Medical Introductions (Part 2 of 2)

Posted on 08 May 2012 @ 1:03pm by Lieutenant Kiri Cho & Lieutenant Commander Pola Ni Dhuinn M.D.
Edited on on 10 May 2012 @ 5:38am

2,079 words; about a 10 minute read

Mission: Episode 01 - Project Sienna
Location: USS Galileo - Sickbay
Timeline: MD04 -1630

Previously...

"Kiri your showing some signs of malnutrition. Even thought your within your eight range for someone of your age and height you are at the extreme end of the low side. Ontop of that I'm seeing signs of anaemia within your body due to iron deficiency. I would hesitate to say that you are only in the extremely early stages of malnutrition but it's enough to cause me some concern." Aware the woman had been showing nervousness of being here, Pola at this point felt that she needed to cut to the chase.

And now the conclusion...

[ON]

That wasn't so bad, Kiri considered this for a moment, her brow furrowed. In a quiet tone as if she had been scolded she replied, "So I should increase the calorific value by ten percent as well more iron and calcium?" If it was just a matter of not getting enough from her current level of consumption it was easy enough to fix. Assuming nothing else was wrong, maybe she misunderstood how the doctor was acting.

"It goes beyond that Kiri. You need to be eating at least three standard meals a day. If your a person who finds it difficult to find the time to eat then we can work out diet plans. I know of a plan for diabetics which means they eat very small portions 7-8times a day which may work for you, it's something you can do at your station. This only eating once every three days cannot continue." Keeping her distance, Pola realised that Kiri might get nervous if she felt her personal space was being invaded.

"I don't think I understand, sir," She slipped back into formality as the ground started to slip from her confidence. Starfleet rations were designed to be eaten once every three days. They provided everything she needed as long as she ate enough, if she wasn't she could increase that. At home she ate like a normal person. It didn't matter how the materials for her diet got into her body, as long as they did. Pure protein or mixed in replicated meat, it was made the same way. It had the same components. What different did it make if she ate once every three hours or every three days with a time release formula? It was exactly the same biologically, just with less mastication.

"Kiri. Starfleet rations are designed to be an emergency food supply should something occur where no access to food is achievable, they are not made to be for longterm survival. It doesn't matter what materials or components make up the ration. They only reason they are created to be eaten every 3days is because if your stranded on a planet, you need to be able to move around and carrying days worth of food is not efficient." Pola forced herself to stay where she was having noticed the woman switching back to a more formal use of words.

Kiri sort of understood that but not the reasoning. She wasn't eating emergency rations, she was eating rations that were a replacement for food. The make up was exactly the same as if she was eating real food, so what was the problem? "I don't understand the problem, what is wrong with it?"

"When you take a ration, you are giving yourself higher doses of each nutrient and vitamin which your body requires, and in all one go. In theory this will break down over 3days, keeping your body supplied with what it requires. But continuous occurance of overloading your body and then waiting 3days before replenishing leads to issues. For example, your body requires nutrients in order to create hormones, build your bones to keep their strength and regulate your heartbeat. If you saturate your body in one go, these processes will run find but towards the end of the three days, it'll start to slow down as it is running out of the required supplements in order to be able to carry out the bodily processes. In the longterm is could end in brittle bone, heart issues." Pola knew she was getting abit technical but she wasn't certain how to break it down to something more easier to understand.

Kiri understood the reasoning but not the argument, it wasn't as if she was just eating normal food in one go. She was finding it frustrating, to her it wasn't an issue, "They are designed to be used this way. When I feel hungry and my body tells me it wants more, I eat more. This is more efficient than sitting down to a meal every few hours. Starfleet carried out extensive testing on a range of species and found this formula to be adequate for three days," Kiri wasn't starving herself, neither was she not eating enough. Yes she was skinny but she always had been, even before this diet. Arguing however wasn't something she was good at, rarely did people disagree with her though. There had been a point when she started the academy when she had calculated exactly how much energy her body needed for a normal day and had matched her habits to it. If things had changed now and she was using more that was easy enough to solve. However it wasn't something she could see any reason to change.

"Kiri. Let me put it this way. What you are doing is unhealthy. As your Doctor, I'm recommending to you that you cannot continue this way, you need to change to regular meals everyday. I've outlined to you the specific reason." Pola realised she sounded aspirated but it seemed that Kiri just wouldn't listen to her.

Kiri didn't like being wrong, to her it didn't seem that she was, there wasn't much chance of her admitting fault in this situation. She had researched the matter in great detail and taken everything into account. If she had the symptoms that the doctor described then the plan of action she presented was the solution required. While the doctor had given examples of what happened when a person didn't eat enough or ate too much normal food in one go, neither of those things applied to her. No evidence other than the fact she might not be getting enough iron and slightly too few calories had been presented. So unless there was something the doctor wasn't telling her then everything had been solved. For three years she had had the energy to do everything she needed and never had to worry about stopping for meals. She passed all her physical before while living like this. All she could assume is that this doctor didn't understand her, though she had tried to clarify. Biologically and chemically, her died was perfect, better than most peoples. What else could she say? Rather confused she finally replied, "I followed this diet for several years. If I am only showing extremely early symptoms now, then wouldn't that be indicative of something else being wrong? I will update my diet as that is likely to be the problem, unless there is anything else wrong." Her voice was quiet but rather firm for her. Unless the doctor was going to order her, or give her actual evidence against what she was doing. She wasn't going to admit it was a failure, as wrong.

It was time like this which made Pola realise that she was so young and so inexperienced as a CMO. Before she'd always had a medical person to ask for advise and to discuss cases with. She had to make a decision. Did she order Kiri to change her diet? Declare her unfit for duty if she continued to refuse? The woman refused to recognise the longterm effect of her decision. Putting her head in her hands, the Doctor rubbed them against her cheeks, feeling a dull headache starting at the back of her head. "Ok....if you insist you continue on the diet you are, I insist that you report to sickbay once a week, and the first sign in anyway that you are further degrading, as a result of your diet, I give you two choices, change your diet or be removed from duty."

Kiri frowned, that was expectable but it seemed very strange. If she had to pick something, it felt like the doctor was out to get her. She knew that she was right, yet the doctor put across that was she was doing was extremely harmful. Why was she acting the way she was? Kiri looked and felt extremely confused, forgetting entirely about everything else. She wasn't going to back down on it though. So she had to go along with it, the doctor seemed to be the one agreeing to let her stay the same. Her voice still not quite her normal quiet one she answered, "That is fine, if it is bad for me then I will stop." If she could provide any actual evidence Kiri would do so happily, other than having to admit she was wrong.

Tired with playing games, Pola stood up and remained firm. "You report to sickbay once a week Kiri and first signs I see of your condition worsening you change." Picking up the PADD, Pola flicked through the notes to ensure there was nothing further she had missed. "Outside of what I've already found, has there been anyother issues? Aches or pains? Anything I need to be aware of?"

Kiri wasn't expecting the firmer tone, she had thought this was resolved. Looking uncomfortable with the order, still she would carry it out to the letter, "No sir, I feel fine." Right from the start Kiri thought she was in perfect health. No different from what she normally did, her right hand holding her left wrist. Her stance not the relaxed one of a few minutes ago. The doctor was the first person in a long time that Kiri felt she might not like. Everyone else she had gotten along with fine, until now it was perfect. With this woman Kiri felt she had wronged her somehow but had no idea how. At the same time she had concept of how to fix it. She didn't want to make her unhappy, but she couldn't do that without giving in against what she knew was wrong.

Turning back to the PADD, Pola updated the notes to reflect Kiri's medical clearance, pressing her thumb against the screen to sign off on it. She would take sometime after Kiri had left, to completely update the notes to reflect what had just happened and also to start to compile more research on the situation. She was serious about this, what the young woman was doing was wrong. It was her job to ensure the well being of this crew, as the Doctor, even more as the CMO, she had the responsibilities. If something happened to Kiri because of something the Doctor should have put the foot down, the fault would only come back to her. Once she had compiled all of the required information, she would seek a second opinion on this.

"Your medically cleared now for duty but I want you to go visit the counsellor. He should have an open position available as he has only just started after an incident with our previous counsellor."

"Thank you," Kiri gave a small fake smile, closing down the program she had only just started to run with a quick glance over her shoulder, "I will see you next week then." She bowed her head then turned to leave, heading straight towards the counsellors office. Part of her wanted to turn right back round and apologise for the unknown transgression. Part wanted to go back and explain to the doctor again why what she was doing was medically sound. Her mind was a muddle and she hadn't even had it probed by the counsellor yet.

Watching as the woman walked away, Pola let out the breath she'd been holding, reaching up a hand to pinch the bridge of her nose as the dull throbbing in her head seemed to get worse. Deciding she needed painkillers, and a break from medicals for a small while, the Doctor headed towards her office, knowing if she was needed her staff would call her.

[OFF]

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Lieutenant Pola Ni Dhuinn
Chief Medical Officer
USS Galileo


Ensign Kiri Cho
Science Officer/Sensor Specialist
USS Galileo

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