Posted by Lieutenant Hegush Falz (Chief Operations Officer) in Reporting in: Medical

Posted by Cadet Vaarek (Medical Officer) in Reporting in: Medical

Posted by Lieutenant Hegush Falz (Chief Operations Officer) in Reporting in: Medical
Posted by… suppressed (6) by the Post Ghost! 👻
=^= Docking bays open, preparing to dock =^= The NE relayed.

Hegush just about jumped in his seat, his eyes shooting wide open. He must have fallen asleep he. He could not remember exactly when he drifted off but it must have been a deep sleep, because for once he hadn’t been woken up by something other than his nightmares. Slightly sluggish still he glanced around the shuttlecraft cabin as he tried to remember where exactly he was.

=^= Acknowledged, when you’re ready =^= came the reply.

The second com was enough to pull the sleep fog from Hegush’s brain. He was on a shuttlecraft to his new posting. The U.S.S Ark Angel. She was a beautiful ship too as she drew closer and closer in the viewscreen as the pilot slowly navigated her way into docking the ship opening wide and gaping to receive them. It was one of Hegush’s parts to flying in the shuttle is just watching it come into port, slowly and surely getting swallowed whole. Eventually there was no more exterior and the shuttle was completely surrounded by the interior of the ship. Taking that as his cue, Hegush stood up, brushing the crumbs off of his clothes as he did and gathered up his few things as he got ready to disembark.

Once he stepped onto the deck of the Ark Angel, his small knapsack in his hand and the two NE’s he had been travelling with behind him. He realised that his legs were stiff and his limp had come back. It would wear off now that he was moving around, but it was just another reminder of the aches of the past. Another reminder that he was getting old. He paused, letting the two NE’s and the pilot step past him so hopefully his limp wouldn’t be quite so noticeable with them walking in front.

“Welcome aboard Lt. Hegush, NE Charlotte and NE L’Pel” one of the shuttle-bay crew members greeted the small group, “I’m NE Edwards, and this is NE Friak and NE Cahson. It’s great to have you all aboard. We are happy to give you all a tour of the ship and show you your quarters so you can drop you stuff off, or…” NE Edwards looked directly at Hegush, “so you can rest. I’m sure it’s been a long trip.”

“Thanks, but this isn’t my first rodeo, just point me in the direction of the Medical and I’ll begin my check in. My bag is light enough I can carry it with me” Hegush replied, more wanting to push through the standard check-in procedures so he could settle into his new room with a nice glass of whiskey. NE Edwards looked doubtful but pointed out directions for Hegush while the other two NE’s let themselves be led off for a tour of the ship. While Hegush nodded his thanks to NE Edwards, slung his bag over his shoulder and headed off towards Sickbay.

~

Thanks to NE Edwards’s clear instructions it only took one wrong turn and a short amount of time before he was outside Sickbay doors. It was enough time for his stiff knee to ease out and his walk return to back to its normal gait. Even so he gave the leg a couple of light kick outs just to make sure before he entered the room to see if he could find an unoccupied doctor or nurse to check him in.

Lt. Hegush COO

In Sickbay, it was Vaarek’s first time to see a patient. Onboarding medical assessments were considered “safe” assignments for cadets to learn and receive supervision on. But as Vaarek pulled up Hegush’s file, he was first struck by the rank and position of his new patient. A lieutenant, chief of operations. Meanwhile, Vaarek was still a teenager, a first-year medical cadet who’d been given leave to do most of his academy work while in deep space.

Vaarek studied the file a bit longer. A Bajoran man. He noted that Hegush was as tall as he, but thinner. There were notes of a history of unfortunate circumstances in a Cardasshian war camp that caused Hegush to lose weight. Vaarek tried to remember what he could about Bajoran physiology and how long-term deprivation of food might affect metabolism and risks for other forms of ill health. He made a mental note to look this up later.

There were also notes in Hegush’s file on incidences of problematic alcohol intoxication, with suspicion of him having potentially met the criteria for alcohol use disorder at certain periods of time. Reading further, Vaarek conceptualised a man with cumulative outcome of early relational neglect, chronic shame, and a history of trauma. Developmentally, Hegush seemed to have been a devalued child in a complex family network, constantly compared to a more favoured twin. To Vaarek, this appeared to be contributing to a sort of psychological pain, characterised, perhaps, shame and guilt. Alcohol seemed to have been a coping mechanism for Hegush.

Training his medical thinking, Vaarek continued his thoughts. From a psychiatric point of view, Vaarek hypothesised a man with probably complex trauma and problematic alcohol use. With well-preserved cognitive functioning and a service record mostly intact, Hegush’s occupational functioning remained likely high. In his assessment, Vaarek would likely try and gauge risk for relapse in alcohol use as well as understanding his trauma triggers. Vaarek was also conscious that a psychological evaluation would be made by a counsellor, but he could not help apply the medical lens so far. However, what stood out in the medical file was the lack of any entries the past six years. That had to be explored.

As such, his thoughts stopped when he understood that the patient had arrived – a few hours earlier than Vaarek had expected. Most new onboarders settle in before their medical evaluation, he had been taught, yet Hegush had somehow come to Sickbay immediately. Curious.

At the same time, Vaarek could not help but think that perhaps this routine case had become far more complex – perhaps more difficult – than Vaarek’s junior capabilities were.

Despite this, he stepped out, and being the only blueshirt available, walked up to Lt Hegush.

“Lieutenant Hegush, sir? Welcome aboard. I am Cadet Vaarek, working under the supervision of chief medical officer Spenn. I can perform your medical evaluation. Do you consent?”

Cadet Vaarek, Medical

Hegush tried not to laugh when Vaarek asked about his consent. In a way he found it refreshing. He hadn’t been asked for his consent in a medical exam quite so formally in a long time, but then he hadn’t had a Vulcan doctor in a long time, and you could always trust a Vulcan to uphold the very strictness of formalities. He had an admiration for the Vulcan people, particularly their ability to stick to logic and never letting emotions distort their focus from whatever task they had at hand. Then again, they might be incredibly intelligent, he had always wondered if the Vulcans on his previous ships knew how to have fun. And this one, this Cadet Vaarek standing in front of him, he did not doubt was clearly intelligent and probably had quite an analytical view of things.

“None other,” Hegush grinned, walking over to an empty bio bed nearby and sat up on it, dropping his bag out of the way so it wouldn’t get in the way of the Cadet. He was tempted to lie down on it but he planned on going to the Counselors after medical and from his experience with Counselors they liked to keep him talking. At least they all had comfy chairs he could lie down on. “I’m eager to get checked in and have no qualms if you are the medical staff member who does it.”

“Work experience?” he asked, wondering if that meant that the Vulcan before him was around the same age as his 20 year old friends (and himself 23) had roughly been were when they did their cadet cruise just before their graduations. Although even that wasn’t quite right. The cruise they had been on hadn’t been a fleet Starship, just an academy ship that was designed to replicate a starship for the cadets to get some experience of what it would be like when they graduated and took on their first posts. The academy staff would create scenarios they would have to solve and even re-enacted some real time scenarios that changed every year.

Was he really that old that they’d changed the system to put cadets on a fully functional starship and released them into space before they graduated? Or was this an exception? Young as he assumed Vaadek was, he was clearly dedicated to his role. He had known who Hegush was as soon as he walked through the doors of Sickbay. That showed a level of preparedness. Or not. Hegush silently amended himself it wouldn’t be hard to spot him out of a crowed of new transfers, an older cynical Bajoran would stand out when the other new arrivals were two puppy eyed NE’s.

“I’ve got my file on me if you want to go through it, but I’m not that young so the quickest way to sum it up is, bumps, bruises, broken bones” at that point he gestured to his nose, “a knee that tells me when the wind is going to change, and an efficient weight loss program that might work but I don’t recommend.”

Lt. Hegush COO

Vaarek noted how Hegush seemed to joked easily. While the jokes were not necessarily careless or aggressive, Vaarek sensed a deliberate function in them. Vaarek tried to understand what the function might be. The file that he had read described starvation, alcohol misuse, physical injury, labour camps. These were heavy and significant things. Yet Hegush spoke of them as if they were weather patterns or old mechanical faults. There was a knee predicting wind changes. There was the off-cut comment of the “efficient weight loss program.” Vaarek understood, intellectually, that humour could reduce distress. He had read this. But hearing it spoken aloud produced a small feeling of imbalance inside him. He could not tell whether Hegush was minimizing pain (avoidance) or demonstrating strength (resilience).

Then he heard Hegush’s question about his work experience. Vaarek felt a brief tightness in his gut at that. He was aware of his age. Indeed, he was more aware than he preferred to be. The other cadets had noticed it. Even for a Vulcan cadet, he was young. Now Hegush had noticed it as well. Not necessarily mockingly, but still… Vaarek became conscious of the rank pips on the man’s collar again. He was a chief operations officer. He was older. He had experience, far more experience than Hegush even seemed to wish to have had. The yoke of that man’s history lay uneasy on his head.

He is evaluating me, Vaarek thought. The conclusion appeared reasonable, and helped Vaarek move on.

“It is a supervised assignment, sir, under the auspices of Dr Spenn who remains clinically responsible.”

Vaarek paused briefly, organising the next thought before continuing.

“I have read your file. You are correct not to endorse labour-camp starvation as a therapeutic weight-management strategy.”

It was not enough to appear as a real joke, but Vaarek wanted to show he tried to meet his patient where he patient was. He wanted to show that he had read Hegush’s file, and knowing the darkness of the story therein.

“Your file does not contain the last six years. I should recommend a full physical check-up, with the aim to examine the long-term effects on your musculoskeletal health and nutritional status. Before we continue, what can you tell me about your health today?”

Cadet Vaarek, Medical

Hegush nodded when Vaarek made the comment that he was acting under the CMO. A statement of fact. A very Vulcan answer. It also gave insight into Dr Spenn, it showed his faith in Vaarek, he clearly trusted Vaarek’s enough ability to claim responsibility for it. Or he was an idiot, but no doctor every rose to a Chief Medical Officer rank, let alone a Vulcan doctor without a fair degree of intelligence so Hegush felt it was safe to assume the former. Dr Spenn wasn’t a molly-coddler either, he was allowing Varrek to grow into his abilities as a doctor on his own a find his own way to put theory into practice. It was a method that Hegush liked because it allowed one to grow and learn self-reliance in their abilities.

Hegush’s training officer back when he was on his first posting had been more of the hovering type. It had its own pros and cons and while it was good crutch at times it had allowed for some to become dependent on the crutch instead of gain confidence in themselves or just annoyed Hegush who had preferred trial by fire.

Then Vaarek mentioned the labour-camp and it was like a cold had squeezed around his heart. The memory came unbidden, huddled up to the others, dirty and gaunt, shoving a mouthful of the grey gruel they had eaten before surrendering the bowl to someone weaker than him. Someone who had probably died anyway. It was 17 years ago and sometimes it felt like it was yesterday. The cadet had done his research, Hegush admired that.

“No, the body doesn’t take kindly to it. Not enough vegetables I think,” He joked the memory off.

“I suppose I probably am a little overdue for a physical” the Lieutenant agreed, “I feel no worse than usual, just my knee gets a little stiff sometimes, but a little walk tends to loosen up again. Don’t get old, everything creaks.” He joked, “Other than that, I’m fit and health. I don’t get sick.” He winked, “Alcohol keeps away contagion, and I’ve apparently still got a good pair of lungs in me” He chuckled thinking of a happier memory of belting out a song at his leaving party. Confidently singing lyrics he didn’t know,

Lt. Hegush Falz, COO

Vaarek tried to analyse the data Hegush provided him verbally. Non-Vulcans were difficult to interact with – it was far more cognitively taxing to try make sense of the logic in what they said. But, it was also what had drawn Vaarek to Starfleet. To be among non-Vulcans, to learn different layers of interactions, dynamics, and how other species make sense of emotion.

At this outset, Vaarek jotted down mentally that it seemed that Hegush responds to emotionally charged subjects reflexively with humour and minimisation. It was possible that the humour was adaptive for Hegush – a way for him to survive and be functional in his role, at the same time as socially smoothing difficult subjects to make it easier for a conversational dynamics to remain light and not emotionally charged with focus on Hegush. But in this situation that Hegush had found himself in, the focus was necessarily on Hegush. Vaarek had to make sense of Hegush’s medical history and how trauma affected it. First of all, there were no medical records for the last six years available to Vaarek. Secondly, the conversational style that Hegush engaged in risked minimising actual somatic injuries, disabilities or conditions. It was imperative for Vaarek to be able to make an accurate assessment. Perhaps he needed help from Dr Spenn to break through those barriers…

He decided to begin focusing on the knee. It was something tangible and delineated. Maybe after that, they could move on to the off-hand references of alcohol use…

As for the knee, Vaarek assessed the orthopaedic hypotheses he needed to test. Was it an old injury? Chronic degeneration? Effect of malnutrition?

He looked at Hegush to assess him visually. They were about the same height, perhaps Hegush was a centimetre or two shorter – but that could depend on posture. He looked leaner than Vaarek, who estimated that Hegush was perhaps 5 or so kilograms lighter. It would still be a healthy BMI. It was hard to assess muscle tone under Hegush’s uniform, but a scan of Hegush while walking would help Vaarek assess both muscle tone as well as gait and any other motor issues in the body.

“I propose we begin with assessing your physiological health. I wish to scan you as you walk around in Sickbay for a minute. I will get data on your skeletomuscular health to help our assessment.”

He paused slightly before asking, “If you consent, please begin walking.”

Vaarek picked up his medical tricorder, and was ready to initiate scan.

[OOC: please let me know what Vaarek can see on his scanner, if Hegush indeed consents].

Cadet Vaarek, Medical

“I haven’t got much to show off,” Hegush said jovially, feeling a little bit silly having to walk around sickbay, despite it being a reasonable request. Of course, with the previous injury to his knee, it was only reasonable for Vaarek to ask him to walk around sickbay. Especially with it still stiffening up every now and again. Subconsciously he stretched it out before taking his first step. He felt strangely exposed as he walked around. “Let me know if you want me to strike a pose,” Hegush joked.

Having already warmed his knee up on his walk to sickbay he didn’t limp as he walked or show any sign of stiffness or pain. On the scanner Hegush’s knee showed some minor signs of early Post-Traumatic Osteoarthritis (which would explain the stiffness that Hegush sometimes experienced). Vaarek would also note it was something that hadn’t been recorded in the Lieutenants last set of medical notes. He could probably safely assume was a recent development.

Vaarek’s scanner also picked up several healed osteo fractures and breaks, many that, while fixed correctly, showed some signs of poor healing, as if the injury had already been healing before it had been treated by a doctor. Nothing that would interfere as a Starfleet Officer, yet. It was something that was going to need monitoring for early signs of osteoarthritis in case it developed in the future. The largest of the injuries next to the knee was one on his collarbone and shoulder which, like the knee also showed signs of the injury being caused by a shot of some sort.

His muscular information showed that Hegush’s had well-toned muscles, he clearly worked out frequently, he could pass any Starfleet fitness test with ease. The molecular structure of his muscles, however, told Vaarek that the threads binding his muscles were weaker than a Bajoran male the same age were expected to be. If Hegush didn’t maintain a high iron diet or work out often his muscles would be eaten up quicker than other officers with the same fitness as him would. This was also new information and most likely a long-term effect of the malnutrition he had suffered in the war-camp. Another indication of his time in the war-camp was also marked in significant amount of scar tissue across his body.

As for his organs, there was surprising little damage to his liver and kidneys given his alcohol dependency. The only area of interest was his metabolic rate was higher than average, probably again related to the malnutrition, although as Vaarek had noted earlier the Lieutenants weight was still within normal parameters.

Hegush walked back to where Cadet Vaarek was standing, “I think I can walk around Sickbay with my eyes closed now,” He grinned, “Let me know if you want me to walk around more but I doubt you’ll find anything exciting. I haven’t booked a stay at a labour-camp recently. Didn’t like it. So I doubt you’ll find anything new or exciting.”

Lt. Hegush Falz, COO

Vaarek studied the scanner output a bit longer than he might have actually needed. The data itself was uncomplicated. The scanner showed a degenerated quality of the knee joint, multiple self-healed fractures across the body, scar formation across the body, other signs of prolonged starvation and physical abuse. Hegush was in a better shape than Vaarek had expected. Somewhat unexpectedly for Vaarek, there were no indications of hepatic or renal dysfunction.

But Hegush’s body had kept the score of all the trauma. Psychologically, it appeared as if Hegush approached the trauma with humour. A defence mechanism of sorts. Was it adaptive or maladaptive? Vaarek decided to let the psychological profiling be done by the counsellor in charge – let the experts deal with her own expertise.

Vaarek put the scanner down.

“Physiologically, you are fit for duty,” he said. “However, there are early degenerative changes in the injured knee. The stiffness you described is physiologically consistent with post-traumatic osteoarthritis – but I will have to have a physician confirm that diagnosis formally and suggest what kind of monitoring and treatment is necessary.”

Hegush nodded, acknowledging what the Cadet was saying, and let Vaarek continue. Nothing he had been told was a surprise, he had been suspecting that since his knee had first began aching if it wouldn’t be something like that.

Vaarek next needed to speak of the awful conditions Hegush had experienced. As if picking up a teddy bear for comfort, Vaarek picked up his scanner, holding it a little tighter than usual. He looked at the readings once more. Although he remembered them, there was safety in confirming what they had said.

“There are also signs that your body experiences the effects of prolonged malnutrition. Several fractures also appear to have healed without medical intervention. Both of these require monitoring to reduce risk of future degeneration.”

Vaarek paused, before continuing again.

“You have survived conditions that would have caused permanent loss of function, or life, of other individuals. To remain as functional as you are after prolonged physiological stress – and psychological too – indicates resilience and adaptive capability. That said, I am concerned with what you have experienced, and how it affects you day to day. The counsellor will perform the psychological evaluation. But I must still approach the subject. You mentioned alcohol. Your file mentioned alcohol use disorder. Are you comfortable discussing recent alcohol use?”

Cadet Vaarek, Medical

“Alcohol keeps away contagion Cadet Vaarek,” Hegush said merrily, hiding the ugly twist in his guy at the mention of loss of life he could have endured that he had seen in so many around him at the camp. Too many ghosts still chased him from there and probably always will. Some pains could be eased but not erased and comparitivly it made the tweaks in his knee feel like nothing. “It is an Earthling saying that I have picked up over time, I quite like it. It seems to have kept things going that, as you said, others would have succumb to.”

“You are very thorough and dedicated,” he said, “Ask anything you like, I’ll do my best to respond,”

Lt. Hegush Falz, COO

Vaarek nodded. There was still much projection in his patient, as if Hegush distanced himself from his past and his pain. It would be logical, as a survival mechanism. But at the cost of deafening the emotions with alcohol, or, perhaps, amplifying competing emotions. Vaarek was still not well-versed in how alcohol affected Bajoran physiology, neurology, and psychology. He probably would need to consult Dr Spenn. Though perhaps, it would be more conducive for a non-Vulcan. Vaarek was not very impressed with his supervisor’s bedside manner. Vaarek thought that perhaps one needed to tread carefully into the psyche of Mr Hegush, so not to lose the therapeutic rapport necessary for assessment and change.

“I trust you know how alcohol affects you, and when and why you intake it. Please help me understand what situations cause you to intake alcohol, how often your intake of alcohol occurs, and in what quantities you intake alcohol.”

Vaarek found himself sounding a little too curt for his own wishes. Being raised on Vulcans had its drawbacks. He decided to contextualize his question. “Alcohol affects your health. That is the role of your physicians to ascertain in what way, and what kind of treatment you might need. But alcohol also affects cognitive abilities, and I must ascertain that you are cognitively fit to serve on this ship, and that intake of alcohol does not affect your ability to perform your duties.”

Cadet Vaarek, Medical