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Medical Clearance

Posted on Thu Sep 2nd, 2021 @ 4:28pm by Lieutenant JG Shoniara T’ghann Dex Dr & Captain Shran dh'Klar & Commander Samantha Howard
Edited on on Thu Sep 2nd, 2021 @ 4:43pm

Mission: Breen in Paradise
Location: Sickbay
Timeline: Prior to Casperia Arrival


Dr Samantha Howard hated being on medical stand-down, and even as she could try and clear herself for duty she was sure Bashir would find out at some point and make her pay for it if she ever happened to grace his Infirmary again. He was that kind of guy and she knew her eagerness to return to duty would bite her in the ass. It wasn't worth trying to undermine his orders. Not on this one.

So - she had spent the two and a half days in her quarters, she had relaxed and tried as much as she could to be calm and allow her body to heal. Her mind still reeled from the trauma of the mirror universe and she was deeply concerned for Jon, but right she had to get herself cleared so she could resume her duties.

Dressing in casual and comfortable attired she wandered down to sickbay, having only just met her ACMO a few hours before it was time to see what the other doctor could do.

Sickbay was fairly quiet, the usual number of starship bumps and bruises, holodeck incidents and workplace accidents. Looking around she tried to locate the new doctor.

“Commander, I did not see you there.” Dex appeared from behind a bio bed on which lay a member of the crew moaning in pain. “One of our engineering crew got burned when a plasma conduit blew on deck 13 “ she looked at her patient. Don’t worry John, there will be no permanent damage. I will give you something for the pain and treat your burns.”
She prepared 2ccs of hydrocortilene and injected him with it. He relaxed immediately. She prepared some Ketoline and applied Dermaline gel to his right arm. “How are you feeling now. Better?” A now relaxed engineer smiled at her. “Thanks doc” he said preparing to sit up. She gently pushed him down again. ‘Oh no, you do not get away that fast. I want you to stay here for an hour or so until I review you.”

“It’s been a quiet shift Commander, Ensign Rosen over there” she indicated a rather sheepish looking young Bajoran, “ Broke his leg whilst skiing in the holodeck yesterday but did not want to bother us until he realized he could not walk.” She smiled.” The metorapan treatments have healed the fracture and he is more comfortable now with analgesia on board. I will be discharging him soon. I’ve also treated a humeral anterior dislocation and a case of fractured metacarpals. Also a case of the common human cold, which I have not seen for a long time.” .. she looked at Commander Howard. Would you like to sit down Commander, how are you feeling?”

" A cold? No doubt picked up somewhere" Sam mused, wondering how many crew may be infected " Are there are further cases yet?" She hoisted herself up on the biobed, not overly liking being on the receiving end of a tricorder. " As for myself, still a bit tender but otherwise not too bad. Just going slowly mad being confined to quarters"

“No further cases reported yet but I have begun a track code in case we begin to get more reports. Probably picked up on Deep Space 9.” She opened the tricorder and slowly ran it down the Commander’s body. “You could probably return to duty if duty meant sitting in front of a desk, but I guess you are much like me and that would not produce much satisfaction.” Dex smiled. “Everything is healed but your organs are still settling down. The only thing I am worried about are adhesions.” She closed the medical tricorder with finality. “But…we will cross that bridge if and when we get to it. You know Commander I would like to recommend Vulcan Dela leaf tea, it will help the discomfort.”

"Dela leaf tea?" Sam wrinkled her nose at the sound of it but tried her best not to sound offensive. " I've not heard of it, and as for sitting behind a desk, it's not my favoured working location, but I'm sure you'll make sure I do overdo it" She said with a smile at the new Doctor.

Dex had seen the nose wrinkle and smiled. “That is what everyone does when I mention the tea, but the leaves have a smooth muscle relaxant effect and might release the tensions in your abdomen.It tastes very pleasant, especially with little honey. I want my CMO to return to duty as soon as she is able.

However you can rely on me to take on as much as you need me too.” Dex turned back to Ensign Rosen. “You can go now Ensign, no skiing for a week and no duty for another 24 hours. I will also need to see you tomorrow. I will let your duty Chief know.” As the ensign left sickbay Dex lowered her voice. “I have read the reports of your last mission and I can feel the sadness and the sense of loss amongst you. I can only say my thought are with you.

"The last mission, no two missions have been brutal" Sam sad sagely, her eyes downcast, "particularly on Commander Grayson, I worry for him" she admitted as she accepted a mug of the leaf tea. She took a tentative sip and was pleasantly surprised. "This is actually pretty good" she sipped the tea as Dex finished the scans " now I'm good for duty tomorrow morning? No heavy lifting blah blah blah, don't overdo it yadda yadda yadda?

“I’m not sure what language you are speaking what does ‘ Blah, blah, blah, yadda, yadda, yadda mean?” Dex raised an eyebrow.

Sam laughed heartily, winced, then laughed again. "It do I explain this.. etcetera etcetera?" She tried, knowing that the colloquium would be lost in translation.

I would say yes you are cleared for duty tomorrow morning with the ‘yadda, yadda, yadda in place.” She smiled.”you know, if you ever need to talk to someone, about anything, or just someone to listen I am always available.” She hesitated..

“Please call me Shoniara…to be honest I also need a friend. The logical Vulcan part of me needs quiet and to be alone, it also strengthens me and helps me work. The Riasan part of me however craves people, friendship, love and laughter and is the part of me that takes chances. I…….do not want to be alone here .” Her voice trailed off and she felt that perhaps she has said too much.

"You will not be alone Shoniara...did I pronounce that right?" Sam hated the feeling of first arriving on a starship and knowing nobody. " The staff here are lovely and you will find a home here." She smiled reassuringly. "Just give it a little time, and I am always around for a chat or a cuppa or whatever you need"

“Thank you Sam. I may well take you up on one or all of those over the next few weeks. I have not yet met the rest of the senior staff especially thinking of Commander Grayson so…”

The doors to sickbay opened to admit two crewmen sneezing and coughing. Dex stood “oh no, I was so hoping this would not happen.”

" I'll do you a deal, you tend to the crewmen, I'll work on a anti-viral that we can release into the environmental system and stop this virus in it's tracks. I take it the scans of your first case are in the system?" She looked hopefully at the new Doctor, knowing she was pushing the boundaries just a tiny bit.

“Yes, I enter my scans immediately I take them. It’s the Vulcan in me to complete the case as I take them. I am afraid I knew we would get further infections, and unfortunately I think it is possibly an artificial construct probably released on Deep Space 9 given the timed nature of its symptoms. We needed other infections to test this theory. I am not sure why this virus would be deployed given the seemingly limited nature of the symptoms but I feel we must inform the Captain.”
She felt a little embarrassed at her directness but hoped Sam would not mind. “In fact it will be interesting to see how it affects different species, if indeed it does.”

"It is rare that a virus is restricted to just one species, considering the common genetic structure of most humanoids" Sam admitted sagely, hoping they didn't have an outbreak on their hands. Hopefully it was nothing more than the common cold being circulated by the stations and now the ships environmental systems. However it's appearance at all required investigation. " Inform the Captain we have a few viral cases and are actively working on a solution, I don't think quarantine is necessary until we have further information" Sam snapped back into 'Doctor mode' without even realising it.

Dex smiled, it was good to see the color in Sams face and the animation she could see in her brain as it began to think in medical mode. She walked over to the crewmen one human and the other Bolian.

“Gentlemen, please take a bed each.” She scanned the Bolian first as he appeared to be having more problems due to the differences in his respiratory system. He had a slight fever, and his right lung seemed to contain some consolidation. She frowned, at that stage pneumonia could be an infection process not caused by the common cold virus. He also had some petechial hemorrhages in his eyes. She turned to Sam the results of her scans undeniable. “Bolian flu, very infective. She snapped up the biobeds quarantine field. As she moved out of the field it automatically disinfected her.

She moved on to the next patient. “Do you work together?” She asked.

“No Doctor, Hennes “ he indicated his coughing crewmate, “is a shuttle pilot and I work in the Captains galley. “Have you spent any leisure time together recently?” He thought about it for a minute. No, we not friends but I noticed him having a drink whilst we were in Quarks bar. Just before we left.”

As he talked she scanned him fever, cough, clear chest, sneezing but….now that was different. Meningococcal infection. This infection seemed to be mimicking the common cold but it’s outcome was different between the two species. She took blood from both patients and addressed them. “You will both need to stay here a little while as you need treatment.” She gave the results of the other scan to Sam. “Well what do you think?"

" Mutating virus possibility, could be something in the ventilation system, mould or spores perhaps that is triggering a range of systems" Sam mused, moving over to Dr Dex and reading over her shoulder. " We need to get a handle on this - sooner rather than later" Sam moved to one of the diagnostic workstations, pulling up the latest scans and comparing them with the 'cold' one from earlier. There were definite similarities between them.

“Doctor, may I speak to you?” Dex had decided to be formal, what she was going to say might break a friendship even before it was formed. She took a deep breath. “My first love in medicine is virology. It is something I know about. I have 2 degrees in extant virology, I cured a plague on Tirellius iiii, I was instrumental in curing a plague on Ensara and I hold two Fedearation awards for my work in virology.

I am not telling you this to oh how do you say it…to ‘crow’ about my qualifications. I know Vulcans do like to tell everyone how ‘intelligent’ they are. It is just that I have developed an innate sense of what viruses do. From what I logically know about this burgeoning incident screams some intelligence has engineered this to look like the common cold. Bolians are immune from most human diseases respiratory viruses being one of them. I think someone deliberately engineered this, infected a member of our crew on DS9 before they came on board and…”

A bio bed alarm shrilled as the Bolian occupying it collapsed. “Hennes !”Dex exclaimed.

Sam had the good graces to accept when someone more qualified than herself offered their opinion, and knew when to defer to someone more knowledgable. Whilst she was the CMO, she was also technically still off duty. Right now though she wanted to help.

" Phillips!" Sam snapped at the nearby nurse who had been treating one of the other patient's. The nurse hurried over and helped stabalise the Bolian, leaving Sam to tend to the other viral patient.

“Doctor!” Nurse Phillips turned round and looked at Dex just as another alarm screamed. “The patients respiratory system.” It looked like she could not believe what she was seeing “It’s..completely failed! He is decompensating.”

Dex looked at Sam and rushed to the patient. She had had difficulty believing the nurse but everything proved her right. Hennes respiratory system was indeed beyond repair in just a few minutes since she had seen him . “Sam your patient was showing meningeal infection, scan his brain function? I have a very bad feeling about this.” Dex and Phillips continued to work on the Bolian but she knew that they would be unable to place him in stasis due to his physiology and there was nothing they could do. The life signs on the monitor bottomed out and Shoniara turned it off. “Damn” she exclaimed hitting her fist on the bed. It made a hollow sound, just the way she felt. “Nurse Phillips, please find out if Hennes had a family?”

“Doctor Howard your patient showed meningeal infection on admission please check his brain function?” She hoped that the patients brain would still be where it should be given the evidence of her own eyes.” This was not the first patient she had lost but it felt like the first every time. She was now worried about Sam as she was in close proximity to the possibly infective patient.

Sam cross referenced the patient's brain function against the one on admission and his baseline data on file, finding a deterioration in the current one " His brain function has decreased 30 percent, but he's not critical yet" She worked the scanner controls, engaging the arch over the biobed incase life support was required at short notice.

She tapped her communicator =/\= Dex to Captain Shran =/\=

Shran was in his ready room when the call came in. He hit his comm badge to respond, =^=This is Shran. What do I owe this page to? =^=

=/\=Captain I am here in sickbay with Doctor Howard. We have a developing situation here. A member of our crew has died. We have been monitoring a seeming outbreak of the common cold, however our patients have been developing other viral symptoms within the supposed ‘cold virus’. It seems to be attacking everyone differently. The crew member that died Hennes was Bolian, Bolians have a differently defined respiratory system to that of humanoids. The virus attacked his lungs and there was nothing we could do. Logic would inform this is no ordinary virus. A genetic viral coding has been put in place that affixes to the ‘cold virus’. Someone has developed this to specifically attack our crew. =/\=

=^= What do you propose we do doctor?" =^=

=/\= Sir, so far we have had three patients. Ensign Matteus human whom I discharged. I am recalling him for further tests, Mr Hennes a Bolian we need to autopsy, Mr Shar who is Bajoran who has slightly different brain chemistry is currently experiencing a meningeal infection. I think this is a virus designed to attack non human members of our crew and, given its mutation rate I fully expect to begin to receive other non human patients.

I think our crew must have been exposed to this on Deep Space 9 on purpose given the time frame for infection. For what reason I do not know. I need to use the science lab to ‘deconstruct this virus’ formulate a cure and quickly. “She took a deep breath. “Otherwise we may be looking at a cascade effect amongst our non human crew leading to deaths. Doctor Howard has given me lead on this =/\=

=^=Are you suggesting we put quarantine conditions for the ship? Near a third of the crew is nonhuman. =^=

=/\= It would be only logical to do so Captain. At least until we know what we are dealing with, and we can come up with a cure. I have a lot of experience with virus types such as this one. Once I can replicate it and know where it comes from it should be easy cure. Do you wish a conversation with Doctor Howard? =/\=

Sam looked up at the mention of her name - pausing from carefully monitoring the patient in front of her. She had managed to stabilize him, supporting his neural functions, sedating and administering a series of broad spectrum antivirals in an effort to stop the infection. So far it seemed to be working.

Dex looked at her, she had gone too far she knew taking charge of this without discussing it with Sam but she knew there was something about the virus that she had seen before, it was just tantalizingly beyond her reach.

" I'm here Captain" She added to the conversation " I think Dr Dex is on to something - if we can act quickly we can stop this before it gets out of hand"

=^=Very well. I defer to your medical judgement. Do what you see fit and keep me updated. We will arrive at Casperia Prime in less than 3 hours, and I'd like for this crisis to be handled by then if possible. Wouldn't want you to have an excuse to miss the conference. =^= Shran thought for a moment, then added, =^=Samantha, is it safe to assume that you have been returned to active duty? =^=

“Doctor if it is alright with you I will be in science lab 2 with my viral specimens Please let me know if we have any more cases?” She took the tissue and blood samples from all their patients and without waiting for Dr Howard to answer she left.

Sam nodded as the other Doctor left the room, turning her attention back to the Captain's question " Ahh I guess you could say that" She smiled ruefully, technically Dex had cleared her... in conversation, but the viral outbreak seemed to expedite return to duty.

Science lab 2

Dex studied Hennes tissue samples under the proton microscope behind the decontamination curtain. She knew that simple viral replication involved six steps: attachment, penetration, uncoating, replication, assembly, and release. Logic therefore would dictate working backwards, as this is how she had worked in the past. She injected a sample of the virus obtained from Hennes and watched as it attached itself to one of the human host cells and inserted its genetic material into it.

She did the same with samples from Matteus and Shar and waited. In a few seconds the viral DNA released and incorporated itself into the host cells as RNA. This caused the cells to die and they broke apart. She tried again, and then again and an hour later her eyes began to grow hazy as she watched the virions attach once again to the cells corona. Then came a breakthrough, yes’ she whispered to herself ‘that is where I had seen this before’. She tapped her communicator =/\= Dex to Captain Shran and Dr Howard. I have broken the genetic coding of the virus. It is Breen in origin=/\= she waited for the reply.

"Breen in origin? That's unlike their usual method of operation" Sam replied, keeping a close eye on her patients. Only one more crewman had arrived, a Bajoran with mild symptoms. " Why would the Breen have a virus on DS9?" She asked more to herself than to anyone else "Have you had any success in an antiviral? Standard treatments are holding the infection from progressing but not reversing it"

Hearing this virus had a Breen origin intrigued and confused him =^=This is unexpected. =^=

=/\= To be honest Sam no, I agree logically why would the Breen release a virus on DS9? Unless they know something we do not. But there is no doubt about it there is a viral RNA fragment in the virus and it can only be from the Breen, the last time I saw this was at least ten years ago.

There was an assassination attempt at the Vulcan Embassy on Delos Prime. I was there with my Bond Brother T’ghrek and there had been an ‘incident’ with the Breen on an outpost world. The ambassador had been injected with the same virus. It was ill conceived and poorly executed and the Breen RNA was unmistakable. =/\=

She sighed, dizzy and dripping with tiredness. She had not meditated for over 16 hours and was feeling it. =/\= As to the antiviral all I can say is that I am working on it. =/\=

" Dex, take a break and don't make me make it an order. Standard Antivirals have bought us some time, I think Hennes was further advanced before we started treatment. If we can get in early we can prevent further progression - take a few hours"
Sam continued to treat those that had already presented and had stabilized them all.

Shoniara sat crossed legged on the floor of her quarters dressed in her deep blue, scarlet and silver robe. Puss lay beside her every so often raising his shaggy head towards the door and listening as though he expected an attack from someone any minute. When his mistress was like this she could not defend herself. The air was thick with smoke and the smell of sweet but acrid herbs. Hardly breathing she gazed into the small, steady flame that drifted up from the lamp. She began to relax and her shoulders slumped. Stars went nova and slid slowly into black holes and her mind flowed free around the universe forgetting all the pressures and thoughts that humanoid life brought. She drifted like this for an hour and then slowly returned to consciousness in the quietness of her quarters. “Hey Puss” she scratched the Sehlat’s ears roughly, causing him to shake his head and yowl in enjoyment.

Feeling refreshed she headed quickly to the sonic shower, dressed in a fresh uniform and drank two cups of black coffee, fed Puss and headed out to the science lab. On the way she touched her communicator =/\= Dex to Doctor Howard, any further patients? I am on my way back to the science lab to finish this…I hope. =/\=

" Negative Doctor, no further cases thankfully, the ones we have continue to be stable as well" Howard announced, her body starting to ache with the unexpected workload. She hadn't been expecting such a crazy few hours.

The familiar lab space excited Dex as she again went over the engendered viral code. The denucleation process had continued to its logical conclusion. Then it hit her, this had been a retrovirus all along. “Surak! that’s it”. a virus that has genomes consisting of Antigens are substances that cause the body to produce antibodies, such as a viral protein. Antibodies would bind the antigens very specifically like a lock and key, neutralising the virus and preventing its further spread.

=/\= Dex to Doctor Howard, I have it, all we need to do is inject our infected patients with human antigens. It will seek out the rogue viral cells and kill them by enucleation, The human antigens will then no longer be able to survive in the host body and will enucleate themselves and die. Thus leaving the patients without infection or the human cells. All we need is healthy human serum injection in a very small amount. I’m on my way back. =/\=

Then she remembered Hennes the Bolian she had failed to save. ‘Yet another death she was responsible for’ she thought. There was no reason to celebrate her achievement. She felt dizzy and her world became very small. Then came the imperative. ‘ Shoniara T’ghann Dex you must return to Vulcan it has been seven years since your last Pon Far. It is time.’. She shook her mind cleat and entered the turbo lift that would take her back to sickbay.

" Well you can use my serum, I don't think I'm infected" Sam had taken all the usual infection control protocols and biocontainment filters. She ran a tricorder over herself to make sure, seeing it come up clean for any viral contaminents. " Yep, all clear here"

Dex arrived back in sickbay. Sam looked pale and appeared tired. “We did it Sam” she said. Please sit down, I want to run my own scan.” She took the tricorder and performed a scan to put her own mind at rest. “Yes, clear as a bell, but I would like you to have a nutrient injection….and I want you off duty until tomorrow…..Do you mind if I use your serum?”

Sam laughed, regarding her new ACMO with a mock glare "give a little, take a little... that's the theory isn't it?" She was referring to the nutrient injection and the taking of the serum " Of course you can use my serum, that's one part of me that hasn't taken a beating lately" She smirked at her own joke then hopped up on the biobed, extending her arm for Dex to withdrawn the serum from. " Take as much as you need"

Dex withdrew a small amount of blood from Sam and placed it in the centrifuge to separate the serum. “Should not take long and then I will be able to inoculate our patients, and any other members of the crew who turn up with….colds.” She smiled. She inserted the nutrient injection into the hypo and injected Sams neck. “There that should give you some zip!. Now just rest here whilst I begin the injections.” ‘Surak’ she thought there she went again ordering her superior around. All she had meant by the order was to make Sam rest in place.

She made up a hypo of serum with a carrier medium and injected Shar with the substance. “You will feel better soon Mr Shar.”

Sam stayed on the biobed, watching the readings on the wall monitor as the serum began to take effect, the viral counters slowly moving from red to green along with the crewman's vital signs.

" Looks like you did it" She said with a relaxed smile " Good work"

“Thank you Sam, it was only logical after all. Too late for poor Ensign Hennes though, do you want to inform the Captain?”

" Sure thing" Sam replied, making a mental note to improve the comfort of the biobeds.

" Howard to Captain"

=^=Go ahead Sam.=^=

" Just letting you know we have contained the viral outbreak, we have no further patients and Dr Dex has developed a antiviral treatment that is working well" She advised through the commlink.

=^=Excellent news. Job well done. My compliments to you and Dex. =^=

“My advice is that you need to leave sickbay and rest now until tomorrow. I will finish the inoculations . I want my CMO to be as ready as possible for anything to come.” Shoniara raised an eyebrow in typical Vulcan fashion. “After all Sam it’s only logical “

" And who am I to argue with logic - you win" Sam replied, a yawn crossing her features before she could hide it. " Thank you for your efforts today - that virus could have caused havoc"

“There is still one thing I do not understand.” She looked thoughtful. “Why would the Breen deliberately target the Washington? Well goodnight Sam and, try to sleep well. Don’t forget Dela leaf tea.” She smiled.

" Yes Ma'am" Sam mock saluted the new Doctor and headed back to her quarters - it had been a hectic few hours and Dex would finish up, leaving Sam to rest up and prepare to return to duty the next day.


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