Sunday, October 20, 2013

Beam Me Up Night Clinic

                   

“Of course you’re working tonight,” Miss James stated. “Wherever there are bizarre events, that’s where Dr. Barnes will be.”
“I don’t know what you mean, Nurse. It’s been five weeks since my last shift here; are you telling me it’s been nothing but chest pain, abdominal pain and PIA?”
“Let’s just say that I haven’t seen a dragon in weeks.”
Can I help if all the crazies come out when I’m working. It’s not like I carry them with me.”
“Speaking of bizarre and crazy, you are aware that the Intergalactic Convention is in town again. Star Trek, Star Wars and every other outer space franchise all together. So I’m sure we’ll get our share of phaser burns, blaster bruises and transporter malfunctions. Oh, and to get us off on the right foot, Derek is back with his annual ‘Trouble with Tribbles.’ I’ve left all the usual instruments in the room for you.”
“Not again,” I moaned. “You would think that after four, no five years, he would learn.”
I picked up the chart and gave it a careless glance. Before I saw the words I knew the problem. I walked into the exam and saw Derek, a regular visitor, lying on his side on the exam table. Seated on a sterile tray were a rigid sigmoidoscope and a tenaculum.
“Derek, we’ve got to stop meeting like this,” I scolded. “And think of the poor Tribbles. They’re supposed to be comforting, I know, but you’re just supposed to hold them.”
“I do hold them, Dr. Barnes; for a little while. But, the way they coo and vibrate and shake. The possibilities are endless.”
“I hope it’s as simple as last year,” I remarked.
I put on a glove and lubed up my index finger and checked up in Derek’s rectum. Sure enough there was a furry object vibrating just inside. Past experience told me not to try to grab it with my hand; it would just slip away. I greased up the scope and passed it into his rectum. Immediately I visualized a furry yellow ball which was shaking and making low Tribble noises. I reached in with the tenaculum and grabbed the object in its mid portion like a pro and pulled scope and tenaculum out with a single, gentle pull. The Tribble, which was a toy available at the convention, popped out.
“Just one this year?” I asked, although I already knew there would be more.
“No, three,” he replied.
I repeated the routine, pulling out one purple and one red Tribble, both larger that the first and still vibrating.
“I’ll dispose of these for you, Derek. And, please, stay away from Tribbles. You know they’re nothing but trouble.
He gave a short grunt as I walked out of the exam room.
“What’s next, Nurse?”
“Intractable vomiting in Room one after imbibing ‘Romulan Ale,’ Darth Vader is in two with a couple of storm troopers.”
“Room one sounds easier,” I commented as I picked up the chart outside the door.
“Kang…unusual name,” I murmured to myself as I opened the door. “Good evening Mr. Kang. I’m Dr. Barnes, what seems to be the problem?”
I was greeted by a dark faced, sweaty man with a goatee, dressed in some sort of outer space uniform, seated on the chair, supporting a basin between his legs. As I approached him he violently vomited into the basin, a dark, violet fluid.
“Curse this Romulan ale,” he sneered. “you think I would have learned by now.”
“When did this vomiting start?” I asked while feeling his pulse. His wrist was wet with perspiration and he felt warm. His heart was beating at about one twenty.
“With the first swig of that vile liquid. I should stick with our own Blood wine. Klingons make by far the most potent drink in the Universe.”
“I’m sure you do Mr. Kang.”
“It’s just Kang.”
“Of course.” I examined his eyes, looked down his throat, listened to his heart and lungs, palpated his abdomen and then wrote him a prescription for Carafate and Phenergan and sent him on his way. He didn’t utter a word of gratitude.
On to Darth Vader.
I picked up the chart on the door. Shortness of breath, hoarseness…no age…no address. I knocked and opened the door to find myself staring at two Storm Troopers aiming what I assumed were fake blasters at me, while Lord Vader sat in the chair, head held high, his right fist clenched tightly. I raised my arms in mock surrender.
“Don’t shoot, I’m only the doctor,” I exclaimed. “Dr. Barnes, Lord Vader. What seems to be the problem?”
I heard the whoosh of jets from his black armored suit and then a raspy, shallow breath.
“I seem to have trouble breathing,” he answered, his voice deep but punctuated with a definite wheeze. “The Force is ebbing away from me.”
“When did you start noticing the problem?” I inquired in my usual doctor tone.
“I’ve been pursuing rebel warriors from one end of the galaxy to the other. The Force had been strong with me, but since I’ve come to this place I’ve suffered.”
“Hmm, it seems your Force has more sense than you; this is not the best part of town. However, I was referring to the breathing difficulty. Can you take that black outfit off so that I can examine you properly?”
“Dr. Barnes, I don’t believe you completely comprehend my situation. My life and very being depend upon this suit. It is designed to maintain the power that flows to me from the Dark side.”
“Dark side, light side, I don’t know how I’m supposed to treat you if I can’t properly examine you.”
“I find your condescending attitude disturbing, Dr. Barnes.”
“Listen, Mr. Vader. I know there’s an ‘Intergalactic Convention’ here in town, but you’re in my clinic now and you came to me for help, so give me a break will you? I’m trying to help you. OK…OK, let me listen to your lungs through your armor.”
I moved closer and pressed my stethoscope tightly against his back. He flinched a little. I was able to detect a definite expiratory wheeze  and even a slight inspiratory wheeze bilaterally. His expiratory phase was markedly prolonged.
“Seems to be an asthma attack, Mr. Vader. A bit of a breathing treatment should fix you right up. Let me find the nurse and she will administer the medication. Where should she put it? It’s designed to be inhaled.”
He fumbled with his black suit and exposed an injection port. I noticed his light saber at his side.
“The medicine can go in here,” he stated.
I left Lord Vader and his Storm Troopers, gave the orders to Miss James and went on to the next room.
Light Saber injury…Mr. Spock. Mixing space themes, this could be interesting.
I knocked on the door and went in holding my hand up in the Vulcan salute. “Live long and prosper, Mr. Spock; I’ve always wanted to say that and really mean it,” I quipped.
 Seated in the room was a dead ringer for Mr. Spock, a deep gash across his lower chest with exposed ribs and charred tissue dotted with greenish black stains, just what one would expect after being slashed with a  light saber. Standing next to the injured party was a companion, Captain Kirk I presumed.
“Mr. Spock had a run in with a tall raspy villain, dressed in black armor. He was slashed with his weapon, some sort of laser sword. Patch him up, doc. We have an appointment in two hours that we cannot miss.” Kirk explained.
“One hour fifty four minutes and eighteen seconds to be precise,” Mr. Spock interjected.
“Commander Spock, I need to get your shirt off so that I can inspect that wound more closely.”
My patient raised one eyebrow, but didn’t move.
“Surely you are aware, Dr. Barnes, that Mr. Spock never takes his shirt off or exposes his arms, except at the time of Ponn Far and that is not due for five more years. I, however, will be delighted to remove my shirt, particularly if your lovely nurse comes back. I’ll take her over Yeoman  Rand any day.”
“I don’t believe that my inspecting your body will do anything for your friend’s injury. Tell me again what happened, Mr. Spock?”
“We, that is, the Enterprise, was attacked by a band of interplanetary fighters. We were in pursuit of a Romulan vessel we suspected of attacking one of our outposts along the neutral zone. Unfortunately, we encountered an energy surge which then drew us into a wormhole, which then deposited us in a completely unknown area of space. We were accosted by a trio of interplanetary fighters when we emerged. We did our best to defend ourselves, but they managed to escape. We pursued him through some sort of portal which deposited the lot of us here, on Earth.”
After finishing his story, Mr. Spock pulled up his shirt just enough for me to get a proper look at his wound. It was about twenty centimeters long, but clean, with dark, dried, green blood along its edges.
These conventioneers go all out, I thought, green blood and everything.  I pulled out my stethoscope and listened to his lungs, which were clear, and his heart, but the heart sounds were barely audible.
“If you are trying to auscultate my heart you would do better to listen here,” he informed while pointing to an area in the right upper abdomen.
“Oh, yes,” I replied, nonchalantly, “I guess I forgot my Vulcan anatomy. I think I missed that lecture in medical school.”
I listened to the area he had pointed to and heard his heart, clear and loud, chugging along at a rate of one hundred thirty.
“Seems a little tachycardic,” I observed.
“It’s actually a bit slow for a Vulcan.”
“And just how did you get this injury, Commander Spock? A phaser blast?”
“I believe the weapon is called a light saber. We pursued the fighters to a venue not far from here. I confronted their leader, a tall being, more machine than creature according to my tricorder…”
His voice suddenly trailed off; I turned to see Captain Kirk gesturing, signaling for Mr. Spock to remain quiet.
“Light Saber certainly fits with the injury. I’ll clean it up as best I can, but you probably should see a surgeon soon.”
“That should be in one hour thirty nine minutes and four seconds, although, Dr. Barnes, your skills seem far superior to our ship’s surgeon.”
“Thank you, but, quoting Dr. McCoy, I’m just an old country doctor.”
Mr. Spock raised one eyebrow, but did not respond. After dressing his wound I turned and saw Captain Kirk with his shirt off. He had a coy look on his face.
“Dr. Barnes,” he inquired, “do you think you could convince that nurse to come give me a shot? Maybe, right in the cheek, if you get my drift?”
I gave him a long stare and handed him his shirt.
“She prefers the quiet intellectual type, Captain, sorry.”
“It’s in my contract, you know,” he informed me with a slight leer on his face, “paragraph twelve, section three states that I will remove my shirt at least every other episode and that sixty per cent of the time I get the girl.”
“This isn’t Star Fleet and Miss James is never anything but professional and never fraternizes with her patients, Captain. So, you may put your shirt on while I attend to Mr. Spock.”
I checked my tray of instruments, poured some antiseptic in one of the cups and filled the other with Lidocaine.
“I’m not sure if I’ll be able to close this up, Commander,” I stated as I began to cleanse the wound.
“I am sure that your efforts will be far superior to the norm, Dr. Barnes, Spock replied.
“I don’t know, I’m in Internal Medicine, not surgery.”
I started to inject some local but my hand was stopped by the strong grip of my patient.
“Not necessary, Dr. Barnes.”
I could see him gritting his teeth, however. But, I carried on, lightly trimming away dead tissue and then doing my best to close the gaping wound.
“Where is Captain Surgery when you need him,” I muttered to myself.
“Did you say something, Dr. Barnes?” Spock asked.
“Oh…no, there we go, all done.”
I pushed my stool away and stood up, admiring my handiwork. The stitches were even and symmetric, the wound closed in a neat straight line.
At that moment the door to the exam room burst open and my other patient, Lord Vader, entered, accompanied by his Storm Trooper sidekicks. I was sure I heard his Star Wars theme song as he raised his light saber. Spock and Kirk jumped back, simultaneously drawing their phasers. The storm troopers crouched at Vader’s side, blasters ready. I stood in the middle of this gunfight.
“Now can’t you…”, but before I could finish a beam shot out from Captain Kirk’s phaser, not more than two inches from my nose. Darth Vader smoothly fired up his light saber and deflected the beam into the wall where it left a gaping hole with smoking blackened edges. Prudency won out over foolish bravery as I dove under the exam table, just managing to dodge a shot from a Storm Trooper blaster.
At this moment Miss James opened the door and stuck her head in to check out the ruckus. Phaser beams and energy blasts shot back and forth while Vader’s skillfully deflected beams from side to side. Pock marks of smoke and flame dotted the walls as the battle progressed, but neither side suffered any casualties. It was just after Miss James entered, before she knew what was happening, that I heard a scream and glanced up to see Miss James pouring blood out from a gaping wound where her right arm used to be. The arm, meanwhile, lay on the floor, fingers still twitching.
Despite phasers and light sabers and blasters I jumped up and yelled as loud as I could, “LOOK AT WHAT YOU’VE DONE, YOU MONSTERS, AFTER ALL WE DID FOR YOU. STOP THIS INSTANT.”
They all looked startled as I jumped to Miss James and bent down and scooped up her arm.
“You should all be ashamed of yourselves. What are you fighting about, anyway? Good versus evil? To tell you the truth I don’t see a difference.”
Vader looked at me as his light saber retracted. “The Force is strong in you, Dr. Barnes. You don’t realize the power you could wield if you would give yourself over to It.”
“To be like you? A shell of a man existing inside a black suit of armor, pretending to be big and powerful? I don’t think so.” I looked at Kirk and Spock. “And you two, can you make this right? Undo the damage you’ve done? You zoom from here to there, playing god, yet never taking any of the responsibility that a God must assume. Star Fleet, my ass. Your wonderful Star Fleet is no better than Vader’s Empire. You speak about “the Prime Directive” yet break it on every episode. Why don’t you all just leave, go back to your own place and time.”
At that moment I heard a familiar whine, the sound of people materializing from a transporter. I recognized Dr. McCoy and Mr. Scott, along with some red shirted security officers (who I’m sure were destined to die sooner or later.)
“Better late than never, Mr. Scott,” Kirk remarked.
I turned away from the Enterprise crew, only to see that Darth Vader and his Storm Troopers were gone. I looked plaintively at Dr. McCoy.
“Doctor McCoy, Bones, do you think you can help Miss James?” I pleaded. I was cradling her head in my lap as she lapsed into unconsciousness, on the verge of shock.
McCoy looked at the severed arm and the wound at the end of her arm, which was no longer bleeding. “I’m just an old country doctor and I can’t perform miracles,” he said, “but, we need to get her to the ship if there is to be any chance.
“Right,” I answered. “just let me close the Clinic and we can be off.”
I saw Kirk looking at Spock and McCoy, shaking his head. Anger and frustration welled up inside me.
“I know what you’re thinking,” I stated, trying to remain calm. “Don’t get involved, don’t do anything to upset the status quo of what has happened or is supposed to happen. Well, your coming here may have already done that. Meanwhile, Miss James is in dire straits, she may be dying. Are you going to let that happen? Could you live with yourselves? Therefore, unless you can show me some compelling evidence which can convince me that nothing should be done and we should let Miss James suffer, you must do something to help.”
At that moment Kirk’s communicator chimed. “Let the fighters go, Mr. Sulu. We have another problem. Transporter room, we have six to beam up and have a medical team standing by.”
I felt a bit of trepidation at the thought of my molecules being disassembled and then reassembled. After all it was just a television show; one that was cancelled after three seasons. But, the familiar whine started and I was soon standing in the Enterprise transporter, still supporting Miss James. Her severed arm was in a plastic garbage bag, which was inside a second bag filled with ice. The medical crew loaded her and her arm onto a waiting stretcher and she was whisked off to sick bay, myself and Dr. McCoy at her side.
“It will be an honor and a true learning experience to watch you in action, Doctor,” I said to “Bones.”
He had a grave, almost worried look on his face and his hand was shaking.
“You have done this before, Doctor? I mean, I did see you restore Spock’s brain and patch up a badly injured Horta. Surely, reimplanting an arm is a common procedure in the twenty third century.”
He just looked at me blankly.
Miss James was placed on the table and her arm placed on a second table.
“Prepare the patient, Nurse Chapel,” Dr. McCoy ordered. The look of worry returned and his hand was shaking even more. I became more concerned. I’d seen the same expression on the faces of newly minted doctors on their first day of internship, but never on a veteran, seasoned surgeon. I took McCoy aside.
“Are you OK, Doctor McCoy?” I inquired, doing my best to keep the alarm out of my voice.
“It’s just that there are so many structures, arteries, nerves, muscle and it’s been so long. I’m just an old country doctor. That’s all I ever really was supposed to be, not a super ship’s surgeon. We’re not meant to flit about the galaxy. It’s not right; I’m just an old country…”
I cut him off, realizing he would never be able to perform such an operation, or any operation, for that matter. I was about to tell the Captain to return us to Earth when I heard a voice.
“Use the Force, Dr. Barnes. You are a doctor, you can do the surgery. The Force will be with you.”
“Obiwan Kenobi?”
“The Force is strong in you Dr. Barnes. Prepare for the surgery and let the Force guide your hand.”
More and more bizarre.
OK, here goes nothing. I stepped up to the OR table and looked at the stump of Miss James severed arm and the detached arm. I put on the operating visor which should have been on Dr. McCoy and, suddenly, the operative field became clear. The computer within the visor neatly illuminated each structure: brachial artery, humerus, basilic vein, biceps muscle, and every other structure became neatly color coded and labeled.
At least the anatomy won’t be difficult, but how am I to put each little vessel and fiber back together.
“Let your mind go, free yourself and rely on the Force,” Obiwan suggested.
Well I was no surgeon, that’s for sure. I’d only had a twelve week clerkship and I’d spent most of that time trying to pick up nurses in the ER.
I turned off the operating visor and put on a blinder. I thought about better times with Miss James and tried to think about nothing at all; trying to remember what Luke Skywalker had done when he blew up the first Death Star.
“Give yourself over to the Dark Side, young doctor. You don’t know the power you can wield.”
GET OUT, GET OUT,” I shouted in my head, trying to remove Vader from my thoughts.
Miss James, Miss James filled my head, the image of her loveliness and all the time we’d worked together.
I sensed my hands dancing across the table, working rapidly, sewing sealing, cleaning, injecting. Vessel sealant here, neural stimulation there, osteoblastic compound, more sealant, dermal regenerator, all sorts of twenty third century medical instruments and therapies I had never thought could ever exist were employed as the Force and I worked wonders. I was oblivious to everything else until I announced:
“Finished.”
Miss James sat up and clenched her hand into a fist.
“Remarkable”, “Wonderful”, “Amazing”, were some of the accolades that were shouted from the many observers. I gave Miss James a hug and then sat down, finally realizing I was exhausted from the ordeal.
“I think it’s time to send the two of you back,” Captain Kirk announced. “But, before you go, there is one more thing to be done. Mr. Spock…”
How could I go back? Knowing what I knew. How could I ever go back to the knives and sutures of twenty first century medicine?
It was then that Mr. Spock approached me and Miss James.
“I shall be forever grateful to you Dr. Barnes, for repairing my injury in such a skillful manner and for teaching me, teaching all of us, about what is truly important.”
And he put his hands on myself and Miss James and I heard him mutter, “Forget, forget.”
We found ourselves back in the clinic. It was 6:45, just about quitting time. Miss James acted like nothing had happened. I however, did remember. I looked at her arm. It looked perfectly normal. I checked out the exam room, every charred, burned out hole in the wall had been repaired. It was as if nothing had happened. And maybe it hadn’t. No one would ever believe such a story.
I turned to Miss James.
“Breakfast?” I asked.






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