Chapter Nine: Do No Harm
Bashir studied the results of the latest battery of tests he had run with an increasing frown. Shan had indeed begun to fight against the illness, and it seemed likely that within a relatively short time the symbiont would be completely free of infection.
But in the meantime, the toxic byproducts of the virus' death were pouring into Trystmar's body, adding themselves to what had been caused by the injection Bashir had given him. It was this that was so dangerous; the virus itself was actually self-limiting and relatively harmless, the vaccine working by killing it before it could reproduce enough for the byproducts of the virus' death to reach harmful levels.
For now Trystmar's kidneys were doing an adequate job of filtering the blood, but soon the poison would reach critical levels and they would be overwhelmed. Bashir's eyes shadowed as he realized he could well have caused the very syndrome he had promised to prevent, but he could spare no time to consider the ramifications of that now; he was not yet ready to give in. Calling a team to assist him, he began prepping Trystmar for surgery.
Trystmar was kept constantly sedated now; there was need for only a little more anesthetic to be sure he would feel no pain.
Bashir first inserted a hemoscrubber to aid the kidneys in their task. The small blood-cleaning device would not completely filter out the poison, or it would be used more commonly in the treatment of Ogravrett's syndrome, but he had hopes that it would at least reduce the concentration to levels the kidneys could handle.
Then he turned to the source of the poison, the umbilical cord that carried nutrients from Trystmar's body to Shan, and waste from Shan to be disposed of by Trystmar's elimination system.
He cut carefully into Trystmar's abdomen, exposing the cord just where it entered the sac that cradled the symbiont. It was a spiraling twist of two tubes, and he tested the blood they contained to determine which was ingoing and which outgoing. Unable to afford making a mistake, he marked the correct twist with a spot of dye, an unnecessary aid to his photographic memory.
He handled the cord with utmost care; the poison it was pumping out was highly toxic to Trystmar, but perhaps would be equally as dangerous to Shan if the flow was blocked for even a short time.
Dr Bashir had the length of tubing ready as he made an incision in the cord, inserting it deftly almost in the same moment. Only a very little fluid escaped, and he cleaned it away carefully to prevent infection.
The liquid gushed into the tube, carried to a receptacle where its level of infection would be analyzed before it was disposed of. The bulk of its volume was pus and serum from the symbiont rather than blood, but Bashir would monitor Trystmar's blood volume closely and give him transfusions as needed.
Glancing once at the monitors to assure himself Trystmar was stable, he began closing the incision up to the point where the tube exited.
He drew a deep breath as he straightened, going to clean up as his team completed their final tasks.
"You may go," he told them quietly, returning to the bedside. Looking at his face and hearing the tone of his voice, they exchanged looks with each other and left without a word.
Dropping to one knee beside the biobed, Bashir took Trystmar's limp hand in his. "I'm sorry," he whispered.
He had been wrong, he acknowledged now; so focused on whether he could report all tests negative that he had lost sight of his true goal as a doctor — not for his patient to be completely free of disease, but to enable him to live the best quality of life at the least risk for the longest time possible. It was not always possible to meet all three; often a balance had to be achieved, a decision made as to which was the most important in this particular instance. But in this case he could well find he had failed at all three; had gone against the essence of the vow he had made as a physician to Do No Harm.
And it had all been unnecessary. He had told Bendris Trystmar had to undergo the treatment, but that had been an outright lie. If each host had been vaccinated, the disease in Shan never would have caused any problems; it was only his own pride that had made him want to eradicate it completely.
Yes, Trystmar had been eager for that as well, but it was his past hosts' memories driving him. Had Bashir told him only of the vaccine, it would have been sufficient hope for him; he might still have been uncomfortable with the burden of infection the symbiont carried, even pushing to have it attenuated, but if he was unsuccessful a few hosts free of Ogravrett's would have quieted Trystmar's fears in Shan's collective memory.
Even now, Bashir couldn't justify not mentioning the treatment to Trystmar at all; it was his duty as a physician to discuss all possible options with his patient. But he should have glossed over it; dismissed it as too hazardous; dissuaded Trystmar even if he insisted he wanted to take the risk.
Now he was faced with the very real possibility that he might have caused the very disease he had promised to cure — a possibility, he realized now, that he had known all along existed but had pushed to the back of his mind as too slight a chance to be worth considering.
And if Trystmar did develop Ogravrett's, what then? He could not condone suicide, yet could he let Shan die another lingering, painful death knowing there was no hope of saving him?
No, he decided. If it came to it, if there was no more hope of saving Trystmar and he could no longer adequately control his pain, he would remove the symbiont and let him die of disjoining.
And then — he would destroy the symbiont as well. Not in an effort to hide his misdeeds by preventing Trystmar's memories from being transferred to another host, but because the symbiont by that time would be so riddled with infection as to be fatal to a new host.
This would be the end of his career, Bashir supposed. He had little hope of hiding it from the Trill Council; they would sue him for malpractice at the very least, and he would not deny the charge.
"I'm sorry," he murmured again.
But as he got to his feet, there was a quiet firmness in his eyes rather than despair. Having decided his course of action, his calm resolve had strengthened to do all in his power to prevent it from becoming necessary.
Next chapter coming next week!
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