Title: Liability
Author: Daria
Rating: PG-13
Synopsis: The death of a crewmember divides the crew at a time when
they most need to be united.
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Warning: Death of an original character
Spoilers: Possible spoilers for anything through the first three
seasons, although nothing I can think of specifically.
Beta: Surya kindly beta'ed this and made it much better, but then I
made a significant revision, and undoubtedly added a lot of errors.
It was quiet, and, with most of the lights dimmed, the room was peaceful. The animals had been fed, so the chirping and chattering that made up the day-time soundtrack of sickbay were absent. Phlox bent over his microscope enjoying the peace and the opportunity to catch up on a little of the research for which he so seldom had time. He didn't need to sleep on the same schedule as his human colleagues, requiring only six days of hibernation a year, a difference for which he was quite grateful. How their species had advanced when they lost nearly a third of each day to unconsciousness was a mystery to him. He had learned to appreciate the hours the majority of the crew used to indulge in sleep, and the opportunities they afforded him.
Too soon the peaceful interlude came to an abrupt end. He hit the button next to him to stop the incessant buzzing of the intercom, and was assaulted by Commander Tucker's agitated voice. "Doctor! The away team is on the way in. They have injuries. The shuttlepod was hit by an asteroid, and they were bounced around pretty good. I don't know how badly they're hurt..."
"I understand, Commander. Can you find out if any of them are unconscious, and need to bypass decon?"
"Can't, Doc. They lost communications. We won't know anything until they dock. It'd be best if you met them in the launch bay. If it turns out they need isolation, we can always secure the bay, and vent the atmosphere to space later to clear out any bugs. "
"I'll do that, Commander." Flipping the intercom off, Phlox activated the sickbay lights, bringing them up to day-time brightness. He glanced around sickbay, making sure everything was in its accustomed place, so he wouldn't be scrambling to find equipment. He activated the imager and then put it in standby mode to save the time normally required for start up.
Grabbing a first aid kit, he headed toward the launch bay.
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The three person crew of Shuttlepod Two stumbled out of the little craft as a team, Captain Archer and Lieutenant Reed supporting Ensign Carey between them. All three were coughing, and covered with soot. The trained physician's eyes took in the obvious signs of injury, as well as other details that a less astute observer might not have noted-- Archer leaning forward a little too far and holding his ribs, Lieutenant Reed's awkward movements as he tried not to jostle his left arm held in an improvised sling, and Ensign Carey's pale face. Phlox mentally prioritized the injuries, and began barking orders to the med team even before he had scanned the injured crew.
When Enterprise had begun its mission earlier than planned, and without a full medical staff, Phlox had quickly asked for, and received, permission to create a first response team from the security personnel and some of the scientists on board. Although Enterprise had since obtained two bona fide med techs, the wisdom of Phlox action had been proven on many occasions, and today was no exception. The first response team arrived mere seconds behind him, and went to assist Archer and Reed while Phlox assisted the ensign to a gurney. She gratefully accepted his help. Archer and Reed both declined the gurneys, protesting that they could walk. Phlox intervened, insisting that Archer accept the assistance, but allowing Reed to remain on his feet, knowing it would probably be more painful for the armory officer to lie on his obviously dislocated shoulder than to remain upright; the doctor made sure a med tech was close by, ready to lend support if needed.
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Archer was first in the scanner- Phlox was concerned that the injured ribs might have punctured a lung. While the machine ran its tests, Lieutenant Reed filled him in on how the injuries had occurred- there had been a large jolt, as yet unexplained, and all three had been thrown forward. Archer, piloting the shuttlepod, had been tossed directly into a control console. Ensign Carey had standing behind the navigator's chair. The impact had thrown her into back into the cargo area, where she had landed on her back again their equipment. She had remained conscious, but had begun complaining of back pain soon after. Reed had been in the back of the shuttle, inspecting the cargo containers, and the jolt had tossed him against a corner of the container, most of his body missing it, but his shoulder taking the full impact. He had narrowly avoided having Ensign Carey land on top of him.
The accident had occurred nearly three hours ago. The impact had knocked out several of the shuttlepod's systems, and they'd had to make their way back to Enterprise at a crawl, unable to go to maximum velocity for fear of overstressing the little craft and uncovering more damage, Reed explained. They had used the non-narcotic painkillers in the shuttle's limited field kit, afraid that the more potent medications would interfere with their ability to pilot the shuttlepod, or to deal with any other emergencies might arise en route to the Enterprise. Reed had strapped the captain's ribs, and Archer had returned the favor, rigging the sling the armory officer wore.
"I'm going to give you both painkillers while you wait. I should be done with the captain's scans in a moment, and then I'll get to you," Phlox informed them.
"Of course, Doctor," Reed replied, sitting carefully on a biobed, making no quick moves that might jar the injured arm. Phlox knew the stoic armory officer was in more pain than he let on, and resolved to work as quickly as possible to get to him. He hoped Reed wasn't concealing more serious injuries, but knowing the armory officer's history he wasn't confident. He wanted him in the scanner quickly, concerned about the injuries he believed Reed might be hiding.
"Doctor, Ensign Carey isn't looking well," Reed drew Phlox's attention back to the young woman on the next biobed. She was quite pale, the doctor noted. She was moving restlessly on the biobed, seeming unable to get comfortable. She squirmed again, and gasped with pain, and then gestured at her back. "Doctor, my back really hurts, and I'm feeling sick."
"Hmmm. Well, I suppose that's understandable. As I understand it, you were thrown pretty hard and landed on your back. Are you experiencing any numbness or tingling in your fingers or toes?
Carey again shook her head no, her face a grimace. "The pain…it's getting worse…" she gasped. Phlox came over and quickly ran his hand down her spine. "Is this tender?" he asked pushing gently on her spine, and then using the hand scanner to look for a fracture.
"No… it's not there. I guess it's the muscles spasming," she replied.
"I believe you have some soft tissue damage. Your spine is intact. When I get you in the imaging chamber, I'll be able to see what damage has been done. In the meantime..." The doctor administered another hypospray, and then turned his attention back to the readings on Archer.
"Yes, just as I suspected, several cracked ribs." The tray holding his patient was slowly emerging from the imaging chamber as he spoke. "Captain, you'll be happy to know that your ribs are only cracked. I'll give you something for the pain, and wrap your ribs, and you can go to your quarters to rest."
"Thanks, Doc," Archer said, slowly climbing off the tray and moving awkwardly toward an unoccupied biobed. He paused, and looked at Reed and Carey, both still looking very uncomfortable. "How are you doing, Ensign? Lieutenant?"
"Fine, sir," Reed's reply was tight-lipped, and Archer could tell by the lines on the armory officer's face that he was lying. But the doctor would be taking care of him soon, so Archer didn't waste his breath arguing. He'd expressed his concern, and that was all he had the energy to do at the moment.
"And you, Ensign?"
"Fine, sir," Carey echoed Reed weakly. "Although my back..." she emitted a groan, "is really spasming..."
"Still?" Phlox looked mildly concerned. "Even after the analgesic I gave you? It should be killing most of the pain of a back sprain." Something tickled at the back of Phlox's mind, and he felt a momentary concern, but he couldn't put his finger on what was bothering him. He looked from the pale ensign to the armory officer, who was using his right hand to hold his left arm tightly against his side, trying to stabilize the joint.
"I'll scan Lt. Reed next, so I can put the shoulder back in joint. It should only take a moment," he told the two junior officers. As expected Reed protested that he could wait, but only weakly, the pain in his shoulder making it hard for him to focus on anything else. It was a slower process than Phlox had anticipated. With Reed's shoulder out of joint it was difficult to find a position on the imaging chamber tray that was tolerable, and it took a great deal of coaxing, combined with careful padding of the tray and additional pain medication before Reed was in position to be scanned. Knowing Reed's propensity for hiding injuries, the doctor was careful to conduct a thorough scan of the armory officer's entire body and was almost surprised to find no other injuries.
The tray was just being ejected from the chamber, when he heard a cry from behind him.
"Doctor!" Archer's voice was raised. "Something's wrong with Carey!"
Phlox hurried to the biobed and glanced quickly at the readings. Carey's vital signs had plummeted, and she was moaning with pain. "My back," she managed. "I feel's like something is ripping inside..." Gesturing to a med tech to carry the ensign to the imager, the doctor yanked Reed, who was slowly and groggily climbing off the tray, out of the way, eliciting a cry of pain from the armory officer. Depositing Carey on the tray, the doctor activated the imager, and watched with horror as the readings began scrolling across the monitor.
"Set up the surgical suite," Phlox snapped. The med tech looked at him questioningly. "She has an aortic rupture." The doctor was moving more quickly than any of the humans in the room had ever seen him move. The ensign was carried directly to the surgical suite, and the doors were closed, leaving Archer and Reed to stare after the medical team.
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Phlox sat on a stool, staring at the sheet covered body. He had other things to do, tasks he knew he should be performing, but a terrible lethargy had come over him. He'd been a physician for many years, had seen many terrible injuries and serious illnesses, and had seen many patients die, beyond medical help. This case was different. Ensign Carey, like the rest of the Enterprise crew, was a friend as well as a patient. And this patient, this friend, might have been able to be saved.
He'd missed it, somehow. Ensign Carey had been in sickbay for an hour before she had crashed. He had wracked his brain, reliving every instant, second guessing every decision. Ensign Carey had complained of back pain, but she'd been stable! He was certain of it. Wasn't he? She had told him several times that her back hurt, and he knew she'd taken a severe impact to her back. Should that have been enough to clue him in? Had he really listened to her? When had he first checked her vital signs… was there a warning there, that he'd missed? Had he given enough credence to her complaint of pain? Had he perhaps been too dismissive? Certainly he had known she was injured, and had planned to do a thorough evaluation, but he had been concerned about Reed. And why was that? Certainly the lieutenant had given no concrete indication that he'd been suffering from any serious injury, other than his dislocated shoulder, a painful, but certainly not life-threatening, condition. Why had Phlox chosen to scan him first? Would scanning Ensign Carey earlier have made a difference? Her condition was one that was frequently fatal, even if caught early. She might very well have died anyway. But the delay had sealed her fate. By the time he had her on the operating table the rupture had progressed too far. Still he had tried to repair the damage, but she'd lost so much blood during the surgery that several transfusions had been required. Her body tried had tried to stem the bleeding, and when the clotting factors had been used up, she had begun to bleed more. He'd been unable to stem the flow. Shock had set in as well, and her kidneys and liver, deprived of adequate blood flow, had failed. Ultimately, the lack of adequate blood to the heart had damaged that organ as well. Her blood pressure, already critically low, had fallen even further. The doctor had countered with drugs, tried all the treatments available, but it was to no avail. The damage was simply too great. Jaylene Carey had died, never having regained consciousness after the surgery.
Phlox planned to review his records carefully, check the biobed monitors and records to see what signs he might have missed that should have warned him of the looming disaster. The records might bear out that he had made proper decisions, that there had been nothing to tell him that she was so catastrophically injured, but the records couldn't show what had been going on inside Phlox head, what biases he might have had that had effected his decisions. Her prognosis had been dismal from the moment she'd been injured, Phlox knew, but what slim chance she'd had left, his delay had stolen from her.