Martha put a call out to the orthopaedic specialist on site. She was relieved to see it was their most experienced specialist James Lloyd on duty. It was quarter past eleven so he'd be in the morning clinic. She put the call out to meet her in the assessment room to give him time to finish with his current patient. She knew there were a couple of UNIT staff receiving on going orthopaedic treatments so they'd be seeing James.

Assisted by Gerald and a trauma unit nurse, Anita, Martha took various scans of the Doctor's leg. She didn't move him to take any of them. The system was portable and the beds were designed so if they did need to take posterior films it could be achieved through the bed. She took X-rays and soft tissue images with the most advanced medical equipment installed in the UNIT base.

"I've got all the images I need for now, Doctor." Martha got Gerald to wheel the bulky machine out of the room again. "I'm going to take them to the assessment room and discuss them with our resident orthopaedic surgeon. Do you want us to come back and involve you fully in the discussion?" Martha didn't know how much the Doctor would want to be involved. When he'd dislocated his wrist and she'd been checking for fractures he'd been keen to share his experiences and what he thought in valuable consultation. She hoped he'd be able to do the same again.

The Doctor was in a lot of pain and he was exhausted. Gerald positioned the bed so he was sitting slightly rather than completely flat. It was comfortable, but he'd never felt anything like the pain radiating in harsh waves from his leg. He knew it was bad because he'd felt it and seen it. He didn't want to have to think about anything else to do with it. He shook his head in response to Martha's question.

"I'll go and discuss it with James we'll see how you feel, alright?" Martha could tell the Doctor was worn out. It wasn't over yet. They needed to reduce his injuries further to cast him, or, they'd risk taking him straight into surgery depending on what the scans revealed. "Is that okay?"

"Yeah."

"Once we have decided what the next stage is we'll see about sorting you a cup of tea." Martha smiled. "While I am off discussing how we're going to put your leg back together I'm going to get Gerald to clean your head wound and stitch it back together. He may put some staples in it for you."

"Okay."

"I'm just going to be along the corridor, Doctor," Martha assured him. "If you want anything then ask Gerald. If he can't do it then he can come and get me. All you should be doing is resting and trying to relax. I know it hurts, but the drugs should help and we'll get you sorted as quickly as we can."

"I know you will…" The Doctor made a deliberate eye contact and regarded Martha. "That's why I came."

Martha smiled sympathetically at the Doctor. She was surprised to get the acknowledgement from him, but she knew he had to be feeling vulnerable, shocked, and unnerved. Each of the injuries he had was serious in its own right. His knee would need stabilisation, ligament reconstruction, and immobilisation for a period of time followed by intensive physiotherapy. His mid-shaft fractures would need fixating and then immobilising without any weight bearing for a period of time and then strengthening up. His ankle needed surgery and would need stabilisation and possibly some ligament repair and then physiotherapy.

The three injuries in themselves were serious, but if a patient had come in with one of them in isolation they'd be treated and taken care of and put into a program of support and rehabilitation. They'd be assured of a full recovery in 9 out of 10 cases. The Doctor had the three injuries together, so it looked like there was an impossible mountain of fractures, dislocations, and soft tissue injury in a gruesome distorted mess, but when broken down there were three serious but hopefully fixable injuries.

Martha could tell the Doctor was still struggling with the pain he was in while receiving Bladamine and she knew he was scared. He'd not bounced and she wasn't sure if he'd ever crashed. He wasn't chattering away, trying to give her hints and advice on what to do, and was just lying on his back quietly subdued. It made her feel even more responsible for his well-being and was an indication of how badly he'd been shocked and how difficult he was finding it. He'd fallen 25 feet off a ladder, shattered his leg, and cut his head open. What Martha found most upsetting was that he'd been on his own and it had been almost fifty minutes between him falling and them getting to him.

Gerald came into the room with a trolley containing all he needed to treat the Doctor's head wound. His still had some dried blood crusting in his hair, in his ear, and over his face. Martha had wiped some out the way, but hadn't cleaned him fully, just enough to reveal the TARDIS blue bruising colouring the left side of his face. They had taken some scans and X-rays so Martha wasn't going to prod him about, but she did worry he may have cracked his cheekbone based on the swelling and bruising. She'd check at the same time as she reviewed the images of his leg.

"Gerald, can I have the camera please?" Martha took the camera from the junior medic. "Right, Doctor?" She rubbed his shoulder to get his attention. "I won't be too long. Be nice to Gerald. Once you're more settled he'll be the one making the most tea."

"Okay." The Doctor gave her a tired half smile aware she was trying to keep his spirits up. He didn't much care about spirits he wanted his leg to stop hurting. He made the mistake of looking down at the splint. He'd thought it would be okay, but even with the splint on he was lying on his back but his knee was rotated to the left and his toes were still pointing down and to the right.

Martha went down to the assessment room. There were several big screens and boards up in the room and the information from the scanners could be instantly downloaded and displayed. She downloaded the photographs Gerald had taken in the TARDIS and she selected one that showed all three injuries in the position she'd found him in. She put it up on the first screen. When looking at it she had to actually concentrate to determine which end was his knee and which was his ankle as it wasn't immediately recognisable. She put a second photograph alongside which showed his leg from another angle and gave a clear indication of the seriousness of what they were dealing with the deep step down from femur to tibia where he should have a knee joint, then a bend in the shaft of his leg.

On the second board she transferred the films of his knee. On the third board she showed those of the mid-shaft fractures, and then on the fourth she put the images of his ankle and foot up. On the fifth board she put up the scans of his skull and facial bones just in case there was anything they had to deal with. She studied them first. Pleased to see there was nothing. No cracks to his skull and no damage to his facial bones. All the damage done whacking his head and face was soft tissue cuts and bruising. She took those images down and put some additional ones of his leg up.

Martha wasn't entirely sure where to start, but his knee had been scanned first so that was what she looked at first. It was still fully dislocated even though she'd got it closer to splint him. It was clear why it had been hard to get to go back. There was a tibial plateau fracture, it involved the lateral condoyle and it was a highly displaced oblique fracture right up into his knee so half of the supporting head of his tibia had come away.

It would only be possible to fully reduce surgically, but they were going to have to get him closer to let the swelling go down. His patella also had a fracture and Martha was highly disappointed to see a hairline crack through the distal head of his femur. The upper neck of his fibular had sheared away with the rotational force applied to his knee and the joint was such that the tibia still sat underneath and behind the femur. She feared that he might have to go into traction to protect his knee until surgery but that was going to be contraindicated by his other injuries. It was going to be a tough call to make.

The soft tissue scans showed what Martha already knew. Both sets of his medial and cruciate ligaments in his knee were ruptured and detached. He would need two or three surgeries on his knee to repair the damage and reconstruct the joint so he could heal. There was a lot of blood and fluid actually in the space that should be occupied by the displaced head of his tibia and she thought that even if they could not put him in traction they might have to put a drain in to make him more comfortable until he could have surgery.

Martha did some work on the computer and an outline appeared around his femur and his tibia on the X-ray of his knee. Martha then took and electronic pen and drew the lines of the fractures in red. She hit a button on the keyboard and they got set into the screen. She used her hand to re-orientate the bones until they were in the right positions. Using the computer to see which way they might go back in before they had to try it on the Doctor.

Martha got a blue electronic pen and she drew some fixing lines through the fracture on the board as they were likely the screws they'd have to put in to hold it while it healed. They'd have to wire his patella as well and plate the fibula. They would not have to do anything to stabilise the crack in his femur but give it time to heal.

Martha moved onto the second board which showed the mid-shaft fractures on his leg. They weren't in line. They were both spiral fractures caused by a violent rotational force exceeding the strength of the bone. The fractures were long and diagonal. The one in his fibula was singular but the face of the fracture was a two inch split along the narrow bone. The tibia was more complicated. It was a comminuted fracture, the bone had been twisted and then it had split and splintered into three bits and then further forces had driven one of the bits of bone down into another and caused it to fragment. It was a nasty fracture but they would be able to fix it. She used the same software to highlight the bones, the fractures, and the metalwork required. The best way would be to put a nail right down the middle of his tibia. They'd be able to fix it at the top and the bottom and keep him straight that way. Then a plate on the fibula would hold if along the length of the fracture. They'd just have to make sure it could be taken out. It was serious but it was fixable and in someone fit and healthy like the Doctor, Martha didn't think there would be an issue with him healing and regaining full strength.

She moved onto his ankle. She got the computer to highlight the separate bones first and then went through with the red pen to highlight the fractures. Both the tibia and fibula were broken above his ankle which was the point of the main distortion. Both malleolus had sheared and there was a fracture through the calcaneus bone of his heel. It definitely ruled out any kind of traction for his knee. She was disappointed to see there were also breaks in three bones of his foot two of which were displaced. It was probably the point where he'd first hit the ladder. She knew he always wore the Converse trainers but she had a pair and she'd stopped wearing them because they tended not to be very supporting. The soles were thin and didn't have a great grip. They were designed for the basketball court and for fashion, definitely not for a single footed landing from a twenty five foot drop onto a narrow metal bar. Martha manipulated the fractures on the board so they all came back in line and then she used the blue pen again to try to fix it all.

Once she had reviewed the injuries she put the 'fixed' images all together on the board she had cleared of his head injury to see how the fixation of his knee would interfere with that of his mid-shaft fractures, and how the fixation of them might interfere with his ankle. They'd have to make significant alterations and adaptations to standard fixation to accommodate the three injuries but it looked doable. She would have to speak to the orthopaedic team and then the Doctor once he was more settled.

Martha stored her manipulated images into the database then returned all the X-rays to their natural state just before the door opened and a prematurely white haired man in a lab coat entered.

"Morning, Martha, sorry I was a while I had Libby Taylor in clinic." James came into the assessment room. "So what have we…" he knew Martha called him to consult. He looked at the initial photographs up on the wall. "Good God, now that's a beauty." James moved closer to look at the photographs. "Wow, which poor bastard has done this to himself? That's spectacular."

"It's the Doctor, James." Martha advised him gravely.

"What? Luke?" James asked. Luke Wilson was the doctor on external duties and judging by the flooring the picture wasn't taken anywhere in medical. He didn't know how such an injury could be received in the unit.

"No, the Doctor. Did you hear we had a code 9?" Martha asked him.

"What, the Doctor, Doctor?" James checked. "Code 9 Doctor? Your Doctor? All of time and space, UNIT Scientific Advisor, Doctor?"

"Yeah, him," Martha confirmed with a roll of her eyes.

James grinned and looked at the picture again. "Is that inside of the TARDIS?"

"Yes, it is," Martha offered. "He's made a mess of his leg, James."

"You can say that again, but, um, don't." James had a look at the films. "You know it looks bad here." He pointed at the photos. "But, when you break it down to the composite injuries it's not the end of his leg." He rubbed his dark goatee beard as he looked at the X-ray image of his knee. "You've reduced this a little compared to the photograph?"

"It wouldn't go fully." Martha confirmed.

"No, not with that fracture. We're going to have to really pull that apart to get it to go back in. We'd put it straight into traction to loosen it right up before we tried to reduce it further, but, not with the tibia and calcaneus fractures. He is going to need it putting back together in theatre." He picked up a black electronic pen and did some scribbles on the board, deep in thought. Martha watched. She was a good all round trauma medic, pathologist, she had a good bedside manner, and she was the medical director so in charge of the full facility on the largest UNIT base. She also knew when to step back. James Lloyd was one of the best orthopaedic specialists in the world. "In your opinion is anything a surgical emergency?" James asked Martha.

"He'd lost blood flow to his foot. I partially reduced and it has been restored. As you can see he needs further reduction, but, the blood flow is good." Martha confirmed. "None of the injuries are open and though there is significant swelling there is nothing to suggest arterial involvement. He had full skin sensation prior to manipulation so no major nerve damage. He remains in an unacceptable level of pain despite being medicated."

"If he has no surgical emergency grade injuries I'll book him in for surgery in 48 to 72hrs time. Let's give him a chance to lose some of the swelling. We'll get him as straight as possible and into a long leg back-slab cast; that will make him more comfortable. We can have him on full bed rest until he's fit for surgery and fix him up and see about getting him non-weight bearing but mobilising out of bed a few days, maybe a week, after that."

"Anything we use to fix him needs to be removable due to his ability to regenerate," Martha advised James. The orthopaedic expert stood and thoughtfully stroked his grey flecked goatee beard as he studied the images. It worried Martha that he studied them for a minute.

"That'll make it more interesting, but it isn't going to make it impossible. If he's in discomfort we should be concentrating on getting him as straight as possible and cast. We can do another full set of scans once that is done and then work out how best to stabilise and fix." James went onto the computer. He selected the photograph of the Doctor's leg taken in the TARDIS and transferred it into a portfolio of the serious injuries he has treated. "This one is going up on the wall of fame." He commented. "So where is he?"

"He's in Trauma Treatment Alpha at the moment. Once he is cast I'm going to ask Celia and Bill to clear out and deep clean the East wing. We've only one patient in there and she is due for discharge. So we can get her up ready to do her final assessment. If she doesn't meet her discharge criteria there are beds in general since she is no longer critical. Then I'm going to have the Doctor transferred in and I'll put a level four quarantine up to keep out non-essential staff and visitors. I don't want him turned into some kind of exhibit while he's here."

"What, you mean like, don't stare at the alien?" James teased slightly.

"Yes, like that." Martha laughed. "I think everyone here is taught about code 9's in their first week of training. He's not really one for fan clubs or scrutiny at the best of times. I don't think he is going to appreciate it while he is laid up, in pain, and frankly a bit scared. If he is under any kind of undue pressure then he will want to run."

"He's not going to be running for a while."

"I think he's scared he won't be running again at all."

"I don't blame him," James commented as he looked at the photograph again. "Barring unforeseen complications he will, so, let's go and reassure him of that. Has he seen these images?"

"No, and, until his leg is straight and he is in a better frame of mind I don't want to show him. In a couple of days we may get him to consult and to approve the course of action for surgical fixation, but he's not up to it just yet." Martha didn't want the Doctor to be frightened by the number of breaks he had in his knee, leg, and ankle. Not when he'd been talking about regeneration and having his foot chopped off. He needed more time to come to terms with it and get over the shock. They needed to get him to a position where he could rest comfortably and not be battling with constantly high levels of pain.

"We've got all the casting supplies in Alpha haven't we?"

"Yes."

"And, we're going to need some additional hands. To look after him and to give us a hand with his leg, so who have you got round today?"

"I've got Gerald. He's given me a hand so far."

"Gerald is good. He will make a fine orthopaedic specialist when I get my hands on him."

"He's mine." Martha challenged as they both laughed at the standing joke they shared when they got good junior medics on the team. Gerald had especially requested to work with Martha due to the variety of the things she did from general practise work with the soldiers and their families living on base, to critical field trauma, they had a tropical diseases centre, they had the main orthopaedic centre and though James and his team consulted. Martha did a lot of the work and she managed it. She could always get Gerald into a good surgery if one came up. She expected he'd want to help with the Doctor's so it would be good for his professional development to be involved at all stages. When the Doctor was more comfortable she hoped the Time Lord would begin to let his personality come out again and mentor Gerald a bit as a distraction.

"I've Barb in today." James advised. "Let me page her to come down. She'll be handy to have round too." James got onto the internal communication system and gave the instruction for Barb, one of his orthopaedic nurses, to attend the Trauma Alpha unit for assessment and treatment.

"So, time to meet the illustrious Time Lord." James advised.

"If he is quiet and withdrawn don't take it personally. He's in pain and I he's been knocked down by this. He's not normally like that," Martha prepared James. "If, however, he's rude and obnoxious?" Martha grinned. "That is just him."

Martha led James down to the treatment room where the Doctor was lying on the bed. Gerald had finished stitching his head for him and the dressing had been removed. He'd used a warm flannel and carefully cleaned all the blood from his face and in his hair. There was a small cut on his forehead and Gerald had crossed a couple of steri-strip dressings over to hold it closed. His left eye was swollen entirely shut and there was dark blue bruising leaking into the lid, across his cheekbone, and down toward his jaw. The Doctor had an ice pack in his hand, but it was resting on his chest.

"Have you hurt your ribs, Doctor?" Martha asked him as he looked at her worried by her return. He knew they needed to do more horrible things to his leg.

"No, ribs are fine."

"Then, shouldn't that ice pack be on your face?" She raised her eyebrows at him.

"Nagging already?" The Doctor pouted but did what he was told. Martha just shook her head at him.

"You will be pleased to hear there is nothing to worry about with regards to your head. Your skull is fine and there are no breaks or cracks to any of the facial bones around your eye socket or your cheek. It's all soft tissue so the ice will do you good," Martha assured him. "Now, your leg is another matter. This is James Lloyd. He's the head of UNIT's orthopaedic team and he's going to be the one fixing up your leg."

"Pleased to meet you, Doctor." James extended his hand to shake. The Doctor nodded slightly and shook his hand back. "I am sure you wish it was under different circumstances and I know you must be worried so I'm just going to cut to the chase. I have reviewed the films of your injury and it is serious. However, I don't see there being anything that is going to have a life changing impact. It is going to take a lot of treatment, a lot of time, and a lot of hard work but we will get there."

"Okay."

"I promise you I'll do everything I can with the skills and experience I have in treating injuries like yours to achieve a maximum level of recovery for you. What I need from you right now from the start is an acknowledgement that you'll comply and adhere to medical recommendations while you're healing and that you'll work hard while you're rehabilitating. That is how we'll achieve the best recovery for you."

"A full recovery?"

"Until we've been able to fully assess and surgically fix your injuries and see how you heal I won't be able to confirm that, but, I am confident that unless there are any complications we will achieve as close to it as possible. At this stage I am optimistic, but it'll depend on a number factors. Unfortunately only time will tell, but we'll know a lot more once we've been able to operate. All being well, we'll be looking at carrying out your initial surgery in the next two to five days. Once that is complete we'll be better able to understand how you're going to come back together." James wasn't going to lie to the Time Lord. "Do you know why we can't operate straight away?"

"Yeah."

"Tell me," James insisted.

"My skin is stretched too tight with the swelling around my injuries. If it was incised you'd not be able to close. That you're not operating straight away means you don't think anything is a surgical emergency so you can allow the swelling to reduce before operating to properly close the wounds and reduce the risk of infection," the Doctor slurred a couple of times with the drugs but he could still think straight, breaking his leg hadn't turned him into an imbecile. Standing slightly behind James he saw Martha smile at his confident response at least she knew better than to ask him pointless questions.

"Excellent." James leant on the edge of the Doctor's bed, resting his hip on the metal frame as he talked to him. "Martha told me you don't want to know the finer details of your injuries just yet, so I won't go into the details. What you do need to know is that you have dislocated your knee and your ankle joints. I am fairly sure you're aware of that at this point."

"With mid-shaft fractures." The Doctor didn't want James to forget them. "They are very unstable. I thought my leg was hanging off," he whined losing his composure slightly. "It was dangling and bent." He grimaced as fear drove his pain levels higher than he could manage.

"Nothing is open, Doctor," Martha assured him. She had always known the active involvement of the Time Lord brain meant the Doctor was able to deal with pain in a way humans tended not to be able to. He could think himself out of a degree of the pain he was in, but it was so severe he could only exist just below his limit. When he got worried he lost that composure and the pain escalated beyond his tolerance.

"Are you sure?"

"Yes, I'm sure," Martha confirmed. "If you had anything open we'd be taking you straight into surgery wouldn't we?"

"Yeah."

"And we're not," she reminded him. "Like you said, nothing is a surgical emergency. We'll make you more comfortable and take some time to design your treatment. Your leg is unstable, but now you're here it won't be dangling or bent because we're going to take care of it." Martha refrained from telling him the way his leg had snapped it probably was hanging off and the fragmented bone made it less stable than if it were a clean break. It hurt her to see him as worried and as in pain as he was. He was in a position where he knew enough to know of the possibilities and was vulnerable and shocked. She hoped once he was cast, they had got his pain to a more manageable level, and he'd been able to rest for a while he'd be in a better frame of mind.

"It's so bad."

"It's serious, Doctor, but it's not going to be cut off and it's not going to be dangling anymore. We're going to fix you up. It would've been harder because you were on your own and it must've been a shock. At the moment it is going to seem worse because you're worried and you're wearing yourself out. I'm sure once you're more comfortable and we can talk properly about what you've done then you'll see that while serious, it is probably not as bad as you imagined when you saw it a little bent?"

"A little bent?" the Doctor whimpered. "Every time I moved it flopped."

"You weren't at the bottom of the ladder when I went into the TARDIS. Why did you move from where you landed?" Martha had no doubt he'd immediately known his leg was seriously injured and that he should have stayed where he was.

"I had to get the handbrake off."

"I'm sorry." Martha caressed his head.

"Right," James interrupted. "We need to see about getting you sorted. Martha did a great job of reducing your ankle enough to restore the blood flow and to get your knee into position to be splinted for transport." James didn't want there to be a loss of clinical focus with the need to care for the obvious, and understandable, emotional impact of his accident. "What we need to do is get you into a better position so we can apply a cast. It will keep you still and secure and reduce the pain you're in and enable you to rest until we're able to perform surgery," James explained. "We're going to give you some top up drugs and reduce your injuries further and apply the cast. Then Martha is going to clear out a whole section of our hospital for you and you'll be able to recuperate there for a couple of days until we operate. Martha and her team will look after you."

James explained what they were going to do to the Doctor firmly and with an authority that came from him being an unfamiliar medic rather than a friend. It seemed less like a suggestion when it came from James than from Martha. The Doctor preferred Martha. Her whole attitude and demeanour was softer. Not once had James asked him how he felt about it or how much he was hurting.

"Have you any questions, Doctor?" Martha checked with him.

"Is he your boss?" he asked her seeing how James seemed to take control of things.

"Actually," James answered. "Martha is my boss," he advised.

"James is the orthopaedic specialist, so he will lead in terms of stabilising your leg."

"I'll be reducing your leg now, Doctor. Then I will be involved with any and all surgeries required. I'll be doing any orthopaedic reviews so you'll be seeing a fair bit of me over the coming months. However, Martha and her team will take care of you on a day to day basis. She'll be the one leading your care and looking after you both as an inpatient and an outpatient. I'm only going to be looking after your leg. Okay?" James checked with the Time Lord.

"You're not taking over from Martha?"

"No, I won't be."

"Good."

"I'm only here to consult and offer my expertise with dealing with traumatic orthopaedic injury. You'll be seeing a lot more of Martha than me." James thought the Doctor seemed to look relieved. He thought Martha looked a little relieved as well. She'd probably thought the Doctor wanted someone else to take over his care. "Now that is all cleared up and we're sure you're going to be getting the best on-going care are you happy for us to proceed and get your leg straight and casted for you?"

"I wouldn't say I'm happy about it."

"It does need to be done, Doctor. I am going to give you a shot of ketamine like last time."

"Will it be enough?" the Doctor asked Martha. "Will it knock me right out?"

"It will be the same as when we were on the TARDIS and I partially reduced your knee and ankle," Martha commented. "Did it hurt you too much then?" She wanted to know herself if it had been enough. He hadn't shouted at her for torturing him and he'd not complained about how much she had hurt him when he had been screaming at her as she'd tugged on his leg. It seemed ketamine worked in a similar way on Time Lords as on humans because the Doctor looked puzzled and disconcerted as he tried to pin down and decipher the associated memory.

"Do you remember me reducing your knee and ankle a bit in the TARDIS when I put the splint on for you?" Martha asked the Doctor.

"I think so." The Doctor frowned.

"Did it hurt?"

"It must have done."

"Do you remember it being the most painful thing you've ever endured in your life?" Martha asked with a knowing smile.

"No," the Doctor accepted and then groaned. "That was getting my leg back out of the ladder."

"Did it get stuck?" Martha felt herself pale as she remembered how the ladder was angled right across the console but wasn't flat because it had wedged against the upper deck of the flight deck. The Doctor said the ladder slammed shut on his leg. If he'd got stuck? She had no idea how he managed, and he had been on his own?

"I needed help and I had to get it out in order to reach the handbrake. With the damage the ladder did there was no way she could circumvent it." The Doctor sounded close to breaking as he recalled what he had to do.

"You did what you needed to do to get to us," James commended him. "Now, you're here we need to do what you came here for us to do. If you don't recall how much reducing your knee and ankle hurt while you were on ketamine I think we should proceed with the same," he suggested and looked to Martha.

"I concur, should we get on?"

"I know you have to," the Doctor accepted.

"It'll be fine, Doctor." Martha caressed his cheek.