Chapter Eleven
The Clinic

Elizabeth Cutler

Eventually, my hair grows long and Malcolm's beard fills in and we decide to risk a visit to the medical camp. The morning we set out, though, I start to get cold feet. I know this is an indulgence for me to use my skills and training as a nurse. Of course, I can't tell the staff at the camp that I'm a fully qualified nurse because they'll want to verify my credentials, and that would be the end of us, but I can claim extensive experience assisting medical providers and let the staff at the clinic think they are teaching me new and better skills. When I start to fret that it's too much of a risk just to let me play at what used to be my profession, Malcolm shuts me up quickly.

"Stop it, Liz," he says, using my real name for the first time in weeks because Grandmother has stayed home. "We've done everything possible to protect Grandmother in case we're recognized. We both agreed that this would be a good test for our new identities and I need to practice my Irish accent around people who have no reason to reassure me that it 'sounds lovely'."

I was never that heavy to begin with, but the hard work of desert life has melted most of the fat off my body and given me the strength, stamina and muscle definition of an endurance athlete – and, much to my dismay, the figure of a teenage boy. I doubt anyone other than my closest of friends would still recognize me. Malcolm, on the other hand, has always been lean as a whippet, so his adaptation to desert life hasn't been nearly as dramatic. His stamina has improved remarkably, and he has added a few kilos of rock-hard muscle to his frame. He's deeply tanned and visibly stronger now than he was the day we arrived at Grandmother's house, and as his recovery progressed, his hair got glossier and darker and his eyes got brighter. Still, except for the beard and slightly longer hair, he looks just like he always has, only healthier, and with those high cheekbones and grey eyes, it's always going to be difficult for 'Stu' to fool anyone who's looking for the formerly infamous General Reed.

So, we've prepared a hideaway out in the desert a few kilometers from Grandmother's place downstream in the arroyo where Bessie and Bossy go to browse. We'll stay there for a while to see what happens after we visit the medical camp.

Actually, we've done quite a lot of preparation for this little visit. I stopped going to town with Grandmother six weeks ago. Excepting Beans, everything from my hair ties to the cat carrier that would indicate our presence in her little hovel has been removed to our hideaway or hidden in the desert. We even rolled up our bedding, stuck it back in the attic, and moved some boxes and crates into the empty space as they were before our arrival months ago.

The one thing we did not do was try to scrub our DNA off the place. MACO tracking devices are so sensitive that there's no hope of hiding the fact that we were there. The best we can do if anyone scans for our DNA is leave them wondering how long ago we left. So, we've been staying the past three days in our hideaway, and fond as we both are of Grandmother, it's been nice to have some privacy, though I do think Malcolm misses Beans a bit.

It's nice to have leisure time. Of course, we still have to do some work to keep ourselves alive, but now we're not dealing with bulk processing (very much Grandmother's style, mostly to benefit others), it's much less labor-intensive. Also, it's good to be able to talk openly about our past, even though much of it now is bittersweet to look back on. When we were aboard Jupiter Station both of us were so busy we really never had time for intense conversation, for learning each other's history, for exploring events from the other's point of view. Sometimes I think Malcolm finds this painful, especially when he revisits the times he gave me more than enough reason to hate him, but I like to think I'm able to see why he did what he did, and my forgiveness gives him the nearest he'll ever come to absolution.

Most of the time, once he was on active duty again, we hardly had time for snatched lovemaking. Now, of course, we do have time, and he proves he can be a patient, tender lover as well as a fierce and demanding one. We play games, not just card games with the couple of tattered packs Grandmother loaned us, but stuff like word association and making up silly poetry; and every night we sit together, arm in arm, and watch the glory of the desert sunset till the stars come out.

Sometimes, during our word games or idle conversation, he'll say something that's so romantic, or sweet, or even almost naïve that it makes me wonder whether I ever really knew him at all. Are his walls finally crumbling and the defensive layers falling away to reveal the real man he always was inside, or is he building a new self on the foundation of the old? Then, I remember my first night back on Enterprise. I was seventeen and a virgin, and he took me by force. But he got me drunk first, anesthetizing me and protecting me from the horror to come. True, he forced the liquor down my throat as a precursor to the rape, and it hardly qualified as a romantic gesture, but given his mental state at the time, it was probably the nearest he could come to kindness. When you assess someone's behavior, especially someone who'd been as traumatized as Malcolm had, it's no use judging them against any ordinary set of values. A penny from a guy in total poverty is worth more than a million credits from a billionaire.

Now, I'm sure, this sensitive, thoughtful, kind, romantic man is who he always has been, always wanted to be.

That doesn't mean he's not still deeply psychologically damaged. Even Ginny couldn't undo what had been done to him, simply help him to understand and control his reactions. Nor does it make him less dangerous; he would still kill without a second's hesitation if he thought it was necessary. But at least now he'd assess whether it was necessary, rather than slaughter almost in reflex, never thinking beyond his automatic reaction that anything that threatened him had to die.

Taking a leaf from Trip's book, Malcolm has used materials scrounged from broken appliances Grandmother had stashed away in the stable to treat the contents of two waterskins. One is an all-clear signal, and the other means get the hell out of Dodge. They're both chemicals the Empire doesn't typically scan for and in low enough concentrations to be harmless to Grandmother and the environment. Malcolm has programmed my scanner to monitor for both compounds, and he rigged a pocket-sized solar panel to power it round the clock. As we're right at the end of date-picking season, no one will think twice about her going into the arroyo. Then all she has to do is dump the right waterskin into the stream, and we'll get the message.

The danger signal can come at any time, and we'll clear out ASAP; but Grandmother will wait ten days to send the all-clear. Then, if we don't get another signal after an additional five days, we'll go home. If we never get any signal, we'll just leave.

=/\=

Conditions at the camp are squalid, and that's putting it kindly. According to Grandmother, the people here are well meaning, but working conditions are so discouraging that nobody ever stays for long. The high turnover rate means the place is always disorganized, there is no follow-through on plans, and very little maintenance ever gets done. When we arrive, medical supplies are stacked with no apparent organizational logic in the corner of the waiting area, still in their shipping crates and boxes. An old man sits propped up in a chair in the corner leaning against the boxes, and a toddler wearing nothing but a diaper sits fussing on his mother's lap. There are no toys to amuse him, so he pulls at her clothing and whines. What we can see of the office behind the receptionist's desk is a chaotic mess of PADDs, scanners and other medical equipment, and the whole place is swarming with flies and reeks of body odor, urine and worse.

"Please have a seat, and someone will be with you shortly." The receptionist, a heavy-set, greasy-haired, sullen-looking woman in mid-life doesn't even look up from her screen.

Malcolm and I exchange a look. The old man coughs loudly and spits into a crusty red bandana. The toddler, startled by the sound, gives an unhappy squeal, slaps his mother and begins to shriek. Malcolm gestures toward me with both hands as if to say, This is your world. You take the lead.

I shrug and step up to the desk. "Actually, we're not here looking for help. We're here to offer it."

For just a moment, she goes completely still, as if someone has paused a video. Then she looks from me to Malcolm and back and frowns deeply as if I've spoken to her in an alien language.

After several seconds of getting no communication, I suggest, "Perhaps we should speak to the clinic director?"

The frown relaxes into a bland expression and she gets up from her seat to open a door in the back corner of her office. "Opie!" she bellows. "People to see you. I think you should come now."

Malcolm and I exchange another look at the unprofessional behavior, but I just shrug again. He's following my lead, and I'm willing to let this play out a little longer to see what's what.

Opie, short for Ophelia, looks a little grimy and unkempt. She's very young, in her early twenties, possibly just out of school, clearly unqualified for the position she holds, and obviously, almost tearfully aware of that fact. Her heart seems to be in the right place, but I get the strong impression that she was posted here either as a punishment or because she was so completely lacking in influence that she couldn't get any job anywhere else. She seems bewildered and distracted as she apologizes for not offering us a drink and explains that their water supply has been unreliable for the past month or so – she isn't sure if the pump has gone bad or the well is running dry – and she has received no response to her repeated requests for a repair visit. The flies, she tells us, are a result of not being able to reliably launder bedding or wash dishes.

"We can dispose of some consumables like bandages and emesis bags in the incinerator out back," she says, "and things like catheters and IV supplies go into an industrial-sized disposal container that's taken away whenever we call to say it's full. But this is a medical facility. When people are bleeding or vomiting or having a baby, stuff gets on things and in things, and without water, we can't clean it up! I mean, when we can't even bathe properly…"

Then the tears really do come, and it's all I can do not to take Opie in my arms. For all the bright lights, technology and cleanliness of a sick bay on an Imperial starship, I've worked in equally brutal circumstances and felt the same despair. Then she catches her breath, pastes on a wobbly smile, apologizes for her outburst and asks me how Malcolm and I were hoping to help.

We have developed a very detailed but suitably vague back story for situations just like this. I introduce myself as Elaine Johnson, and he is Stu O'Donnell. We're very direct about living off the grid, explaining that unforeseen circumstances put us into debt that we could never hope to repay. Since we both have useful skills, we decided that rather than going to the workhouse or the comfort house, we would strike out on our own.

We're obviously not looking for wages. Living off-grid we have no credit chips and therefore no way to accept monetary payments. A hearty lunch on the days we volunteer and maybe a set of scrubs for each of us, once we've earned them, would be payment enough; and perhaps, by the time we're ready to move on they could see their way clear to providing us a well-stocked first-aid kit.

I tell Opie about the skills I've developed and the devices I've learned to use in my 'extensive experience assisting medical providers'. I also offer to help her establish and implement some of the protocols that I've seen in use in my travels, and she brightens up. The turnover of staff, she says, has been so high in the past few years that everybody was just doing their own thing when she got here, and she's been so busy she hasn't had time to establish any routines with the staff. When I tell her Stu can probably fix their pump if there's water in the well, she looks stricken.

"But what if there isn't?"

Stu smiles reassuringly. "This place is a camp, love," he says with his gentle, lilting Irish brogue. "It's meant to move. If it becomes necessary, we'll just find a reliable water supply and move you there."

Opie is instantly charmed and we're both put to work on the spot. Water is flowing freely within an hour or so – apparently, the problem was a clogged filter or something – and every idle hand is put to work mopping and scrubbing, laundering and washing dishes. Surgical tools are loaded into the autoclave and sterilized, and work surfaces are wiped down with an antiseptic soap solution. The staff of eight, including Opie and the receptionist, Nina (who is now as cheerful and sunny as she was grim and sullen when we arrived), work with alacrity, barely stopping to wolf down some cold ham sandwiches, carrot sticks, and apple slices for lunch. They're clearly eager to clean up their work space and make it look and smell like a proper clinic again. When Nina happily volunteers to clear the table and do the washing up after we've eaten, Malcolm shoots me a wink, and I grin back at him. He's clearly pleased to have been able to help so much so quickly.

Late in the afternoon, the clinic staff begin taking turns showering. When a freshly-scrubbed, heartily cheerful Opie comes to us bearing little baskets filled with travel-sized toiletries – soap, shampoo and conditioner, lotion, deodorant and a flimsy plastic comb – we both gratefully accept her gracious offer. I'm sweaty and feel cruddy from having worked all day cleaning with hot water, so once I am clean, I turn the temperature down. Though I'm careful not to waste too much water as I stand under the cool flow from the showerhead, I do allow myself to luxuriate for a few minutes. The gravity shower Malcolm rigged up at Grandmother's is perfectly serviceable, but you have to wash quickly and turn off the water while you're lathering up. Also, it lacks pressure because the tank from which the water falls only holds a few gallons. I haven't showered under actual running water since we left Jupiter Station, and the only thing that could improve this moment would be having Malcolm in here with me.

By five o'clock, the whole place smells fresh and clean and the flies are even starting to dissipate. We accept Opie's invitation to dinner, a hearty meal of spaghetti and meatballs, green beans, salad, and tiramisu (a decadent treat, and a specialty of one of the nurses, Luca, who tries flirting with me, until he catches a murderous look from Malcolm), but when we're offered cots in the staff dormitory we politely decline.

"We've already holed up in the desert," I explain, gesturing vaguely in a direction away from our hideaway. It's always been part of the plan that Malcolm and I will head off in the wrong direction and then circle back once we're out of sight of the camp.

"Besides, lass," Malcolm adds with a cheeky smile for Opie and an evil eye towards Luca, "Elaine and me, we're a couple, and I doubt very much that your dormitory cots allow sufficient space and privacy for the things a couple might do when the lights go out."

The sun is blood red just above the horizon when we take our leave. The whole staff is there to see us off, and Luca even offers Mal his hand.

"I meant no offense, Stu," he says, and glancing at me adds, "to you or Elaine. I was under the mistaken impression that you were just traveling companions."

Malcolm nods warily and clasps Luca's hand. "Apology accepted," he says. "Perhaps next time, lad, you'll think to ask first."

With a wry look, Luca agrees. "I'm sure I will."

=/\=

Back at our hideaway that evening, we discuss the events at the camp and whether it's safe for us to go back.

"Not for a few days, at least," Malcolm says.

"But there must be a dozen loads of laundry left to wash. And two consultation rooms to clean and restock, and…"

"And the plan has always been to wait a bit to see what happens before we go back," he reminds me. "Liz, I'm as eager to help as you are, but we need to be smart about this. We need to be safe, and I didn't like the way Luca was looking me in the eye when we took our leave this evening."

"Seriously?" I scoff. "That's your excuse for staying away? Jealousy? Malcolm, he was apologizing for flirting with me. If Trip were here, he'd tell you that's what a man does when he apologizes."

"It's also what one does when one is trying to place a vaguely familiar face," he reminds me quietly.

I go hot and cold all over, feeling foolish, ashamed, and afraid all at once. "You're right. I'm sorry."

"No need to apologize, love," he says lightly as he pulls me in for a hug. Then his voice turns darker. "I was a bit jealous."

"Well, I can fix that," I say as I melt into his embrace and we share a scorching kiss. Then I slide down his front and begin teasingly tugging at the drawstring of his trousers. I'm sure we'll talk later about how the authorities would have been upon us at the clinic if any one there had recognized us today and wanted to cash in on the reward, about how we need to watch and wait for a little while to see if anyone places us after the fact, and about how we need to be ready to flee at a moment's notice. But in the meantime, it's been a very long while since we've had any real privacy, and as I slide Malcolm's trousers down, he grins at me and I smile up at him and lick my lips.

=/\=

For several days we watch the clinic from the shade of a rocky outcrop some distance away. While we watch and wait, we work on memorizing and elaborating our back stories, legends Malcolm calls them, about who we are and how we met and where we come from. Since we'll be traveling together, it's important that we tell the same stories. People living off the grid are always under suspicion, and even the smallest discrepancy could provide a thread for a stranger to pull that could then unravel everything.

We decide to say Stu and Elaine met in Las Vegas, because that town still has a reputation for crazy things happening, and they still have the motto, 'What happens in Vegas, stays in Vegas.' It'll give us an easy out for anything we don't have a ready lie for. Additionally, along with Macau, Atlantic City, Monte Carlo, and a few other places around the world that have economies based on gambling, Vegas still uses hard currency as well as the credit chip, so it's an easy place to live off the grid, provided you can find work.

I was working off the books for one of the comfort houses taking their monthly blood and urine samples and preparing PAP smears which they then bribed a physician to certify and send off to the Imperial Testing Facility in Carson City – it was cheaper for them to bribe him to certify my samples were taken according to protocol than to pay him for his time to take them himself. The rest of the month, they kept me busy providing first aid and basic gynecological care to the workers. Like all of the sex workers, they included room and board as part of my compensation, and I also had a small medical office that I had to keep stocked and tidy. It was one of the lower-end places, with an Imperial license, but no subsidy, so it was just a little run down and in a rough part of town.

'Stu' was just kicking around Vegas, taking whatever work he could get when he could get it, and that's all I know about what he was doing there, though I suspect he may have been an enforcer for one of the criminal organizations or a debt collector for one of the loan sharks in town. I was returning to the comfort house from a run to the pharmacy (the same physician who certified my samples also wrote the prescriptions I requested, really, it was no different than a doctor supervising a physician's assistant, except that it was all under the table) when I was accosted by two men and Stu came to my rescue. I was so scared I don't really remember what happened, except that it ended with the two muggers on the ground moaning in pain and Stu seeing me safely home. He came by a few days later to see if I was ok, and then started calling on me a few days a week. The next thing we knew, we and all the people around us, considered us a couple. If anyone asks about our histories before we met, well, we've never really talked about that. Personal history is often a large part of the reason people go off grid and we decided we didn't want to share and have always assumed it had something to do with debt or legal troubles, so if they want to know that, they'll have to go ask the source.

A few weeks after we met, we fled Vegas when the government initiated a crackdown on undocumented workers. Undocumented workers are often conscripted into military service, and one of the main reasons the Empire allows sanctuary cities like Las Vegas to exist is to have a ready supply of conscripts whenever they initiate a new campaign. Since neither Stu nor Elaine wanted anything to do with the military, and since the hard currency we had accumulated while working in Las Vegas was worthless elsewhere, we pooled our funds, bought some travelling gear, and hopped a train out of town. That was several years ago.

We make up several stories about adventures that Stu and Elaine have had, setting them in cities that Malcolm and I have both visited or smaller communities whose names no one would expect us to remember. In every story, Elaine has found off-the-books work in a clinic of some kind, and Stu has done odd jobs where he can find them. That way, if someone catches one of us (probably me, I expect, because Malcolm is too well-trained in undercover work) botching the details, it will be easy to explain that we just got confused what happened in which city.

=/\=

When nothing worrisome has happened at the clinic by the fifth day, Malcolm tells me it should be safe for us to make another visit. It's amazing what a little fresh running water can do. Everyone is cheerful, everything is tidy, and the place smells fresh and clean as a proper medical facility should. The staff is neither as downtrodden as they were when we arrived last time, nor are they as giddy as they became after 'Stu' fixed their water. Instead, they're pleasant and professional.

Nobody requires my assistance with any patients at the moment, so I'm put to work doing clerical tasks. Not having my clinical background, 'Stu' is stuck doing menial labor. On the one hand, it doesn't surprise me how willingly he goes to work – the tinkering he did for Trip on Jupiter Station taught him that no job, no matter how petty, is beneath him, so long as it helps the cause. On the other hand, I am surprised how merrily he goes about it, and that makes me a little sad because Trip isn't here to see how far he's come. I swear I even hear him humming as he washes linens, mops and sweeps, disposes of the trash and wipes down counters with an antiseptic cleaner, though when I recognize "Danny Boy" I suppose it could just be part of the Irish persona he has adopted.

As for me, there are chart notes to file, lab results to report and prescriptions that need to be researched before they can be provided to the patients. When documented people go to an official facility, they just offer their ID for scanning, and all of their notes, diagnoses, lab and imaging reports, medications, and any other documents generated about them are automatically attached to their medical record as it is generated. In a licensed Imperial pharmacy, a warning would automatically appear on screen when a prescription with dangerous interactions or contraindications was ordered, but because this place is a charity clinic for people who can't afford care and for people living off the grid, the dispensary software is not as user friendly. All of a patient's medications must be typed into the search engine, and checked against the new med and any other medical conditions to ensure that the new medication doesn't become the cure that kills.

As I'm working my way through a stack of PADDs, I discover that the clinic's software actually does have the capacity to function very much like the record keeping system we used at Starfleet Medical. When I bring my discovery to Opie's attention, however, she seems doubtful that it could work.

"Most of our patients live off-grid for a reason, just like you and Stu," she says. "That's why they give us fake names or different names every time and don't have official IDs. Anyone who does have proper government documentation can't afford the cost of medical care if they're coming here. They're not going to give us their IDs because they don't want to be billed – not that we would, but that's what they're afraid of."

"But that's the beauty of this system." I'm adamant that this could work. "The computer assigns each file an alphanumeric ID that doesn't correspond with any name or address in the real world. It only relates to the file it identifies. We just print the patient a card with their number on it, and they bring that with them when they come in for treatment."

"What about people who forget their cards?"

"Well, that's no different than what's actually happening now." I feel a little frustrated that Opie seems to think minor flaws in the system constitute reasons not to try, but then I remember what this place was like when we first visited and realize she probably hasn't had much success lately. It's no wonder her thoughts are geared towards failure. "You'll always have people who just can't keep track of things like that. But we can search by sex, age, date of birth, and medical condition, and we can do a date-range search for their last visit, so patients who want you to have access to a good medical history before treating them can still help us find their files. People who are more protective of their identities can just refuse to cooperate, and for them, we can issue a new case ID that will at least pull all their documentation together for the current course of treatment. Either way, it lets the computer do all the work of filing the records."

Opie begins to smile. "And then, using those ID numbers, you can build patient profiles in the dispensary computer so all we have to do is check the new med against the ID to know if it's safe."

"Exactly!"

"And this isn't any coding you wrote? We've had this capacity all along?"

"Yep. I just figured it out because I've used similar systems in the past."

"Damn! See? That's the problem with turnover in this place and having such a young staff. Nobody's ever had the time to set it up."

"Well, I'm happy to get it started," I tell her. "I can also show Nina how to set patients up as they come in and train the medical staff to use it. That way, I can focus on the backlog."

Opie nods decisively. "Do it."

And just like that, I have a job to do anytime I'm not working with patients.

When no warning signals come down the creek from Grandmother and we are able to return safely to her little hovel, the clinic becomes a part of our lives. We never visit on a predictable schedule because, as Malcolm says, being predictable can get you killed, but we do manage to get out there two or three times a month. Once the staff become familiar with my skills, I'm soon trusted to take vitals and triage patients, and eventually, I'm put in charge of some of the simpler cases like wounds that need dressing, well-baby visits, sexual health care, and strains, sprains, and minor fractures. It's nothing close to the exciting and challenging work I had under Jeremy Lucas on Jupiter Station, but I'm working with patients again, and I couldn't be happier.

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