Can You Crease The Wrinkles Back Into The Cracked and Open Brain?

Posted on 20 Jan 2014 @ 10:59am by Lieutenant Teth Miir & Lieutenant Olsam Mott

3,772 words; about a 19 minute read

Mission: Episode 05 - Solstice
Location: Starfleet Medical, SFO
Timeline: MD 12, 0730

[ ON ]

Ironically, Neurosurgery Suite #7 at Starfleet Medical looked like something off of a Borg ship. Simple surgeries could still be done by hand on starships, but even those had been given over to equipment at ground facilities where space wasn't as much of an issue. Neurosurgery in particular had long used machines to facilitate the surgeon's craft, dating back even as far as Earth's 20th-century. The brain was too delicate and complex an organ to allow someone to go swinging a laser scalpel around among it.

Dr. Mezkan Choka's voice clicked and trilled slightly with his Saurian accent. One of the Federation's most eminent neurosurgeons, he was now positioned behind an incredibly sophisticated computer terminal that was guiding the machines now cutting through Teth's skull.

"Dr. Olsam, I am removing the bone flap now and preparing to cut through the dura."

"Understood," Olsam said, monitoring the display next to him.

While Dr. Choka stood at some distance from the surgical table operating the surgical equipment, Olsam and a few nurses were clustered around the caitian's body to monitor his vital signs, observe and assist where needed. The Bolian was very grateful Dr. Choka had conceded to his suggestion to administer the anesthesia before bringing Teth in; all of the machinery would have likely just drudged up traumatizing thoughts of the Borg.

"Dura is now opened," Dr. Choka trilled.

The surgical instruments had pulled back the dura - the layer of tissue protecting the brain - to reveal the gray matter beneath. Olsam was always amazed by how similar internal anatomy looked among humanoid species. Without a trained medical eye, one might not be able to distinguish the exposed caitian brain on the surgical table from a human or a betazoid.

"Accessing the implant in the midbrain now."

Olsam's eyes cut to the monitor next to him. It displayed an array of medical information about Teth Miir, including his basic vital signs but most importantly his neurological activity. Accessing the deep midbrain had become routine enough that things very rarely went wrong, but this wasn't a typical case. The eloquent cortex area of the brain was particularly susceptible to interruption, and they definitely didn't want to leave the poor caitian without the use of his right arm or wake up completely blind.

"Observing extensive inflammation and neural damage around the site of the implant. I am attempting to reduce the power of the implant to allow for piecemeal extraction. Prepare to bring the neural regenerator online."

As Dr. Choka began accessing the primary implant controlling portions of Teth's motor cortex, Olsam noted the expected changes on the display while one of the nurses moved away to prepare the indicated piece of equipment. Non-essential portions of Teth's brain began to power down along with the implant itself, though they would hopefully be restored soon under their own power.

"Implants now operating at minimal power levels, beginning peripheral extraction."

A faint, high-frequency sound began to be emitted from the piece of surgical equipment now hovering over Teth's body. Olsam turned his gaze to the monitor displaying the same view that Dr. Choka had, which showed an incredibly small device cutting away portions of the implant and removing them through an equally small tube. The equipment was moving at an incredible speed under the watchful eye of Dr. Choka, guided by computer algorithms that would be difficult for either physician to fully fathom.

Prior to the surgery, Olsam and his colleague had discussed the best approach. Or, rather, Dr. Choka had outlined his thoughts and Olsam had listened. Surgery was definitely not his strong suit; in fact, he generally looked forward to it with sinking dread. He'd enjoyed his surgical rotation the least at Starfleet Medical, and being in the surgical suite only brought back those feelings. You couldn't interact with a patient who was under anesthesia and that made him deeply uncomfortable.

Dr. Choka had decided to removed the implants working from the outside in toward the primary processors. Along the way they would stop at predetermined points and regenerate the neural tissue surrounding the implant; slowly but surely they would remove the Borg implant and replace its function with organic tissue.

"Disengaging; bring the neural regenerator online."

One sound was replaced by another, and Olsam turned eagerly to the monitor to watch the relatively new and advanced device begin to stimulate the repair of the neural tissue surrounding the implant. The irritated tissues seemed to return to a healthy state before his eyes and new tissue was growing to replace the gap left by the removed portions of the implant. Watching the process brought a smile to his face: so far, so good.

And for that brief moment, something sparked to life in the recesses of Teth's mind. He was in a bright white room in some distant hospital on some far away planet. R'lara was standing beside him, young and wearing her school uniform. She turned to Teth and laughed, speaking soundless words. He tried to get closer to hear her more clearly, but he was paralyzed. Stuck standing in place like a statue he watched a fluid blackness creep in through the cracks in the walls. Hands reached out from the darkness and were surrounding R'lara, she was blissfully unaware. He tried screaming, but it was too late. In an instant she was gone and the darkness cas coming to consume him as well.

"Phase one complete," Dr. Choka droned on. "Beginning phase two, removal of implant's secondary co-processor."

And Teth felt himself slipping into nothingness. Encapsulated by the void, a sharp wave of coldness washed over him and he wondered if he was dying. Before he could carry that thought any farther, there was nothing left at all.

Almost as soon as the surgical device activated, alarms blared on the monitor next to Olsam. The Bolian physician moved with alacrity as he pulled more data from the sensors hovering above the surgical bed.

"Neural energy is dropping...down 8 percent... 17 percent...."

The alarms became much more persistent; several portions of the display were now flashing an angry red color. Though he felt the urge to do so, Olsam resisted taking a look at his friend on the surgical table. Friend Olsam was gone, replaced by Dr. Olsam. The nurses beside him had moved to the side to begin preparing for any emergency measures they might be forced to take to save Teth's life.

"Neural energy continuing to fall...down 37 percent.... 42 percent.... Energy readings from the primary implant are rising again. It's attempting to compensate for the loss of its secondary co-processor. Power it down. Now!" Olsam demanded, turning from the monitor to face the terminal behind which Dr. Choka was working.

"I'm trying, but it's not responding," Dr. Choka replied, sounding frustrated.

Olsam turned back to the monitor and keyed up additional information, scowling. The implant had seemed to object to Dr. Choka severing its secondary co-processor; unfortunately, it was trying to adapt to the procedure by drawing energy from Teth's brain. Olsam watched with no small amount of panic as the implant began to regain control of the functions that had originally been powered down, including along the bridge that ran between the primary and secondary implants. The latter controlled Teth's autonomic functions, and if it began to malfunction then it threatened several key body systems.

"Reconnect the secondary co-processor," Olsam said coolly, staring at the device hiding Dr. Choka.

"What?" the Saurian asked incredulously, his reptilian eyes appearing above the terminal for just a moment. "That defeats the entire purpose of the surgery. If we can just compensa-"

"No time," Olsam snapped, turning back to the monitors. "Reconnect the secondary co-processor."

"Doctors, neural energy is down by 61 percent," one of the nurses warned, her voice wavering with nervousness. It was bad enough the patient was bottoming out, but two doctors arguing in the surgical suite was uncommon and never good news.

He could hear Dr. Choka scoff and prepare to offer another rebuttal, even as more alarms were triggered on the monitors. Olsam's eyes narrowed, and he glowered over Teth's prone form at the Saurian steps away. Neurosurgeons were famed for many things, good and bad; they were known as risk-takers, arrogant, occasionally reckless, vain, insubordinate. Throughout the centuries they had been accused by no small number of colleagues as being drunk on the power of "playing God."

None of those things had a place in the surgical suite this day.

"Do it! Now!" Olsam finally shouted, turning a darker shade of blue as his body threatened to tremble from the uncharacteristic emotional outburst.

The Bolian could see in the eyes of his colleague that he'd just burned a bridge for himself, but no amount of favors were worth the life of a patient. His patient. His friend.

"Reconnecting secondary co-processor," Dr. Choka said bitterly. "Complete."

As the secondary co-processor of the primary implant came back online, Olsam watched the monitors hopefully. Much slower than they had dropped, the displayed indicators began to return to normal. Flashing red warnings began to fade into a soft blue glow while the implants began returning to a state of minimal power usage. Teth's neural energy levels rose appreciably, and his respiration, heart rate, blood pressure and other indicators began to level-off within acceptable ranges.

Olsam unclenched his fists and immediately felt guilty about his outburst. Thankfully no one in the surgical suite knew him well, otherwise he would later be called to account for his behavior. For anyone who knew him, it would have seemed most certainly out of character. The happy-go-lucky Bolian facade wasn't a cover for anger management issues or anything of the like; however, Olsam took the health of his patients very seriously so he was unlikely to stand by idly while some other physician dared to threaten their life by continuing to pursue an already risky procedure.

It was highly likely that Dr. Choka would never speak to him again. With wounded ego, he'd probably speak poorly of Olsam to anyone who would listen. It might tarnish the Bolian's reputation in certain circles of the medical community, but that was a price he was willing to pay. Gladly.

"To minimize unnecessary risks," Olsam began, placing no small amount of emphasis on the phrase, "I suggest we proceed with removing as much of the outer sections of the implant as possible and regenerate the neural tissue at those sites. Some organic restoration is better than none, and it should better help him regulate the adverse tissue reactions due to the presence of the implants."

"Agreed," Dr. Choka responded flatly. "He's your patient."

"Yes," Olsam said, quietly and almost to himself as he looked over the sleeping form of his shipmate and friend. "He is."

=-=-=-=-=-=-=-=

"Good morning," Olsam said cheerily, his bald blue head hovering over the biobed like a Spectral Class O star.

Teth blinked and was fascinated by the various lights on monitors around him. He looked past Olsam and at one monitor in particular, it had a pulsating blue light and a high pitched beep. He was fascinated and immensely irritated by it at the same time.

"I feel drunk." the Caitian said finally, pointing at the monitor "What does that do?"

Olsam smiled. "The anesthesia is slow in leaving your system, so you'll feel 'drunk' for a little while. That screen is showing a lot of different information, but mostly related to your neurophysiology. A lot of brain activity, neural energy, so on and so forth. It's showing key indicators for your recovery. How are you feeling? No loss of sensation anywhere at all,

Teth sat silently for a moment, waiting for his vision to clear and for the room to stop spinning. After he felt grounded enough in reality, he felt it was time to ask the important question.

"So how did the procedure go?"

Olsam pulled up a nearby chair and took a seat beside Teth's recovery bed. He folded his hands in his lap and let out a small sigh. "Well... The procedure was not as successful as we would have hoped. There were some complications, and we were only able to remove about 15% of the implants without risking irreparable damage to your brain."

Teth's felt the blood in his veins harden into glue and he was overcome by an intense wave of nausea.

"But I thought you were optimistic about the outcome? Only fifteen percent?"

Olsam couldn't help but cut his eyes at the changing numbers on the monitor next to the bed, although he didn't need them to tell him about Teth's emotional state. For his part, the Bolian looked like the rug had been pulled out from under him. He was hunched over slightly; the perpetual half-smile and laugh lines were nowhere to be seen. He wasn't by any means telepathic or empathic, but he was feeling his friend's pain.

"Perhaps a downfall of my species," Olsam said quietly, mostly speaking to his hands in his lap. "We're always optimistic. I hope I did not set unreasonable expectations in my enthusiasm. Dr. Choka and I tried very hard... When we attempted to disconnect the secondary co-processor, the primary implant had an adverse reaction. It was draining your neural energy and..." For a moment, Olsam began to doubt himself. If they had pushed onward, perhaps deactivated the implant altogether, would the procedure have been successful? "...the procedure was amended as a result. It was my decision."

Teth broke eye contact with Olsam to stare intently at a small dent in the door to the recovery room, not knowing what else to say or do. He knew crying might be an appropriate response, but he felt too exhausted and numb to go through such a display of emotion. Going into the procedure he'd felt hopeful that he could be the way he was before. A living, breathing, healthy person. Not some form of cybernetic living dead.

"Thank you for trying."

"Of course," Olsam said, looking almost as deflated as his patient. "We managed to regenerate the brain tissue around the implant sites, and I believe that will reduce the intensity and frequency of the problems you were experiencing. It may also..."

Olsam stopped and cleared his throat. Although he believed it, he wondered if given the circumstances what he was about to say might sound hollow.

"...it may also be possible to try again at some point in the future, as medicine advances, new techniques are developed and we come to better understood the role of Borg technology in regulating the nervous system."

Teth nodded and then sighed.

"You know, I remember when I first woke up after the implants were put in. The last thing I remembered was walking around the city, and then I was in a hospital room. I was awake, my parents were there, they were very upset but trying to hide it. I thought maybe the whole thing was a bad dream. But the way they dodged my questions told me otherwise."

He paused, looking back to his uncharacteristically solemn friend.

"I was dead when they found me. The police found me, my family had reported me missing at that point. But I died outside of an inter-planetary medical convention. So they put me back together with experimental implants and sent me home." at this point he was gritting his teeth in an attempt to hold back the tears that wouldn't materialize a few moments before.

"I am pretty sure Teth Miir died thirteen years ago. I'm just the collection of ghosts. Just fragments of all those who died to give life to the collective and to every last nanite. I am not a spiritual man, but I feel that I am an abomination to anything sacred in this universe."

"Well that's selfish," Olsam blurted. He gasped audibly and had to resist the urge to clasp a hand over his mouth. His already wide eyes were wider and his hairless brow was lifted so high in surprise that his face took on the appearance of cosmetic surgery gone awry. Struggling to recover before Teth could respond, he stumbled over his response.

"I just mean... I mean, it is selfish. But not, it's not like... I don't think you're a bad person. I'm trying to say that, um. Yes. Okay, yes, very many sentient species have perished at the hands of the Borg. We may never know which one of them developed the implants that have saved your life, but I think... I mean, I understand why you are saying it - it was a traumatizing experience, and you have a great deal of grief... But I think it may be unfair to their memory to say that you are an abomination, to take their suffering and mistreatment at the hands of the Borg and use it for your own victimization. They saved your life... Their technology - whatever species pioneered these medical breakthroughs - they gave you a second chance to do some good in the universe. In a time where they are no longer to be able to do so."

Olsam abruptly stood up, almost knocking his chair back into the monitor. He fumbled for a PADD on the end table next to the recovery bed and then nearly tripped over the chair. A curse actually escaped his lips, an occurrence nearly unheard of.

"I'm sorry, I should be going, forgive me," Olsam mumbled.

"I have been doing my very best to make my life worthwhile." Teth said, tension building in his voice.

"But at what point does the end justify the means? Obviously your opinions on medical ethics differ wildly from mine. Should I be grateful to the Borg? Should I send them a thank you note and a fruit basket every year? I didn't ask for this technology. There were other avenues they could have explored to help me, but they didn't. My parents were scared and Borg technology was just so in vogue at the time. So yes, I am here and I am alive because of it. I don't plan on going anywhere, but I will never be thankful that any of this happened. The dead didn't make a noble sacrifice to save others. They were murdered. Their individuality was stripped from them and they were lost forever to the collective. You're cheapening the worth of their lives by implying that some minor medical advancement was somehow all worth it. And really, Olsam, what in the hell makes me special that I get to use the technology to live while everyone else dies? I like to think I am a good therapist, but surely there are countless others just as good if not better than me. I wasn't given a second chance to accomplish great things. I was a medical experiment."

Teth stopped to take a breath from his rant, he was shaking and he could feel his pulse pounding in his temples. Normally a calm and passive person, he felt himself losing his grip on rationality. He had a strong urge to grab the Bolian by his collar and smash his head into the floor repeatedly until it became as damaged and fractured as his own. But he knew that was wrong and even if he really wanted to, he was still to weak and disoriented from the anesthesia.

"If you think that I am selfish or misguided for feeling this way, then please doctor, by all means just leave. Obviously you are in the position to take the moral high ground here."

Olsam stood in the doorway with one blue hand against the frame, stark against the sterile white. He spared a glance at the monitors to make sure the elevated readings begin to normalize, and then he looked back at Teth.

He pursed his lips as if he were at a loss for what to say, though he had plenty that he could offer. He suspected over the years the young caitian hadn't been accustomed to anyone speaking to him like that, and perhaps rightfully so. Olsam was certainly no mental health professional - he had no idea how long post-traumatic stress disorders should carry on, how to deal with the anguish of a survivor's guilt - and he came from a species with a higher than normal psychological resilience. It was sometimes difficult for him to grasp a patient's difficulties when it came to matters of the mind.

All he knew was that at some point one had to stop feeling sorry for one's self and turn the page, grant forgiveness, move on. Function. Olsam offered a weak smile and dropped his hand from the door frame in preparation to leave.

"I'll return in the evening to check on you."

"I am sure the nursing staff here is quite capable." the counselor replied flatly, poison dripping from his words as he mentally etched a target in the back of the doctor's head.

As the doors closed behind him, Olsam's hand stretched out instinctively toward the door pad. Eventually he dropped his hand but continued staring at the small control panel, debating whether to engage the door locks out of concern for Teth's own safety. He knew he probably should have alerted the counseling staff, but the Bolian imagined his patient may actually grow to resent him even more for taking either action.

So he turned and walked away.

Teth held his breath until the door closed behind Olsam, and then collapsed back into his bed. Burying his face in his hands, he tried to sort through the rapid fire stream of thoughts he was having. Between violent fantasies about his new Bolian friend, lessons on neurology from his medical rotation during the academy. Recently recovered memories that were too difficult to even put into words and the unstudied implications of spending the rest of his life with Borg parts- he always half expected to be fully compromised and just become a Borg outright. The passing waves of humiliation at his emotional outburst.

But at the end of all of it, he just wanted to sleep and pretend the entire procedure never took place. That Dr. Olsam was just another new crewmate. Maybe if he pretended hard enough, Olsam would forget the entire thing as well.

"So much for making friends."

OFF:

Lt. JG Olsam Mott M.D.
Assistant Chief of Medicine
USS Galileo

&

Lt. JG Teth Miir
Counselor
USS Galileo

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