Posted by Cadet Simon Starr (Security Officer) in Sickbay - Cadet Starr boarding exam

Posted by Cadet Alex Winters (Doctor) in Sickbay - Cadet Starr boarding exam

Posted by Cadet Simon Starr (Security Officer) in Sickbay - Cadet Starr boarding exam
Posted by… suppressed (1) by the Post Ghost! 👻

As soon as Starr followed her instruction, Alex pushed a button. The scanner formed an arch over Starr’s body. “Would you like to see what the inside of your arm looks like?” she asked.

She’d rather ask, before confronting the Cadet with a fait accompli. Some people, she knew, preferred blissful ignorance in certain areas. Such as the intricate workings of their various bodily functions.

Cadet Winters, Doctor

It wasn’t the first time Starr had been asked such a question “I’ve seen a lot of the inside of myself” he chuckled, quickly adding “in scans, of course” realising how the first part might sound out of context. “So, let’s see what’s going on in this hand of mine shall we?” he said after the scan.

Alex nodded, glad – but not surprised – that Starr didn’t seem to be the squeamish sort.

On the console at the head of the biobed, a three-dimensional image of Starr’s entire body began to appear, layer by layer. Alex pushed a few buttons to restrict the output, so that it would only show the Cadet’s left arm. “Computer,” she said, “transfer the imaging data from biobed one into holoprojectors one and two.”

The computer chirped its acknowledgement, and a disembodied arm appeared in-between the biobed where Starr lay, and the next one. “Remove the epidermis,” she went on. With another chirp, the floating arm became a disembodied collection of bone, muscle, tendons, nerve tissue and blood vessels. Alex peered at it for a moment, but didn’t see anything out of the ordinary.

“Isolate the brachial plexus, and highlight me the the electrical signal traffic moving through it,” she said. One more chirp, and the arm became a roughly arm-shaped network of tendrils, surrounded by plenty of empty air where the bones, muscles, tendons and blood vessels used to be. What was left consisted of various long dendrites that traveled from axons in the spinal cord into the outer reaches of Starr’s arm, wrist and fingers. As the Cadet lay under the scanner, the computer visualized electrical signals traveling from his spine into his arm as bright flashes moving down the various nerve endings in his arm, almost too fast for the human eye to catch at all, let alone trace.

“Slow the animation by a factor of 10.000,” Alex said. The computer chirped again, and the nearly invisible bright flashes slowed down into easily traceable pulses, moving up and down the dendrites at regular intervals.

“Cadet, could you please clench your fist, please?” Alex asked. When he did, the number of pulses and the pace at which they traveled increased markedly. Alex saw no evidence that any of the pulses were being blocked or slowed down in any way. “Well, there goes one theory,” she said quietly, and then, to the Cadet: “The good news is, you don’t have RSI, or any other form of nerve damage.”

Alex touched a few buttons on the console. The disembodied arm restored itself, epidermis and all. Alex grabbed and reoriented it, until it floated horizontally about a meter off the floor. “Computer,” she said, “Isolate the blood vessels.” The computer did so, and again, a roughly arm-shaped object appeared, this time consisting only of blood vessels. It was at this point that Alex’ eye caught the irregularity.

The scan itself showed that in addition to a couple of tight blood vessels, one of them seemed to be slightly twisted. The knotting taking place there so minisicule that it’s very easy to miss.

Cadet Simon Starr

She smiled. “Mr. Starr, do you know what an aneurysm is?”

• Cadet Alex Winters, Doctor

Simon thought for a moment “ah, yes, an abnormality in a blood vessel. My mother had one in her foot.” Then the fact hit him “and it can be hereditary” he said, having that eureka moment. He chuckled to himself and said “at least it’s not on the brain” as the doctor pointed out where the issue is on the scan.

Cadet Simon Starr

Alex nodded. “Yes. There are hereditary conditions that can cause an imbalance between the proteins responsible for building vascular walls, and the ones breaking them down. But if your mother was afflicted with one of those, it affected her entire body, and she probably had more than just one aneurysm. Also, although it can take decades for aneurysms to actually become detectable even in people who do have the condition, there are obvious warning signs that I’m not seeing in you. You do have a few other things going against you, though.”

Alex moved over to the console and tapped a series of buttons, so that the floating collection of holographic blood vessels between the two biobeds became a smaller cluster, highly enlarged. “First, as you can see,” she said, “there is a malformation here.” She pointed at the spot where one of the blood vessels on display made an unnecessary twist. “This may or may not be the result of an imperfect repair after the accident with the bale of hay you talked about earlier.”

She twisted the holographic display around, so that they were now looking at the twisted vessel in the background of other blood vessels surrounding it. “Second, as you can see here,” she pointed at a cluster of smaller vessels that were now in the foreground, “the affected vessel is surrounded by a few tiny ones. These aren’t usually this small in people your age. That’s probably something you were born with, and I don’t think it would have caused problems on its own, because the human circulatory system actually has quite a bit of redundant capacity built into it. If enough blood can’t pass through one vessel to reach its destination, it will get there by a different route. In fact, that’s pretty much exactly what your body has been doing: it’s been rerouting blood that should be going through these three tiny little things into the one with the twist. Which means local pressure is higher in there. That by itself might have caused you to develop an aneurysm by middle age or so, through nothing other than increased wear and tear. But if you damaged that vessel in childhood, and it grew back a little crooked, then its wall may be thinning more quickly now than it otherwise would have. Which gets us to … a visible aneurysm in an otherwise perfectly healthy twenty-something.”

She paused, considering her next steps. “My guess is, the occasional tingles you’ve been feeling were caused by temporary increases in blood pressure across your entire body. When the pressure hits a certain threshold, blood pools in the twist back there, and the three tiny little guys over here have to work overtime, but they can’t quite bear the load. Which leads to slightly decreased blood flow into your hand, which translates into tingles. If your normal pressure is on the low end of normal, but you find a medical exam intimidating, that may explain why your pressure spiked and you felt the tingle as you walked in here, and yet, I didn’t detect any significant spike.”

Alex shrugged. “This could probably have gone undetected for quite a while, if you hadn’t said anything about it just now. It’s a minor inconvenience at worst, and even if we don’t do anything, the worst that’s going to happen is the vessel bursts at some point in the future, and you’re stuck with a nasty bruise on your wrist for a while. I wouldn’t be surprised if that has happened a few times in your life already, and you simply attributed it to having bumped your arm against something and moved on.”

Alex hit another few buttons on the console, and the floating constellation of blood vessels disappeared. “That said, I can stint it, if you want. Given where that vessel is in your body, I wouldn’t have to dig deep. It’s a minor surgical procedure that can be done under local anesthetic. You can even watch, if you want. The only thing is, we’d probably have to get authorization from both of our CO’s, since your arm would be out of commission for a day or two, and I, as a Cadet, technically can’t do anything surgical without direct supervision. So once again, it’s up to you: do we alert them?”

• Cadet Alex Winters, Doctor