*If you're not familiar with any of my previous works, you probably believe my medical team is overkill. Three doctors? Why on earth do they need three? The important thing to note about these men is that they each bring a different specialty to the table. Luke is the trauma expert/chemist/crew chief. Marcus is an orthopedic specialist...talented at fixing the nasty injuries I'm known for inflicting. And Caleb...his specialty is about to really come in handy again.
Leonardo waited with bated breath for Luke to come out of the Lab again. It had been three days since Donatello had initially come around, and it was the first time that the docs had done any in-depth tests aside from checking his basic vitals.
Everyone had been lingering in the living area for the last couple of hours, hoping for a tiny bit of good news concerning Donny's progress. Leonardo had been overjoyed to watch life return to his brother's face, and the mobility he'd gained with his neck to at least turn his head different directions.
Yet the longer the docs stayed behind closed doors, the more Leonardo wondered what type of lasting damage Donatello could be facing. He glimpsed Jenna across the room every now and then, as she waited nervously for news inside her own private world.
I don't blame her. If I had nails, they'd probably all be gone by now.
Leonardo glanced to his right to lay eyes on Brandon. A shadow clung to the man's face, as if there was no light powerful enough to drive it away. Brandon had been on his feet independently a couple of times over the last 24 hours, but he displayed no satisfaction in regaining some strength.
Brandon didn't speak or smile at anyone. For the most part, Leonardo realized the man was even avoiding meeting the eyes of those around him. The blue-masked turtle wanted to apologize to him, to beg the man's forgiveness that they hadn't realized he was missing sooner, but that would have involved forcing him to revisit the events.
Luke had urged them to avoid the subject matter of Brandon's kidnapping at all costs for the time being, unless the man was the one to bring it up. Leonardo quickly looked away from his friend before Brandon could notice that he was studying him.
I don't want him to think that I'm analyzing him, even if that is what I'm doing.
The opening of the door to the Lab got a reaction from several people at once, and Leo sat up further in his chair too. Luke led the way out into the living area with Marcus and Caleb trailing behind him. As the blond doctor nodded at the other two men to sit down, Leonardo saw Raphael scooting to the very edge of his chair.
"Talk to us, Doc," Raph insisted. "We've been in the dark for long enough."
"Yes, you have," Luke acknowledged. "Donatello's motor function is suffering due to the extent of the injuries to his brainstem. Now there's no paralysis, which indicates that he should be able to regain function in time, or with therapy. More likely it will take a combination of both."
"What kind of function?" Mike asked. "Are you saying he could be stuck in that bed without being able to move or talk for a long time?"
"He's already moving some," Luke pointed out. "Donny might need to learn how to walk again, and he'll definitely need some help with handwriting. He couldn't even hold a pen correctly. At the same time he still recognizes the alphabet, and I'm betting that with more time, he'll be able to put words and sentences together."
"How do you know he recognizes the alphabet?" Greg asked curiously.
"We set up one of the tablet computers with the touch-screen keyboard for him. Don was capable of confirming a few of the specific letters that I asked for, though he couldn't group them together. I kind of figured it might be the easiest way for him to communicate with us in the near future. He could tap out messages, which would then be transferred to another screen for us to read."
"Why can't he talk?" Jenna asked. "Do you think it's permanent?"
Luke shook his head. "I don't know; there's nothing wrong with his vocal chords. There appears to be some kind of disconnect, a lack of coordination between his breathing and his voice. It's something we see more often with Locked in Syndrome, but Donny definitely doesn't have that. Once again, time and therapy may be the keys to him regaining the ability to speak."
"What about his mind?" April asked hesitantly.
Leonardo could tell she hadn't wanted to ask, but he knew that everyone else was wondering the same thing, even though they were afraid to speak the words.
"It's too early to be certain," Luke replied. "There's a lot of confusion right now. Don's problem-solving ability seems to be intact, but it's extremely slow. It took such an intense amount of concentration on his part that I almost called a couple of tests off altogether.
"I don't enjoy watching him struggle, but it does demonstrate to me that he's fighting. If Donny's willing to go the distance, I believe he stands a chance of being normal again." Luke glanced in Caleb's direction.
The bespectacled man swallowed deeply. "There are also other factors…um…possible solutions for helping Donatello. Scientists in China have been using stem cell therapy in conjunction with traumatic brain injuries for quite some time. They've been targeting the brain tissue itself, and they've seen evidence that the stem cells are promoting the body's 'self repair' mechanism.
"I've never done anything like it in my own testing, but we already possess the equipment to reproduce the necessary iPs cells. Donatello has his own reserve cells already built up in the bank from the procedures we went through for Mike's treatment. From that experience, I know that we can reprogram the adult stem cells effectively, and it gives us another option at the very least. I think that it would improve the chances of Donatello recovering his full mental capacity."
Leonardo nodded at Caleb. "We've seen you in action, Caleb. I think I speak for all of us when I say that your particular expertise in this situation is appreciated."
The older man fussed with his glasses nervously. "We had success with Michelangelo's lungs, partially because your cells were so easy to adapt—"
"But mostly because you're a genius in your own right," Mike interrupted. "My mutation doesn't have anything to do with the fact that I'm alive today. That's all you, Caleb."
The man shook his head. "With a lot of trial and error," he said ruefully. "In any case, I've been researching the possibility of transplanting iPs cells to Donatello's brainstem. While I don't want to rush into anything that we're not prepared for, time is of the essence. The sooner we act on something of this nature, the better chance we have of the procedure working."
"Is the reserve of Donny's cells gonna be enough? You know any of us will step up," Raphael spoke up.
Leonardo nodded his agreement. Through a combination of therapies including a "receptor blocker" that interfered with the body's natural defenses to reject cells that weren't a genetic match, it had actually been Raphael's stem cells to serve as the best candidates to save Michelangelo. If that wasn't complex enough, the stem cells had to undergo a transformation of their own before they could be implanted.
What Caleb referred to as "iPs" cells was actually nothing more than adult stem cells that had been reprogrammed to behave more like their embryonic stem cell counterparts. The process gave the created "iPs" cells the ability to transform into different types of tissues and other cells as needed. Caleb had a lot of research and experience already invested in the new technology at the time when he'd met the turtles. All the jargon had made Leonardo's head spin a few months back, but weeks of explanations and patience from the docs had achieved some understanding for everyone.
"I think I can reproduce enough stem cells from Donatello's reserve to stick with his type," Caleb answered. "I'd rather not attempt using the receptor blocker inside his brain, without knowing of the possible consequences."
"How long will it take to make the iPs cells?" Leo asked.
Caleb smiled a little sheepishly. "The cells are already in production. I started the process last week. I knew they would need a few days to mature, so I didn't want to hesitate and wait for him to wake up first. I had no plans of using them without the express blessing of the family."
Leo grinned as the man faltered. "We put Mike's life in your hands when we didn't even know you, Caleb. Do you think we're going to hesitate to put Don in your hands now?" Leonardo looked around the room slowly. "Is there anyone who would object to this procedure?"
The blue-masked turtle made another sweep across the room, but no one spoke. "It seems like all of us want you to use every ounce of experience and knowledge that you possess to get Donatello the best outcome possible, Caleb. But we also recognize that this is probably all experimental, just like in Mike's case."
Caleb nodded. "On my part it would be, though the procedure is already taking place in different parts of the globe."
Brandon raised his head to look at Caleb squarely. "This family needs Donny too much," he murmured. "It has to be done, doesn't it?"
Luke cleared his throat. "I agree with Caleb that it's his best hope for regaining full cognitive ability. There could be so many complications relating to a brainstem injury, anything from memory retention and reasoning ability, down to his actual personality being affected. Therapy can help, but it can't reverse the damage, not the way that a stem cell transplant may be able to. I've talked about this with Donny, and he appears to understand. If all of you agree to it, we'd like to push forward with the procedure as soon as the cells are ready."
"We trust you guys, Luke," Jenna said tightly. "We always have."
The blond doctor came over from where he was standing to meet the young woman. "We are going to do everything we can to give him back to you, Jen. I promise you that."
She nodded. "I know you will…and there's no one who could take care of him better than the three of you."
When the meeting was complete, Leonardo went back inside the Lab with Luke to see Donatello. His younger brother looked like he was asleep, but Leo settled into a chair beside him just the same. He glanced at Luke as the man leaned over the desk, turning back on the monitor of the computer with a flick of a button.
"What was that device you were talking about, Doc? The one Don might be able to use to communicate with us?"
Luke picked something up off the desk and brought it over to show the turtle. Leo recognized the so-called "tablet" as something Donatello had only recently started using since returning to the city. The computer was impossibly thin to Leonardo's eyes. With a sweep of his fingers, Luke brought up a digital touch screen that resembled a real keyboard.
"Like I said, he was able to confirm what several letters were for me. By intentionally calling some of them by the wrong name, I was able to determine whether he recognized what they were or not. For obvious reasons, I think Donny will pick this up much faster than he would writing. With the particular structure of your hands sign language would be difficult, though we may able to adapt some signs for him. His comprehension is intact, which is one of the most crucial areas for him being able to recover."
Leonardo nodded solemnly. "The other crucial part is having all of you on board," he said seriously.
Luke pursed his lips as he visibly struggled with emotion. "I wish he didn't have to go through this, but having Caleb…it gives us much more hope than we might have otherwise. We should have brought a geneticist on the payroll a long time ago," he said, forcing a smile.
"That's thanks to you too," Leo reminded him.
"He was my parents' colleague, Leo, and if you recall correctly, I didn't want him involved with Mike to begin with."
"It sure would have been easier than navigating the Genetic Institute turned out to be," Leo said morosely.
"Don't remind me."
A soft groan came from Donatello's direction, and had Leonardo spinning around hopefully.
"He's been making some sounds like that, Leo, but they're completely involuntary, and mostly in response to pain. I need to check his IV." Luke was all business again, moving to examine the bag of formula that the younger turtle was receiving.
Leonardo reached to grip his brother's fingers. At his touch Donatello opened his eyes, and craned his neck toward Leo.
"Hey," the older turtle greeted him. "We just heard you're going to get to be Caleb's next project."
Don gave him a half smile in response.
"That's something to look forward to?"
His brother nodded.
"We like the idea too. We're all going to be here for you, Don. I know you're going to get through this, because you never give up on anything."
He felt Donatello's hand stiffen in his grasp, and released it at once. To his surprise, he realized his younger brother was forming a fist. Leo grinned openly as he bumped Don's fist with his own.
"You're one of the toughest guys that ever lived, Don. You're going to make it."
Donatello flashed him another smile that ended in a grimace.
"Doc's working on your IV," Leo said quickly. "Are you in pain?"
Donny nodded again, and Leonardo covered his brother's fist with his hand.
"Doc will get you squared away. Hang in there with me, Bro. Please hang in there."