To Honor You Call Us (18 page)

07:47Z Hours 23 January 2315

Naval regulations prescribe that, fifteen minutes before the beginning of any watch, any man who feels as though he is too ill to report for duty is to report to the Casualty Station for Sick Call.  Officers, of course, have the privilege of seeking medical attention at any time, but the naval custom is that they check in by comm to make sure that the Casualty Station is not busy.  As the Union Navy follows the time-honored three watch system, dividing the men into three teams known as “Blue,” “Gold,” and “White,” standing five watches, each of which is four hours long, and two, two hour “dog watches,” there are seven sick calls a day.  With a crew of only two hundred and fifteen men and boys on board, most in the prime of life, physically fit, living on board a scrupulously clean starship, eating carefully selected and professionally prepared food, and isolated by light years of deep space from most sources of disease, Sick Call is not exactly the lunch rush at Feinberg’s Deli in Silverstein City on Alphacen.

When setting up the Casualty Station policies for the ship, Doctor Sahin directed that he would take two of the seven sick calls per day, rotating through the schedule, with the others delegated to nurses.  Of course, if anything more serious than a headache or a runny nose showed up, the nurse was to call him.  And, when he took Sick Call, he did not have a subordinate screen the men who reported, but greeted them himself and took their histories personally. 

So it was that, a few minutes before the beginning of the Forenoon Watch—the one that runs from 08:00 to 12:00—the doctor personally greeted a crewman who reported for Sick Call.  Sahin had him sitting on the examining table in his underwear, having stripped off his SCU, while the doctor sat on the little stool with wheels that physicians had been putting in their examining rooms for nearly half a millennium.  “What’s your name, Spacer?”

“Rhim, sir,” the man answered slowly. 

The doctor touched his padcomp a few times to pull up the man’s records.  “Ordinary Spacer Second Class, right?”

“Right.”  That answer seemed sluggish as well, which struck Doctor Sahin as odd.  Spacers were not slow.  They had to score in the 85
^th
percentile in general intelligence just to be accepted as Midshipmen and the ones who were not also quick witted never made it to Recruit Spacer.  And what was it about this man’s eyes that seemed odd? 

“Been on the
Cumberland
for thirteen months, correct?”

It took the man a few moments to count the months.  “Yea, that’s right.”

“Born on Jeffries IV, right?” 

“Right.  No.  Jefferson IV.”  He blinked.  For the first time since the doctor had been speaking with him.  That is what was odd about his eyes.  The man was hardly blinking. 

“All right, I have your medical history right here.  Nothing unusual that I need to be worried about.  Now, why are you reporting here this morning?”

“It’s my hand, Doctor.”  He held up his right hand.  “I’ve got this feeling, a tingling but it’s almost painful, and it’s been getting worse the last few hours.”

“I think a colloquial expression for that, Spacer Rhim, is ‘pins and needles.’  Is that it?”

“Yeah, exactly.  That’s what it feels like.”

“Let me see it.”  The man extended his hand and the doctor took it, carefully checking the texture and rigidity of the skin, the color, its size relative to the other hand, its temperature, how damp or dry it was, and several other characteristics that he could not have named without careful thought but that, nevertheless, were a part of his examination.  Sahin trusted his senses first, before having recourse to instruments and laboratory tests.  He noticed that the hand was slightly inflamed, being redder, larger, and damper than the other.  It was almost as if the hand had suffered a mild sunburn or been very lightly scalded in hot water.  One thing that could cause that kind of injury on board a starship came immediately to mind.  “Let’s see what your duty assignment is.  I’m going to guess you work in Engineering somewhere around the compression drive.”

Before Rhim could respond, the doctor had the information in front of him.  “Indeed.  My surmise was correct.  You are a Compression Drive Operation, Maintenance, and Repair Technician, aren’t you?”

“That’s right.”  During this conversation, the doctor was shining his pen light into Rhim’s eyes checking his pupil response, looking in his ears, feeling his pulse, checking his cervical glands for adenopathy, and so on. 

“And was your hand anywhere near one of the compression phase regulator feedback streams recently?”

“Yes, it was.”

“But, I thought there were safety procedures to be sure that the stream never touched human tissue.”

“There are.  But, well, Doc, it’s like this.  Every now and then, we need to swap out one of the regulator buffers that the stream flows around.  It’s just this little cadmium-praseodymium-ytterbium rod with a liquid boron core that plugs into a socket in the stream conduit.  You open the conduit, pull the old rod, and insert the new one.  We don’t shut down the drive when we do that.  Since there are ten streams, we run the other nine at a hundred and eleven point two percent and shut down the one we need to do the buffer swap out on.  It’s OK, since the system lets us shut the stream down for up to eight seconds at a time and the book says they can be run at up to a hundred and thirty percent for up to a minute.  So, we shut it down, open the door, pull the old rod, stick the new one in, close the door, and restart the stream.  Simple.”

“But, you were a little slow pulling your arm out as the stream restarted and it caught your hand as it was just beginning to power up.”

“Hey, you got it pegged, Doc.  That’s exactly what happened.”

“When did this happen.”

“About eight hours ago.”

The doctor regarded him severely.  “Spacer, you know that regulations specifically require that you report immediately to the Casualty Station upon any exposure of that kind.  Why did you not report?”

“I didn’t think it was all that serious.”  There was something evasive about the answer.

“Were you the senior person performing this operation?”

“No, sir.  That was Petty Officer Third Starcevik.”

“Then, it was his responsibility to make sure that the injury was reported promptly.  I will deal with the Petty Officer later.”  He made a note on his padcomp.  Starcevik would soon be hearing from the
Cumberland
’s
Chief Medical Officer in a manner that would get his attention; the safety of the crew was paramount and superiors were strictly responsible for the safety of those under their command.  “Was Starcevik aware of the incident?”

This question apparently required considerable thought.  “Yea, he was standing right there and he asked me if I was OK.”

“I see.”  The doctor walked away from the man to the corner of the examining room, as though in thought, while slipping his pen light out of his pocket.  Without warning, he turned and tossed the light to Spacer Rhim.  “Here, catch.”

The light hit the spacer squarely in the center of his chest and fell to the examining table before the man so much as flinched. 

“Spacer, look me in the eyes and tell me how long you have been a tranker.”

Rhim gazed back at him in apparent shock and horror at the accusation.  “Bones, I don’t use that stuff.  You know it’s against regulations to even have it on the ship.”

Sahin actually smiled.  “Now, Rhim, that line may work on some worn out, second rate, gone to space because he can’t make it in a modern clinic doctor, but it doesn’t fill the water skins with me.  I can spot it a mile away.  Your movements are slow, your answers to questions were slow, your reflexes are slow, and you hardly ever blink your eyes.  Most Spacers are nervous in the presence of the Chief Medical Officer but you have not even so much as fidgeted or twitched.  Your pupils are dilated and unreactive, your facial capillaries are dilated, and there is a characteristic pigmentation change in the oral and nasal mucosa.  To trained eyes, you might as well have painted a sign on your forehead.  Now, I know that most of the drugs used by men on a warship do not show up very well in ordinary blood tests.  But they can be tested for very easily from a sample of cerebrospinal fluid.  Spacer, are you going to tell me what you are taking, or do I need to perform a spinal tap?”

“Spinal tap?”

“Oh, yes, a spinal tap,” the doctor responded cheerily.  “More properly called a lumbar puncture.  Very simple, really.  I take a one hundred and twenty-five millimeter needle and insert it directly into your spinal column right between your L3 and L4 vertebrae,” Doctor Sahin jabbed him with his index finger roughly in the middle of his back, “and slowly push through the tissue until I feel a slight ‘give’,” he gave the finger a slight shove, “which tells me that the needle has penetrated the
ligmentum flavium. 
Then I continue to push the needle deeper into your spine until it ‘gives’ once more,” another shove, “telling me that I am through the
dura mater
and . . . I see signs of alarm on your face, Rhim.  Truly, the needle is not all
that
long, only as long as your hand is wide, there are many larger that we commonly use, so put that concern aside.  In any event once the
one hundred and twenty-five millimeter needle
is inside your spinal column very near your spinal cord I very carefully withdraw some cerebrospinal fluid for testing.  Of course, if I penetrate too deeply, the needle could puncture your spinal cord and paralyze you for life, but there is only a very slight risk of permanent paralysis resulting from the procedure.  Don’t worry.  I am quite the old hand at jabbing long needles into people’s spinal columns.  I’ll be right back with a nurse and a spinal tray.”  He started for the door.

“No, Doc.  Wait,” the Spacer pleaded.  “You don’t need to do that lumbar tapping puncture spinal thing.  I admit it.  I’ve been tranking.  But only when I’m going off duty.” 

“Thank you.  And what, exactly, are you using?”

“The Chill.” 

Of course.  It
had
to be the Chill.  The Chill was the “street name” for a prescription medication known as Atanipine used to treat cases of extreme anxiety disorder.  When a patient was so severely anxious that he could not even speak about his problem to a therapist, this drug was a Godsend, virtually eliminating the anxiety so that the patient could talk about his issues without going into an anxiety attack.  It was generally administered only a few hours before a therapy session, and even then only for a period of a few months because, as the treatment went on, the drug was known to slow reflexes and mental responses long after its anti-anxiety effects wore off.  It could be synthesized by any but the most basic MediMax units once the authorization protocols were disabled.

“Rhim, just sit right there for a moment.  I’ll be right back.”

“You’re not going to get . . . .”

“No, I’m not going to get the spinal kit.  I’m going to get a piece of diagnostic equipment.”  In less than three minutes, the doctor returned with a device that looked like a black gauntlet with mitten fingers and two thumbs (one on each side) plus a small numerical readout on the forearm.  “This is a Neural Transmission Analyzer.  Simple device, really.  It stimulates the fingertips and then measures the timing and the intensity of the neural response as it travels up the nerves through the upper forearm.  It tells how efficiently the nerves are transmitting their impulses and how rapidly they are doing so.  We have a more sophisticated test that involves putting a measuring device on your head and stimulating several different parts of your body, but this is accurate enough for our purposes today.  Just put your arm in here, no the other one.  I do not want to use the hand that you injured.  There.  Now, you will not feel anything except a bit of a tickle, then a vibration, then a gentle poke or two, all on your fingertips.  Nothing terribly unpleasant.”

Rhim inserted his right hand and the doctor activated the device.  It was just as promised.  First he felt a light brush across his fingertips, almost like a feather, then a slight vibration of each finger in turn, and then pokes by a sharp but not penetrating object, much like a somewhat blunted pencil point, in several points on the tips of each finger.  The stimulation then stopped and a green light came on at one corner of the readout unit.  The doctor removed the device and pressed a button.  Two numbers appeared:  7.1 and 6.5.

“Doctor, what do those numbers mean?”

“The first number is the speed of your neural transmission.  It is an index calibrated for each patient’s gender, age, and other factors—I input the calibration data before I stepped in.  Ten is normal.  The second is a similar index for the sensitivity, accuracy, and precision with which your nerves respond to the impulses.  Again, ten is the calibrated norm.  Your responses, I am sorry to say, are significantly below normal in on both indices.  How long have you been using this substance?  Please be honest with me.  I already have a good idea from the degree of neural impairment.”

“More than a year.  Let me see, thirteen and a half months, I think.”

“That is not surprising.  How much do you take?

“I usually take a pointer when I get off duty.  When I have a day off, I take a deuce.”

“A pointer is one and a deuce is two milligrams?”

“Yea, that’s right.”

“At least you’re not a heavy user, although the drug has still taken a substantial toll on you.  Now, young man, again I need you to give me a perfectly and completely honest answer to my next question.  It is my job to treat this problem and see you returned to full health and, in order to do that, I must have accurate information.  My job is to cure, not judge.”  The Spacer nodded his understanding.  “If you do not use for a day or two, do you experience any symptoms, such as nervousness, anxiety, loss of appetite, inability to sleep, or muscle twitches, particularly around the eyes and corners of the mouth?”