25. Calculated Risk
Date: 40/1/2733
Patient: Olea Aander, Adrilaen
Patient ID: N/A
‘Hi, I’m about to have a heart attack.’
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Please consider supporting us on Patreon! The bonus story for this episode is called ‘[Comms ID Unavailable]’ and is available here!
To avoid spoilers, content warnings are available at the bottom of this page!
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Transcript
[MUSIC: Background music]
RADIO AD
[Pre-recorded] You are listening to Tower of Terre, the only radio station bringing you the best of Earthern music.
RADIO ANNOUNCER
That song gets better every time we play it! No matter where you’re listening from, I sure hope you’re ready to relax, because it’s time for our Sunday chill. I don’t know about you, but I think it would be wrong to start with anything other than GALileo. This is her newest track, apricity.
[MUSIC: song starts]
FAYE
I like this song.
[SEC: typing on screen]
[SOUND: whoosh, crackle, exam bench creak]
OLEA
[Breathless] Hi - !
FAYE
[Shriek]
[SOUND: chair]
What in the - ?
OLEA
We don’t have a lot of time. I’m about to have a heart attack.
FAYE
What?! Wait - what??!!
OLEA
Respectfully, I’m going to go ahead and pull this buzzer for you before I - [Groan of pain]
[SOUND: buzzer pull, alarm sound]
Come on, Dr Underwood. Get the defib. That’s the spirit!
[SOUND: rattling as FAYE gets the trolley]
FAYE
Who are you?!
OLEA
[Exhausted] Olea Aander, I’m an anaesthetist. Work on Ganymede. I was trying to [wave of pain] - oh, Europa’s freckles - when your nurse comes in, I’m gonna need some of the good stuff - trying to enjoy a holiday.
[SOUND: door open, hurried footsteps]
XAELEST
What is going on in here?!
FAYE
I - don’t -?
OLEA
Xaelest! Hi! I’m about to arrest, so if you could get your colleague to close her mouth and do a rhythm check?
XAELEST
Oli?
OLEA
Can we do this after you’ve cardioverted me, maybe?
[SOUND: door open, RAI enters]
DAKARAI
Olympus’ sweaty mons.
FAYE
Xael? You know them?
XAELEST
Are you human on the inside?
OLEA
What a - [Pained groan] - What a question. Yes.
XAELEST
Faye - lead.
FAYE
What?!
XAELEST
Patient. Arrhythmia. Monitor. Now.
OLEA
You’ve got about 5 seconds before this gets really spicy.
FAYE
Xael, I -
OLEA
4
XAEL
Get the pads -
FAYE
They’re on, I don’t know where to plug this?!
OLEA
3, 2
XAEL
Stars, Faye!
OLEA
Let’s try this again.
[SOUND: ticking and beeps of a FASERUNR, warped noises]
RADIO ANNOUNCER
I don’t know about you, but I think it would be wrong to start with anything other than GALileo. This is her newest track, apricity.
[MUSIC: song starts]
FAYE
I like this song.
[SEC: typing on screen]
[SOUND: whoosh, crackle, exam bench creak]
OLEA
Hi! I’m about to have a heart attack.
[SOUND: buzzer pull, alarm sound]
Dr Underwood, you’re going to lead. Get the crash trolley. I’ll hook myself up.
FAYE
What the - ?
OLEA
MOVE Dr Underwood!
[SOUND: chair]
FAYE
Oh . . . my stars. Who are you?
[SOUND: kerfuffle as FAYE get the crash trolley]
OLEA
Olea, anaesthetist, Ganymede. This is our third run, Underwood, so if we could skip the formalities? I don’t actually want to die!
FAYE
Okay?!
OLEA
Give me those! It plugs in at the back!
[SOUND: rustle, sticky sounds as the pads are applied]
[SOUND: door open, hurried footsteps]
XAELEST
What is going on in here?!
FAYE
They’re about to have an MI?
XAELEST
Oh my stars. Oli?
OLEA
Lovely to see you, I hope you remember your Advanced Life Support, Xay. I’m human on the inside.
DAKARAI
Is this . . . who I think it is?
OLEA
[Pained groan]
FAYE
Calyxy - can you get the emergency drugs box? Please?
DAKARAI
Guys, they look rough.
OLEA
It’s because I’m about to go into an arrest rhythm. Keeping my fingers crossed for VT, but you can’t always get what you want!
XAEL
Why did you come here instead of somewhere with an ICU?
OLEA
If I told you it’s because I miss you, would you believe me?
CALYXY
Faye, I can’t remember the code!
FAYE
What?! Stars. Xael? Xael? What’s the code?
XAEL
Stars, um. 5247? Faye do the rhythm check.
[SOUND: buttons pressing in the background]
FAYE
Me?!
CALYXY
It’s not working!
DAKARAI
Uh, I had it written down somewhere here - one second -
OLEA
Alyraa’s arsecrack, people. I’m gonna arrest!
DAKARAI
5472!
[SOUND: buttons pressed in the background, the lock opens]
OLEA
5472, 5472, 5472, 5472
[SOUND: ticking and beeps of a FASERUNR, warped noises]
RADIO ANNOUNCER
- than GALileo. This is her newest track, apricity.
[MUSIC: song starts]
FAYE
I like this song.
[SEC: typing on screen]
[SOUND: whoosh, crash as OLEA arrives]
OLEA
5472!
FAYE
[Shriek] Stars! What the - ?
[SEC: questioning ping]
[SOUND: chair]
OLEA
5472! 5472! Write that d-OW-n [word interrupted by pain].
[SEC: typing on screen]
FAYE
What are you talking about?!
OLEA
Listen, I’m about to arrest so can you - please -
FAYE
Shit.
[SOUND: buzzer pull, alarm]
Is that a FASERUNR?
OLEA
Yeah - [pained groan], oh, ow.
[SOUND: trolley brought over]
FAYE:
Let me hook you up here. Sec, can you scribe?
[SEC: affirmative ping]
Airway patent.
[SEC: affirmative ping]
Stick this on. Sats 96%.
[SEC: affirmative ping]
Pulse . . . that can’t be right -
OLEA
Oh my stars, you actually are a doctor. I was beginning to wonder.
FAYE
What’s your name?
[SEC: negative ping]
[SOUND: door, hurried footsteps]
XAELEST
What is going on in here?! Oli?! Oh stars, Faye. Can you lead?
FAYE
I think so. Sec, pulse 164, regular. There’s some obvious ST elevation on the monitor.
XAELEST
Are your internal organs human?
OLEA
Mhm. Can I have some human opiates for my human pain?
DAKARAI
Guys, they look rough.
FAYE
Ough, déjà vu. Calyxy, please can you get the emergency drugs box?
OLEA
[Groaning] The code -
FAYE
Oh! 5472!
CALYXY
Got it!
XAELEST
I thought you were out on Ganymede?
OLEA
[Groan] Holiday.
FAYE
Right, um. Listen. If they are about to arrest. I’ll take airway. Xaelest, can you do the defib please and Rai . . . you might need to go on the chest. Calyxy can give the drugs -
[SOUND: Defib alarms]
OLEA
Oh, too late.
FAYE
Does he have a pulse?
XAELEST
Yes . . . just.
DAKARAI
Rewind them!
FAYE
What?! No!
XAELEST
Yes! Before they lose output!
[SOUND: ticking and beeps of a FASERUNR]
FAYE
Xael -
[SOUND: warped noises]
RADIO ANNOUNCER
I don’t know about you, but I think it would be wrong to start with anything other than GALileo. This is her newest track, apricity.
[MUSIC: song starts]
FAYE
I feel . . . really nauseated. Ugh, stars. Weird.
[SEC: questioning ping]
OLEA
OUGH! Europa’s -! Did you send me back?! Stars alive!
FAYE
[Overlapping] Stars! What in the - ?
[SOUND: buzzer pull, alarm]
OLEA
I’m Olea. Anaesthetist. I’m going to arrest really soon and you’re going to stop me from dying, okay?
FAYE
WHAT? Oh, stars, Okay. Lie back. Um, tell me what happened.
[SOUND: trolley]
Sec, do your thing. And bring up the resus guidelines, please.
[SEC: affirmative ping, file open]
OLEA
I was on holiday - you know we only get three days orbital leave on my current rotation? It’s a joke. Anyway, I was using a FASERUNR to make the most of it. Here - let me -
[SOUND: pads on]
FAYE
This - is a weird trace - do you have?
OLEA
Atrioventricular nodal re-entry tachycardia? Maybe.
FAYE
And you used a FASERUNR?!
OLEA
Less - [groan] - judgement, more saving my life, please.
[SOUND: door, hurried footsteps]
XAELEST
What is going on in here?!
OLEA
Hey, Xay, big day for you. You’re gonna electrocute me!
FAYE
Calyxy, can you get the emergency drugs box, please!
XAELEST
Oli?! Stars!
FAYE
I’ll lead from the top end, Xael take over here. Where’s Rai?
OLEA
[Pained groan] Not long, team. Get - [Pause, they’re exhausted] cracking.
FAYE
Um, you might need to go on the chest. Sec, scribe.
[SEC: affirmative ping]
OLEA
[Groans]
[SOUND: defib alarms]
XAEL
Do they have a pulse?
FAYE
No. Start CPR. Xael, pass me - thank you!
[SOUND: ventilation, crack of ribs, CPR]
It looked like a shockable rhythm. Calyxy, we need those drugs!
CALYXY
The - it’s - the code isn’t working!
FAYE
Shit, um.
[SEC: typing on screen]
5472!
Xael, tell us if you’re getting tired.
XAELEST
Let’s send them back.
FAYE
What?!
XAELEST
We don’t even know what organ system we’re working with! They’re adrilaen.
FAYE
Xael.
XAELEST
Time travel is arrhythmogenic, it might cardiovert them!
FAYE
We can do that here!
XAELEST
Please.
FAYE
Xael, that’s so much riskier that this -
XAELEST
We have to try.
FAYE
[Warning] Xael.
XAELEST
We have to try!
[SOUND: ticking and beeps of a FASERUNR, warped noises]
RADIO ANNOUNCER
This is her newest track, apricity.
[MUSIC: song starts]
FAYE
Ugh, can you feel that?
[SOUND: whoosh, crash as OLEA arrives]
OLEA
AGAIN?!
FAYE
AH!
[SOUND: chair]
OLEA
Ow! You broke my ribs?! Fuck, Dr Underwood! I can’t keep doing this!
[SOUND: FASERUNR removed]
Take this.
FAYE
What? What? Is that a FASERUNR?!
OLEA
Listen to me. I’m about to have a cardiac arrest. I’m a doctor too. I know exactly what’s about to happen and I need you to try your absolute best to save me but DO NOT use time travel again. I can’t - [Exhausted] I can’t keep doing this.
FAYE
What - ?
OLEA
Do you understand me?!
FAYE
Yes! Yes? I think so?!
OLEA
Good. Pull the fucking buzzer then. Please.
[SOUND: buzzer pull, alarm]
FAYE
Lie back. Let me -
[SOUND: grabs trolley]
Let me hook you up here.
Airway patent, Sec. Sats okay. Stars, okay. Heart rate 226.
[SEC: questioning ping]
Are you human?
OLEA
Adrilaen. But - [breathless] close enough. I have - AVNRT.
FAYE
But - FASERUNR?!
OLEA
Listen - no more time travel. Tell Xael -
[SOUND: defib alarms]
FAYE
Oh, shit.
[SOUND: rustles]
Sec, I’m starting CPR!
[SOUND: door, hurried footsteps]
XAELEST
What is - oh, stars!
FAYE
I’m on cycle one, they just -
XAELEST
Calyxy get the emergency drugs!
CALYXY
Of course!
[SOUND: footsteps as DAKARAI arrives ]
DAKARAI
Oh, bash my basins.
FAYE
Rai, swap in?
DAKARAI
Yes, boss.
FAYE
3, 2, 1. Xael, can you cannulate and do the defib please? We’ll rhythm check in a minute. Pass me the mask - ?
[SOUND: rustle, breathes for them]
CALYXY
What’s the code?
FAYE
Um.
[SEC: typing on screen]
CALYXY
Thank you!
FAYE
They appeared in the clinic room a few minutes ago. They have AVNRT and have been using a FASERUNR.
XAELEST
Why?! The idiot! Wait- can’t we just?
FAYE
No. They knew they were going to arrest and said no.
XAELEST
Europa’s freckles, Oli. What are you doing?
[SOUND: rustles]
The IV is in. Rai, are you okay?
DAKARAI
Yes, boss.
FAYE
Let’s rhythm check? Off the chest, Rai.
XAEL
Pulse?
FAYE
No.
XAEL
It’s VT - I’m going to give a shock.
FAYE
Okay.
XAEL
Stand clear. Oxygen off.
[SOUND: bagging stops, oxygen hiss off, buttons, shock]
Pulse?
FAYE
No.
DAKARAI
No.
FAYE
Okay, back on the chest.
[SOUND: bagging, chest compressions]
[SEC: typing on screen]
What’s he say?
XAEL
You can give stacked shocks.
[SEC: affirmative ping]
FAYE
Uh, fine. Fine! Uh, rhythm check again?
[SOUND: compressions stop]
DAKARAI
[Breathless] VT, isn’t it?
XAEL
Yes.
FAYE
Another shock, then.
CALYXY
The adrenaline is ready if you need it.
FAYE
Thank you, we might need some amiodarone too.
XAEL
Stand clear! Faye, oxygen!
FAYE
Sorry! It’s off!
[SOUND: shock]
Pulse? Yes? [Increasingly sure and excited] Yes?
DAKARAI
I can feel a radial! Just.
XAELEST
Oh, stars.
OLEA
[Groan]
FAYE
Okay, okay, let me take this out of your mouth. You’re okay!
OLEA
[Coughing] Xaelest? [Mumbled and confused] Saturn’s rings.
FAYE
You’re safe. You’re at The Vesta Clinic. Lie still for us. They’re still in VT, right?
DAKARAI
Hey, sweetie, that’s it, open your eyes. I’m just going to have a listen to your chest.
FAYE
Sec, can you pull up the - ?
[SEC: file open]
Thank you. Amiodarone.
OLEA
No - [Cough] Wait! Let me see the trace . . .
FAYE
Seriously?
XAELEST
Oli, your brain hasn’t had blood for -
OLEA
Look - look - zoom out. Stars, I feel like shit.
DAKARAI
Not surprising.
OLEA
That looks sinusoidal to me.
XAELEST
The screen is tilted.
OLEA
I need a stat bag of magnesium, that’ll sort me right out. Ugh. [Pained] And something for these ribs you broke.
FAYE
The amiodarone first though? Right?
OLEA
300mgs, if you absolutely must.
XAELEST
Ignore them, Faye. You can’t restart a personality with DC cardioversion. Unfortunately.
OLEA
It’s always so good to see you. You look a little different, though. What happened to those big, burly arms of yours?
CALYXY
I’d suggest you get a room, but you’re still in ventricular tachycardia so why don’t you give me your arm instead?
OLEA
[Laughs, then realises it hurts their chest] Ow. Hey - hey? Is he okay?
FAYE
Rai?
DAKARAI
Hm? Yeah?
XAELEST
Are you alright?
CALYXY
That amiodarone is running.
FAYE
Thank you.
DAKARAI
Yeah! Sorry! Miles away!
OLEA
If you wanted to be miles away, getting me some mag would be spot on, ‘sweetie’.
XAELEST
Ignore them.
CALYXY
I’ll get it. You’ll only mess up my organisation.
DAKARAI
Thanks, Calyxy.
[SOUND: Calyxy footsteps as she leaves]
OLEA
Can I cannulate myself?
XAELEST
No.
OLEA
Boring. You guys should expect a call from the BTCC. We - ah - I think it took about seven rounds to get here.
[SEC: Typing on screen]
OLEA
[Brief, pained laugh] Well -
FAYE
Xael, look at this - do you think that’s the amiodarone, or?
OLEA
Show me.
Show me! I look at more ECGs in a week than you do in an orbit.
Oh, yeah. That’s what it usually looks like.
XAELEST
This? This is what your ECG usually looks like and you used a FASERUNR?!
OLEA
[Brief, pained laugh] I calculated the risks.
[SEC: typing on screen]
What?
DAKARAI
[Amused] He says: I’m not sure how to feel about an anaesthetist who’s that bad at maths.
[MUSIC: Vesta pips]
FAYE
To summarise: This patient used their FASERUNR device a total of 3 times during their time at the clinic and it was also accessed twice by staff members before . . . the futility of time travel attempts were fully appreciated.
The patient presented in ventricular tachycardia secondary to an underlying AVNRT and this preceded a pulseless VT arrest. They recovered with two consecutive DC shocks and were given 300mg of amiodarone to treat the underlying arrhythmia. [Sigh] And a magnesium infusion.
[SEC: typing on screen, questioning ping]
Yeah. I’m alright. I think it was the temporal disturbance making me feel sick. Someone’s done a fat vomit in the waiting room, but none of the patients out there have owned up to it.
Are you okay?
[SEC: typing on screen]
Oh, Sec. You did a great job. So much goes on during an arrest, it’s important to have someone keeping track. You did great.
[SOUND: door opening, footsteps]
Oh, it’s you. Thank stars.
XAELEST
Worried it was going to be Olea?
FAYE
Yes! I keep glancing at the exam bench thinking they’re gonna spontaneously appear in it.
[SOUND: footsteps, chair, cup being placed down]
[SEC: typing on screen]
XAELEST
They’re on their way to hospital . . . I think you’re safe.
FAYE
Good. Did you make that nitrobrew for me?
XAELEST
I confiscated a nitrobrew from Rai, who really doesn’t need it. But yes, it’s for you.
FAYE
[Laugh] Are you okay?
XAELEST
[Not giving much away] Yeah.
FAYE
I can’t imagine doing that to someone I know.
XAELEST
Knew, really. We haven’t spoken in orbits.
FAYE
Right. How did you - ?
XAELEST
[Interrupting] I told them.
FAYE
Sorry, you go.
XAELEST
No, no, go on?
FAYE
[Beat] I was just wondering how you know - knew - each other?
XAELEST
Oh. We - they - worked on Pasiphae, during their training. They’re a really good anaesthetist - in spite of . . . the bravado. And a good friend.
FAYE
Oh! Cool.
XAELEST
Apparently, the kind of friend who only pops up when things are going particularly wrong.
FAYE
What - um - what were you going to say?
XAELEST
I told them about NOSL11.
FAYE
Xael?!
XAELEST
Not everything! Nothing about Swiftswitch. Not yet. They said they’d help us.
FAYE
Seriously? I thought you were completely against -
XAELEST
I am. I am against doing it. But, if we have no choice. I’d rather do it with someone I trust. Someone who isn’t going to run to the GMC if things go wrong.
FAYE
You’re sure you trust them?
XAELEST
Yes.
FAYE
Okay.
XAELEST
I’m going to need to make some ‘Changes’ so I can practise the operation properly.
FAYE
Okay?
XAELEST
It means I’ll be tied up for the next few weeks - is that something you can handle? I’m sorry, I don’t think there’s another way.
FAYE
Yeah. Yeah, of course. Do what you need to do.
XAELEST
Thank you. And - [pause] You did well today.
FAYE
Oh. I mean, it was a team effort, really. I was just telling Sec -
XAELEST
Faye.
FAYE
Thank you.
[SOUND: chair]
XAELEST
I’m going to go call the BTCC.
FAYE
Ugh.
XAELEST
Mhm. Call me if you need me . . . I’ll listen out for screams.
FAYE
[Laugh] Appreciated.
[SOUND: footsteps, door close, drink]
Hooo! Rai - what was he thinking?! Oh my stars, it is a good job Xael confiscated this, we could have restarted Olea’s heart with it. Ha.
Right, well, seeing as I’m now going to be awake all night cycle, shall we get this letter done and make a dent in the waiting room?
[SEC: affirmative ping]
There were no further episodes of arrhythmia and the patient has been transferred to hospital for monitoring and further treatment. Their FASERUNR will be returned to the hire company in due course as Olea will never be -
[SEC: typing on screen]
Oh, you’re right! As, in their current form, Olea will not be safe to time travel.
Happy?
[SEC: affirmative ping]
Signed,
Dr Faye Underwood,
The Vesta Clinic
Credits:
This episode of the Vesta Clinic was created by AMC. It starred Dr Wifey as the Radio Announcer, AMC as Faye Underwood, Kamen Cooley-Greene as Dakarai Solari and The Radio Announcer, Christopher Stoops as Olea Aander, Ruby Campbell as Xaelest Adra and Calyxy L’Torra, and Sec as himself. Music by AMC and Ruby Campbell.
Please check out our show notes for content warnings, transcripts, and your prescription of: excellent headphones.
If you enjoyed this episode and would like to help the show reach more ears, please tell someone who loves podcasts to check into the Vesta Clinic. You can also follow us on your social media of choice at @vestaclinicpod! A huge thank you to our Patreon supporters. We hope you enjoy this week’s bonus story and bloopers like this one:
Ruby: Let’s send them back . . . okay. As in . . . back - what do you mean?
AMC: In time.
Ruby: Oh! Duh!
[Laughter]
Hi me again which is weird because I’m recording this at a different time to the me that you were just listening to which is kind of like time travel??Kind of.
Anyway, just wanted to thank you again for listening to this first half - we’re going to take a brief break from regular episodes for a few weeks but we have some fun bonus episodes that are ready to go and I hope that you’re gonna enjoy them. Be sure to subscribe so that you don’t miss out on those.
The Q+A form is now open! Please check out the show notes or our social media to find the link to submit questions. We can’t wait to hear from you and, um, just hope you have a fantastic day!
Bye!
Content warnings: Patient is insulting to staff members; ignoring medical advice; swearing
