Part V, Act V: Trauma and Assessment
Julian scarcely had time to brace for impact before the Second charged into him like an oncoming torpedo. He did manage to shift the angle of his body so that the Jem'Hadar slammed into his right shoulder instead of his left, but that only did so much to mitigate the jarring pain that tore across his upper back. He grunted as he was pushed back towards the lip of the ring, leaning frantically into his opponent as he fought to keep his legs from buckling. A fist, hard and heavy as iron, blasted into his side, just below the right floating ribs. Julian's forehead bounced against the Second's breastplate as his body tried to double over against the blow and discovered there was nowhere to go.
His right hand flew up, grappling for a hold on the back of the Jem'Hadar's neck. He had no thought but to pull himself upright and regroup, but with a viper's reflexes, the Second jerked away and seized his arm, twisting it and lifting. He pushed off, and drove Julian to his knees by the sheer force exerted on his forearm and elbow. Julian didn't fight it. Not my arm, he thought frantically. He can't break my arm. I don't even know what's wrong with the other one yet.
Luckily, the Second didn't seem interested in the limb except as a means of subduing his attacker. As soon as Julian was on the ground, the Jem'Hadar kicked him savagely in the abdomen. He struck too low to hit the celiac plexus, but Julian crumpled nonetheless, his brow brushing his knees as he collapsed forward over his lap. His right palm smacked the floor and he tried to push himself back up, but two knotted fists came down on the back of his head and he rolled onto his side, gasping and disoriented. The boot struck him again, this time squarely in his left pectoral muscle, and the dizzy fragments of the atrium he could see around his defensively curled right arm grew very dark.
He didn't know if he actually greyed out, or if that was only an illusion caused by a disoriented moment of temporal displacement, with a few seconds seeming to stretch on into sightless eternity. But Julian wasn't so dazed that he had forgotten the reason for all of this otherwise senseless pain, and he fought to rock back to the left so he could push himself onto his knees again. He tried to use both hands to clamber to his feet, but the left would not obey him at all anymore. The agony on that side was now a column of nebulous fire driven like a stake through his body, from nipple to shoulder-blade. He knew that ought to tell him something important about his condition, but as there had been no time for remorse while he treated the Eighth, so there was no time for differential diagnosis while he was fighting for his life.
Julian exerted a great surge of will and every shred of strength left to him, and he hoisted himself up off the ground. He was bent almost double and swaying from side to side like a troll, with his left arm dangling and his right clutching his belly, but he stumbled to the nearest post and struck it, turning as he did so to seek out his opponent.
The Second was weaving to and fro on limber feet. His thickly muscled legs looked solid as tree trunks, and his arms were at the ready. Julian watched them as he would have watched a plasma rifle trained between his eyes. They were the deadliest weapons in the ring, and he had to keep them in his sight.
He was groggy and unsteady, his chest heaving and hitching with the effort to draw breath. He couldn't think clearly enough to strategize, not through the fog of agony and exhaustion. But when the Second came for him again, Julian's legs remembered something his mind couldn't quite grasp, and he sprang out of the way. There was no wall with a bright neon target to bounce off of, no whistle and clonk of a ricochetting rubber sphere, but it was a racquetball manoeuvre all the same, and it worked. The Second could not turn in time, and he whisked past Julian's right side as the human skittered away and struggled again to regroup.
"Well done!" someone snarled, a vehement but very distant voice. "Well done, Doctor!"
Julian couldn't imagine who had possibly spoken: all he could see, all around the borders of the arena, was an ocean of hostile, spiny faces. The Jem'Hadar were hungry for his blood, and their Second intended to oblige them. He darted for Julian again, and this time the Doctor evaded him by a far narrower margin. The impact of his landing jarred his whole body, awakening every individual pain at once — not ferociously, but perniciously. Julian reeled, fighting to keep his feet, and his hip smacked the nearest post.
The hand came out of nowhere, and as it closed about his throat, Julian could not understand how he had possibly lost track of it. Steely fingers gripped him just below the jaw. Thumb and forefinger pressed in on either side of his larynx, awaking a new, horrible pain that, in its immediacy and its deadliness made all the other agonies fade into insignificance. Julian tried to breathe, and managed only a thin, painful wheeze. Then the Second began to lift, hoisting him into the air.
His weight was thrust onto his mandible, and Julian could feel the joints of his jaw stretching and straining and struggling to hold. His neck was stretched and tractioned by the weight of his body as first his heels, and then the balls of his feet were lifted off the ground. Panic and outrage gripped him — not anger or wrath, but outrage: his mind rebelling against the offence of this position, the unnaturalness. He was choking, strangling, he was sure of it. Although he sucked in another meagre measure of air through vocal chords that burned as if they were wreathed in flaming plasma, Julian was certain that he was going to suffocate.
Something shifted between his second and third vertebrae, and his mind's eye was momentarily eclipsed by the image of the Hunter in his red battle suit, neck canted horribly to once side. The Second had done that, and now it was Julian's turn. At the same time, in the three agonizing seconds that it took him to be hoisted from flat feet to the tips of scrabbling toes, his physician's mind was nattering on at him about dislocated jaws and ruptured larynxes and the long, agonizing death of slow drowning as his throat filled with blood. The Jem'Hadar's thumb was more medial on his throat than the fingers were, impinging on the right carotid artery. Julian's left eye seemed to bulge and throb, and the world grew very grey on that side — greyer even than the utilitarian Dominion decor demanded.
Well, well! some sarcastic part of his mind sneered nonsensically. Who's Khan now?
Julian did the only thing he could think of, in the circumstances. He grabbed the Second by the wrist, and tried to hoist himself higher. It was the only way to alleviate the pressure on his throat and his jaw. The fingers of his right hand clamped tightly, and it seemed that his left arm could still work after all, at least under deadly duress: it flew up as well.
On Invernia II, where Julian had spent most of his tenth year as the only human child in an embassy classroom full of the offspring of the sort of Federation diplomats relegated to remote postings on minor unallied worlds, the indigenous population had a tradition of adrenaline sports. One of the most popular, and Julian's especial favourite, had involved the rapid climbing of elaborate courses suspended in the lower canopy of the vast deciduous rainforests of the equatorial continent. Constructed of platforms and beams, ropes, vines and ladders, the courses were exhilarating and challenging, engaging the mind and using every part of the body. Julian, who at the time had been ravenous for any and every activity that might stimulate either in ways his homework and schoolyard athletics were incapable of doing, had taken to the sport with a passion. Despite his mother's protests and his father's prohibitions, he had scurried up into the canopy whenever he had the chance.
That was what this manoeuvre reminded him of: Julian gripped the Jem'Hadar's arm as if it were a branch, and tensed the lean muscles of his biceps, his forearms, his shoulders. The left one was less responsive than the right, but he still felt himself rising, and the pressure on his jaw let up a little. But the Second was tightening his grip instead, and Julian heard an ominous creak of cartilage. When next he tried to draw a breath, he got only a thin tendril of air that burned in his constricted throat and did nothing to relieve the ghastly pressure in his lungs.
In another moment he would pass out; he was certain of that. But he couldn't seem to muster himself to fight back: it was all he could do to maintain the grip that was preventing his jaw from detaching from his skull. Julian tried to kick at the Jem'Hadar, but his right foot just swung leadenly at the end of his leg.
Then suddenly they were turning, the Second rotating clockwise in a motion that made Julian's head spin violently. When the grip on his neck released, he wasn't quite able to process what had happened. His head snapped back and he fell, hanging briefly from arms that still clung to his opponent's wrist. When he was flung off, Julian crashed to his knees, only to be clouted across the side of his face with a swinging fist. He jolted to the right, and was promptly driven back to the left by its partner, clubbing the other side of his skull.
He scuttled away on hand and knees, his left arm once more forgetting how to obey him. He was groping along the floor, trying to find the nearest post despite the bursting flares of blackness obscuring his sight, when a hand closed on his hair, yanking his head backward and his body upright so that the Jem'Hadar could buffet him under the chin with the heel of his hand.
Julian reached out even as he reeled backward, and his fingers closed on the Jem'Hadar's forearm. He felt the loose hide that rippled over the hard muscle, and his fingers closed upon a flap. He twisted as hard as he could, as if reefing on a fistful of a fitted bedsheet. The flesh rippled into a tight swirl beneath his fingers. It wasn't nearly as effective as grabbing Talak'ran's gill had been, but it was painful enough to elicit a hiss of anger from the Second. A moment later, Julian was crashing to earth again as the Jem'Hadar's free arm swung around for another blow.
He landed on his left shoulder, and the jolt of anguish that shot through that side of his back almost robbed him of the will to stay conscious. Booted feet were thundering next to him, crowding him, threatening to kick. Julian's long limbs were trying to curl inward, his body shrinking into a defensive ball. He couldn't remember who he was or why he was here, or why there was so much pain. He wanted it to stop. Why didn't someone make it stop? Please, please, Mum, make it stop!
But he knew he had to get up again, somehow, and so he got his knees under him and huddled there while he drew an agonized breath, his right arm curled protectively around his hanging head. The wave of blackest vertigo that seized him as he pushed himself up onto his left foot was almost enough to carry him away into merciful oblivion, but it didn't and his right hand was already groping for the pylon. This time, the gong seemed to rattle his brain, and Julian squinted through the noxious fog to track the dark hulk of the Jem'Hadar Second as he surged forward again.
Julian caught him under the arm, pressing his body against the oncoming one as much for support as to undercut the Second's line of attack. For a moment they were motionless, meeting one another with equal but opposing force. Then a sweeping foot knocked Julian's feet out from under him and he fell again. This time, something gave way in his right knee with a soft pop that he could feel right up into his hip. His lips parted to scream, but only a hiss of tormented air escaped. He crumpled forward again, and that was when the Second kicked him in the face.
He didn't feel the impact; not exactly. He saw the boot coming for him, eclipsing his sight. And he heard the sickening crack reverberate through his skull. He thought he heard it with his external ears, too, but he couldn't be sure of that. All he really understood was that his head had exploded, a blazing pulsar of pain. He felt himself falling, flying backward with the force of the impact. The back of his head smashed into something hard and approximately cylindrical: he felt his scalp tear open on one rigid edge. His skull bounced, rolling off to the left, and it settled between two of the hard nubs. Julian knew, distantly, that his legs were bent unnaturally beneath him, in a way that was sending little tremors of strain into the ligaments of his knees and his hips, but he couldn't do anything about that now.
"Doctor!" a thunderous voice hissed, very near at hand. "It is over. Stay down."
Julian's lips parted to protest that it wasn't over, that he had to keep fighting — but he couldn't remember why. And then something appeared above him, pale and greenish in the unnatural light. It swam, an indistinct blur before dazed, watering eyes, before finally taking on a familiar form. Two keen eyes. Thin, strained lips. A chevron of bony protuberances above dark, oblique brows.
Her name is Kalenna, Julian thought vacantly, pleased that he could remember that much. She used to be a Major with the Tal Shiar. We all used to be something other than this, once upon a time…
He didn't feel the toe of the Second's boot as it blasted into his ribs one final time. He was already slipping away.
(fade)
Julian felt his way around the edge of the pain, a blind man in a lightless room on the dark side of a forgotten world. He would draw too close, and he would feel the fire, and he would shrink away like a whipped puppy, bewildered and afraid. Yet he came back again and again, trying different approaches, groping at the black doors that led back to consciousness. He was a seeker, an explorer: he had left Earth and its tumultuous interpersonal tangles behind to find adventure in the stars, to seek out not only answers, but questions yet unimagined. And it seemed he could not stop exploring, even if the only galaxy left to him was his own mysterious and miserable body.
There was something wrong with it. Several somethings, in fact. It posed an interesting diagnostic puzzle. How to determine what was wrong with this patient, when every time the Doctor drew too near, he too was overtaken with pain? It was difficult to remain calm and clinically detached when you could feel your patient's agony. It shouldn't be allowed.
None of this should be allowed.
Julian decided to be methodical about this. Airway, breathing, and circulation: the first criteria for a casualty assessment. Any first-year medical student knew that. Airway… impossible to assess without movement, but he was almost certain he was breathing. No, no, he was certain, because he could feel the sawing pain in his chest every time he dragged in another shallow draught of air. He could feel it burning in his throat, too, but the flow was steady, both in and out, and there was no crackling or whistling or bubbling that might indicate a rupture of the larynx. Fine. Airway, operational. Breathing, laboured but steady. Circulation…
If he was breathing, he had a pulse. That, too, was first-year medical student logic. Whether the blood was getting where it needed to go was another question. Open wounds, impinged blood vessels, cyanosis… none of these things could be evaluated unless he opened his eyes, which he simply was not yet prepare to attempt. So he thought about his body instead. A proper assessment should proceed from head to toe, but he wasn't willing to think too hard about his head yet, either. So he started with his toes.
He could feel them. They felt engorged with the cold, but when he wiggled them, they obeyed him. He could feel the perfectly-fitted caverns of his standard-issue boots. Why weren't standard-issue boots warmer? Yes, they were primarily meant for wear on-board ship and in other controlled environments, but they were worn on away missions as a matter of routine, and some places a Starfleet officer might be called upon to visit were less than temperate. Julian's feet were cold, ergo his boots should be warmer. It seemed as simple as that. He was annoyed that the designers of the uniform hadn't anticipated his predicament.
He flexed his left ankle first, and then the right. They, too, obeyed him, but he felt a dull pain in his right shin when he moved. It made him reluctant to try to shift that knee, but when he bent the left one, ever so slightly, it obeyed him. He was too tired to try to move his hips, so Julian focused on his hands instead.
He had been working on the left side, and so he tried to move his left fingers. They didn't obey him. He tried again, focusing all of his will on the lean, delicate muscles that controlled his phalanges. Nothing. Panic gripped him, overwhelming the calm and clinical voice. He remembered the numbness, the loss of function, and the inexplicable pain. What had happened to his arm? He needed his arm. He was a doctor, a surgeon, and he needed his two skilled, steady hands!
He moved the right one frantically, rippling his fingers and flexing his wrist and bending his elbow. His knuckles stung and he could feel the tremors, but at least it was moving when he told it to move. Then suddenly, it wasn't moving anymore, because thin, cold fingers were closing around it, grasping it and trapping it and preventing him from moving it.
"Doctor?" The voice was near at hand, but muffled by the ringing in his ears. Tinnitus, common after a blow to the head. And he'd had more than one blow to the head, hadn't he? "Doctor Bashir. Lie still. Try not to move. You'll hurt yourself."
He had to open his eyes now. He knew that voice, but it wasn't one of his nurses. If he'd been injured in the line of duty, it should be Nurse Jabara at his side now, tending him. She was the next most senior member of the Infirmary staff. Or Nurse Barrett, if he was on the Defiant instead of the station. Until three years ago, Julian hadn't had any Starfleet officers in his department. He'd preferred to reserve the postings for representatives of the Bajoran medical community. It had seemed more equitable, more respectful. When Starfleet Command had sent the warship, they had sent personnel to staff it.
Julian forced his eyes open, blinded briefly by light that quickly resolved into dreary gloom. His left eye blinked wide, but the right one only opened to a slit. He could see the blurry ridge of inflamed tissue. The right side of his face felt enormous, hot and swollen and curiously numb. He had to turn his head in that direction in order to find the face hovering beyond his shoulder. This time, the recognition came more quickly but without any shred of satisfaction. Julian's heart sank as he remembered everything, and understood why Nurse Jabara wasn't here.
Major Kalenna was gripping his hand, studying his face worriedly. He was lying flat on his back on the unyielding cot in the back left-hand corner of Barracks 6 in Dominion Internment Camp 371.
(fade)
Recollection grew grey for a while after that, and Julian floated in a haze of pain and shock. He was shivering under the two thin blankets tucked around him, and eventually Parvok came over with a third. The Romulan Sub-Lieutenant was reluctant to look at him, and he scurried away as quickly as he could. Julian had a thousand questions, but he couldn't seem to figure out how to master the gift of speech. Sometimes Kalenna was at his side, and sometimes she went away. He came back from a dalliance in the Demilitarized Zone between waking and unconsciousness to a sharp stinging sensation as she dabbed at his lip with something spongy and damp. It stung: apparently he had a contusion of the mouth. When she lifted her hand to attend to his eyebrow, Julian recognized one of his sterile pads. He felt anger and indignation and frustration in equal measure. There had only been eight left in the case, and his patients needed them! She had no right to waste one!
"Your scalp was bleeding," Kalenna said softly. "You hit the lights on the lip of the ring after the Second kicked you. I don't think the skull is fractured, but I don't know how to be certain."
There was no way to be certain, per se, without imaging studies: a depressed skull fracture was easy enough to appreciate on palpation, and sometimes even visible to the naked eye, but a hairline crack was much harder to detect. Julian didn't vocalize any of this, of course. He still wasn't sure if he could talk. Snatches of his last fight were coming back to him, and he remembered how the Second had seized him by the throat. He tried to work his jaw gingerly, concerned about the state of his temporomandibular joint, but the deep and horrible pain that shot through the right side of his face at the attempt made him think better of that effort. He lifted his right hand instead, finding his ear and exploring with cautious fingers.
The joint seemed to be intact, but there was appreciable swelling on the crest of his cheekbone.
"Don't," Kalenna said softly, but she did not try to stop him as he prodded the hollow of his cheek, once again skirting the borders of the pain — this time physically, instead of in his mind. There was a hard mass of inflamed tissue across the bridge of his cheekbone, and when Julian tried to palpate it, white-hot agony blazed into his sinuses and his eye socket and his teeth. A quick, anxious pass of his tongue while he rode out the wave of pain reassured him that the teeth, at least, were all intact and where they were supposed to be. But the pain in his face…
He probed his eye socket next, digging deep into the edematous mass despite the deep, pernicious anguish. Pain was transient, and he had to know. But the socket was still smooth and unyielding, and as he grew more accustomed to the pain it seemed to narrow in its focus. He remembered the black mass of the Jem'Hadar's boot coming for him, and he remembered the sound of the impact — not the thunk of a reinforced toe against a human face, but the deafening crack that had ripped through his skull. Julian thought he understood, and he stopped his palpation before he actually put pressure on the source of the pain.
He had a non-displaced fracture, hopefully hairline, of the inferior aspect of his zygomatic arch.
After that, Julian had to rest for a while. Kalenna was speaking to him, and there was a dark shadow just at the edge of his periphery that was surely General Martok. But it was too hard to listen, and speech was impossible. Julian simply let himself drift, shivering and hurting and trying to lie still. His forehead felt very light, as if his frontal lobes were inflated with helium gas and might float away if not for the tether of his neck. He didn't want to think about the state of his dura. He tried to remember how many blows to the head he had taken, but he couldn't.
Something else was niggling at him, but Julian couldn't think what it might be. He was too absorbed in trying to puzzle out how severe the damage was to the rest of his body, all while trying to move as little as possible. He was nauseous and miserably thirsty, but he was afraid to ask for water. Moving his jaw at all seemed very unwise, even though the right side of his face was mercifully numb again. But there was something, something else that he needed to know. Something even more important than the mystery of his deadened left arm. And it was hovering just out of reach in the mists of concussion and pain.
Pain. Brain. What was there to gain? a singsong voice asked, mocking him. Julian was visited by a vague memory of a child chanting a rhyme, her voice high and light and slightly off-key. And she was playing a game. Hopscotch. Jules didn't understand hopscotch, but all the other children played it. The shapes in the squares meant something to them. They were nonsense shapes to him, like the Dominionese letters on the Vorta's medkit. Only it wasn't hopscotch, not exactly, and the words to the song were different, too. He tried to remember, but he couldn't. All he could hear was this other string of rhymes, the new one. The wrong one.
Pain. Brain. Gain. Tain.
Tain.
"Tain!" Julian croaked, remembering. He reached for Kalenna's quilted sleeve, groping with long fingers. His knuckles were torn. He remembered getting in a few blows of his own, though not against the Second. That didn't matter now. Nothing mattered anymore, unless he had managed to last long enough in the ring. "Tain…" he repeated, hoping she would understand.
Kalenna nodded tightly. "Yes," she said, grim fervour in her voice. "He did it. The transmitter is wired into the power grid now. There's no sign that the Vorta knows anything. You kept him out there long enough, Doctor. Everything…" She faltered, casting her eyes down at his shoulder for a moment before she could make herself go on. "Everything went exactly according to plan."
And Martok was there, no longer a shadow in the hazy distance, but a looming guardian high above Julian's head. His battered face was set in lines of hard pride and joyless satisfaction. His lone eye gleamed even in the gloom. "You are victorious, Doctor," he declared fiercely. "You were defeated in the field, but your sacrifice has won us this battle. All is well."
Julian wanted to nod, but the preliminary tensing of his neck awoke a wave of uncontrollable vertigo and his vision began to go dark. Thickly, speaking against a ravaged throat and a fractured face, he mumbled; "That's all right, then."
Afterwards, for a long time, there was only darkness.
(fade to black)
