CHAPTER 4

The last previous mass Upsilon Radiation exposure had occurred eighteen years ago. A terrorist ostensibly trying to prevent the expansion of Federation influence had detonated an Upsilon Radiation device near an orbiting Starfleet installation. Medical assistance arrived at the installation within hours, but all efforts to save the exposed personnel were in vain.

Dr. Julian Bashir reviewed the records of the attempted treatments. Most of the attempted treatments were conventional, but some were radical, and the some of the most radical treatments bordered upon being gruesome. The list of techniques and medicines that that been tried was a long one. Opiates, therapeutic viruses, stabilizing irradiation, local and general anesthetics, interruptive stimulation, fluid immersion, combinations of analgesics, induced coma, various forms of surgical intervention, and numerous other techniques for addressing pain had been tried. Some of the treatments had been effective in the early stages of nerve degradation. But for the later stages, the results were troubling. All treatments had failed.

Some of the treatments were bigger failures than others, as they actually made the patients' suffering much worse. A few treatments actually caused the patients' deaths.

Reports about treatments tried in other cases of mass exposure were less detailed, but were equally discouraging.

Sixteen members of the crew of USS Observer had arrived in Deep Space Nine's Infirmary. Within an hour, four of them had died. Bashir had "followed the book," ordering conventional treatments for them, none of which did any good at all.

Bashir focused on efforts to help the remaining twelve survivors. These twelve survivors were in the early stages of exposure, and only two of them were symptomatic so far. The reports were clear that the most effective treatment in early stages was Dyneuryllin, specifically Grade Orange Dyneuryllin. Regular Dyneuryllin, also known as Grade Blue, was far less potent and far less effective; the boosters included in Grade Orange were shown to bring greater relief to patients and to bring that relief significantly faster. The reports cautioned, however, that Grade Orange Dyneuryllin could not be replicated on an "as needed" basis. The Dyneuryllin needed to "settle" for at least an hour after replication. After it settled, it would remain potent for several days.

Bashir ordered that two hundred fifty doses of Grade Orange Dyneuryllin be replicated. He hoped he would not need that many, but the reports indicated that it was far better to have too much than not to have enough.

Bashir gathered the remaining twelve survivors. He told them that they had been exposed to Upsilon Radiation, and that the exposure would very likely take their lives in a matter of days. The survivors were unsurprised to hear this news. Some sniffled quietly but most took this news with stiff upper lips.

He further told them that they would soon start to experience pain from the exposure. In the early stages, the pain would be manageable. He also told them that there would come a time when the medication would no longer have any effect. The exposure to Upsilon Radiation would hurt. It would be very, very painful. As their nervous systems failed, the pain would become much, much worse. It would become intense, even excruciating.

The twelve took this news bravely, too. Having served aboard a ship that was authorized to use Upsilon Radiation, they knew what Upsilon Radiation was and what it could do to a living body. None of what Bashir said was a revelation to them.

Bashir promised each of them that he would make them as comfortable as he could, and that he would do everything in his power.

Although it gave him grave discomfort to say so, Bashir also told them that, in all likelihood, there would be nothing he could do to stop what was going to occur.

He pledged to each of them, however, that he would give his best efforts, and that he would answer every inquiry they had with full honesty.

At that time, all of his patients were lucid. Bashir requested from each of his patients permission to test any and all medications and treatments to see if the effects of Upsilon Radiation exposure could be addressed in any way. Perhaps the effects could not be stopped or cured, perhaps they could be delayed or reduced. Would the twelve remaining survivors grant their consent to be test subjects for experimental treatments, which may or may not help themselves, but which might help future patients?

All of the patients gave their permission. Their consents were duly recorded.

Less than two hours later, Lieutenant Moses Ishcid and Ensign Kimberly Gunderson reported burning pain in their limbs and lower backs. Bashir administered Dyneuryllin, which had previously been effective in eliminating the discomfort.

This time, however, the Dyneuryllin injections were ineffective. This meant that Ishcid and Gunderson were entering the final, most excruciating phase of Upsilon Radiation exposure.

It was as Bashir had thought it would be: Ishcid and Gunderson had been closer to the Probe Preparation Bay than the other survivors, so they had received trace doses of type-two exposure, along with doses of type-three. Bashir had expected that they would enter the final stage, and die, sooner than the others.

Bashir ordered Ishcid and Gunderson to be placed in isolated wards. He ordered them to be held in flexible restraints and that the wards be sealed so that his patients' screams would not be heard by any of the other patients.

Bashir intensified his efforts to find something that might afford relief. He had decided not to try those medicines and treatments that had already been tried on others and that had been shown not to work. In the past eighteen years, there had been some advancement made with respect to nerve damage and cell degradation, and some intriguing research with respect to treatment of severe pain. Even so, the progress in knowledge was marginal. There were no obvious breakthroughs. Nevertheless, Bashir decided to start with medicines and treatments that had been developed in the last eighteen years.

He tried some on Ishcid and others on Gunderson. None of them halted the progress of nerve degradation or relieved any pain.

Bashir decided to try an extreme approach that, as far as he could determine, had never been tried: a mixture of a military nerve agent, delivered in a vehicle of ethyl alcohol. He hoped that the mixture might interrupt transmission of nerve impulses, which might affect the brain's perception of pain.

He prepared a mixture using a high yet non-lethal concentration of nerve agent. He subjected the mixture to a tissue test. The tissue test showed that the mixture was disruptive to cell activity but not overly disruptive. It clearly was not toxic, which was another point in its favor. The tissue test further confirmed that the alcohol vehicle would be effective in taking the agent where it needed to go.

Further tests and simulations seemed even more promising, indicating disruptions of pain pathways could be affected while other nervous system activity would be less impaired.

The tests and simulations predicted some shortcomings, however. For one thing, a patient would experience the effects of intoxication. For another, the patient could experience a loss of normal sensation, possibly a loss of proprioception or a feeling of paralysis. Liver and kidney functions would likely be impaired. Perhaps most troubling was that the tests were unclear as to whether there might be a positive effect on the degradation of the nervous system. In other words, although there were indications that the mixture might slow the effects of exposure, there was no indication that the mixture would reverse them.

Nevertheless, Bashir was somewhat excited about the prospects of his discovery. At the very least, he judged the mixture to be worth a try.

Bashir prepared a hypo. He administered a dose of the alcohol-based nerve agent to Gunderson, who almost immediately went into convulsions. Gunderson's pain levels also jumped alarmingly, and then her heart stopped. With considerable difficulty, Bashir restarted her heart and stabilized her.

The elixir that he thought might have the best chance of helping his patient had nearly killed his patient.

Bashir made an official note that this mixture was ineffective, and he made certain all the details had been duly recorded. He added some comments, saying that the cardiac issues were unexpected, but they could be addressed. Of greater concern was that a treatment that ought to reduce pain had actually multiplied it. Such paradoxical results had been observed before, in other situations; but those other situations had various explanations, and none of those explanations could be mapped to this case.

Bashir felt he owed it to his patients to tell them about the results of his efforts. He decided not to discuss the details of Gunderson's experience.

He also thought it best not to say that he was running out of ideas.

Each of the survivors from the Observer had a private room near the Infirmary. Dr. Bashir looked in on one of the rooms and found it empty. He checked another room and found it empty as well. When he poked his head into the room of Lieutenant Pitts, he found her along with nine of her shipmates. They were conversing and laughing, but stopped when Bashir entered the room.

Bashir wondered what was funny, but he didn't feel right asking. So he said, "Sorry for intruding. Hello, everyone. Amy. All right if I come in?"

"Sure, Doctor," Pitts said. "We were just sharing a little gallows humor amongst ourselves."

That explained the laughing, Bashir thought. "How are you feeling?"

"Fine," said Pitts.

"And everyone else?" Bashir scanned the room. "Any discomfort?"

Everyone else nodded that they too were fine.

"How are Mose and Kimberly doing?" Pitts wanted to know.

Dr. Bashir lowered his eyes momentarily. "Not well, I'm afraid."

An ensign named Foster nodded. "We know. We can hear them."

Bashir was simultaneously surprised and embarrassed. Moses Ishcid and Kimberly Gunderson were in states of unspeakable agony. They wailed uncontrollably, and Bashir had hoped that the soundproofing of their wards would prevent the other survivors from hearing their cries.

But apparently their cries could be heard all the same.

An ensign named Holly spoke up. "Doctor, is anything you're doing for them working?"

"Nothing so far has been effective." Bashir put a little extra emphasis on the words "so far," to show that he had not given up all hope. "I will keep trying."

Holly spoke again: "What is happening to Mose and Kimberly: is that the end that awaits us?"

Bashir remembered his promise to answer all questions honestly. "Yes. I think that is likely."

Tears welled in Holly's eyes. "I don't want to die that way!"

She was joined by her shipmates, all of whom said that they did not want to die that way, either.

Bashir wanted to tell them that he would continue to work on a treatment, and that they should not give up hope. But he knew that the chances of him curing Upsilon Radiation sickness were next to nil, and he could not bring himself to give his patients what he believed to be false hope.

Instead, he said: "You're not dead yet, none of you. Have you all sent messages to your families, your friends, your loved ones? Have you? Do that! Let them know that you care about them. It's important."

He looked at the faces of the Observer survivors. They had been laughing when he came into the room, but now there were tears in every eye. These ten patients were afraid of what was to come, and with reason. Bashir felt his own throat tighten.

"Tell your loved ones how you feel, focus on that!" Bashir wagged a finger. "No gallows humor! Just tell them how you feel about them. I'll check on you in a short while."

And with that, he left the room and immediately felt his own emotions rising. There was burning in his eyes. He could not accept that there was no way to help these people. But how could he help them?