The Trouble With Prosthetics

Posted on Thu Sep 3rd, 2020 @ 8:49pm by Lieutenant Commander Mara Ricci & Captain Benjamin Ingram Dr

Mission: S0E0: What Came Before
Location: Sick Bay
Timeline: MD1: 2018

After spending all day itching at her left arm just where the prosthetic connecter was attached, Mara had finally taken off her uniform jacket to inspect it. It was red and swollen. And hot to the touch. That was definitely not good.

So, after checking with Bulusu to make sure there wasn't a malfunction with the prosthetic itself, she headed to Sick Bay. At once, her eyes lit on Dr. Jacobs and as he had done her last check-up, she decided to see if he was free. "Excuse me, Dr. Jacobs?" she said as she approached. "Do you have a minute?"

He'd been in the middle of running some of Dr Paulsen Jr's blood work, but Murray looked up as soon as he heard his name. A grin snuck across his features as he noted Lt Commander Ricci's concerned features and he abandoned his current work for her with no shame whatsoever.

"For you, of course, Commander," he told her with a smile. "Come over here and take a seat," he directed her towards a bed, the infirmary quiet right now. "What's up?"

She shrugged out of her uniform jacket before hopping onto the biobed. "This," she said, indicating the swollen red skin just above the connector. "It itches and it's hot. I hope it's not infected."

Murray offered up a sympathetic, concerned frown as Mara revealed her issue, then sucked in a breath as he picked up his tricorder to scan the skin. "Certainly looks that way," he said, as he studied the display. "When did this start? Any injury or contact with any particular substance that you're aware of?"

"Just grease," replied Mara. "At least since that rider thing got ahold of it. Wait!" she said, eyes going suddenly wide. "You don't think some of it got left behind, do you?"

"If grease was gonna be an issue," Murray noted gently. "You'd have had issues a long time ago." he rested a supportive hand on her other shoulder as Mara started to freak out a little. "No," he promised. "That would have been picked up in a prior scan. This is something else..." He scoured the tricorder's return of information and frowned. "It's not an infection either though..."

"Do you think I injured it without realizing?" she asked. "Maybe pulled a muscle?"

"No," mumured Murray quietly, as he grabbed an hypospray and placed it against Mara's neck. "Don't think that's it." He stepped away the short distance to the counter to check her blood sample for clues. "How do you feel? Little hot?" He asked, as he studied the screen. "Your white blood cell count is higher than normal, you're fighting something." A soft sigh and a slow exhale followed. "I think your body is rejecting the prosthetic's connector," he stated, turning back to look worriedly at Mara.

“Oh, you’ve gotta be kidding me!” said Mara, frustrated. “Even after I’ve had it so long? What’s it been? Like three months? Or something.”

Murray nodded. "It's not common, but it happens," he said. "Our bodies are one big complicated chemistry and biology experiment, after all," he added with sympathy in his tone. "And yours has decided this thing has to go." He paused, considering options for a moment. "Now, I could give you some immunosuppressants," he mused out loud. "But out here, that might be more trouble than help."

“True,” agreed Mara, thinking about that fungus floating around as well as the myriad of other diseases that could exist. “And they’d probably ship me back to the alpha quadrant, or at least confine me to the station. Are there other options?”

"To keep you here? Um... remove it, regrow the arm. Or... something a bit more risky, maybe." Murray frowned. "But even if you like that idea, Captain probably won't..."

“If it’s risky, the Captain will love it,” Mara replied with a roll of her eyes. “I’ve already gotten used to the prosthetic and lab grown replacements aren’t as good. I think I’d rather keep it if I can. What’s the risky option?”

He raised one eyebrow, and Murray's gaze darkened some. "Sometimes he takes the risks," he said, "sometimes not so much. I'm still trying to figure him out." But Dr Paulsen Jr was a whole different mess, and Commander Ricci deserved his full attention. "Nanobots," Murray said, cutting straight to the chase and studying Mara's face as she responded.

Of course Mara knew the risks of using nanobots. Most of the serious ones could be resolved by simply sending a remote command to shut them off. But, it would mean staying in Sick Bay for awhile as well as biomonitoring for at least a week. She didn’t know if Ingram would like that. She didn’t know if she would like that. “Yeah,” she sighed. “We’d better talk to Ingram about that.”

That wasn't, Murray noted, a hard no. She was considering it, which meant that - yes - the Captain would need to be consulted. He couldn't jeopardise his position here by upsetting the top man, any more than he wanted to cause Mara any real harm. She'd done nothing to him, and losing an arm was a heinous event to happen to anyone. "Agreed," he said, simply, then met her eyes as he added. "It'd mean you'd be stuck in here for a full day/night cycle, and there are, as I imagine you already know, risks involved. Big ones."

Dr Jacobs hit his comm badge, and took a deep breath. "Captain Ingram, request your presence in the Infirmary, please."

Minutes passed, but soon enough Captain Benjamin Ingram was entering sickbay with a skowl.

"Mr Jacobs, I put you in charge of the medical complex because you have proven yourself universally useful. These constant calls to sickbay to hold your hand are beginning to make me feel I might have overlooked your somewhat...rural upbringing among the Rish," Ingram said, looking at Mara. "Especially given the fact my Chief Engineer has been here instead of elsewhere doing her assigned duties. It would be prudent that an explanation be forthcoming."

Murray scowled, and opened his mouth to say something.

"It's not his fault, sir," Mara interjected, standing up for the doctor who had been so kind to her. "It's this." She held up her left arm, red and swollen over the thin silver bad that gave away her arm as a prosthetic. "My body is rejecting the connector. And since you're my direct superior officer, we need your input on treatment."

"I might be that, but bodily autonomy is the cornerstone of Federation medical practice. Trust me, I've gone through the formwork to initiate human trials in the past. Nothing can get ordered to be done to another without their consent, even if that consent is forfeited by the breaking of laws," Ingram said, picking up a data slat from beside the biobed and looking over the medical data. "Huum...white blood cell count is high. I can see why you would assume it was a rejection issue."

"I understand that, sir, but we'd still like your input," she replied. "It's either immunosuppressants or nanobots to retrain my immune system. Or we grow a biological arm and attach it. I think I'd rather leave that as a last resort as if would require me to be off duty for a month or more. Assuming my body doesn't decide to reject that, too," she added with a roll of her eyes.

"Immunosuppressants or nanobots, quite the collection of buzzwords you have there. I assume you've run the various tests needed to see if any part of the neural connectors might be causing an allergic reaction? Perhaps even an allergic reaction to something picked up in Messier 4. After all, we might not be biologically compatible with the native life here, but we're more than compatible as a source of water and minerals," Ingram mused, scrolling through more of the data.

"It's not about consent," Murray spoke up, having allowed the two of them to take turns for long enough. "And it's not about indecision on my part, sir," he added, a little testily. "It's a clear-cut rejection situation." He didn't need to look at the data to keep explaining and he didn't defend his investigation to the nth degree. "Mara has high levels of immunoglobulin and histamine in her system, Captain. I could, of course, try a different prosthetic or change the connector, but that would take time, might not resolve the issue, and, as you state - your Chief Engineer is an extremely necessary person to have operational. I figured you'd want to be involved in any decision that would mean downtime." Murray sighed. "Whatever we do, you're looking at 24hrs where the Commander won't be at her post, and light duties for probably a week."

"And also," added Mara. "I value your opinion."

"As well you should," Ingram said after a moment of consideration. "The prophetic nerve connectors are made of medical-grade palladium, it's a non-reactive metal. I make that point of distinction because the medical nanomachines are also made of the same material. If you go ahead with the procedure as it stands, to supplement the bodies autoimmune system, you'd best be on the lookout that the machines are are not adding to the problem."

Bugger, Murray cursed internally. He hadn't realised that. Perhaps that 'rural upbringing' as Ingram put it was letting him down, but he wasn't to proud to admit his failings, or the shortcomings in not having been through years of Starfleet medical training. This, after all, was definitely not his first choice of career move, more a case of wrong place, wrong time and Bossa's request for him to involve himself in the literal guts of this station's human population.

"Ah," he said, making a 'fine, you win' facial expression. "Didn't know that." Murray looked from Ingram to Mara and projected sympathy. "He's right," the medic noted. "I wouldn't want to risk giving you the same issue a hundredfold. "Perhaps we just manage this by growing you a whole new forearm? Takes longer, sure, but way safer."

"Let's not be too hasty," Ingram said. "A simple blood screening should rule out a reaction to palladium. If that's ruled out then moving forward with the nano therapy should not pose such a problem."

“Let’s do that, then,” Mara agreed. “I’d much rather keep the prosthetic if I can. If I’m not reacting to palladium, we can try the nanobots. And if the nanos don’t work? I’ll let you clone me a new one. I don’t think immunosuppressants are a good idea out here.”

Murray nodded, took another blood sample and ran it. He frowned, while they waited the minutes it took to come back with a result. "But if the allergy isn't the connector, what is it?" He asked, continuing to muse out loud. "And why has it taken a few months to manifest? Seems more likely it's environmental, but the previous tests seemed to rule that out." A brief pause and he regarded Mara. "I think it'd be wise to clone a new arm, regardless, just in case this problem reoccurs. At least then we'll be prepared, right?"

"The first person to say 'that would be handy' in earshot of my personage will find themselves scowering stellar dust off the hull of the station," Ingram said pointedly. "As for the cause...that is a mystery worth solving."

"But, as long as it's not palladium, we can use nanobots, right?" asked Mara.

"Yes. You may use medical-grade nanobots," Ingram said with a weary sigh.

Of course, Mara wasn't sure she wanted to go that route, but if she didn't, the alternative was immunosuppressants or a cloned organic. She didn't like any of the options, but right now, nanobots looked like the best one. "Sometimes you only have bad choices," she muttered, "but you still have to choose. Okay, let's do the nanobots."

"It's official. No allergy to palladium," Murray responded with that simple news and a raised eyebrow expression. Seemed Ricci had a knack of working her way out of the Captain, and, he mentally noted, that was good information to have. He made a point of giving the sort of world-weary sigh that station and ship medics were prone to needing to meter out, then looked from Ricci to Ingram with a solid frown game. "Final decision?" He said.

"If the Captain has no objections, neither do I," replied Mara.

"Good, excellent. Are we done here? Or perhaps you require my opinion on the colour pallet being used? Gunmetal, or brushed silver?" Ingram said with a roll of his eyes. "Cheif Ricci, I hope to see you back on duty before to long. Dr...emergency calls only from now on.”