[JP] Dr. Jansen Orrey & Lieutenant JG Roy Bancroft - Threshold Conditions (Part 2)
Carter Schimpff
Orrey: Perhaps an interruption in the osteoblasts. I myself have a condition that interrupts cellular communication. It causes rapid cellular aging. I managed to come up with a weekly gene therapy based on modified Caitian DNA. ::offering a smile toward his colleague:: Mysterious space radiation really does make the job difficult.
Bancroft: ::expression softening:: The things we run into in deep space, huh? But that kind of firsthand experience carries real weight. You’ve lived inside what disrupted signaling feels like – and brilliantly out-thought it to keep your own cells behaving. Perhaps this is that. Or, it could only be one thread in a larger knot…
Orrey: Or...if not the osteoblast or some other signaling deformation.The acid-base homeostasis could be interfered with. An unbalance of the ph in extracellular fluids…
Bancroft: ::a slow nod:: That would track with the patterns we’ve observed. If the extracellular environment is even slightly hostile to mineral deposition, then it becomes… ::searching for the right words:: not necessarily malformation so much as a construction delay.
He drew his fingers through the air, and a new layer of holographic data surfaced: infant metabolic panels, maternal electrolytes, arterial blood gas values – sparse, because newborn sampling always was, by necessity, conservative.
Bancroft: We haven’t pulled anything more invasive than we absolutely had to yet. Mostly because she’s a week old and I’m trying not to treat her like a thesis project.
Orrey: Absolutely not.
Roy’s shoulders loosened by a fraction. The words of his peer – if Dr. Orrey could be called such a thing, with the gulf between their two levels of experience as wide as it was – were a salve to his burdened conscience.
Bancroft: ::quietly, smoothing his mustache:: If I’m right about the mitochondria – or if you’re right about signaling – the last thing we want in either case is to take an already stressed system and light a match in it.
Orrey: It won’t get us anywhere.
Roy let out a breath through his nose – not quite a laugh, not quite a sigh – as Dr. Orrey’s words brought to the forefront something he’d been lying to himself about for quite some time: he wanted to help Leera Bex Dakora because she needed help. But he also wanted to do it, at least in part, to absolve himself of his own guilt.
He thought briefly about suggesting an addendum to the oath all Starfleet doctors swore: “Try not to soothe your own anxiety at the patient’s expense.”
Roy’s eyes dipped briefly back to Leera’s file. The tiny scan rotating in the air had a cruel kind of serenity to it – a neat diagram of an unfinished world.
The two of them stood in shared silence for a beat – the kind of pause that wasn’t empty, but instead full of thought. In the distance, holodeck systems hummed along, indifferent in their perfection.
Bancroft: Alright, I think we can both agree that we’re not going to “fix” her leg today. In that case, the priority now is mapping. Define what’s stable, what’s progressive, and what’s responsive. I can do serial imaging at safe intervals. Metabolic panels. Look for markers of disrupted differentiation in signaling. To be clear, not because I’m eager to label a newborn with ‘Bancroft’s Syndrome’...
Orrey: The Doctor’s Dream.
Bancroft: ::wry smile:: …but because I’d like to avoid the future where Leera grows up thinking pain is what ‘treatment’ feels like.
Orrey: Not even for a second. Not in this day and age.
Roy’s throat tightened, just barely. He disguised it by clearing his throat and tapping a command into the console before him.
Bancroft: And not thinking about just her future. Sam’s, too. She’s… holding it together. Better than most people would. But she’s a scientist. She knows what questions to ask, and she knows the difference between a real answer and the physician’s version of ‘hell if I know.’
Orrey: ::smiling:: I would expect nothing less from Sam.
He looked back at Leera’s file and, for the first time since this call began, the ‘metallic taste of failure’ eased into something else. Not hope. Not relief.
It was the steady sense of direction.
Bancroft: So here’s the decision point we’re circling: how aggressive do I get with early supportive care? Supplements, metabolic scaffolding, tests and imaging and more tests and imaging… I could have that poor girl in sickbay being poked and prodded every day.
Orrey: Most of that can be done in the home without stress to the child or parents.
Bancroft: ::faint smile:: I like the sound of that. I’ve always believed ‘boring’ is the highest compliment you can pay true healing. ::a beat:: I just want to make sure I get out well ahead of that ‘worst case scenario.’ This time, at least.
Roy’s jaw flexed. Saying the words out loud somehow made it momentarily harder for him to bear. Leera’s worst case scenario, as he’d defined it earlier – a prosthesis – was potentially only the opening paragraph of a much more tragic story.
If he didn’t get a handle on why this had happened, the true worst-case was a full system-wide expression: it might not stay politely localized in one leg forever. Bones today. Muscle tomorrow. Something else when she grew older.
Orrey: You are already leagues ahead by searching for other opinions.
Bancroft: On your side – if you’re willing, sir – I’d like you to remain looped in as a consult. And, if you can find the time–
He almost laughed, didn’t, but thought he detected just the slightest twinkle in Dr. Orrey’s eyes.
Bancroft: –it would be monumentally helpful if you could review your original ‘Frontier Day’ notes about Sam’s osteogenic response and crack into the stuff between the lines. Anything that could help us.
Orrey: I can. I can think of a few journals to look through as well for inspiration if nothing else. I will forward what articles I find.
Roy swallowed, and for a moment his voice softened – not broken or shaken, but at its most human.
Bancroft: Thank you. ::long pause:: I’ll schedule a follow-up with you after our next few rounds of labs, imaging, and examinations – when we have enough new data to have another fruitful conversation.
Orrey: Do not take so long, and do not torment the family. They deserve some peace. Let them know we are working on it and tell them to take solace in that.
Roy straightened his lab coat again – still unnecessary, but now the gesture felt less like nerves and more like ritual. Like suiting up.
Bancroft: I appreciate your time, Dr. Orrey. When this started, I was… afraid. Afraid that reaching out would signal incompetence. You’ve helped me understand the real truth. I’m doing what I should have done from the beginning: build a team.
Orrey: “Asking for help isn’t giving up. It is refusing to give up.”
Roy’s hand hovered over the command on his console that would end his call, but didn’t tap it. Not just yet.
Bancroft: And Doctor, if you do ever find sweet tea in deep space…
Orrey: Hmm?
Roy smiled.
Bancroft: I’ll hold you to that.
End Scene for Orrey and Bancroft
(OOC: Huge thanks to Craig, Dr. Orrey’s writer, for generously taking the time during an active mission to co-write this JP. I really appreciated the collaboration!)
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Jansen Orrey M.D., M.Sc.
Chief Medical Officer
Amity Outpost
O238506JO0
And
Lieutenant JG Roy Bancroft
Medical Officer
USS Artemis-A
A240205RB1