Stardate 2260.185
"Thank you for your time, Dr. Govorski," Voris said, rising to his feet.
"It's like the Vulcans say, I'm here to serve," the human doctor replied with her usual warm smile. "Now get some rest, I know it's quite late there."
"Good night, doctor," Dagny added, aware that she was slouching in her chair but too weary and exasperated to sit up. "And thanks."
Voris terminated the transmission. "She is correct. It is late."
"We should check in with Aisla," Dagny murmured, thinking of their Orion nurse who was assisting one of her Orion friends in the early stages of labor.
"I will go within the hour," Voris replied. "But I must finish amending the clinic's logs. I would also like to begin synthesizing your new medications."
"I can help you then."
"You should rest."
"It sounds like I'm going to have plenty of time to rest soon enough," Dagny said darkly.
None of Dr. Govorski's recommendations had surprised her, but she still wasn't looking forward to them. Aside from the continued monitoring of her hormone levels, Dr. Govorski wanted her to start wearing a device to monitor her internal body temperature.
Vulcan body temperature was more variable than that of humans but on average, it was two degrees cooler. Because her usual temperature of 37°C would essentially be considered a fever in a Vulcan mother and because the fetus was approaching a stage in its development where it was extremely sensitive to temperature changes, overheating even from light exercise could spell disaster for the baby, leading to neurological damage and potentially even death.
Not that she would have much opportunity to exercise. Next week she would be at twenty weeks gestation and Dr. Govorski wanted to begin a regimen of more aggressive immunosuppressants. She would have to begin a series of medications to downregulate human pregnancy hormones and increase production of mid-stage Vulcan pregnancy hormones that were necessary to the development of a healthy hybrid baby. The hormones would stimulate her immune system, which would then in turn attack the baby if her immune response wasn't sufficiently tamped.
With a weakened immune system, she would be vulnerable to infections until the final month of her pregnancy, when she would no longer need the Vulcan hormones or immunosuppressants. Unfortunately, it still meant spending most of the duration of her pregnancy wearing a face mask and being confined to the clinic where biofilters continually purged the environment of pathogens. They would need to install a similar filter in their quarters and she would have to be mindful of food handling and contamination. She wasn't sure whether she hated the idea of being handled with kid gloves or being a prisoner in the clinic more.
"You are annoyed," Voris said, cocking his head as he turned to look at her.
Dagny pursed her lips and gazed back at him through sluggish eyelids. Ever since their confessions about being able to sense each other's jealousy the week before, Voris had taken to commenting on her moods, as though she didn't know what she was feeling at any given time. Not only was it annoying, it was also extremely distressing. It felt like a complete violation of her privacy that he could just know she was feeling sad or irritated or bored throughout the day. He was more skilled in concealing his feelings. She wasn't sure if his talent was in concealing them from himself or from her, but either way, the exchange of feelings between them was very one-sided.
She realized Voris was looking at her as though he wanted some kind of confirmation of his statement, so she rolled her eyes, searched her mind, and slowly replied, "Yes, I'm… ornai'ga."
"Ornai'tau," he corrected.
Dagny gritted her teeth and forced a smile, recognizing her linguistic mistake immediately. By altering the ending of the word, she'd claimed she was annoying rather than the one who was being annoyed. T'Mir had been very patient in trying to teach her the basic aspects of the Vulcan language and Voris had made a few attempts to continue expanding her command of Vuhlkansu, but most of the time, it all sounded like gibberish. "Your language is hard."
"It is, but you are making fair progress with the vocabulary."
"I know you still think my pronunciation sounds like I'm shaking a bag of rocks."
"You have a human tongue."
"And you have a Vulcan knack for stating the obvious."
Voris' eyes shifted from right to left. They stared at each other without speaking. When Dagny's guilt over her snippy attitude finally outweighed her irritation, she sighed and said, "I'm not very tired. I don't feel like resting."
"Would you prefer to continue your studies of Vuhlkansu?"
"Nirsh," she replied with a smirk, using the Vulcan word for "no." Two weeks of intermittent and informal Vuhlkansu lessons had been as agonizing as pulling teeth. She hated failing at something so miserably no matter how hard she tried.
"Then perhaps we could resume last night's lesson on novel amino acid synthesis," Voris suggested.
"I can't do chemistry tonight."
"I am aware of your dislike of organic and physical chemistry, but amino acids are a topic more closely aligned with biological chemistry."
"It has the word 'chemistry' in it, doesn't it?"
Voris uttered the slightest of sighs. "Chemistry is integral to virtually all aspects of medicine."
"I know."
"If you wish to matriculate into a medical training program-"
"I know, Voris," she snapped. "I know I need to study harder and learn more. I know I'm 'underperforming,' as you say. I know."
"If you know these things then why do you raise your voice? It is illogical to be angry with facts."
Her cheeks started to burn and she literally bit down on her tongue to keep her from unleashing the full weight of her fury onto the clueless man standing in front of her. She wasn't sure if it was the pregnancy hormones or if he had always been such an obnoxious know-it-all, but at that moment, he was the most irritating thing in the entire galaxy.
Voris took a step toward her, tucking his hands behind his back as he moved. "During my fellowship on Earth, I worked with a highly respected human physician named Dr. Kelley."
"What does that have to do with anything?"
"He relished in shouting and seemed to delight in belittling the staff underneath him."
Dagny crossed her arms and leaned back in her seat, wondering where he was going with this. Was he about to apologize for making her feel stupid on a regular basis?
Voris continued. "I once asked a colleague why he did this, and I was told Dr. Kelley simply had a habit of punishing other people for his own frustrations and failures. I believe the colloquial phrase Dr. Kayala used was 'to take it out on the wrong person.'"
Dagny's breath caught in her throat. It was bad enough that he seemed to understand everything she didn't, but now he had to show her he understood her better than she understood herself?
Angry tears welled in her eyes. She stood and stormed in the direction of the stairs to their quarters, feeling ashamed she was being so mean but still annoyed that Voris was an obnoxious know-it-all. She didn't quite make it to the stairs before the after-hours buzzer sounded. Voris gave her a patient but knowing look and answered it to find Sora, a young Tellarite woman, being propped up by her fiancé, frothy red blood bubbling from her mouth.
"She said she couldn't breathe," the man cried, clutching her tightly. "We were halfway down the tunnel when she started choking on her own blood."
Voris and Dagny immediately jumped into action, scrambling for diagnostic and supportive medical equipment.
"Has she been ill recently?" Voris asked, scanning her chest with a tricorder.
"No, she was fine," Gaz, Sora's fiancé, insisted. "She was good just a few hours ago. Is she going to die?"
Dagny rifled through the closet for the supplies to insert a nasal cannula to deliver supplemental oxygen and looked over at Sora, who looked delirious and on the verge of losing consciousness. "Not if we can help it," she answered firmly.
"We're supposed to get married next spring," Gaz cried, pacing back and forth between the doorway and his partner.
"And Voris and I are going to make sure that happens," Dagny insisted, hooking up the supplemental oxygen. She glanced over Voris' shoulder and was shocked to see the woman's blood pressure was almost non-existent.
"Why did this have to happen to her?" Gaz wailed. "What's wrong with her?"
Voris began to explain. "I believe your betrothed is suffering from a-"
"Pulmonary embolism," Dagny finished, racing to the pharmacy cabinet to load a hypospray with empinidrine, a Tellarite vasopressor to treat Sora's plummeting blood pressure.
Voris looked in her direction and nodded. "She'll require ten milliliters of a ten percent solution of empinidrine to stabilize her-"
"Blood pressure," Dagny interrupted, programming the dosage into the hypospray. "Already on it."
"And the next recommended course of treatment after stabilizing blood pressure?" Voris asked, heading toward the pharmacy cabinet.
"Thromolysis," Dagny answered. "Either through medication or surgical removal."
"Surgical removal?" Gaz choked, stepping forward and pulling anxiously on his long beard.
Sora seemed to half understand and gripped Dagny's hand. Her breathing was even more labored now and a bloody bubble was forming on her lips.
"Yes," Voris called over his shoulder. "According to my readings, blood flow through the pulmonary artery has been reduced to approximately thirty percent. I believe her case is severe enough that anticoagulants and thrombolytics will be ineffective-"
"I don't understand all these words," Gaz cried, falling to his knees in front of Sora and grasping for her free hand. "Just tell us."
"Your fiancé has a large blood clot in her lungs," Dagny explained as calmly as she could manage, looking back to Voris for his medical opinion. "We need to take it out so she can breathe."
Five minutes later they were in the surgical suite, wearing surgical gowns and standing over Sora. She watched as he guided her through the steps of intubation, explaining that it was typically contraindicated for pulmonary embolism patients but necessary in this case due to the general anesthesia required for surgery. Dagny's hands were shaking, but if Voris noticed, he said nothing. She had assisted him in several surgeries before, but most of them had been routine and scheduled.
He threw question after question at her as they worked. It was nerve-wracking, handing Voris equipment and trying to answer questions about blood flow in the inverted Tellarite heart and whether administering fluids would lead to worsening ventricular dilation or hypovolemia. It was made much worse by the fact that she could hear Gaz sobbing just outside the door.
She appreciated that Voris did his best to use every patient as a learning opportunity and she recognized many medical school hopefuls probably would have killed to get this kind of practical experience, but when it came to really serious emergencies, it was just plain overwhelming. She was still only a paramedic, not an interspecies cardiologist. She wasn't even trained as a surgical technologist, and so helping him during this surgery felt mildly surreal. Life as his assistant on a remote colony world was like living a unique kind of imposter syndrome.
Even so, thirty minutes later, the clot had been removed and Voris was sealing the surgical site when they heard a knock on the door.
"She's doing wonderfully, Gaz," Dagny called. Her nose and chin were sweaty and itchy from the fabric of the surgical mask on her face and she groaned inwardly thinking that pretty soon, she'd be wearing one full time in the clinic to keep her from getting sick.
There was another knock. Voris and Dagny exchanged looks, and Dagny called through the door, "We're almost done. She's stable and it looks like she'll recover."
"It's not about Sora," Gaz called, before another voice cut him off and added, "My friend is having a baby and I think something is wrong."
Dagny made eye contact with Voris, who said, "I am able to finish surgery without your assistance."
She nodded and stepped back, quickly exiting the temporary sterilizing force field around the surgical biobed. She rinsed the blood from her hands and sanitized them in the sonic sink, making sure to remove her face mask, apron, and surgical scrubs before exiting the surgical suite to avoid upsetting Gaz. The moment she opened the door, she was approached by Gaz and an Andorian woman, who began speaking at the same time.
"So, she's going to pull through?" Gaz insisted.
"My friend needs help," said the Andorian woman, who Dagny didn't recognize.
Dagny gently laid her hand on Gaz's arm and said, "Dr. Voris is finishing up surgery and he'll be able to tell you more in a few minutes. Things look very good for Sora."
She didn't wait for his response before turning to the Andorian woman to ask, "Who's your friend?"
"Melana. She- she's having a baby and, well, her face is so hot and- I don't know. Something's wrong."
Dagny wasn't aware of any obstetric Andorian patients but the Andorians lived above ground and generally kept to themselves, so she didn't see the point of bringing that up. If the woman's friend was in labor, Dagny supposed it didn't matter. She hurried up the stairs to grab her coat, scooped up her medical bag, and offered another quick round of reassurance to Gaz before heading out the door.
She suspected Voris would dislike the idea of her hiking all the way to the Andorian settlement above ground in her condition, but she didn't see much of a choice. Aisla was already attending to a patient and it wasn't like she could finish up Sora's surgery on her own. Surely even Voris with all his logic would agree.
Still, she thought of Dr. Govorski's recommendation that she should wear a monitor to track her internal body temperature. If overheating could hurt the baby, was it a good idea to go racing up to the surface? She still didn't see that she had much of a choice.
The thought of all those stairs was immediately daunting. There were industrial turbolifts in some of the mines that would get her to the surface faster but they were so far out of her way it didn't make sense to use them. There were plans to install a passenger turbolift in the spring, but that did her no good right now. Dagny made sure to consciously walk at a quick but careful pace as they moved through the tunnel to the stairs. "How long has your friend been in labor?"
"I'm not sure. I heard her crying and found her on the floor on her hands and knees."
"Does she have any other children?"
"No."
When they reached the stairs leading to the surface, Dagny charged upward, but it wasn't long before she was struggling to breathe against her terrible state of fitness. She was also starting to sweat, and the sweat made her panic. She was barely a quarter of the way up when she paused and moved her bag over to her other hand, wiping the droplets from her forehead and wondering if this exertion was hurting her baby.
The Andorian woman turned around and offered a look between scorn and concern. "Are you sick?"
"I'm expecting a baby of my own and I'm a little out of shape," Dagny explained, trying her best to remain calm and opening the buttons of her coat.
"I see. I can carry your bag, if you like."
Dagny typically would have hated needing help performing her job but knew she really did need it, both for her own sake and that of her obstetric patient on the surface. She handed her bag over and continued slogging up the stairs. It was grueling and slow going, but she had too much pride and too much concern for her patient to quit.
Her worries about overheating quickly faded. The temperature dropped with every step they took and halfway to the top, she noted the whistling of an angry wind. They went a little further and then Dagny decided there must be a storm raging above ground. She re-buttoned her coat and pulled it tighter around her body, but she still wasn't prepared for what she found when they reached the surface.
It was snowing so hard and the wind was blowing so fast she could barely see two meters in front of her face. The cold air shocked her tired lungs, sending her into a coughing fit. Life aboard a salvage ship had never prepared her for anything like this.
"Are you going to make it?" the Andorian woman asked.
"I'm fine," Dagny choked.
"Well then—come on, pink skin," the woman laughed. "We still have a long way to go."
She was glad the shrieks of the wind drowned out her instinctive whimper. She followed the woman slowly and steadily, wondering how she knew where she was going. She thought of her conversation with Voris from a week ago, about how Andorians used their antennae for detecting magnetic poles, and supposed that probably had something to do with it.
"The storm knocked out the direct comm lines to the mines," the woman shouted over her shoulder.
"Oh," Dagny yelled back, unsure what to really say.
Within minutes, Dagny's fingers and toes were numb. The wind tore at the exposed parts of her face, sending involuntary tears streaking down her cheeks where they quickly froze. They walked for hours—or at least it felt like hours. It was probably closer to twenty minutes, but by the time they reached the dome-like house at the end of the lane, Dagny wondered how long she could survive in this weather without becoming frozen solid.
The first thing Dagny noticed when the Andorian woman cracked the door were the cries of a woman in pain, which while not unusual for a woman in the throes of childbirth, were unusually soft and garbled. The other thing was the smell.
"Leera, is that you?" panted a quiet voice from a back room in between yelps.
"I brought the doctor," the Andorian woman replied, looking nervously at Dagny as she marched forward.
"I'm not actually a doctor," she whispered through chattering teeth. "I'm just a paramedic."
"You're better than nothing," Leera answered darkly.
Dagny followed her into a pale and dimly lit bedroom where they found a woman with a bulging stomach on her knees on the floor gripping the footboard of a bed and crying bitter tears of pain. This was also not surprising. Most women had a tendency to adopt strange positions in an effort to seek pain relief, but she could tell even in the poor light that something was very wrong with Melana.
Her antennae were flat against her white hair and she was sweating—a biological process Dagny didn't even realize was possible for Andorians. The room smelled stale and slightly putrid and as she grabbed her tricorder and stepped forward, she recognized the smell was coming from her laboring patient. Her first thought was that it was some kind of Andorian biochemical process, the way certain immunological responses in humans gave off a particular vinegary odor.
"Melana, I'm Dagny," she said, shocked that she could see her breath in the freezing cold air of her patient's bedroom. "I'm a paramedic, here to help you and the baby. How long have you been in labor?"
"I don't know," the woman hissed. "I woke up feeling sick but I held myself together long enough to see Shrell off to work in the mines." Her hiss descended into a guttural wail. "It hurts."
"I know," Dagny replied, putting a hand on her shoulder and lifting the tricorder to take some readings. "I take it Shrell is your husband?"
"Yes, and he can't be here. I need to have this baby in the next four hours before he comes home."
"I can't make any promises. Babies come when they come…" Dagny's voice trailed off as the first set of readings came in on the tricorder. Melana's blood pressure was low and she had a dangerously high fever.
"What's wrong with her?" Leera asked, crossing her arms tightly and inching in Melana's direction.
Dagny held her breath. She sometimes got frustrated when Voris drilled her on possible diagnoses as they worked on patients, but she would have given anything to have him here now to offer some suggestions. She'd felt so confident earlier when she had correctly identified Sora's embolism. Now she was completely lost. How had she managed for so long on her own in the Albret's clinic? She knew very little about Andorian physiology, and though she had a database available on her handheld tricorder, Melana's symptoms were so generalized that the tricorder was suggesting everything from systemic infection to cancer.
"Have you been feeling sick recently?" Dagny asked, taking a stab in the dark. "Fever, aches, chills?"
Melana started to scream. Dagny set the tricorder down and squatted behind the kneeling woman to rub her upper back through the contraction. "Deep breaths, deep breaths," she urged.
Delivering babies had always been exciting and rewarding, but now that she was expecting one of her own, she often felt like she was in a constant struggle to keep terror at bay whenever she attended a birth. Was it really that painful? In five months, would she be kneeling on her bedroom floor, begging Voris or Aisla to do something?
Leera joined them on the floor and rubbed her friend's shoulders, exchanging nervous looks with Dagny as Melana continued to cry. The warmth radiating from Melana's back through her sweaty nightshirt would have been about normal body temperature for a human, but it was a dangerous clinical sign for an Andorian.
"Can't you do something?" Leera mouthed.
Dagny's thoughts were paralyzed with fear. She kept running over Melana's symptoms in her mind, the high fever, the odd smell, the low blood pressure, but she couldn't form a coherent thought in order to even guess at a diagnosis.
"I don't know," Dagny admitted. It occurred to her that Voris was almost certainly done with Sora's surgery by now and might be able to help. She turned to Leera. "Can you call-" She remembered the storm had knocked out the direct comm lines linking the surface to the underground colony, forcing Leera to go all the way to the clinic on foot. "Can you go get Dr. Voris?"
Leera frowned and opened her mouth, but instead of saying anything, narrowed her eyes, nodded, and left the room. Melana slumped against the foot of the bed, taking rapid breaths, likely as a result of her low blood pressure. Dagny needed to find a way to treat her, but she was poorly trained to cope with Andorian obstetric complications. She started flipping through the medical database on her tricorder, searching for ways to treat Melana's hypotension that weren't contraindicated for pregnancy.
"Am I dying?" she moaned, her voice barely heard over the shriek of wind outside.
"Not if I can help it," Dagny reassured her patient, wishing she could reassure herself.
"I'm so afraid," Melana mumbled, starting to cry.
Something about her raw confession made something click in Dagny. "Let's see if we can get you up in bed so I can examine you, ok? We'll get this sorted out."
Melana started to scream again as another contraction tore through her, and after allowing her breathe through it, Dagny got her up on the bed. She followed the tricorder's recommendations for treating Melana's hypotension by adding fluids with standard Andorian electrolytes, just in time for Melana to lean over the side of the bed and vomit.
She was about to perform an internal exam when Melana gasped and yelped, "I think I wet myself."
Dagny leaned back and froze. There was a strange, purplish blood beginning to stain the bottom of Melana's nightshirt. Andorians had a form of hemocyanic blue blood and though she had no explanation for the bizarre purple color, the presence of so much blood at this stage of labor indicated a placental abruption. Melana needed to give birth immediately to save the baby and needed immediate surgery to save herself.
Why hadn't she recognized earlier how severe the situation was? Why hadn't she sent Leera to find someone to help her get Melana back to the clinic rather than sending her to fetch Voris? Even with all his skills and education in interspecies medicine, there was little he could do for this woman in a frozen, primitive hut in the middle of a snowstorm. She was torn between going to get help herself or waiting for Leera to come back with Voris. How long ago had she left? Ten minutes? Twenty? She balled her hands into fists, her muscles sluggish from the frigid air.
"What's wrong with me?" Melana sobbed, choking back tears.
"Things aren't going quite as planned, but help is on the way," Dagny managed to reply. "I'm just going to do a quick internal exam, ok?"
She had just finished putting on her gloves when Melana experienced another contraction. Dagny seized on the opportunity to get another tricorder scan and saw that her vital signs were getting worse. Dagny exhaled sharply, the warm vapor in her breath visible in the freezing room.
"Do you have any family that can come be with you?" Dagny asked, gently tiptoeing around the fact that Melana's condition was fading fast. "Your husband?"
She whimpered a reply Dagny didn't understand.
"Melana, stay with me. I need to do an internal exam and figure out how fast this baby is coming, ok? Can you-"
"He can't know… please."
Dagny heard the door open in the next room. She was both shocked and extremely relieved that Leera had made it back with Voris so quickly. It had taken her nearly twenty minutes to get here through the storm, but she had been moving at a snail's pace in her condition.
"Voris?" The sight of him breezing through the doorway was the most welcome thing she'd seen in a long time.
"What are her vitals?" he asked, stopping at the side of the bed and putting his hand to Melana's skin while examining the scene.
"Her blood pressure is still dangerously low for an Andorian," she sputtered, holding up the tricorder. "I think. It's-"
He grabbed the tricorder out of her hand, skimmed it quickly, and then glanced down at the dark purple blood staining Melana's legs. "Is the father Andorian?"
"Of course Shrell is Andorian," Leera answered from behind them. "What else would he be?"
Dagny felt her heart thump harder in her chest as the full weight of Voris' implication hit her like a train. A hybrid pregnancy explained a lot, especially if Melana was hemorrhaging hybrid placental blood.
"Can you find a way to notify the transporter operator we need to initiate an emergency medical transport to the tunnel entrance?" Voris asked Leera, without bothering to look at her. "We also need to arrange for a team to assist in carrying her from the entrance to the clinic."
"Melana, what are they talking about?"
"Please, your friend is in the midst of a medical emergency and requires immediate surgery," Voris interrupted. "We need to get her to the clinic and time is of the essence."
Once Leera left and the door shut behind her, Melana rolled her head along the pillow to look at Voris with tired eyes. "I'm so ashamed."
"I am not here to judge your shame, I am here to tend to your health and the health of your unborn child. I need to know—is this child fully Andorian?"
"I don't know."
Melana uttered a weak cry and started to scream. More blood gushed from her, prompting Voris to stand up. "I do not see that we have any choice but to assist her in delivering here."
"I'm so sorry," Dagny whispered. "I didn't realize it was so bad."
"Apologies are irrelevant at the moment," he replied. "Let us see to our patient."
The following five minutes were a gruesome and bloody nightmare. In the end, Voris had to forcibly pull the baby from its mother while Dagny held her hand and begged her to hold in there and keep trying her best. Dagny's emotions were running high but for a brief moment, she detected abject shock and disbelief and realized it was coming from Voris. Several seconds later, he shook his head and said, "Will you tend to the neonate while I continue treating the mother?"
Dagny leapt to grab a tricorder and a blanket and when she reached over Voris' shoulder to take the baby, she understood. Her heart broke the moment she caught sight of the tiny form lying on the bed between its mother and the doctor who had delivered him.
All four limbs were severely deformed and his skin was an unusual pattern of mottled blue, gray, and white. His head seemed too large for his body and there was an odd, bulging sac protruding from his chest. She had never seen a dead baby before and her instincts told her to cover her face, cuddle the baby, run away, and comfort Melana all at the same time.
"She has lost consciousness," Voris announced, jumping from the bed to grab equipment from his medical kit.
The blood pulsed through Dagny's ears and time seemed to slow. She felt so bitterly responsible. Why hadn't she called for Voris earlier? Why hadn't she known what to do? How could she have let this happen?
If the baby was dead and Melana was dying, she knew she needed to assist Voris, and yet she couldn't bring herself to let the baby lie open and exposed to the cold like a piece of medical waste. The moment her fingertips made contact with his chest, his mouth snapped open and he gasped.
"He's alive!"
"Tend to him," Voris barked. "I do not believe his mother will be so fortunate."
Dagny had just scooped him up and started to run a quick scan for his vitals when the door flew open again. She instinctively knew it wasn't Leera coming back with help.
"Is it here yet? Is it a boy?" called a strange, masculine voice brimming with excitement.
"Sir, if you could wait outside-" Dagny began, but the tall Andorian man she assumed was Melana's husband strolled in with excitement, that was, until he saw the state of his wife.
"Melana? What are you doing to her? What happened?" he shouted at Voris.
"Please, wait outside," Voris replied.
"I will not. This is my bedroom." His eyes slowly shifted from Voris to Dagny, and then to the bundle in her arms. "Is that him? Is he ok?"
"Please, please go outside," Dagny urged, annoyed that she couldn't get accurate vital signs on the tricorder.
He took a few steps forward and recoiled. "What is that thing? Is that- that's…"
"He's very sick," Dagny explained, resisting the urge to tell him to shut up with every permutation of swear word she knew. "So is your wife. Please give us some space and let us work."
"That monster can't be my son. It can't."
"Get out!" she yelled.
"No!" he yelled, lunging at her.
Dagny wasn't exactly sure what happened next, because she flipped around and pulled the baby tight to her chest just as the Andorian man lunged at her. She stumbled forward, trying to get away and protect her tiny patient, but glanced under her armpit to see Voris grabbing the man by the neck just before he slumped to the floor. The moment after that, they all disappeared into a matter stream.
Voris glanced at the time and then back at the neonate in the biobed. He didn't have a pediatric unit, but the standard one was functioning well enough, even if it was grossly oversized for his little patient. The temperature monitor continued to swing between 27 and 37°C. The biobed was programmed to automatically detect a patient's species and adjust its settings to accommodate for standard resting body temperature, but the biobed couldn't determine if the child was human or Andorian.
Moments later, the machine dinged, alerting him that the scan was complete and the biobed was compiling its comprehensive report on the child's anatomy. He initiated a secondary neural scan and turned to collect his PADD from the computer desk and check on the status of the DNA and biochemical analyses.
The infant was a male Andorian/human hybrid. According to the medical literature, no such naturally conceived hybrid had ever survived and the success rates of genetically engineering healthy offspring between the two species was extremely low. Few reproductive specialists would even attempt to create such a hybrid because it posed great risks to the mother for such a small chance of a viable child.
He gazed at the cot in the corner where the child's mother lay. Despite being covered with a sheet, it was evident the early stages of rigor mortis were setting in. In a modern hospital setting, corpses were kept in stasis units to preserve the bodies for autopsies and funeral rites, but he did not have such luxuries at Bergeron colony. On Cestus III, he did not even have the luxury of preventing maternal mortality, something the modern world had all but eliminated centuries ago.
Had Melana come to the clinic for care prior to the birth, he could have informed her that the child she carried was a hybrid and that the placenta was not only malformed, but also dangerously positioned above her cervix, which was certain to result in hemorrhage during a vaginal delivery. He could have informed her that without preventive intervention, she was almost certain to die giving birth to a child that also had no hope of survival.
Yet neither he nor Dagny had ever seen her prior to that evening. The Andorian community on the surface tended to eschew the company of the rest of the colony, but he still could not understand why she would have refused all medical care for her pregnancy. He thought of Adelaide Proctor and her aversion to doctors and wondered whether Melana suffered from a similar phobia or if she had preferred to ignore the possibility that her pregnancy might have been the result of her infidelity. Denial was such an illogical phenomenon. Humans seemed to adore it; perhaps Andorians did also.
He transferred the anatomical scan data from the biobed to his PADD and began reading the infant's grim prognosis. His cardiopulmonary system was an inverted maze, neither exclusively human nor Andorian. His heart was behind his lungs, which was typical of Andorian anatomy, but the organs more closely resembled human ones, except that his lungs were undersized, his great arteries were duplicated, and his heart appeared to only have a single atrium. Rather than focus on the task of devising a plan to surgically repair the extensive congenital defects to his heart and lungs, Voris decided to read on. The more he read, the more astonished he grew that the child even made it to full gestation and birth.
His digestive and renal systems were likely beyond treatment, even for the best Federation medical specialists. He had a single enlarged kidney where a human liver should be that did not appear to be functioning, a vestigial tubule where an Andorian bladder should be, and no obvious stomach or small intestine. He was just beginning to analyze the child's enlarged liver when he heard a soft chime, indicating the biochemical analysis was complete.
His biochemistry was a tangle of competing human and Andorian proteins and hormones. It was as unsurprising as it was serious. Many Andorian metabolic proteins denatured or failed to function at human physiological temperature and pH. Were it just a matter of correcting for a single deficiency, his condition might be treatable, but the list of absent and malformed enzymes was extensive. Even a cursory reading of the report made it obvious that treating one problem would exacerbate others.
If he found a way to repair the genes that generated fumarase and aconitase, enzymes necessary to a key metabolic human pathway, they would have an improper conformation at Andorian physiological pH. If he found a way to compensate for that, other critical Andorian enzymes would denature. He read on, growing more convinced there was nothing he could do to keep the infant alive.
"How bad is it?"
Voris looked up from his PADD to find Dagny standing on the last stair leading up to their quarters, clutching a blanket. He had sent her up to rest a short time after the constable had taken Shrell, Melana's husband, back to his home on the surface to help him "clear his head." The memory of Shrell attempting to assault Dagny flashed through Voris' mind. It was regrettable that he had been forced to subdue the man with a nerve pinch, but his initial, primal instinct had been to do much worse.
"How bad is it?" Dagny repeated.
"He has extensive systemic defects."
"I understand: it's bad. But can you help him?"
"Based solely on his anatomical issues, it is unlikely he would survive multiple, extensive surgeries."
"But we should try, at least," Dagny whimpered, pulling the blanket tighter to her chest and wiping away a tear. "Please tell me you'll try."
"Were it only a matter of correcting his anatomy, I would believe it my duty as a physician to make an attempt, yet his problems extend beyond that. His body is at odds with itself even on a molecular level."
"There has to be something you can do."
"Sustaining his life in the long term would require medical interventions than science has not yet devised. I believe attempting to treat him would only prolong his suffering."
She sighed heavily and shook her head. "Then how long does he have?"
Voris cast his eyes downward. "It is remarkable he is alive at all."
"How long?"
Voris' eyes fell on the biobed. "Minutes? Hours? It is impossible to estimate. If you would like to examine the scans, I believe it would make an excellent case study in-"
She cut him off. "No. He isn't a medical specimen, he's a baby. He's a baby who just lost his mom and apparently isn't long for this life himself. Not everything has to be about learning, Voris. Can't we just let him be a baby in the time he has left?"
"What do you propose?"
"I want to take him home. He deserves to live in a home, even if just for a little while. He deserves to be held and loved."
Voris searched his logic and ethics for an answer. The biobed was trying to maintain homeostasis of the infant's biological processes, but it was failing because there was no possible set of conditions that were ideal for his physiology. Removing him from the biobed would likely hasten his death, but by how much, he could not say. Regardless, he would die soon no matter what they did. More tears fell down Dagny's cheeks. He nodded.
He slid back the hood of the biobed as Dagny walked around the backside. She flipped open the blanket to reveal a diaper and a set of baby clothes tucked inside. She took great care in dressing him, gently pulling his gnarled limbs through the arm and leg holes and talking to him in a loud whisper as she worked. When she began swaddling him in the blanket, the baby emitted a series of squeaks suggestive of discomfort.
"I'm not trying to hurt you, little one," she cooed. "I just want you to be warm."
"That is part of the problem," Voris tried to explain, moving alongside her to examine the child in her arms. "It would be necessary to keep a human infant warm, but an Andorian infant would be overheating under the same conditions. Neonates are not as adept at regulating their body temperature and unfortunately, he is both hot and cold at the same time."
Dagny bit her lip. "Then what should I do?"
Voris hesitated before answering, "The best you can."
He followed her upstairs and helped her get into bed. She cradled the baby in her arms, resting him on her growing belly. He wasn't sure if her pregnancy was driving her toward this instinctive maternal behavior or if she was acting on innate compassion, but she seemed both so at ease and so upset at the same time.
"That's it," she whispered to the baby. "It's going to be ok. We're going to be ok."
Voris wasn't so sure. She had been through quite a lot that evening, emotionally and physically. He did not known how best to manage her emotions, but he could manage her health. He had not had the chance to assess her physical state or that of the fetus. "Will you allow me to examine you?"
"I already checked our baby's heartbeat," she replied, not taking her eyes off the baby. "It doesn't seem to be any worse for wear. I'm not on the strong immunosuppressants yet and there wasn't exactly a huge chance of me overheating in a snowstorm, was there?"
"No, but I would still encourage you to wear the temperature monitor, per Dr. Govorski's recommendation."
He braced himself for her curt rebuttal—she had been so irritable lately, whenever he'd attempted to remind her to look after her health—but she said nothing. She canted her head to look at the baby in her arms and her chin started to quiver.
"He called him a monster."
Voris said nothing. There was nothing that could be said.
She started to cry. "I'm sorry. I'm so sorry."
"Why do you apologize?"
"His mother is dead because of me. I didn't know what to do."
"There was little you could have done. Melana is dead because she did not seek medical care for her pregnancy until she was in labor."
"But she was dying and needed help and I completely choked. I made all the wrong decisions. I don't think I'm cut out to be a doctor."
"Hindsight often has as many lessons to offer as experience."
"But she died… having a baby. A hybrid baby."
"You are sad, but you are also worried."
"How could I not be? Am I really that different from her? What if our baby-" The words caught in her throat as she looked down at the child in her arms and cried harder.
"The child you carry appears to be healthy and your pregnancy is progressing normally, given the circumstances."
"But you said the scan only showed the likelihood of survival as being ninety-four percent. That means our baby has a six percent chance of dying. What if I die like Melana did?"
"All of life is a gamble," Voris replied. "Even if the child inside you were fully human, nature provides no guarantees."
"It just doesn't seem fair," Dagny sobbed. "Why should I get to have a healthy baby while this one is dying? I want to help him but I can't."
"I was once given a sage piece of advice by a respected colleague."
"Are you going to tell me I'm taking my anger out on you again?" she wailed.
"No. I was going to say that someone once told me there is only so much you can do. You do the best you can with what you have."
"I don't see how that's relevant right now."
Voris approached her bedside and sat down at her feet. "It is more relevant now than it was when you said it to me two months ago."
Her face softened as she ran her forefinger over the stubby bridge of the baby's nose. Silent tears continued to rain from her eyes. He watched her for a time, but soon her eyelids began to drift shut. When he was satisfied she was fully asleep, he rose to his feet, wondering what to do about the infant.
He fetched a tricorder from the clinic, silenced it, and ran a quick scan of the child's vitals. He was still alive, but barely. He thought of Dagny's insistence that he should be held and loved rather than tucked away in a biobed to die. He did not wish to violate her wishes, but neither did he relish the prospect of her waking the next morning to find a dead baby in her arms.
Voris very carefully extracted the swaddled infant from her grip. As he gazed down at him, he was struck by a strange emotion. Pity, perhaps? Sorrow? Anguish? He did not know. He did his best to repress the sentiment, but he could not resist the urge to lightly stroke the baby's forehead with the back of his knuckles. He had held babies before, but this experience was novel somehow.
The child licked his lips and tried to bite Voris' finger. He clearly retained the instinct to feed, but he could not digest food without a stomach or small intestine. Voris could attempt to deliver nutrients intravenously, but he lacked the necessary enzymes to metabolize them into biologically useful molecules.
Voris loosened the blanket and began to pace back and forth across his quarters. The child looked up at him with milky, unfocused eyes. Voris started to lose the battle over his emotions. He had lost patients before, but never one so young as this. It was remarkable that he had been born alive, but now that he was alive, it seemed so regrettable that he should soon die. There was nothing more he could do for the infant, and the feeling of helplessness that the situation created only added to his growing tide of emotions. He did his best to push them aside and focus his thoughts. He would need to meditate on the night's events, but not now.
Less than fifteen minutes later, the child slipped away in Voris' arms. He looked at Dagny, thinking he would greatly dislike breaking the news to her when she woke. It was easier to think of managing Dagny's emotions than his own.
He quietly walked downstairs to lay the child next to his mother. Tomorrow he would have to figure out what to do with their bodies. Perhaps Melana's husband would want to claim them and hold a funeral, or perhaps Melana had other friends who would tend to it. Regardless of how their remains were handled, he had two death certificates to process, and he did not look forward to that unpleasant task.
He sat down at the desk by the door, turned to the clinic's computer, and said, "Computer, begin processing a death certificate."
The screen illuminated, showing the computer had finished compiling the data from the infant's neural and DNA scans while he and Dagny had been upstairs. The header of the DNA scan caught his eye. He had been curious about the child's genetics from a medical perspective, but had not intended for the system to search the medical records of the colonists to establish paternity. The child did indeed have a human father. The name at the top of the file read, Schoenbein, Pearson J.