She wasn't sure how much more she could take of this.

Doctor Lelania Tigan closed her eyes and sunk deeper into her chair, her looped ponytail riding up and around her nape as she surrendered herself to the soft embrace of the cushioned armrests. After thirty-six consecutive hours of triage, patient consultations and back-to-back surgeries, she welcomed the respite afforded to her by the dimmed lights and electrochromic windows of her office in sickbay. To say that her shift had been draining, both physically and emotionally, would be a gross understatement.

Like any other Starfleet physician, she was no stranger to pain and suffering. From her first, abrupt deployment as a freshly-graduated premed in the aftermath of the Battle of Korvat, to the firestorms on Terra Nova and the viral epidemic on Krana III, she had always found herself thrown right into the center of the action. She'd held the hands of many young officers succumbing to battlefield injuries, offered soothing words to salve the pain of patients, and snatched countless lives from the jaws of death with little more than a scavenged medkit.

Yet none of this had prepared her for the Iconian War.

She remembered how, as the Iconians cut a swath of unrelenting destruction throughout countless worlds, the Odyssey's sickbay had been flooded with wave after wave of casualties - refugees fleeing from forsaken homeworlds, along with the ragged and dispirited troops that evacuated them. Every waking moment, every corner she turned, she was surrounded by despondent figures huddled against bulkheads, as anguished cries for help and the scent of burnt blood lingered in the air. Hands would reach out and tug desperately at her trousers and sleeves, until eventually falling limp and slipping away.

And for the first time in her life, she had felt truly helpless.

For every patient she and her staff brought back from the brink, several more would be silently carried past them covered in sheets. It was as if she herself was drowning in the sea of misery, with every life she fought for a labored breath or a desperate thrash to stay afloat.

What had affected her the most was seeing the bodies fill the cargo bays, set up as temporary morgues. Some were accompanied by surviving family, inconsolably clutching and rocking them, while others remained unmourned and forgotten. Every corpse that came through the door was a bitter reminder of the consequences of failure, tide after tide pounding against her sanity.

Then one day, she snapped.

For one shift, she stopped being Doctor Lelania Tigan the compassionate healer, but instead became Doctor Lelania Tigan the automaton - mechanically hypospraying, cutting, regenerating, hypospraying, cutting, regenerating, hypospraying, cutting, regenerating - mentally blocking everything else out to cope with the task at hand.

And when she had woken from her haze, she was so horrified with what she let herself become, she had collapsed in the privacy of her office, surrounded by a pool of her own tears, sweat and vomit.

One would have been forgiven if they believed Tigan's ordeal ended the moment the Iconians agreed to withdraw in exchange for Captain Zhang returning to them their long-lost World Heart. In retrospect, the Trill doctor mused, those who lost their homes or died during the war were the lucky ones.

Because as it were, what the Iconians did not outright destroy, they devastated beyond any hope of recovery. Entire planets doomed to slow, agonizing deaths from catastrophic ecological collapse and tectonic disintegration, as once-vibrant cities and communities became little more than crumbling graveyards for the half-living, despite Starfleet's best post-war relief efforts.

As she struggled to come to terms with the perpetual tides of suffering, a single sentence emerged in her mind.

A small rock holds back a great wave.

It was the motto on the ship's plaque, which the captain had shown her over five years ago when she first came aboard in preparation for the shakedown cruise.

"Perhaps our little ship may be all it takes to stem the tide," he had encouragingly noted. "As long as I'm in the chair and you hold the scalpel in your hand, we can make a difference."

Looking back now, she wondered what difference, if any, the lives she saved throughout her career were compared to the countless victims of the war. For all she knew, a life spared today might regardless be taken tomorrow-

"Barber to Sickbay," a woman's voice from her combadge interrupted her unhappy thoughts.

"This is Tigan," she squirmed before answering. "Go ahead."

The voice softened. "Hey."

"Hey."

"You okay?"

"Y-Yeah," the doctor turned up the lights. "Is there something wrong?"

"Oh, no no, just wondering when you're coming up for dinner. Wednesday nights are Girls Nights, remember?"

"You and Mirra can get started without me. I'll be running a little late finishing off today's casualty reports."

"Lelania, you've been practically living out of that office for almost two days straight now. The Captain's not going to bite your head off if you leave it until tomorrow," Barber reassured her. "Besides, it's your birthday. You need the break."

Tigan chuckled. How ironic that, of all people, it was Tactical Officer Christine Barber, the paragon of punctuality, responsibility and straightening crooked rank pips, who was suggesting she put something off until later. That being said, she did have a point.

"I'm on my way."

=Λ=

Shift changes typically involved a frenzy of crew weaving past each other on their way to duty stations, meals or recreation, but as Tigan stepped out the turbolift doors, she couldn't help but notice that the corridors were unusually deserted this evening.

To be fair, with the Odyssey on its way back to Earth after concluding its latest relief mission, many departments were now operating under a reduced duty shift schedule. Still, there should have been at the very least a security team making their rounds around this time of day, or the two Bynars from Engineering performing their daily inspection of the ODN main trunk panel near the mess hall.

Speaking of the mess hall, she wondered as she entered if Ktarian chocolate puff would go well with Trill Grakizh salad and Chicken Chou Farci. Or perhaps she should skip dessert altogether, considering that something so rich and heavy might not be conducive to late-night report writing-

"Happy Birthday!"

Tigan's heart skipped a beat.

Waiting inside were dozens of officers and crewmen, raising their champagne flutes to her. Cheering, clapping and whistling followed.

"Oh my gosh, you guys!" she choked, still trying to catch her breath and not keel over amidst the excitement. Steadying herself with a hand on a nearby mess table, she turned to accept a tall glass from a brunette with a stripe of Tactical Red across her uniform. "No wonder you were so adamant that I came to dinner!"

"We weren't going to wait around all night, you know," Barber quipped. "Mirra's been bouncing off the walls since this afternoon-"

"LELANIAAA!" Security Chief Shran leapt out from behind them and squeezed the Trill doctor a very enthusiastic hug. "I made you Chocolate Liqueur Cake!"

"Jeez, calm down," the tactical officer reprimanded her. "You almost spilled your drink all over her."

"That won't be a problem," Shran winked mischievously, before downing all the champagne in her glass while keeping her arms around Tigan. Several junior officers immediately burst into laughter.

"Typical Mirra," Barber rolled her eyes. "And you made me eat all the failed ones, too!"

"Christine, you're sooo mean. Those were taste tests!" the blue-skinned minx pouted as she let go of the doctor. "Besides, you know Andorians can't eat chocolate," she added, while miming a choking gesture with a silly gagging noise.

Tigan giggled as the two women continued their exchange. Sweet, playful Mirra and assertive, sensible Christine, polar opposites to each other, and yet somehow the three of them had grown into inseparable friends throughout their time aboard the Odyssey. They'd celebrated each other's triumphs, lent sympathetic shoulders to cry on and drew strength from each other through thick and thin. Just seeing them right here was enough to make her put aside her troubles, if only for a brief moment.

Amidst the spectacle, a Cardassian man in Sciences Blue politely but eagerly approached with a thin parcel. "Many happy returns, dear doctor!"

"Thanks Corat!" the doctor beamed, recognizing the smooth, effeminate voice of Science Officer Remara. "Is it alright if I open it right here?"

With Remara gently tipping his head to the side in approval, Tigan carefully unfolded the precisely-creased wrapping paper and foam padding, leaving behind a plain cream-colored rectangular board with a thin black frame. The doctor stared at it briefly in confusion, before sheepishly flipping it the right way around to reveal its true nature - a candid charcoal sketch of herself reviewing a PADD in sickbay, whilst her staff went about their business in the background. A fleeting moment in time, captured through the harmonious interplay of ragged lines and subtle shading, creating indistinct yet recognizable forms.

"Oh, this is wonderful!"

She showed it to the others, eliciting a murmur of approval.

"I thought you only did landscapes, Remara," Barber leaned in to study the drawing more closely.

"A small experiment in new genres," the Cardassian grinned broadly. "Commander Barber, I understand you have been exploring various subjects in your oil paintings as well. Perhaps you would be interested in joining me in a study of humanoid forms and figures sometime in the future?"

"No, thank you," the brunette took an indifferent sip from her flute. "What I paint is my own business."

"But of course," Remara dipped his head again in a manner akin to a shrug, then turned to a colleague. "I do believe you're next in line, Commander Ong."

"What's up, Doc," the mop-topped Operations Officer greeted Tigan with a friendly hug.

"Geoff! I'm so sorry I haven't caught up with you in ages," she squeezed him in return. "It's been crazy stressful these past few months. I should've dropped by to say hello yesterday, but my whole department got blindsided by a new batch of patients."

"Naw, it's alright. Here, this'll cheer you up."

The doctor gingerly accepted a baton-like cylinder, and after a small fumble, unscrewed what turned out to be a cap of some sort and tapped the other end gently. To her bemusement, nothing happened.

"Um, is there supposed to be something inside?" she wondered as she held the opening up against one eye, when her face suddenly burst with joy. "Zal'relodh! You got me a zal'relodh! I had one of these when I was a little girl!"

"A zal-whatsit?"

"It's a childrens' novelty from Trill, that you look inside and see colored patterns change as you turn the tube," Tigan rolled it between her fingers. "But how did you get one all the way from the homeworld?"

"Actually, this is an Earth toy called a kaleidoscope," Ong explained. "But it sounds like it's more or less the same thing."

"Such a pretty name. And it's beautiful, too - it's like a nebula dancing in a sea of stars," the doctor glowed and drew him into another hug. "Thank you so much!"

"Anytime, Doc."

She then noticed a Caitian security officer fidgeting behind the Ops Officer. "Ensign F'ris? Are you okay?"

"Hey Doc," the felinoid handed her a PADD. "Thought you'd appreciate this."

Once Tigan finished reading, she had to suppress her laughter with a not-quite-exasperated sigh. "Really, F'ris? A promise to not eat cheeseburgers for a whole week?"

As farcical oohs erupted from the junior officer cadre, the ensign shrugged. "Actually, that was Chavek's idea-"

"Unbelievable! Throwing me under the shuttle!" His Romulan colleague, feigning offense, sought sympathy from the others.

"Serves you right, snail-eater," F'ris quipped back, before producing a small flat wooden chest from behind his back. "I think you'll find this more to your liking."

Tigan ran her fingers over the varnished surface, tracing the unfamiliar logo embossed on top. When she released the latches and opened the lid, she was greeted by a symphony of herbal fragrances emanating from nine small metal tins inside, gently caressing her.

"Ooh, this is lovely."

"Nepeta Tea Leaves from my uncle's plantation," the Caitian explained. "This blend here is great for winding down after long shifts, and this minty one works really well with chocolate - or so I've been told, anyway."

"Very thoughtful of you, F'ris," the doctor opened one of the tins briefly to savor more of the minty flavor.

"Least I could do for a doctor who's put up with a hypochondriac for this long."

"Recovering hypochondriac," she reassured him with a friendly rub to the shoulder. At this, a murmur of awws filled the room, and Chavek gave his Caitian friend an encouraging pat on the back as well.

And so for the next thirty minutes, Tigan continued working her way through the rest of her presents - a day spa reservation from First Officer Richardson and Counselor McGill, a rabbit plushie wearing miniature Medical Blues from Barber ("How adorable!") and a levitating crystal mood lamp from Chief Engineer K'vov, among other things. With the unwrapping of each gift came not only the joy and excitement of receiving mementos to mark today's occasion, but also the pleasant discovery of new facets to her friends and colleagues that she would otherwise never have known.

They, too, were enjoying each reveal as much as she was, punctuated by merrymaking, laughter and the occasional witty remark. It went without saying that this party was for them as much as it was for her, especially with the tipsy and hilariously off-key rendition of For She's A Jolly Good Fellow by Transporter Chief Andrews, Assistant Chief Engineer V'ruk and Botanist Akorem. For that moment, there were no ranks, chains of command or responsibilities.

Responsibility.

The word silently stung Tigan at the back of her mind, each syllable laced with guilt. Light-years away, entire planets of people were dying by the hundreds of thousands, and yet here they were, enjoying themselves without a care in the world. Even when it favored her, life was still unfair.

She sighed as she caught a glimpse of Ong helping Shran and Barber lay out the desserts on the buffet table nearby. With everything that must have gone into making this party for her happen, the least could do was try to be happy for everyone's sake.

Tink tink tink.

"May I have everyone's attention, please?"

Everyone turned to see Captain Zhang holding a spoon near the side of his champagne flute. Satisfied that he had their undivided attention, he lowered the cutlery.

"Twelve years ago, a nurse fresh out of the Academy saved the life of a young ensign, the woman who would go on to become our tactical officer and my partner," the Captain began. "It was through Lieutenant Commander Barber's recommendation that we bought her friend on as Chief Medical Officer, and since then she has touched countless lives with her professionalism and compassion."

"Tonight, we not only celebrate Doctor Lelania Tigan's thirty-third birthday, but also express our deepest appreciation for her six years' of dedication to the Odyssey family." He rose his glass. "To Doctor Tigan."

"To Doctor Tigan," the crew chorused.

"And so," the captain continued, "it is my pleasure tonight to present a special performance by one of the Federation's most critically-acclaimed young concert musician duos. A virtuoso pianist prodigy with an unparalleled talent for perfection, together with an unorthodox violinist who breathes new life into classical pieces. From their lauded debut in the 2407 Towa Classical Music Gala in Tokyo, to standing ovations at the Federation Presidential Concert in Paris and the New Jalanda Forum Memorial Series on Bajor, they have captivated the hearts and minds of countless audiences throughout the Alpha and Beta Quadrants."

"Ladies and gentlemen, androgynous and non-binary gendered individuals, please welcome Mister Kousei Arima and Miss Kaori Miyazono."

On cue, a man and a woman quietly stepped before a grand piano that had somehow been near the far wall of the mess hall the entire time, and gently bowed to polite applause.

The dark-haired and bespectacled pianist sat down before the keyboard, his deep blue suit and plain tie barely creasing as he settled in. Tigan was no empath, yet she could sense in him a calm, reserved politeness, behind which hid an introspective passion.

In contrast, the violinist could not be any more different from her partner. Vibrant and energetic, with a passionate twinkle in her eyes and cascading waves of golden waist-length tresses adorned with a single cherry blossom hairclip. A simple yet opulent white dress draped softly against her body, barely revealing her bare feet.

Sharing a brief yet longing glance at each other, both musicians took a deep breath and whispered an inaudible prayer.

With firm but gentle fingers, the pianist opened with a simple melody, soft and pleasing to the ears. Slowly but surely he wove in a chord or two, the sound resonating throughout the room as the ship's crew fell silent, transfixed. Even the playful weaving of Shran's head antennae stopped.

At that moment, Tigan felt the room change.

Somehow, the duranium bulkheads and panoramic viewports of the mess hall began to fade away, like the early mists of dawn. The next thing she knew, she found herself standing along the powdery white shorelines of a lake in winter, the tranquil waters as smooth as a mirror, surrounded by walls of snow-dusted spruces.

Steady notes from the piano continued to fill the air, glistening like snowflake crystals, beautiful yet sterile. It felt as if the pianist was merely channeling the pure, unadulterated will of the composer like an automation stepping through its motions. Artificial emotions in a world of monochrome, white as the snow, grey as the skies and black as the looming clouds.

All this time, Tigan had not noticed the growing darkness, until eventually all that was left in the world was just her and pianist, slowly consumed by a spectre of muted despair while still soldiering on to the beat of a phantom metronome. The timbre gradually became more and more subdued, evoking a sensation of slowly drowning deep in the depths of the lake, the last glimmers of the surface having long faded into oblivion.

Then, a spark of color.

With a deft draw of her bow, the violinist began her accompaniment, each light and joyful shrill spreading ripples across the surface of the water as rays of light pierced through to the darkness down below. The golden slivers scattered into glowing specks, shimmering against the black void as they floated and danced softly around the pianist. As one drifted towards him, he lifted a hesitant hand from the keyboard and reached towards it - yet to the doctor's amazement, music from the piano continued to flow as the keys moved of their own accord.

The moment the pianist's fingers touched the speck, it exploded in a swirl of pink, stirring a gentle and refreshing breeze that washed over them. Darkness gave way to light, and the specks transformed into cherry blossom petals fluttering and tumbling in the wind, as the gloom of the deep waters segued into the warm pastels of a park in springtime.

Finding herself beneath a canopy of pink flowers, Tigan turned to see two figures in the distance - a free-spirited schoolgirl beckoning a reluctant schoolboy to join her on a journey to a world of color, every step the girl took an innocent and delightful skip. Likewise, the bright and delicate strokes of the violin dominated the piece, daring the pianist to break free from the clinical prescription of the sheet music - and instead, to soak in the gentle sunlight, to listen to the soft rustling of the flowery branches, to savor the fragrance of the petals.

As she followed the two further along the footpath, the melody from the piano slowly began taking on a crisp lightness, notes ringing clear and free, soaring up with the pigeons in the sky. At the same time, clustered patches of white, gold and lavender bloomed all over the verdant ground, explosions of color blossoming with each draw of the violinist's bow.

Gradually, the blankets of pink high up in the treetops dissolved into lush green foliage, and Tigan crossed the threshold into summer.

There, within a golden sea of sunflowers, she found the boy seated before a piano, fingers fluttering across the keys with intricate finesse. With each invigorating note, the yellow petals of the flowers would unfurl, turning towards him and basking in his aura of rediscovered joy and new-found confidence.

Not to be outdone, the girl played her violin with the energetic vigour of an impulsive barefooted dance in the fields of green and gold, as if goading her partner into a playful argument while competing for the doctor's attention. Hearing their mock quarrel, she laughed at how much it resembled the snarking between an old married couple.

Yet beneath the violinist's joyful melody, a tinge of hesitancy laced every stroke of her bow.

For a brief moment, Tigan thought she saw the sparkle in the girl's eyes flicker, carried away on a single tear in the breeze, seemingly hinting at a sense of sadness from shouldering a secret burden. Just as the droplet glistened, it disappeared in a flash, behind a flowing veil of flaxen silk bouncing softly to the violinist's twirling revelry.

Then, swept by the whirlwind of gold and white cavorting around the piano, the petals from the sunflowers came free, drifting and tumbling across the field towards the bottom of a riverbank, gleaming like fireflies against the star-studded night sky. As the two teenagers wandered their way through the tousled grass, the specks floated and ebbed to the soft strokes of violin strings and gentle caress of piano keys, constantly moving yet frozen in time.

Every now and then, the girl would pause to gently cup a glowing mote in the palm of her hand, letting it fly free after a longing moment shared with the boy by her side. The gentle silence between them spoke of an innocent tenderness, hidden yet emerging feelings.

With a sudden gust of wind, the scene transformed once again, to a sleepy suburb on a mid-autumn's afternoon.

Amidst a shower of falling amber and red, the boy ambled along the sidewalk, consumed in his thoughts, while the girl trailed behind him, a subtle limp in her legs as she tried to keep pace. In contrast to the warm and confident piano chords that now led the sonata, the hesitant undertones of the once-vibrant violin melody became strained quivering, imparting an air of dissonant harmony to the sonata as a whole. Yet the boy trudged onward, seemingly oblivious or even indifferent to the plight of the girl.

Or perhaps, from the way the tears streaked silently down his face, he was in desperate denial.

As the last of the leaves drifted to the ground, they shattered and crumbled, warm hues fading to white. Jagged tree branches, stripped bare of their foliage, clawed at the grey skies of a monochrome wasteland stretching as far as the eye could see.

Standing before Tigan now was a lone, eerie spectre of the girl who once was - rosy complexion washed away to a ghostly pallor, pale hair hanging limp without the waves of vitality, and a baggy hospital gown draped over frail limbs. A pair of eyes dulled with sadness gazed longingly back at the doctor.

Was I able to live inside someone's heart? the girl seemed to ask. Was I able to live inside your heart?

Then, drawing the last of her strength into trembling hands, she bought her violin to her chin. As one slow and graceful draw of her bow followed another, music poured forth, hauntingly beautiful cries of a bittersweet swan song in the midst of a relentless blizzard.

Just as the notes rose to a crescendo, a flash of recognition and hope lit across her face - the boy emerged in the distance, wading through the ankle, then knee-high snow towards her. She poured her entire essence into her instrument, the melody guiding him like a lighthouse reaching out to a wayward ship in the night.

The boy lunged to close the gap, and the girl released her grip on her bow to respond in kind. But her strength gave out and she collapsed just one step away, her fading form scattering to the four winds.

Tigan felt a sharp, aching tug in her heart as she watched the boy collapse on his knees, clawing through the sterile white powder in the futile hopes of bringing back the girl who once existed inside spring. Youthful fingers left meandering ridges and valleys in the ground, becoming shallow with his faltering heart. The sight of the boy's numb despair once again brought back memories of the traumatic wartime sickbay shift in the doctor's mind.

The notes of the piano had now regressed to despondent plodding, punctuated by the subdued cries and longing pulls from the violin. Two instruments, two hearts, separated by the threshold of day and night, light and darkness, life and death.

As the boy continued tracing his hands idly through the snow, a finger struck a piece of smooth ivory, then another. Broken from his trance, he brushed aside the blanket of flakes to reveal a set of flat monochrome levers, and found himself seated once more before the keyboard.

After what felt like an eternity of anguished trepidation, he knew what he had to do.

With a passionate sensuality like never before, he channeled his whole body and soul into the piano as he called out to the heavens through his melody of emotions - joy and gratitude for the memories shared with the girl, grief and longing for his loss. Fingers danced and fluttered across the keys with exquisite grace, each loving note and chord dedicated to her from every fiber of his being.

Little by little, patches of color flickered throughout the desolate landscape, each lingering longer than the last, before being swept away by the relentless blizzard. Nevertheless, he persisted, as he waged a terrible battle against the engulfing despair.

Suddenly, a silhouette appeared just beyond the horizon, fading in and out with the howling wind and snow. Another flicker, and the shadowy form became gold and white.

A surge of hope and determination flowed through Tigan. Reach her, she begged from the depths of her heart. Reach her!

The pianist must have heard the doctor, for at that instant the music began to transcend far beyond earthly conventions of notes, chords and melodies - and became hope itself.

Music is freedom!

Vanquished at last, the blizzard howled in defeated anger, before exploding into a swirling shower of cherry blossoms. The pink petals parted to make way for the girl stepping out into the blooming fields of color, reborn anew from the crucible of illness as her dreary hospital gown disintegrated to reveal pristine white voile, and her golden hair billowed in the breeze.

Spring had returned once more.

Her heart filled with boundless elation at their reunion, the violinist unleashed exuberant notes with a series of dainty strokes, as she twirled back to the pianist's side. He, in turn, loosened his tie with a deft tug of a thumb, joining his partner as they interwove their melodies into a duet celebrating their final triumph.

With a flourish of violin strings and the descending harmony of piano chords, the final coda drew to a close. In an instant, Tigan had returned the familiar surroundings of the Odyssey's mess hall.

As silence descended upon the audience, the musicians slowly turned, expectant faces so moist, it was impossible to tell where the perspiration ended and tears began.

Like a rolling wave, the crew erupted into thunderous applause, punctuated by rambunctious cheers and whistles from the enlisted. Those seated leapt right of their chairs with hardly a second thought.

"Magnificent!" Remara cried. "Most magnificent!"

The violinist rose her bow in gratitude, her face beaming, while the pianist was satisfied with a serene smile.

"That was Sonata of the Stars, an original composition by Kousei Arima and Kaori Miyazono," the captain announced once the noise died down. "And this brings us to the end of this evening's program. On behalf of the senior staff, I wish to thank all our guests for honoring Doctor Tigan with your presence tonight. Please feel free to partake in refreshments near the aft side of the room."

With this, the audience dispersed, breaking off into twos and threes as awe and praise remained on their lips all the way to the buffet tables. Tigan caught a glimpse of Shran beckoning her over to the desserts, and she gently waved back in acknowledgement. Manners dictated she do something else first.

The musicians had just finished packing up when the doctor approached them from behind. Sensing her presence, the violinist spun around mid-conversation with her partner.

"Mister Arima? Miss Miyazono?" Tigan called to them softly. "I wanted to express my deepest appreciation for taking the time out of your busy schedule to give us your wonderful performance tonight."

"It's our great pleasure," the violinist beamed. "Kousei and I-"

She hitched suddenly, as surprise flashed across her face. After a moment's hesitation, she finally found her voice again.

"I… should be the one thanking you," she stammered, a corner of her eye glistening with moisture as she slowly bowed. "T-truth be told, I wouldn't be alive today if it wasn't for you."

"...?"

=Λ=

Eight Years Ago

"Temperature three six point five, pulse one one seven, respiratory rate six, bee pee one five five over nine two. Cortical and neural levels nominal."

"Thank you, T'Pria," Tigan acknowledged, without taking her eyes from the laparoscopic display floating before her. She fiddled the waldoes in her fingers with the slightest of touches. "Coming up on the pericardium now."

"Looking good there, Lelania," Ra-Ghrovlitreii grinned from the other side of the operating table, a wisp of the Efrosian's facial hair curling with a twitch. "I've just passed tee eleven myself. Fairly tight in here."

"Well, she's only fourteen," a Bolian assistant surgeon beside them noted. "Poor thing, going under the scalpel at such a tender age."

The Trill doctor sighed in agreement. The pre-op briefings had described in excruciating detail the heartbreaking extent of the young girl's condition - an advanced, unusually aggressive case of Friedreich's Ataxia that ravaged the spinal nerves and burdened the heart with tachycardia, condemning her to a tragically shortened lifetime of pills, stumbling and wheelchairs. Despite the best efforts of doctors at Totsuhara University Hospital, the rapid progression of the autosomal disease meant that every surgical intervention were merely fingers plugging an inevitably weakening dike.

Until today.

Through a chance encounter with an acquaintance at a medical conference, Totsuhara's Doctor Ishikawa managed to pique Starfleet Medical's interest in the case, and successfully petitioned them to include the patient in the clinical trials of a new neurosurgical technique. While the best everyone could hope for was that the procedure would at least slow the degeneration, every extra year of life would buy a chance of a definitive cure eventually being found.

It somewhat bothered Tigan that neither she nor Ra-Ghrovlitreii - or quite frankly, anyone in their team - actually had the chance to meet the girl in person before the latter was wheeled unconscious into the theatre. "Double-blind testing", "practitioner bias" and "emotional over-involvement", the oversight committee had justified, going as far as stripping the child of the dignity of her name with the designation Patient Epsilon-41.

The one thing she did know about the girl was that she had unhesitatingly agreed to the experimental surgery when it was first offered to her, despite her family's reservations. And if there was any truth to the hushed whispers of the grapevine, apparently the girl was adamant on fulfilling some sort of promise.

But now was not the time for distractions.

As she recalled from the briefing, Ra-Ghrovlitreii had located the lesion running from vertebrae L1 down through to L4. An incision would be needed to expose the lateral corticospinal tract and facilitate the local delivery of synth-frataxin, followed by exposing the damaged tissue to a myelin regenerator. It was the surgeon's hope that the nanoparticle encapsulant would slowly and periodically release the protein into the neurons long after the operation, compensating for the patient's deficiency and therefore retard the deterioration of the spinal nerves.

Concurrently, Tigan herself would tackle the accompanying tachycardia. Preliminary scans indicated that most of the affected cardiac tissue and associated nerves were localized along an approximately ten centimeter-wide strip running over the sternocostal surface, from the right atrium all the way to the apex of the heart. All she would need to do was to peel back the pericardial sac, and regenerate any damaged tissue she found; as the heart could remain beating during this time, an cardiopulmonary bypass was deemed unnecessary.

With the battle plan in mind, Tigan glanced at the holographic overlay covering the patient. The probe was in position.

"Probe Beta in starting position over right atrium," she announced, tapping a nearby panel. "Initiating deep tissue scan."

The hologram of the heart flickered into a salmon-colored blur, before gradually reforming back into clarity. Arteries in red, veins in cerise and nerves in cream, crispness and detail returning to every twist and turn.

Suddenly, a flashing glyph zeroed in on a nerve. Then another. And another. Before long, the surface of the heart was covered in a sea of reticles marking discolored splotches.

"This isn't right," the Bolian uttered.

"No, it isn't," Tigan concurred. "Computer, compare current readings with pre-op scans."

"Analysis complete," the operating theatre itself announced in a sterile female voice. "Increased levels of neural autolysis and myelin breakdown detected between atrioventricular node and left anterior fascicle."

"Computer, how long ago was the pre-op scan taken?"

"Last pre-operation scan completed twelve hours, fifteen minutes and forty-seven seconds ago."

"Lelania?" Ra-Ghrovlitreii peered over from behind his laparoscopic display.

"The cardiac nerves in the left bundle branch...," the Trill doctor stammered, "they're deteriorating much faster than anticipated-"

A warning tone sounded.

"Bee pee dropping, now seventy over thirty," T'Pria noted.

"Polyadrenaline, fifteen cc's," Tigan called.

"Administering fifteen cc's," a Saurian nurse pressed a hypospray against the patient's neck and fired. Moments later, the tone faded and the vitals display returned to a steady rhythm.

"Bee pee returning, nine eight over seven five."

Sighs of relief filled the theatre.

Then, another alarm.

"Bee pee falling, sixty-five over twenty. Respiratory rate now three point five."

"Five more cc's."

"Got it," the nurse dialed in the new dosage. "Administering five cc's."

Another moment, and the patient's vitals began to settle-

"Bee pee falling, forty-two over fifteen," the slightest hint of concern laced the Vulcan's voice. "Now thirty over ten-"

"Ventricular conduction pathways are erratic," the Bolian quivered. "Cardiac arrest imminent."

"Our priority is to keep the brain oxygenated," Tigan motioned for the assistant surgeon to take hold of the waldos, before heading for a cabinet. "Let's get her on the blood-oxygen perfusion pump. Berol, tri-ox compound, ten cc's."

"Yes ma'am."

With fluid and practised motions, the Saurian's webbed fingers flicked the hypospray, ejecting the old vial and loading the new one.

As soon as the Trill returned, her Efrosian colleague helped her attach the self-tapping catheters to the patient's neck. The puck-sized gadget glowed red and blue as the rotor spun to life, drawing crimson from one tube and pushing scarlet out the other.

"We've got less than thirty minutes until primary brain dysfunction," he noted grimly. "Should we try Inaprovaline, or go straight to Chloromyd-"

Shrill overlapping screeches filled the air, as several displays flashed warnings. "Fluctuations in the isocortex," Berol warned. "Cortical and neural levels just took a nosedive."

"That was hardly thirty minutes," Ra-Ghrovlitreii snarled under his breath. "Computer, initiate neural scan."

"Working." A pause. "Scan complete. Autonomic functional levels outside normal parameters."

The surgeon shook his head. "I've never seen anything like this before - imminent cardiac and brain stem failures within minutes of each of each other. Maxa, cortical stimulators."

"I doubt they'll do us any good," the Bolian sighed, but brought out the pair of metallic discs anyway. He gently eased back the patient's surgical cap slightly and brushed aside a lock of pale hair, before applying the devices to her temples. "No effect. Autonomic and higher functions still declining-"

"Put her on ice."

Four surprised faces snapped to Tigan's direction. "What?"

"If we lower her core and brain temperature, it'll slow down the deterioration and buy us some time."

"But a cryogenic chamber needs an hour to-" Maxa began to protest.

"No. Cooling packs, head and torso."

"R-right, um, we'll need at least a couple dozen."

"I'm on it," Berol dashed for the stores. Some rough slamming and thumping of cabinet doors later, he returned with an armful of the translucent blue gel packs.

Whipping off the surgical blanket, the five of them packed and covered as much of the girl's bare form as possible with the bags. Tigan had winced when one pack accidentally jostled the exposed shaft of the laparoscope hose against the incision the latter was inserted through, tearing at the edges just a little more. But there would be time for apologies later.

"Temperature three six point one," T'Pria noted. "There is ninety-five point two percent probability that target temperature three two will be attained in two hours."

"We don't have two hours," the Trill resisted the urge to tear off her cap and run her fingers through her hair in frustration.

"I'm sorry, Lelania," the Efrosian sighed. "Short of cutting the patient wide open and stuffing her full of cold packs, we can't possibly cool her down fast enough."

"And it was going so well," the Bolian assistant surgeon slumped in defeat. "I was gonna celebrate with a Slusho after this."

"Maxa!" Berol chided.

"Slip of the tongue," he sank lower into his gown.

Tigan wasn't sure whether her hands were shaking from the dread of their patient's imminent demise, or the simmering anger at her colleague's insensitivity. A young girl was less than a hour from death, and yet he had the gall to talk about ice slurry drinks-

Ice slurry?

Like the nucleus of a snowflake, the answer gradually coalesced in her mind, the beauty of its simplicity leaving her in awe.

"Can we get some sort of ice slurry around her heart and brain?" she blurted her suggestion, the words snagging at how ridiculous it must have sounded.

"You want to inject ice into the patient?" the Saurian nurse's reptilian eyes bulged even more than they normally were. "Even if you could get it in, there'd be tissue damage when we thaw her out afterwards."

"If the ice crystals are small enough and suspended in a biocompatible medium like saline, we could mitigate some of the side effects."

"Her logic is sound," T'Pria declared her approval. "The close proximity of the supercooled fluid medium will significantly reduce cooling time. I recommend a maximum ice particle size of one hundred microns to ensure optimal ice loading and fluidity. "

"The fastest way to get heat away from the thorax and brain would be to pump the slurry directly into the lungs, cool the surrounding capillaries and let the blood circulation take it from there," Ra-Ghrovlitreii added. "By the time it melts, the body should be able to safely aspirate the supercooled saline."

With an exchange of nods, the team set to work.

"Computer, stand by for custom replication request," Tigan called to the replicator terminal. "One liter of standard saline solution, containing a suspension of ice microparticles one hundred microns in diameter, maximum loading. Save as Surgical Coolant Tigan Beta One, replicate four bags."

"Temperature three five point nine, pulse zero. Fifteen minutes to primary brain dysfunction," T'Pria continued her updates.

"Hang on," Maxa fiddled with one end of a second perfusion pump. "The IV line adapter's giving me some trou-there we go."

Another hiss of the hypospray near the patient's neck. "Ten more cc's tri-ox," Berol declared. "Maximum safe dose reached."

"Here, pass that end," Ra-Ghrovlitreii took the modified pump outlet and twisted the luer connector closed over the ventilator tube's auxiliary port. "Lelania?"

The Trill handed over the first IV bag. "Ready."

As soon as the last coupling snapped together, the cold slime sloshed and swirled its way along the tube down into the patient's throat. The team watched the holographic overlay tracking the flow of the slurry, as it rapidly filled the girl's lungs, followed by a cascade of chilled blood coursing through arteries and veins, before branching out into the capillaries in the chest and head.

"Temperature three two point four, minimal activity in isocortex. Metabolic processes retarded. Time to primary brain dysfunction is now one hour and fifty minutes."

"That will have to do," the Efrosian nodded to the others.

Laying her fingers on the waldoes again, Tigan steered her probe to a point somewhere over the atrium, and squeezed the trigger. She watched from her display as the exoscalpel cut a slit in the pink translucent membrane of the pericardium, curling up along the growing edges of the incision. A few capillaries and nerves peeped out from the exposed cardiac muscles. Another button tap, and the display became awash with the pink glow of the myelin regenerator in the probe. The discolored splotches covering the nerves gradually faded to supple cream fibers.

"Cardiac nerve repair complete," she finally declared.

"I'll take it from here, ma'am," the Bolian offered. "Doctor Ra-Ghrovlitreii might want a hand."

"Excellent timing," the Efrosian acknowledged the Trill as she stepped around to his side. "The boundary between the cuneate fasciculus and the posterior spinocerebellar tract is a bit narrower than expected."

"I'll hold the probe steady. You steer the exoscalpel."

"Ready."

On Ra-Ghrovlitreii's display, a line formed on the spinal cord and parted bundles of fibers, revealing their target.

"Commencing synth-frataxin delivery, five cc's," Berol announced, and a needle extended into the largest mottled mass of nerve tissue. "Drug uptake nominal."

After an agonizing eternity, the injector assembly bottomed out. "Full dosage delivered."

Once again, under a pink glow, the discoloration in the nerves vanished. A moment later, the incision slowly pulled itself closed again, leaving the spinal cord none the worse for wear.

"I hope that all that counted for something," Maxa exhaled deeply behind his mask.

"There's only way to find out. T'Pria?"

"Temperature steady at three one. Fifty-three minutes to primary brain dysfunction."

"Let's warm her back up, nice and slowly. T'Pria, bring me a new intubation set."

The nurses worked their way quickly through the mound of cold packs, draping a warming blanket over the patient as soon as they were finished. At the same time, Ra-Ghrovlitreii gently removed the ventilator tubing and tipped the girl's head to the side, letting as much of the half-melted slush drain out as possible.

"Alright, cordrazine, ten cc's," Tigan helped ease the head back up and inserted the new tubing. "Cortical stimulators, level one."

A hiss of the hypospray, and a beep of the stimulators. "Limited response. No higher brain functions, cortical and neural levels still below autonomic threshold. Fifteen minutes to primary brain dysfunction."

"Getting some cardiac activity," Maxa's face lit briefly before it fell. "No good, she's vee-fib."

"I'm starting CPR," the Trill doctor dove in, fingers entwined as she placed one hand over the other and began firm, rhythmic presses to the girl's chest. "Berol, bring the defibrillator around."

The nurse returned with the gear on a dolly, and helped lay the gel pads diagonally across the patient's torso.

"Ventricular fibrillation detected. Shock advised, eighty joules," the computer recommended.

"Override, authorization Berol Delta Phi Six Two. Go to one hundred."

"One hundred joules, ready," Maxa nodded.

"Clear!"

Thump.

"No good, still vee-fib."

"One twenty."

"One twenty joules, ready."

"Clear!"

Thump.

"No joy."

"One fifty-"

"That's too high," Tigan motioned the others to move aside. "Five more cc's cordrazine."

"Maximum safe dose reached," Berol administered the drug.

The Trill resumed her compressions. "It'll have to be enough."

One, two, three, four, five, six, seven, eight-

-work with me, Epsilon-41. Let's fulfill that promise of yours-

-seventeen, eighteen, nineteen, twenty, twenty-one, twenty-two, twenty-three, twenty-four-

"Temperature three six point five, ten minutes to primary brain dysfunction."

-one, two, three, four, five, six, seven, eight-

"Lelania," Ra-Ghrovlitreii shook his head sadly, "you've already done your best."

-fourteen, fifteen, sixteen, seventeen, eighteen, nineteen, twenty, twenty-one-

Reach her, an unfamiliar voice whispered.

-twenty-three, twenty-four, twenty-five, twenty-six-

Reach her.

-twenty-seven, twenty-eight, twenty-nine, thirty-

Reach her!

"Lelania, please-"

"Sinus rhythm!" Maxa suddenly shouted.

Tigan almost hurled herself to the back wall out of shocked reflex.

"Pulse five five, respiratory rate four point five, bee pee eight five over six four. All vitals, cortical and neural levels coming back up," the Bolian triumphantly confirmed.

A cacophony of relieved laughter and wheezed cheering erupted amongst the team.

"Call ICU," Ra-Ghrovlitreii ordered, "and tell them Epsilon-41's on her way. Let's clean her up."

He then laid a supportive arm on the Trill's shaking shoulder. "You've earned this, Lelania."

Tigan responded with a choked nod. It had been a long day.

=Λ=

Present Day

The two women sat in silence beside each other on the piano stool, as the revelry of the party around them faded to a muted blur. Hot tears stained the lap of the violinist's dress.

"Hello, Kaori," Tigan finally spoke, gently laying a hand on her former patient's own. "I'm glad I know your name now."

"I'm glad we've finally met, too," the musician smiled back softly behind wet eyes. "I almost thought I'd never have this chance to thank you in person."

"You have no idea how much what you did meant to Kaori and I," the pianist supported his partner's shoulders with his forearm as he stood beside her. "We met in junior high school, back when I had abandoned the piano in the wake of my mother's passing, because I was so traumatised I couldn't hear my own notes." He hesitantly lowered his spectacles. "She was tempestuous, hyperactive and left the worst impression, but she bought color back into my world by showing me how to feel the music in my heart and play again."

"I've known Kousei for longer," the blonde leaned back ever so slightly, savoring his warmth. "I first saw him in a concert when I was five, back before people called him the Human Metronome. He was so different at the time, the way his notes glowed like a twenty-four color palette. I decided I wanted to become a violinist worthy enough to play by his side."

She took a deep breath before continuing. "After I collapsed in seventh grade, I was in and out of the hospital constantly, and I eventually realized that I didn't have much time left. So when I found out we went to the same school, I promised myself I live long enough to be able to share one duet with him, for the whole world to remember us as we were."

"You know, doctor," Kousei sat down in a borrowed chair, "on the day of the surgery, I was alone on stage at a regional competition. We'd all but said our goodbyes to each other, but after everything she did to bring me back to the world of music, I realized how terrified I was of a future without her. I don't know what came over me that day, but somehow, I prayed that my performance would reach her and lend her the strength to pull through."

Reach her.

Of course. It all made sense now.

"The operation would only have given me a little over a year, two at most," Kaori continued, "But because of what you did, a year was enough for me to join Kousei onstage again, to come to terms with how we felt about each other…" her voice trailed, calming only after her partner rubbed her shoulder, "...and to live long enough for a cure to be found."

"You're giving me too much credit," the older woman blushed. "It was a team effort-"

"It was, doctor," Kousei nodded, lowering his arm to his partner's waist. "We spent the next eight years trying to contact your team, but we never heard back from any of the others-"

Tigan closed her eyes wistfully. Maxa had frozen to death as a prisoner of war on Rura Penthe. Berol's relief team succumbed to the virus ravaging Carnegie V. Ra-Ghrovlitrei's Expeditionary Forces unit was overrun by Bluegill neural parasites on Paria III. And T'Pria had been disemboweled by Iconian Heralds while holding a shelter door closed with her body on New Romulus. Colleagues and friends, reduced to mere names on casualty reports.

"-and they said you died in the war, too," Kaori warbled, her trembling hand squeezing the doctor's own just a little tighter.

Oh, Tigan inwardly slumped at the unpleasant memory. That.

In the aftermath of the devastating Battle of Midnight that ended the Iconian War, the Odyssey had been erroneously declared lost with all hands, never mind that the ship and its full complement had docked to a hero's welcome at Earth Station McKinley. It took months for Starfleet Command to untangle the resulting clusterfuck, during which the doctor had the misfortune of having a subspace video call to her parents back home on Trill interrupted by the arrival of a pair of casualty notification officers.

"I'm glad," the violinist sniffed back her tears, "glad that it wasn't true. After everything you did for us, you deserved a happy ending."

"Kaori," Tigan shook her head, "I'm not the all-powerful doctor that you make me out to be. I've lost just as many patients as I've saved, maybe even more after this war."

The young musician felt a sudden and inexplicable urge to comfort the older woman, reaching out and gently clasping both her hands. A face subtly and indelibly worn by the burden of duty, yet so kind and gentle, smiled sadly back at her.

"Doctor," the violinist finally composed herself, "Kousei and I know how it feels to be helpless, as if nothing you do matters. Every time we step on stage, we might not be able to turn in a performance we could live with. But if we could reach out to someone, help them find hope through our music, then maybe, we could leave some lasting good in this world."

"And the truth is, you've brought hope to more people than you could ever imagine," the pianist encouraged. "I share the stage across countless worlds with the love of my life, instead of wallowing away in an empty house with a dusty piano. Her parents are planning to expand their bakery instead of mourning their only daughter. And our friends and fellow musicians are grateful that she's there to constantly push them to new heights. All because you never gave up on her."

"So please," Kaori laid a hand on the doctor's shoulder, "let us support you in this moment that you're losing heart, even just a little. Never forget all the good you've done for all the people who are here today because of you."

"Yes, I won't forget," Tigan drew her into a tearful hug, "because you reached me."

=Λ=

"And here I thought you were trying to upstage everyone else," a mollified Barber commented to Zhang as they observed from the drinks table.

"No, of course not. Admiral Quinn informed me of Miss Miyazono's request last month, and asked me to make the necessary arrangements."

"So what did you get Lelania anyway?"

"Just a small glass sculpture from Liuli Gongfang," he sipped from his tumbler, before catching a passing Ong. "By the way, fantastic work with the holoprojectors, Mister Ong."

"No sir, that wasn't me. Mister Arima and Miss Miyazono didn't ask for holoprojections in their performance."

"Huh?"

"Then how…?"

Something fluttered down from the ceiling, catching the attention of the three bemused officers before gently landing on the tip of the captain's boot.

A cherry blossom petal.

A/N: Although therapeutic hypothermia induced with ice slurries is a real (if experimental) method of slowing brain death in the event of cardiac arrest, please don't try this at home, kids. I'm an otaku, not a doctor.