Forwarded by the ASC-VSO Posted: 28 Apr 2004 03:59:33 -0700 In: alt.startrek.creative From: keroth1701@sbcglobal.net (Ke Roth) Title: Echoes Author: Ke Roth (keeroth@startrek.net) Series: TNG Part: 154/? Rating: R (violence and language) Codes: P/C, D/f Summary: Lt. Andile, Starfleet's oldest and shortest engineer, comes make any money from writing this. FYI: This story takes place approximately 2 years post "Insurrection", but pre-"Nemesis". Feedback is welcome. Chapter 154 "There appears to be some stiffening of the ligaments..." Jemat muttered, more to himself than to the physician standing beside him, gently manipulating the hand of the unconscious woman, flexing the fingers back and forth, then gently rotating the wrist. "Minimal regeneration of pseudo-epidermis as well," he added, prodding carefully at the raw flesh that stretched over the bones. "I didn't want the flesh to heal over, Jemat," Beverly protested, somewhat defensively. "Andile had massive rejection issues with her previous transplants; once she stabilizes, I was hoping to draw skin fibers down from the existing tissue on her arms and allow them to regraft - but that has required a higher degree of immobilization of the joints than is standard. Still, I have been using intermittent range-of-motion therapy and adjunct chemotherapies to maintain a degree of muscle tone..." Jemat, still hunched over Andile's bed, her hand still resting in his, looked back at Beverly - and smiled. "I was not criticizing, Doctor," he replied respectfully. "Indeed, I am not sure I would have been able to maintain this level of flexibility in the joint in one of my own patients in a similar condition. And, as you have surmised, the failure of the underlying tissue to lay down a pseudo-epidermis will minimize the trauma of any attempts to create a true epithelial layer; had a secondary layer begun to attach itself, we might have been faced with having to excise the flesh once more, and repeat the surgery that was performed on our ship. Considering the amount of time that ahs passed, and the fact that we were unable to complete her surgeries before she returned to your ship, I am quite pleased. When you feel she is stable enough to tolerate the procedure, we can perform the surgery to restore the outermost layer of flesh to her hands." Beverly stared at the Breen for a moment - then nodded, letting out a sigh of frustration and tension. "My apologies, Jemat. As much as I appreciate your opinion - and your expertise..." "It's difficult to not feel as though your work was being judged," he concluded for her. "I understand; I don't think there are many, human or Breen, who appreciate having someone second guess their decisions. "And that is not why I am here," he continued as he watched the last vestiges of tension fade from her face. "I offer the expertise and knowledge I have acquired - but to be used as you see fit. She is, after all, your patient, Doctor," he said. "She was yours, as well," Beverly countered sympathetically, knowing how difficult it was to relinquish the care of a patient to another physician. Jemat nodded, appreciating her understanding and turned back to his examination of Andile. "As was the captain," she added, somewhat more softly this time. Jemat glanced back at her - then returned to his examination. "He was," he agreed after a moment. "There is a slight increase in the amount of adipose tissue in the forearms," he murmured. "Actually, I'm rather happy about that, Jemat. Normally, a healthy human body carries a percentage of body weight as fat - but Andile had metabolized most of her body fat in recovering from her last... injury," Beverly murmured. Jemat nodded absently, turning over Andile's arm, studying the underside, then lay it back down again. "I am aware of the nature of her last...injury, Doctor - and of the physical and emotional sequelae. Perhaps more so than you are," he added, then fell silent for a time. "All that she is, Doctor, all that she was, is a part of us now," he informed her quietly, then let his hand drift down over Andile's arm, stopping as just before he reached the exposed muscles that surrounded her wrist. "There were scars here," he said quietly. "Yes," she answered softly. "I removed them," he said. Beverly nodded. For a moment the two were silent. "Are you aware of cause of the scars?" he asked at last. "I know they were self-inflicted," she answered obliquely. "Self-mutilation - but they were not suicide attempts." "No," Jemat agreed. "Andile are forbidden suicide. But they are not forbidden punishment. And she had to be punished - for living when the child did not; for killing the budling whose life she had sworn to protect. "She tried to cut off her own hands," Jemat said, almost angrily - though whether his anger was directed at Andile, or at Starfleet for their having sent her on the mission - or at himself for his people having placed Andile - albeit it indirectly - in the position she found herself, Beverly did not know. "She tried to cut them off, not once - but hundreds of times, always knowing she could never succeed, knowing she would fail - and try again, punishing herself over and over for her crime." "Her crime?" Beverly repeated, appalled. "Her crime," Jemat echoed, "her sin. She returned, whole and intact, when the child did not." Beverly shook her head. "She came back, Jemat, but she was neither whole nor intact," she countered softly. "There was no crime - but even if there had been, she's been punished enough for a hundred lifetimes." "We know that," he agreed. "But she does not. Repairing her body is one thing, Doctor; the harder task will be repairing her spirit." "If there is a spirit that can be repaired, Jemat," Beverly cautioned. "She was oxygen deprived long enough that there was significant brain damage. Even if her brain can physically heal, those areas will have lost their function. She'll have to re-learn tasks - from simple to complex - but, given time, that can be accomplished. What can't be re-learned, Jemat, are the memories that were lost. When those areas of the brain were lost, so were the memories." She sighed thoughtfully. "And perhaps that will be for the best: if she can't remember the painful episodes..." "An hour ago, you questioned my people's ethics, Doctor," he reminded her. "Would those some ethics you touted so readily permit you to pick and choose what aspects of a person's life you would return to them, given the choice?" he asked pointedly. "To spare her pain..." Beverly began. "Sometimes, Doctor, our work requires us to hurt our patients, to cause them pain, that we might, in the end, achieve a greater good. Would you opt not to perform a surgery, knowing that if you did the procedure, the recovery would be painful - but knowing that, in the end, the patient's life would be spared?" "It is not the same thing, Jemat," she argued. "Andile... Garave... the lieutenant," she finally decided, "would be alive either way..." "Would she?" he interrupted. "Her body would survive, yes - but the woman, the spiritual being might not. We are the totality of our life's experiences, Doctor; what we said and did and felt - what we cherished - and what we regretted - all these things make us who we are. All Garave's experiences made her who she is - both for good and ill; would you take that away from her, would you risk changing the person she was, even to spare her pain?" he asked. "Would you want someone to do that to you?" he added softly. "_For_ you?" Beverly studied the alien for a long moment - then shook her head. "No," she conceded. "But as a physician, as a human, as a compassionate being, how can I permit her to return to this... this self-induced hell?" she asked, her eyes locked on the woman's wrist. "You must," he said softly. "For now, at least. She must find her path - as you must find yours," he added. "As we all must find our own way." Beverly looked at him, hearing the silent message in his words, finding herself tempted to pursue them - then stopped herself, stopped the flicker of hope that sparked in her soul. No, she told herself. Not this time. Not again. Never again. "If she can find her way," Beverly countered ominously, "To be blunt, Jemat, I'm not sure that's possible. Her condition is stable..." He nodded, giving a very human sigh. "... but that is all, yes?" Beverly drew a deep breath - then let it out in exasperation. "Yes. She progressed wonderfully the first few days after we placed the lines into the cerebral cortex - then she plateaued out. There's been progress since then - but it's been minimal at best," she admitted. "Given her genetic make-up, I had expected to see the same healing patterns now as we had seen earlier - rapid wound closure, quick tissue regeneration - and yet it's not happening. She's making no progress - and I'm at a loss to explain it, let alone to reverse it," she admitted. Jemat pursed his lips, the human facial expression oddly out of place of the Breen's near lip-less face - but the intent unmistakable to Beverly. He too was perplexed. "Rapid healing is to be expected from one of the genes that was transplanted to all of our subject groups," he agreed. "There are only two biological limitations to that effect..." "I know," Beverly interrupted. "Malnutrition and neurotransmitter insufficiency. I've tried to monitor her nutritional status since she came back, especially in light of having had to resect her bowel. I've kept a very close eye on her nutrient balance in order to ensure that she's receiving - and absorbing - the necessary proteins required for the healing process to occur. The balance and absorption are as good as I could hope - but the healing is not," she said. "Liver damage?" Jemat tried. "That could affect the protein levels..." She shook her head. "Liver function is still slightly depressed from her previous injuries - but it's higher than it was when she just before the accident - and her healing rate was remarkable then," she countered. "As it was - briefly - after we began the infusions of the neurotransmitters. Damn it, she's getting a continuous influx of everything she needs - and it's having no effect!" she muttered in frustration. "Perhaps the balance of the transmitters...?" Jemat began. Beverly shook her head again. "No. I've maintained the same proportions that were in the samples of cerebral-spinal fluid we extracted prior to the... incident; the infusions worked prior to the accident and during the surgery - but since then, they've been almost completely ineffective." Jemat considered for a long time, then looked at her. "Some Breen neurotransmitters have different ion suffixes than the human forms of those same transmitters," he said. "Perhaps the infusions worked at first because they filled an immediate need - but as her body accustoms itself to the presence of the transmitter, it requires a more specific chemical match to her receptor site. If so, we may be able to replicate the appropriate transmitters from our pharmacoligcal replicator files," he suggested. "May I see her transmitter profile - and the molecular configurations of the transmitters she is receiving?" he asked. Beverly nodded, then turned to the terminal in Andile's room. A moment later, the two pieces of data were displayed on the screen. "Hmm..." the Breen mused. "A carbonate ion here, where there would be a sulfate ion in the same chemical in a Breen brain... but that should not account for the difference in the two transmitters. Not if it worked before..." He considered for a few more minutes - then looked at Beverly. "The dialysis, perhaps? A change in her kidney function..." Beverly shook her head, negating the idea. "I considered that idea - and dismissed it. Jemat, I've found almost nothing that's changed since we began the therapy - except the results," she protested. Jemat considered. "Perhaps the therapy itself is responsible for the change," he said at last. "The increase in mental processing may be affecting the balance in the available neurotransmitters. If you were to analyze the fluid in the ventricle..." "Not possible," she said flatly. "The tritanium in her skull blocks the medical scanners - and when the scanners are remodulated to allow for the presence of the tritanium, the readouts are, at best, imprecise." "Then an analysis of the fluid itself," he countered. She drew in a long breath. "That's a surgical procedure, Jemat - and a dangerous one, given Andile's... Garave's... condition. It could kill her." "And it could save her," he countered - then looked at Beverly. "Doctor, I know we can regenerate the tissue of her left hand, restore much of the function to the limb. I also believe that we can induce the regrowth of the vascular tissue that would allow you to reattach her right arm. But without the certain knowledge that she can heal from those injuries, there is no point in attempting to do so. I will not cause a patient pain - not without there being at least some chance of recovery - not even for the sake of the survival of my people," he said bluntly. Beverly studied the alien for a long time - then touched her commbadge. "Alyssa, prepare the OR - and let's prep Biji for surgery. We're going back in." The chimes to his room rang out, once, twice, then a third time before the fact that they were ringing found its way into his unconscious mind. It took a fourth repetition of the chime, however, before he could wake himself enough to rise from the bed, calling out, "One moment," as he reached for the familiar blue and white-striped robe that lay draped over a nearby chair - and a fifth repetition before he could wake sufficiently to successfully pull the robe over his sleeping clothes. "One moment! Computer - lights!" he called out again as he fumbled with the belt - but the caller, whoever it was, apparently was in no mood for patience. The door chimed a sixth time - and most likely would have chimed a seventh if Picard had not finally called out in frustration and mounting anger, "Enter!" The door had barely opened when he began to add, "What the hell is so damned important..." when Beverly pushed her way into the room. "Beverly?" he asked, confused by her unexpected appearance, his wrath fading instantly. "It's two in the morning," he began to add, only to be interrupted by the physician. "We have a problem," she said bluntly - and he realized a moment later, quite angrily. He stared at her for a moment, fatigue and confusion lingering for a moment - then turned walked to the replicator. "Tea, Earl Grey - hot," he said quietly. He waited a moment for brew to appear, then took a long sip, feeling the heat of the tea travel down his throat and settle in his stomach before turning to face her once again. "What kind of a problem?" he said at last. She shoved the padd in her hands at him. "Someone's trying to kill Biji. I think," she added a moment later, a little less certainly this time. "Or maybe not kill her, but keep her from recovering. Or maybe they're trying to kill us all... Or... " She shook her head, then raised a hand to her temple rubbing at it. "Or maybe it's just another computer problem," she admitted wearily. "I don't know. I... I'm sorry," she finally said. "I shouldn't have come here. I just didn't know who else I could talk to, who else I could trust," she said softly, shaking her head. For a moment, Picard studied the woman - then reached out for her arm, guiding her toward the couch, gently pushing her into its depths before returning to the replicator. "Here," he said a few seconds later, pushing a second cup and saucer filled with steaming tea into her hands, then settled himself into the opposite end of the sofa, watching as she took a sip of the strong brew - then gave a long sigh. "Better?" he asked softly. She nodded - then opened her eyes and looked at him, a hint of embarrassment coloring her cheeks. Which needed color, he thought to himself; she looked awful, her complexion grey, her eyes dark with exhaustion... She looks, he decided, like I feel. No surprise there, he added; her day had been as long as his... longer, he amended, realizing he had gone to bed almost an hour ago - while she was obviously still working. At what, however, he had no idea. "You think someone is trying to kill the lieutenant?" he repeated. Beverly hesitated - then shook her head. "No. Maybe. Damn it, Jean-Luc, I don't know," she admitted. "All right," he said calmly, "then let's start with what you _do_ know. And that is...?" he prompted. "At Jemat's suggestion, we extracted several milliliters of fluid from Andile's ventricle this afternoon. She has not been recuperating as we hoped..." Picard nodded sympathetically. "I know; I've read your reports..." "And we agreed that the only possibility left to investigate was to examine the fluid from her brain to see if there was some indication as to why she's not recuperating. An imbalance in the neurotransmitters, perhaps an infection, receptor site blockage... There were dozens of possibilities that could have explained it," she said. "The one I never anticipated however, was the one I found." "And that was...?" "I spent the last eight hours studying the fluid from Andile's brain, Jean-Luc. The balance is correct, the chemical composition is correct..." "But...?" he prompted. "The conformations are wrong," she said quietly. He raised a brow at the revelations - then gave a vague nod. "Indeed," he murmured. "The conformations." It took her a moment to realize the significance of the information was not as self evident to him as it was to her. "All drugs," she explained quietly, "rely on two components to function in the body: chemical composition - and conformation. Structure. Not only must the drug contain the correct atoms in the correct quantities and correct organizational arrangement - but they must be shaped correctly as well. Shaped correctly, the drug works. Reverse the shape - make a mirror image of the drug .." She shook her head. "...and the drug doesn't work. Worse, the results can be devastating - or fatal. "Chemically, the neurotransmitters that we've given Andile are perfect - but the organizational structure within the molecules themselves are mirror images of what they are supposed to be - and as such, they simply don't work." "But... I saw the effect during surgery! They were working..." he protested gently. "Yes, they were," she said, emphasizing the last word slightly. "But something has happened to change that," he murmured understanding registering. She nodded. He sipped his tea, thinking, then looked at her. "You said that her brain deconstructs the neurotransmitters, then reforms them," he reminded her. "All human brains do that," she confirmed. "Then couldn't this simply be a matter of her brain breaking down the transmitters you gave her and reforming them?" he asked. "It could - but we would have seen the left-handed conformations in her CSF the first time we extracted a sample," she countered. "But you said she'd experienced brain damage," he countered. "Couldn't that have caused her brain to..." He stopped in mid-sentence as Beverly shook her head. "The process of catabolism and reconstruction is genetic in nature, Jean-Luc; to see this sort of change from within her body, she would have had to have had her entire genetic structure altered at the cellular level. I don't know that it could be done on this level - not without killing her - and certainly not since she's been returned to the ship. No, I think we have to face one of two possibilities - neither of which is good. "One: there is still a problem with the replicator system..." Picard shook his head. "Geordi and Data have checked the system thoroughly," he reminded her. "They checked it after the discovery of the sabotage," she corrected. "Not since - and since we know the neurotransmitters we gave Biji were functioning correctly in those first few days, we know the replicators were also functioning correctly... then. But now?" Picard gave her a hard look. "Sabotage? You think we may have had another event in the interim?" he asked worriedly. "That's one possibility," Beverly said. "Meaning we may still have a saboteur aboard," he concluded grimly. "Possibly - but what are the chances that a saboteur would allow the same type of replicator error to announce his - or her presence - twice?" she asked him. "Unlikely," he concurred after a moment's thought. "Sandra James may have made that mistake the first time - but if there is a second saboteur aboard, he or she would have known better than to repeat the error. Of course, if it was only affecting the pharmacological replicator in Sickbay, the saboteur might not have known..." Beverly frowned. "Jean-Luc, the Sickbay replicators are the most accurate, most carefully protected replicators on the ship; there are more safeties, more internal double and triple checks on that piece of equipment than on any other on the ship - and for good reason: one error, one misaligned component in a medical device, one atom missing - or one too many..." "One incorrect conformation," he said, understanding at last. "... and my patients could die - or worse." He studied her for a long moment, his eyes narrowing with concern. "Then you think the neurotransmitter wasn't malformed by accident," he said. "The odds are almost inconceivable. No; it was done deliberately, not to sabotage the ship or the crew - but specifically to hurt - or maybe even kill, Biji," she replied. "Someone intentionally programmed the replicator to reverse the conformation on some - but not all of Andile's neurotransmitters. Enough to harm her - but not enough to be self-evident. The problem is that I don't know who - or why," she conceded. "The why can be inferred," he countered. "There are more than a few people who would prefer that the lieutenant - and what she knows, what she's experienced - never see the light of day. Permanent incapacitation might be preferable to her dying, since it could be explained away by her injuries - whereas her death would require an autopsy - but either might suffice, as long as, in the end, what she knows remains locked in her mind. As for the who, however..." His voice trailed off. Beverly nodded grimly. "I know. She's been in Sickbay for weeks - and there have been dozens - maybe even a hundred or more - people in and out of there. Any one of them could have made the alteration to the program..." "But wouldn't they have needed the specialized knowledge of what to do, what changes to make in the neurotransmitters?" Picard countered. "You mean, wouldn't it have had to be one of my medical team?" she asked. He hesitated, reluctant to confirm her worst fear - then nodded. "Yes." "I hate to think it was one of them, Jean-Luc," she replied miserably. "I hate to think that there's one of them who I can't trust - but, yes, it's possible. Probable, even - but it's not absolute. With the computer's security systems damaged, almost anyone could have had access to Andile's medical records; it wouldn't take a genius to figure out what we've been trying to do for her - and how to affect that regimen. Someone - an engineer, for example, could have made the changes in the replicator program - God knows there were enough engineers coming in and out of Sickbay when Geordi was constructing her room to have made the change without us noticing it - and my medical staff would be administering the affected transmitter to Andile without ever knowing we were doing it. "Unfortunately, the replicator records are tied in to the same areas of the computer that records other information; I have no record of who made the change in the program - or when," she conceded. "All I know is that they had to have done it at the Sickbay terminal - but as I said, that could be almost anyone who has passed through in the last few weeks." "So it could be anyone," Picard agreed quietly. She nodded. "Anyone," she echoed - then bit her lip, tears welling in her eyes. "One of my team, one of my friends... Jean-Luc, I don't know who I can trust any more," she said. Picard studied her for a moment - the reached for the tea cup, taking it away, setting it on the low coffee table - then taking her hands in his. He ran his thumb over the soft flesh of her hand for a moment, savoring the familiar touch - then stopped and met her eyes. "Thank you, then, for trusting me, Beverly," he said softly. She looked back - then turned her eyes down to where their hands were joined - and gently withdrew from his touch before looking up once again. "You're the ship's captain," she reminded him - not coldly, but distantly. "If we can't trust in you, then we're all dead," she said. He froze at her words - then forced himself to nod in agreement. "Yes. Of course," he replied - then rose from the couch. "As her physician, how do you suggest we address the lieutenant's medical needs from this point forward? Can she recover from what has been done to her?" "I don't know," she admitted. "I don't know that she can recover at all, let alone what the effects of the infusions of altered transmitters will be. If they've simply blocked the function of the other transmitters, then, in theory, her condition should reverse, and she should - in time - begin to recover once again. If they've damaged her brain further however..." Her voice trailed off. "What I do know," she continued a moment later, "is that it won't continue. I've already deleted the incorrect neurotransmitters and blocked their re-introduction to the system; if anyone attempts to alter any of the other neurotransmitters, I'll know about it," she replied, her voice growing firm as her emotions faded. "It won't stop someone from trying the same thing with other drugs, however - which means that only I can be responsible for ordering the drugs Andile is to receive - and even then, I'm going to have to test them for purity and potency." "I understand," he agreed. "However, you can't be responsible for watching over her around the clock, Doctor," he reminded her. "I know," she agreed, having already considered that possibility - and dismissed it as impractical - and dangerous, both to Andile's safety and to her own health. "Then we're going to have to trust in someone else," he continued - then sighed. "And while Data would be the optimum candidate, I can not afford to have him away from his duties indefinitely," he informed her. "I know," she agreed. "and I wouldn't want him - or anyone - there constantly. Working with someone who is so ill, so unresponsive to all our efforts as Andile is, is emotionally debilitating. It takes its toll on those of us who are prepared for it . For Data, for anyone whose emotions are still so new, so undeveloped, such prolonged contact could be unhealthy, perhaps even dangerous. "No, I was going to suggest limiting Data - and myself - to one shift per day, each." "And the third shift, Doctor?" Picard pressed, "I was going to suggest... Worf," she said quietly. Picard raised a brow in surprise. "Worf?" he echoed - then considered the suggestion. "I'll agree he can be trusted, but.." he mused. "Trust has nothing to do with it, Jean-Luc." "No?" he replied, surprised again. "Then what?" "Honor," Beverly replied. "Worf dishonored Andile. He insulted her, disparaged her, publicly damaged her credibility - and he was wrong," she added, her voice so cool, so bitter, that, for a moment, Picard was unsure if she was talking about the Klingon - or about someone else who had dishonored - unjustly - a loyal crewman. For a moment, there was a heavy silence between the two - then Beverly spoke again. "Now his honor demands that he do something to correct his offense - and putting him on guard duty over her would go a long way toward doing so," she explained. "He would die before allowing her to come to harm - and it would keep her safe," she added, almost as an afterthought. Picard studied her for a long moment - then nodded. "Make it so, Doctor," he agreed, then rose to his feet, tightening the belt to his robe, and moving toward the door. "You will, of course, keep me informed of the lieutenant's status?" Taking the less than subtle hint, Beverly rose as well, following him. "Of course, Captain. You'll speak with Worf?" "In the morning," he agreed. "Fine, I'll stay with Andile for the time being - until we can get a schedule arranged," she added. "Good," he said - then touched the actuator pad on the door frame. The door slid open, and Beverly looked out at the hall - then turned back to Picard, her eyes seeking his - and finding them. For a moment, they both hesitated, searching for something in the other's expression, seeking out... What? Beverly asked herself. Hope, she answered herself - then turned away, knowing hope was a thing of her past. Still, she hesitated before she stepped through the door, looking back at him one more time. "Thank you... Captain," she said softly. "You're welcome... Doctor," he replied, then watched the door slide shut as she entered the hallway. He watched the door for a few minutes, just he had done once before, when she had walked out of his life that night a few years before - then he too, turned away. -- Stephen Ratliff ASC Awards Tech Support http://www.trekiverse.us/ASCAwards/commenting/ No Tribbles were harmed in the running of these Awards ASCL is a stories-only list, no discussion. Comments and feedback should be directed to alt.startrek .creative or directly to the author. Yahoo! Groups Links To visit your group on the web, go to: http://groups.yahoo.com/group/ASCL/ To unsubscribe from this group, send an email to: ASCL-unsubscribe@yahoogroups.com Your use of Yahoo! Groups is subject to: http://docs.yahoo.com/info/terms/ From ???@??? 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