24. Chromatophore

Date: 36/1/2733

Patient: Garthangrosk, Ceresaur 

Patient ID: 2348739 

Presenting Complaint: Star Map Pain 

Dr Adra has a long day.

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 EPISODE NINE - CHROMATOPHORE

[MUSIC: The Vesta Clinic Theme]

XAELEST 

[Pull yourself together, Adra. 

COMPUTER

Did you want me to call: Dr H Adra? 

XAELEST

No! No, stars, no. 

COMPUTER

You have 6 missed calls from this contact. 

[SOUND: Bleep] 

XAELEST 

No. [Sniff] 

[SOUND: Bleep] 

Come on. 

COMPUTER

Incoming call from D Solari. 

XAELEST 

Stars, I just - 

[SOUND: Bleep, sound of the bleep being picked up and hitting the wall] 

Come on, Xaelest. 

Superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular - 

[SOUND: comms call ends]

COMPUTER

Incoming call from F Underwood

XAELEST 

Shit . . . Answer. 

[SOUND: comms call answered]

FAYE 

XAEL! I’ve just got back - they’re NOT dead! Not even CLOSE.Oh my stars, I nearly shed my entire dermis like a - Xael? Are you okay? 

XAELEST

I’m - yeah. 

FAYE

Wait right there. 

XAELEST

No! Wait - 

[SOUND: comms call disconnected] 

Ugh, stars. Computer? Set message settings to urgent only. 

COMPUTER

Urgent messages only. 

XAELEST

Message to D Solari: Busy, sorry. Call back if urgent. 

COMPUTER

Message sent. 

[SOUND: Footsteps]

XAELEST

Computer. Open door. 

[SOUND: door opening, footsteps, sound of something being dragged in, door closing] 

FAYE

Hey! Stars, Xael. 

XAELEST

I’m fine. 

FAYE

Did something happen? 

XAELEST

Just a long day. That’s all - I - 

FAYE

A day long enough for you to throw your bleep at the wall at . . . 1000 hours? 

[SOUND: footsteps, plastic scrape as FAYE picks it up]

I’ll be taking this. 

XAELEST

[Arguing anyway] No. 

FAYE

Come on, you should take . . . thirty minutes. 

XAELEST 

No! 

FAYE

Fifteen. Final offer. 

XAELEST

I’m fine. 

FAYE

Did your mothers call? 

XAELEST

No . . . It’s not that. 

FAYE

Do you want to - ?

XAELEST

No. 

FAYE

Right. Fine. Maybe later. I brought you a friend - 

[SOUND: footsteps, hover of trolley] 

To make your day a little easier. 

XAELEST

Oh. I don’t want him -

[SEC: power on] 

FAYE

Hi, bud. You don’t mind helping Xael while I answer some bleeps, do you? 

[SEC: affirmative ping, typing on screen] 

XAELEST

[Trying to be subtle] Faye - 

Faye! 

FAYE

I know, I know. I’ll call you if I need you. 

[SOUND: footsteps, door open] 

I’ll be back with some tea if none of these are urgent. 

[SOUND: footsteps, doors close] 

[Silence] 

[SEC: questioning ping] 

XAELEST

What?

[SEC: typing on screen]

I don’t need help. 

[SEC: typing on screen]

Not from you. 

[SEC: typing on screen, questioning ping]

Since when have you given a millisecond’s processing to my feelings about anything? 

[SEC: questioning ping] 

You know what I’m talking about. 

[SEC: negative ping, typing on screen]

Dakarai’s right. I haven’t forgiven you. 

[SEC: questioning ping, typing on screen] [Why?]

I begged you - begged you - to just stay awake and help me and you said no. 

[SEC: typing on screen]

We were all grieving, Sec. 

[Pause] 

[SEC: typing on screen]

They kept things from me, too. 

[SEC: typing on screen, negative ping, typing on screen, questioning ping]

[Sigh] Fine. I can’t leave Faye with that bleep for too long or we’ll end up with a queue of patients from here to Mercury. How do you two usually do this? 

[SEC: typing on screen]

I’ll tell her you said that. 

[SEC: negative ping]

[MUSIC: begins]

Date: 36/1/2733

Patient: Garthangrosk, Ceresaur 

Patient ID: 2348739 

Garthangrosk is a young ceresaur who - 

[SEC: typing on screen, questioning ping]

Uh. [Sigh] A young ceresaur of 6 Vesta Years. Please don’t feel the need to edit me, Sec. 

[Pause] 

[SEC: affirmative ping] 

[With purpose] Garthangrosk is a young ceresaur of 6 Vesta Years who presented today in considerable pain associated with an emerging epidermal constellation map. 

[SEC: typing on screen, questioning ping]

The star charts, yes. 

Their second and most recent independent flight had taken them wide of the Eos system and it appeared that the scale marking was attempting to arise on their forearm. Uh, left forearm. 

[SEC: affirmative ping] 

The pain was described as a gnawing pain which had been present for 2 days and started approximately 5 hours after landing on Ceres. Garthangrosk had a single other epidermal constellation across their neck which appeared healthy. They did not report any new issues with this site. 

Over the course of the 2 days, they developed increasing systemic upset, with symptoms of nausea, headache and sleeplessness. Their distress was clear to me as they tugged their forearm against the sky of their stomach and hunched over it, ready for another wave of pain to strike. 

It was difficult to delineate how much of this particular behaviour was driven by the experience of the pain itself or . . . fear. 

I had the opportunity to observe Garthangrosk during a flare of pain. They paused, mid-word and pushed down on their forearm with a hiss as though - 

[SEC: questioning ping] 

As though trying to push the rising chromatophores back down beneath the dermis. 

I questioned Garthangrosk about the methods they had used so far to try and bring out the star map and they blinked their inky green eyes at me. 

‘What do you mean?’ They rumbled and I failed to keep a frown off my face - it’s really irritating that human faces do that. 

[SEC: typing on screen, affirmative ping] 

Um. From my knowledge of ceresaurian culture, it is highly unlikely that Garthangrosk would have been able to hide the unformed constellation from their nestmates. Ceresaurs usually take great pride in sharing their new maps with the ones who have missed them. Their nestmates and fellow pilots will have been swarming all over them with ‘helpful’ - you can put that in quotation marks - 

[SEC: affirmative ping] 

‘Helpful’ suggestions for how to bring the epidermal map through. 

[SEC: typing on screen, questioning ping]

Um, usually it’s things like eating certain roots, bathing at a certain temperature and using hot compresses. I once heard a rumour that ceresaurs should consume a freshly discarded Adrilaen cocoon to bring out their maps quicker but, thankfully, that was regarded as general nonsense. The last thing you want as a freshly altired Adrilaen is to emerge to an agitated ceresaur who wants to eat your discarded skin . . . 

[SEC: negative ping, negative ping]

Mm.. 

Garthangrosk confirmed that they had not tried any of the usual remedies before another wave of pain stole their voice. They clamped down over the site and bared their fangs as their snout seized into a grimace. Their relief was palpable as the ache subsided and they peeked beneath their hand to reveal the empty blue expanse of their forearm. 

I reassured them that we could try several basic things in the clinic today to help bring the epidermal constellation through and ease their pain. Their tongue flicked out as they stared resolutely at the wall, informing me that they simply wished for some pain killers. 

[SEC: questioning ping, typing on screen, questioning ping]

Yes. I was . . . surprised. 

I explained to my patient that the simplest and most effective way to reduce pain and prevent complications was to bring the chart out onto the skin. They promptly hissed at me, pupils widening as they registered that they were doing it. The pale blue of their forearm contrasted against the indigo of their ribcage as they tucked their arm away from my potential grasp. 

I assured them that the manifestation would not be more painful than what they were already experiencing. They reiterated their desire for analgesia and nothing more. 

I had all the information I needed. 

[SEC: typing on screen, questioning ping]

Yes. 

‘You’re blocking its manifestation.’ I said. They looked away. And nodded. ‘Why?’ 

[SEC: typing on screen]

[Tutting] It’s not ‘harsh’, it’s direct. You’ve been spending too much time with Dr Underwood. 

[SEC: typing on screen, questioning ping]

If I was speaking to Faye, or a patient like her, I would have said: ‘The formation of constellation maps can be more difficult after challenging flights. Are you aware of anything that might be making this manifestation more difficult for you?’ 

[SEC: typing on screen, questioning ping]

[Sigh] This patient was not a squishy human and, like me, they did not train with the same warm-blooded mentors that taught Faye her bedside manner. Our tutors had sharp teeth. And you often don’t realise you’re being chewed up until they spit you out. 

[Pause] 

[SEC: typing on screen, questioning ping]

No. Not the Prof. Are you still dictating? 

[SEC: affirmative ping]

I explained to Garthangrosk that I could see that there was a reason they were trying to prevent their markings manifesting and explained the limits of medical confidentiality. They could tell me anything in complete confidence providing that what they disclosed didn’t involve actual or potential harm to themself or others. 

Garthangrosk nodded, tongue flickering, a physical manifestation of their uncertainty. Their claws made indentations against the unyielding plates of their skin. 

‘I think I saw something out there.’ They admitted in a slow sibilance. I asked them what it was that they thought they saw. ‘I don’t know.’ The overhead lights made white smatters of stars in the dark bulge of their eyes. ‘I must have left it on the ship.’ 

Garthangrosk went on to tell me that they knew something had happened during the flight when they were met by their commander upon landing, asking if they were okay and what they had seen. I suspect that, in an attempt to protect themself, they transferred some of their memory of the flight to their shuttle and this is no doubt contributing to the difficulty in actualising the star map. 

[SEC: typing on screen]

Quite. 

With verbal consent, I examined Garthangrosk’s scales. Constellation maps arise through quorum sensing, the maps only arise once a sufficiently dense population of chromatophores has been reached in a particular area. I could tell which was the affected area as it was warm to touch. There were palpable, circular plaques under the surface of the skin where the pigmented scales had become inflamed. 

Garthangrosk’s problem list is as follows: 

One - Traumatic experience 

Two - Bioelectric memory suppression of ‘one’. 

Three - Anxiety related to ‘one’. 

Four - Impaired epidermal constellation mapping secondary to above 

[SEC: typing on screen, questioning ping]

Just number it. Faye should also be writing problem lists . . . 

[Pause]

[SEC: affirmative ping] 

Treatment plan: 

One - analgesia 

Two - Referral to ceresaurian psychotherapist for memory retrieval and trauma therapy 

Three - The pain should resolve once Garthangrosk is psychologically ready to process the event 

I shared my treatment plan with the patient and it was met with resistance. After a reiteration of the confidentiality code I am bound to, they told me that they had lied to their superiors about where their route had taken them. The formation of the star map would provide evidence of their lie. 

[SEC: typing on screen]

What do you mean? That explains what? 

[SEC: typing on screen]

Yes, Sec, it has reminded me of when I lost my training post, thank you. 

[SEC: typing on screen]

No! I do not want to talk about it. Not with you. Not with Faye. Stars, definitely not with Dr H Adra who has decided now is the time to send incessant invitations to ‘talk’. There is only one person who has ever been able to make me feel like anything less than a monster for what I did and they’re not here! 

The others don’t want to hear it! They want to hear how excited I am to perform NOSL11’s gestational retrieval! Faye in particular does not need to know that the last time I operated I nearly killed one patient and mismanaged another to - oh, what was that fun phrase the courts used? ‘Catastrophic functional decline’. 

[SEC: typing on screen]

Europa’s - ! I thought I was doing the right thing. I would make the same decision again in those circumstances. Minus the lying. That’s what I told the examiners in my interspecies management exam, seeing as they were subtle enough to present me with a nearly identical clinical scenario. 

[SEC: questioning ping, typing on screen]

Sec, they are furious that I was given a job here. I would have been struck off entirely if not for the Prof giving me a second chance. 

[SEC: typing on screen]

True. [Sigh] But if I’m to do this operation, I’ll need to undergo altiraans. I’ll need my arms back . . . Before I changed last time I couldn’t look at my hands without thinking about it . . . 

[SEC: typing on screen]

[Clears throat] Which reminds me, I have advised Garthangrosk to seek advice from trusted and experienced Nest Mates or senior pilots who may be able to provide reassurance about how to proceed professionally in light of this experience. It may be that they require some time away from flight. Alternate duties may be beneficial to maintain a sense of purpose. 

[SEC: typing on screen, questioning ping]

No. And I didn’t suggest they look me up. Any comfort that my similar work-related incident may have provided would surely have been mitigated by finding out that your doctor nearly killed a child . . . so . . . . 

[SEC: typing on screen]

No. No, I can’t. Rai knows. That’s . . . enough. 

[SEC: typing on screen, questioning ping]

No, I do. I do want to operate on NOSL11. That’s the problem! I - it’s not like I quit by choice! But I don’t know what I’ll do if there are . . . complications. And finding a suitable anaesthetist is - 

[SOUND: footsteps] 

Computer. Open door. Sec, clear your screen, please. 

[SEC: affirmative ping, ping]

[SOUND: door opening, footsteps, door closing] 

FAYE

Hi, sorry. I just have a few things to talk to you about when you’re free. I brought tea! 

[SOUND: tea is set down]

XAELEST

How many patients are you bringing in? 

[SOUND: footsteps, chair]

FAYE

Uhh, all of them? 

XAELEST

Stars. 

FAYE

Lots of lumps! It’s hard to get a handle on a lump without getting a . . . hand on the lump, right? 

XAELEST 

[Sigh] Sec and I are nearly done, you can have him back. 

FAYE

Have you not behaved for Dr Adra? 

[SEC: questioning ping,  typing on screen, negative ping, typing on screen, affirmative ping]

[Laugh] 

XAELEST

I have a new appreciation for how distracting he is. 

[SEC: questioning ping]

FAYE

Exactly! It’s never just me rambling, he encourages it! 

[SEC: questioning ping, negative ping] 

XAELEST 

Anyway . . . 

FAYE

Yep, sorry! 

XAELEST 

Garthangrosk has been supplied with both oral and topical analgesia to reduce the ache associated with the map. This should be used as prescribed and weaned as symptoms begin to improve. 

I have also recommended against attempts to reconnect with the memories aboard their spacecraft without the supervision of a professional. There is the possibility that more psychological and physical harm could occur and, without appropriate reprocessing of these memories, there may be long term consequences for their mental health. 

I have discharged them from the clinic today as there is little we can offer further for this complaint unless their situation changes. I have advised them to seek urgent medical attention if the site develops increasing swelling, bleeding or pus or if they develop fevers or confusion. Additionally, if their anxiety worsens or they begin to have troubling memories or thoughts associated with the suspected incident, we would happily review them again. 

FAYE

Sounds rough, Xael. 

XAELEST

. . . Yes. 

FAYE

You’re right though, I don’t think taking a break or talking about it will make you feel better. 

XAELEST

What? 

FAYE

I think you need to see Mx Erita. She’s got a lump in her armpit that cries when she’s upset. . . I think reviewing her will make you feel so much better.  

XAELEST

[Sigh] You are not having my bleep again. 

FAYE

[Laugh] 

XAELEST 

Sec, attach signature. 

[MUSIC: The Vesta Clinic theme] 

Credits: 

This episode of the Vesta Clinic was created by AMC. It starred Ruby Campbell as Xaelest Adra, AMC as Faye Underwood and Sec as himself. Music by AMC and Ruby Campbell.  

Please check out our show notes for content warnings, transcripts, and your prescription of: frog noises. 

A huge thank you to our Patreon supporters. We hope you enjoy this week’s bonus story and bloopers like this one: 

RUBY: Ascending pharyngeal (pronounced incorrectly) [Laughs, wheezes] I can’t control [Laughs] What comes out of my mouth!

Content warnings: Work-related trauma (undisclosed); reference to medical errors