Helena looked
from Alan's pale, relieved face to Sandra who rolled her eyes in good humor
for her husband's overreaction. After thanking Helena for taking the
extra time, Alan left following Sandra out the door.
Helena did have to smile as she dictated a quick
note for Alan's file. Alan had become a dear friend, but he was just
about the worst medical wimp she knew.
Except maybe for Tony. Who, by coincidence
was her next patient and ten minutes late.
She was almost ready to have Mina track him down
when the door opened and he staggered in on his own. He was very pale
for someone with his Mediterranean coloring and looked shaky. Helena
grabbed a wheelchair and guided him to a safe landing.
"John said you called in ill, when did it
start?"
"I woke up in the middle of the night feeling
a little sick, but didn't feel really bad until I tried to get out of bed
this morning."
Just then, Tony broke out in a cold sweat and
looked about frantically. Mina immediately presented an emesis basin
and Tony emptied what little there was in his stomach.
"Maya?" Helena asked as they helped
the security chief up onto an exam table. She didn't expect the Psychon
would come down with a terrestrial infection, but one never knew. Infections
could cross the species barrier on Earth, and all the research they were doing
to help Tony and Maya conceive a child was revealing an amazing and exceedingly
unexpected degree of similarity between their two species.
"Fine. I sent her on into Command Center
before this hit hard. Told her I would check in with you."
Tony smiled wanly. "Here I am."
"Hmm." Helena did a quick physical
exam as Mina helped Tony change into a blue exam gown, checking for swollen
glands, listening to his heart and lungs and palpating his belly. His
throat was a bit red and his belly tender but otherwise nothing remarkable.
She had Mina draw the labwork and start an IV for fluids. She medicated
Tony for his nausea and fever while she awaited the lab results. Tony
opened his eyes and looked at her with a worried expression.
"By the way, Helena, can you let Maya know?
But don't worry her."
Helena smiled her reassurance as she slipped her
stethoscope back into her pocket and waited by his bedside until he drifted
to sleep, the lines of distress easing from his face. She nodded to
Mina to keep an eye on him while she went to wash her hands thoroughly.
As no one else was reporting in ill, food poisoning seemed less likely.
She suspected Tony had nothing more severe than viral gastroenteritis, but
telling him he just had the stomach flu was not likely to reassure him until
he was actually feeling better.
She looked at her schedule. Her 10:00 appointment
had been a no-show, which was unusual given the patient, but it had put her
roughly back on schedule. She'd have to find out later why Bob had wanted
an appointment to see her. Taking a moment's rest, she called Maya to
update and reassure her.
Next up was Katya Glovaskaya, head of Laundry.
She was a very prim and proper Russian who demanded the best of herself and
others. She had been diagnosed with a fairly common blood disorder soon
after Breakaway when she had presented bleeding from her gums and covered
with bruises. Katya's fears of radiation poisoning were quickly allayed
by Helena who in turn was worried about possible physical abuse. While very
rare on Alpha, it was not unknown. Katya had denied any such problems
and a battery of blood tests had diagnosed isolated low platelets. She
had been treated with medicines that had been only marginally successfully
over the past few years and now the risk of complicating osteoporosis was
becoming too real. After reviewing the latest tests with her patient,
Helena put down the datapad and looked at Katya with a sympathetic smile.
The inevitable had come.
"Katya, I know this is not something you
wished to pursue initially, but we are running out of options."
"Da. I thought as much."
The tall, blond woman took a deep breath and looked Helena steadily in the
eye. "When do we schedule it, Doctor? I can have my section
prepared for my absence as early as tomorrow."
Helena restrained a smile. Once she accepted
the inevitable need for splenectomy, Katya did not dilly-dally.
"Let us plan on three days from now, then
you won't have to rush."
Katya stood from the exam table and quickly dressed.
"If that is the earliest, then good." She nodded curtly to
Helena and left.
Helena sighed with relief. At least Katya
didn't have a dreaded 'by the way.' That was one phrase that was certain
to send any office schedule immediately off kilter. She dictated the
note including a request to schedule OR time and to notify Katya of the routine
pre-surgery protocol.
Eva Zoref was waiting in the next room and her
appointment to review her mild cardiac condition of frequent skipped heartbeats
was mostly one of reassurance, even if the palpitations were distressful to
feel. Helena refilled Eva's medicine, taking the occasion to ask about
her social life. Eva had yet to settle down with anyone, although Anton's
'death' had been years prior. Helena provided some encouragement
in that direction also. Besides wishing to see Eva happy, she was one
of the women young enough to potentially bear multiple children.
As Helena opened the door and prepared to walk
out, Eva shyly touched her arm.
"By the way, Doctor, would the birth control
injections interfere with my heart medicine?"
Helena smiled, turned around and let the door
close behind her. This was one 'by the way' she was happy to encourage.
Again running behind, Helena took the time to
review Tony's labs. Yes, it was all consistent with a mild viral infection.
She walked over to reassure him, but he was sleeping quietly. She would
fill him in later and call Maya after her next appointment.
Patiently stretched out on the exam table, Jim
Haines was waiting for her. As the door closed behind Helena, the young
scientist sat up. Even sitting, he towered over her. While Helena
was well used to tall men, Jim was easily five centimeters taller than John,
and his thinness made him look even taller. Helena pulled up the results
of Jim's latest echocardiogram and eye exam.
Shortly after Breakaway, Jim had made an appointment
with her and had shamefacedly admitted he had lied on his initial physicals.
He had hidden the information that Marfan syndrome ran strongly in his family
although he had never been formally diagnosed with it, mostly because he had
avoided doctors. Any hint of congenital cardiac abnormality would have
kept him Earth bound, and not even Dr. Linden himself lobbying for his favorite
assistant to accompany him would have been successful. The initial cardiac
exams had been normal, but over the past few years a subtle dilation of the
aortic root had been noted. Although she had not yet heard any murmurs,
nor did she now, Helena continued to watch and listen carefully. There
was a fair chance that surgery would eventually be needed.
The required eye exams proved trickier.
Alpha had not had an ophthalmologist at the time of Breakaway, something that
Helena lamented frequently. Pressure from her and Bob had finally convinced
an optics specialist to fill that role reluctantly. With Alphan's aging,
corrective lenses would become an inevitability. Toby Leung had happily
volunteered to make any lenses needed, an easy enough request to fill with
the endless silica available, but Helena had pushed him in the direction of
learning how to do laser corrections on the cornea itself as well as devising
lens implants for the cataracts she was even now starting to see in their
older scientists. That had gone over less readily, but with John adding
his official encouragement, Alpha was working on having a viable corrective
laser surgery unit up and running within the year. Then, Helena would
push Dr. Leung to teach one of his fellows so at least two Alphan's had the
important skill. At least until they could teach someone in the upcoming
generation.
In the mean time, Helena had taught herself the
basics of a good slit lamp eye exam and kept a watch for any evidence of eye
problems in Jim. So far, everything there looked good.
As Jim pulled his rust-sleeved shirt over his
thin, concave chest, he looked as if he had something else to say. Helena
braced herself for the inevitable.
"Dr. Russell, uh...by the way, would you
like to come to my wedding? I still have to ask the Commander
if he'll officiate, but... Sylvie finally agreed."
Helena smiled happily. "Of course we'll
come. Just tell us when and where." Helena walked over to
give him a congratulatory peck on the cheek. Now was not the time to
talk about how they would have to screen to try to minimize passing on his
condition, but soon. "Make an appointment with me, both of you,
before the wedding."
Jim's smile faded a little. He understood.
"Yes, ma'am. And thank you."
Exhausted, Helena sat down in the chair of the
now empty exam room. She dictated her note, including an addendum to
herself to make sure Sylvie and Jim stayed on their birth control measures
until she could have her counseling session with them.
The morning seemed to be passing very slowly.
She pushed herself out of her chair and again went to check on Tony.
A quick glance showed all was well and she went to her office to update Maya.
Mina poked her head in to tell her that her next appointment, Kate Lancing,
had called to reschedule. With a tired smile, Helena acknowledged her,
took the stethoscope off from around her neck and laid it on the table.
She rested her head on her arms, grateful for just a few minutes respite.
~~~~~~~~
"Helena, Dr. Russell, wake up."
Helena startled awake. She looked up to
see Bob leaning over her.
"How do you feel, Helena?"
"Fine. Just tired." She
made to stand up. "I'll check with Mina to see if my next patient
has arrived."
Bob laid his hand on her shoulder and held her
gently down in her seat for the moment. "Mina called me when she
found you asleep and she couldn't easily awaken you. We cancelled your
last two appointments. Why don't you lie down and rest for a while.
I'll stay available in case Ed needs any help."
Although embarrassed to have fallen asleep at
her desk, Helena was tired enough to agree with Bob. She stood a bit
shakily and was grateful for Bob's steadying hand under her arm as she walked
over to the small sofa across from her desk.
"Have you had anything to eat today, Helena?
No? I'll send someone for a light lunch to be waiting when you wake
up." Bob anticipated what she would say next. "No, don't
argue with me. Doctor's orders."
"Yes, sir." Helena smiled as she
lay down and closed her eyes. Bob could make a very effective mother
hen when he wished. She felt Bob cover her with a light blanket and
then heard the door close softly.
~~~~~~~~
Helena awoke to the sounds of familiar footsteps
crossing her office. She opened her eyes to see John crouch down beside
her. He rested his hand on her arm.
"Hi, pretty lady. Are you feeling any
better? I didn't mean to keep you up so late last night."
Helena pushed herself to a seated position and
smoothed the hair back from her eyes. She shared a smile with John.
She had been a willing participant in their late night activities.
"Did Bob tattle on me?"
John nodded his head, a look of concern crossing
his face. "Well, I did come to check on Tony as well as see my
favorite doctor." He kissed her gently on the forehead. "And
Bob left me with strict orders to make sure you ate lunch."
Although she was hungry, the thought of eating
just then was unappealing.
Seeing her expression, John reached the short
distance to her desk and picked up the plate of bland food. He sat down next
to her on the sofa and placed the plate in her hands. "Consider it Commander's
orders."
Helena made a moue of displeasure, but ate knowing
she needed the calories.
John leaned back on the sofa as he watched her
eat and made small talk about the day's events in Command Center. "With
Tony here, Maya worried about him, and Sandra even less talkative than usual
right now, Command Center has been as quiet as temple. I've even thought
to ask Alan to come over and sit Eagle Ops just to have someone to talk to."
He watched her eat and rambled on about other minor inconsequentialities.
Helena finished off her sandwich as the door opened
and Bob walked in. "Feeling better with a nap and food?"
Actually, she was. "Yes. Thank
you, Bob, for covering for me."
Bob waved aside that consideration. "Not
a problem, Helena. Well, now that I have you both here I can tell you
what I didn't earlier."
"You mean at your missed appointment?"
Bob nodded.
"And you want John to stay?"
John looked as confused as Helena. They
both looked at Bob who was actually looking slightly smug, but that expression
was erased as loud voices could be heard coming from the main treatment area.
Bob and Helena both stood, but Bob made it to
the door first. He looked at John with the authority a medical crisis
bestowed. "Commander, take Helena to your quarters to rest.
Ed and I can deal with whatever it is." He looked next to Helena,
"and I'll take the afternoon's
physicals. Go." He left quickly.
Sharing a look of surprise with John, Helena headed
toward the door. She was not about to be ordered out of her own department
without good cause. Just then the door again opened and Bob stuck his
head back in. Seeing his section head almost immediately in front on
him with a perturbed expression on her face, he smiled.
"Oh, by the way, Helena. Congratulations.
You're pregnant."
14 July 2006
MGK
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