28. the Human Club
Date: 628/2/2731
Patient: Hafín Tracktee-326, Hygan
Patient ID: 584209
Presenting Complaint: Blower pain
IF this was their last case . . . better make it a fun one.
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Transcript:
AERGLO
[Sigh, laugh] That was my last consultation. One couldn’t write it.
[SEC: questioning ping, typing on screen, questioning ping]
[Lying] If! I said, ‘If that was my last consultation’. Can you imagine?
[SEC: negative ping, typing on screen]
She was entirely lovely.
[SEC: typing on screen]
[Amused] Yes, I know exactly how you feel about Mx Onkantanko, they won’t be returning. . . [Coughing fit]
[SEC: typing on screen, questioning ping]
[Collects self] I’m okay. I’m fine, Sec.
[Pause] Shall we, dear?
[SEC: affirmative ping]
Date: 628/2/2731
Patient: Hafín Tracktee-326, Hygan
Patient ID: 584209
[MUSIC: begins]
It was a pleasure to review this young, 39 Vesta year old Hygan, who joined us in clinic with several troublesome health issues.
[SEC: typing on screen]
I have stopped saying ‘complex’ - to describe my patients’ medical backgrounds, at least. I find it - oh, how should I say? At the very least, it provides very little useful information, except to alert lazy medics who may wish to palm the patient onto someone else. And ‘complex’ . . . I’ve found that things are seldom so opaque once one has taken the proper time to go through them. As we saw first-hand, a complex problem may have a simple solution.
[SEC: affirmative ping, typing on screen]
Thank you. I’m glad you agree.
Hafín floated into the clinic room with a strange combination of body language. Granted, I have met very few Hygan in the last few orbits, but I found her particularly difficult to read. Her blowers trailed along behind her, mere centimetres from the ground. Her glossy, lateral facing eyes darted around my clinic room, but she had projected a picture of a smiling, human face onto her ventihalo membrane, which stretched between her large, pointed earhorns. Altogether, it made a confusing first impression. Was she comfortable here? I couldn’t tell.
She took the seat I offered with a last huff of ‘fragrant’ air from the orifices on the soles of her feet.
[SEC: typing on screen, questioning ping]
Her blowers, yes.
I introduced myself and my role and thanked her for visiting us. She apologised for declining the ‘other doctor’, referring to my colleague, Dr Adra.
Has she gone back to bed?
[SEC: affirmative ping]
Good, good.
[Back to the letter] I assured her that this was no issue, though I was surprised by her reasoning for the refusal. Hafín had apparently seen several episodes of - stars, I can’t even remember what they called it - InterMed Mars, or something equally nondescript.
[SEC: typing on screen, questioning ping]
Ha, did I not tell you about that? It was, uh, a number of orbits ago now. There was a big push to improve public understanding about interspecies relationships and some streaming company had the idea to chase us around the hospital as we treated whoever came through the door and generally tried to put out biological fires before they started.
[SEC: typing on screen, questioning]
It clearly still exists on the network somewhere! I had no idea how or why a young Hygan would have any interest in a dated Martian stream, though. To my memory, there weren’t even any hygan on the show.
‘Did you really cure that thyreophoran [thigh-ree-oh-for-ran] of his imphanklomyotosis?’ She said it carefully, as though she had been practising. The projection of the human face moved ever so slightly out of time with her words. I confirmed that I did. She adjusted her blowers and folded her bony upper limbs. The projection flickered.
‘I hope you can help me.’ She said. I assured her that I would try my best.
[SEC: typing on screen]
That’s . . . very sweet, Sec.
[SOUND: syringe pump beeping, buttons]
[SEC: typing on screen, questioning ping]
No, it’s okay. Don’t worry, there’s plenty left in it yet.
Hafín’s main presenting complaint was pain. She feels this, I quote, ‘everywhere’. However, during the current flare, she has predominantly been suffering with blower pain and a discomfort which traverses her undulating lower limbs up to her core. She has had pain deep within her thorax also, and a burning sensation which is the most recent symptom to develop.
In addition to this, she has had several months of mobility issues. As I am unclear who may come across these notes in the future, I will elaborate. Hygan use the gaseous products of their digestion to propel themselves along. Their ‘feet’ are more like fins: circular membranous appendages which can be folded closed to reduce or redirect the stream of air driving them.
Does that make sense?
[SEC: affirmative ping]
This system works most efficiently in the low gravity environment of their home satellite network in the Kepler system, but they can adjust the gas production to meet the needs of less buoyant environments.
Hafín has noticed a generalised swelling in the nine trailing appendages which form her blowers, and is finding it harder to set off moving or maintain motion for as long as she used to. She described to me a feeling as though someone had stuck weights onto the bottom of her blower-membranes and she was having to drag this extra weight around with her. She also reported a new pain at the site where the foot attaches to the sleek iridescence of the blower appendage. This would be an ankle joint in most species’ anatomy, but there is limited range of motion here in a hygan.
Alongside these pain and mobility symptoms - and, I suspect, part of a cycle of worsening symptoms - Hafín has noticed fatigue. Hygan have a unique cultural set-up with regards to sleep; unlike cultures with a history of or current dalliance with Capitalism, it is perfectly acceptable for a hygan to sleep for as long as they need, whenever they need.
[SEC: typing on screen]
Yes! The hygan have found that it maximises an individual’s well-being and productivity. I mean, they are the most - at least in the general opinion - the most technologically advanced lifeform that we are currently in contact with. Innovation happens in well-rested minds.
[SEC: typing on screen]
[Laugh] It's a little late for me to catch up on all the sleep I've missed.
Hafín - she has found that her regular 10 hours of sleep, split across two shifts is not enough any more. She is finding it harder to get to sleep because of her discomfort but she is also finding it very challenging to wake up. She told me that even after an extra nap she does not feel refreshed. This is having a knock-on effect on her studies and she has taken some time out of education while undergoing investigation for her concerning symptoms.
It is worth noting that she has not suffered from any fevers and her weight is stable.
And, finally, she has also noticed some issues with her projector. The biotech uses luminescent cells to project the image onto the ventihalo. Hafín's social circle has reported that her projections flicker and change unexpectedly. This started around a year ago and no medical professional from her home satellite has been able to provide her with an adequate answer.
Which . . . I think leads me very nicely onto a summary of the previous investigations.
[SOUND: syringe pump beeping]
[Disgruntled noise]
[SEC: typing on screen, questioning ping]
Ah, yes, it is my syringe pump. It’s just the anti-sickness, I’ll be fine.
[SEC: typing on screen, questioning ping]
Oh, no. No, don’t do that. [Cough] I’d - I’m not really -
I don’t want any interruptions. I want it to be just us for a little while.
[SEC: affirmative ping]
Okay.
Hafín brought her extensive records of previous investigations with her to the clinic today. This was useful as it prevented me from repeating measurements that were normal on recent testing. However, the hygan are a deeply inquisitive people with an astounding proficiency for medical technology. There’s a reason most of our scanners and medications are from Hygieanine! It’s a hygan company! If the stream of test results she’d already undertaken had not revealed a diagnosis, I was concerned about my ability to change that.
[SEC: typing on screen]
I know. It would have been more interesting for you to have access to her results, but I’m not having anything plugged into you unless I’m sure it’s safe. I don’t want to compromise . . . our future home.
[SEC: affirmative ping, typing on screen]
And did I tell a lie?! You are temperamental!
[SEC: questioning ping, negative ping]
Yes! Just last night you wouldn’t show me my files.
[SEC: typing on screen]
[Laugh] I wanted to talk too. After I’d sorted everyone’s equipment requests!
[SEC: typing on screen]
[Laugh, sigh] You would have approved everything that Rai asked for . . .
[SEC: typing on screen, affirmative ping]
And nothing Xaelest asked for. . .
[SEC: typing on screen]
Terrible. You’re terrible.
[SEC: questioning ping]
You know . . . I think . . . I want you to know that having you here has been the best thing that happened to us - to me.
[Pause]
I just want you to know that.
[SOUND: fabric rustle]
[SEC: typing on screen]
Yes. Well, let’s talk about Hafín.
[SEC: affirmative ping]
I reviewed Hafín’s most recent test results on her device that appeared to be some kind of multi-purpose comms. There was nothing striking in the results. All of her blood tests were within normal ranges and her scan reports contained a lot of detail, but nothing overtly pathological. There were a number of tests performed on her gaseous samples which don’t actually exist in this Solar System and I explained to Hafín that I would not feel confident interpreting these myself, though it appeared that the results were within the normal ranges provided.
It appears that Hafín has been in contact with medical professionals for most of her relatively short life -
[SEC: typing on screen]
Yes, she is. Technically. But I’m not old! And, in hygan terms, she's . . . a teenager. It's rare for hygan to need medical care until they're well into their 90th Vesta Year.
She had a complicated birth. The saccules that she was grown in were exposed to an unexpected range of environmental conditions during the Arbolite Migration season. The last decade's unrest around Kepler has meant that the Arbolite's migration patterns have been less predictable and the hygan offspring, who are buried beneath these grand, photosynthesising lifeforms have been subjected to unprecedented soil and root disturbance. Due to this, she and her sacculibs have been closely monitored for research purposes in case these changes in early life have long-lasting effects.
Hafín is a chronic earache sufferer and hygan medical professionals attribute this to an anatomical defect in which gaseous excretion from the digestomotile system can enter the ear canal and cause pressure changes. Through assessments for this, she was found to have yasmodynamic processing disorder, a rare condition in which certain loud noises provoke an intense emotional response. To her knowledge, none of her other sacculibs experience this. She considers the condition a blessing, not a curse, as the emotional surge helps her enjoy the noises more than she would otherwise.
It's interesting - I wonder if the curious and research-led nature of the hygan leads to the pathologising of a number of benign physiological quirks. Certainly, it appears that a physician Hafín saw as a child trialled her on a strong suppressant medication for the yasmodynamic processing disorder. She did not take the medication for long.
With regards to her pain symptoms, she has been seen by a range of medics over the years and, failing to meet specific criteria for the discrete classifications of hygan pain syndromes, she was labelled with the umbrella term: 'unclassified pain syndrome'. I . . . understand, to a point, that it is named so to promote ongoing evaluation and research into finding an answer for Hafín and other patients like her. However, I do get the impression that she found it distressing to be given such a broad diagnosis.
SEC: affirmative pings]
As part of the diagnostic process, several different physicians decided to try various analgesics and anti-inflammatory medications on Hafín in case a clear response helped narrow the possible causes. As such, she has taken a vast range of pain medications with varying amounts of improvement in her pain symptoms.
She currently takes: actrajanmophen twice daily, zappadren as required (currently 4 times a day), tizyracline once a day and frupexol once daily.
[SEC: typing on screen, questioning ping]
Yes. The frupexol concerned me. This is a particularly potent anti-inflammatory medication with profound cardiovascular and renal effects in prolonged use or misuse. It was not clear to me exactly why the hygan medics thought that this would help. Of course, it is also known to have anti-depressant effects . . . I was concerned that they were treating her pain as a mental affliction without explaining that to her.
Otherwise, she has no known allergies. There are no known instances of similar health problems in her Track.
I needed to understand how this pain and fatigue was affecting her life.
On questioning, Hafín told me that she had recently ceased her higher education course, where she had been studying Applied Membrophysiology. This decision was made following a prolonged period of absence due to ill health. I asked her if she missed studying and was momentarily taken aback by the clap of her blowers as she huffed out her amusement.
‘This is confidential, right? Like on the Intermed stream?’
I assured her it was and she told me that she had no intention of returning to her course. She’d chosen the field on the recommendation of a particularly pushy tutor and was ill-suited to the long hours in the library or laboratory that the course demands.
She told me that she had been living with fellow students before travelling to our star system in the hopes of finding medical help here. She has a good relationship with most of her sacculibs and has a group of close friends who have travelled with her to see the sights en route.
[SEC: typing on screen]
Yes, it is very sweet of them. Though, I suspect they had a slightly ulterior motive given what Hafín revealed to me.
[SEC: affirmative ping]
Hygan are known for their relaxed rules around stimulant drugs but Hafín does not use them regularly. She feels that the subsequent chemical hangover dramatically worsens her fatigue. She has no plans to use drugs while travelling here, either. I have supported this decision as there are potential interactions with the medication she is currently taking.
I enquired into her hobbies and watched as her projector flashed and the human face she had displayed until that point was replaced by a swirling pattern of colour, reminiscent of an Adrilaen in the change cocoon.
'I don't really have any . . .' She told me.
[SEC: typing on screen, negative ping]
Well, exactly! I expressed my disbelief in this. She knew she wasn't interested in Membrophysiology, there must be something that caught her interest. Everyone has something!
[SEC: typing on screen]
That's not true! I have lots of interests.
[SEC: typing on screen]
No! No. I . . . Well, let's see, I . . . I . . . Like . . .
[SEC: questioning ping]
Oh, come on! That's not fair! I'm just - it's a busy time! And, stars, my treatment regime doesn't exactly fill me with energy. I talk to you.
[SEC: typing on screen]
You are not a hobby.
[SEC: typing on screen]
Or a passing interest. You're my home.
[Pause]
It was only with persistent gentle prompting that I was able to get Hafín to open up to me. I tried to help her understand that it was important to share as much as she could - especially things that she might not have been asked about before - if we were to get to the bottom of what was troubling her. It was only when I asked her if there were any particular streams that she enjoyed watching that I remembered what had brought her to The Vesta Clinic in the first place - she had seen that old docustream from Mars. When I asked her how she came to see that, her projector switched off completely, denying me access to a visual representation of her thoughts.
She admitted, in a soft rush of breath, that she and some of her friends were big fans of human culture. There was very little available about it in Hygan media, so they had to search for other sources to feed their interest in . . . us - uh, humans. They had been expanding their knowledge of human music, literature, cuisine, et cetera. Human music tends to be much more, um, vigorous than the hygan music I have heard. I can see how, with her yasmodynamic processing disorder, she would have heightened emotional responses upon hearing it. I think, sensing my lack of judgement, Hafín told me that she was vice presider of what she and her friends called 'The Human Club'.
[SEC: laughs]
Why does that amuse you?
[SEC: typing on screen]
Hm. Well, I won’t tell you what happens at parties of humans who are interested in alien culture . . . No - don’t! Don’t search for it, I’ll uh, I’ll get put on a list.
[SEC: laughs, typing on screen]
It’s nothing that I haven’t seen before.
Um, with this information, I decided to move on to the physical exam.
Hafín floated over to the bench, clearing the floor by mere centimetres. I manoeuvred my chair into a good position and smiled as she remarked that she had never met a human who could hover.
[SEC: typing on screen]
That’s exactly what I said.
The majority of her examination was unremarkable. Her projecting apparatus appeared normal from what I could tell, as did external examination of her ventihalo membrane and ears.
She was very excited to see a real human stethoscope. Unfortunately, she was anatomically unsuited to try using it on herself - I would have given her the opportunity - but there was nothing abnormal to hear on the chest.
To my eyes, the digestomotile sac appeared slightly distended and was mildly tender on palpation.
I concentrated the majority of my time on the blowers as these had been causing the most symptoms. Hafín was born with nine blowers and all remain intact. I examined each appendage in turn and found them to be mildly swollen and slightly hot to touch - though there was no colour change or oozing to suggest infection, and the swelling seemed to come from trapped gas as opposed to oedema. Most peculiar, were the rings of shed skin around the blower-membrane joint, present on several appendages . . . it didn’t look like any rash I remembered, more like something had been in prolonged contact with the skin and had caused pressure-related changes.
[SEC: typing on screen, questioning ping]
Oh, you are very good. I thought it looked like an old blister - yes. But why would someone get a blister on their blowers? And why so many?
As I examined her, I could feel the silence stretch through the room and prompted Hafín to fill it with more detail about the activities of The Human Club. I must admit, I was only half-listening at first, as I traced the rough epithelial edge of the lesions and compared them across her different blowers. Then I caught her shy admission that ‘sometimes we even wear human clothes’ and a new differential shot straight to the top of my mental list.
Upon asking, Hafín shared with me that this interspecies cosplay included wearing human footwear. A number of questions spring to mind at once.
[SEC: typing on screen, questioning ping]
[Laugh] Hah! No! Not that one! Though . . . where did she get nine of the same shoe? No, my main concern was how she fit her blower inside the shoe itself. As I mentioned, Hygan have mere approximations of ankles and the membranous discs can be far wider in diameter than human feet. Hafín told me that it took some getting used to, but she had found a way to fold her membranes into the shoes and she had been wearing them for the majority of the day since leaving her course.
I was . . . I - well, I do love it when a consultation doesn’t end the way you expect it to. I was astounded. I confirmed that she’d started wearing the shoes intermittently around about the time that the pain started, and it had worsened as their use increased. She was on multiple medications, had been dismissed by multiple, baffled hygan medics . . . because of the shoes.
[SEC: typing on screen]
Yes, exactly, that’s a very good point. Who can say . . . it likely felt less daunting to talk about human clothes with a human but . . .
Let me get this down clearly.
Hafín described deliberate, prolonged confinement of her blowers inside human shoes. The position that she had to angle the appendages likely created kinks in the gas tract, leading to occlusion and a build up of gas. This contributed to the swelling and pain in the blowers and, over time, less gas will have been produced, leaving Hafín less able to mobilise. The shoes were ill-fitting by design and also appeared to have rubbed the skin, causing more pain.
Oh! The gas build up was likely also contributing to the upper abdominal pain and distension - though I think the change in diet to include new, human foods is also a contributing factor.
[SEC: affirmative ping]
I explained this to Hafín and she projected a sad face onto her ventihalo. I explained that I didn’t have an answer for everything she was experiencing, but the shoes were almost certainly making her symptoms worse. I suspect this is an acute on chronic issue and it is vital that she maintains a relationship with her primary physician at home to continue to manage any ongoing symptoms.
Fortunately, we could do something about the shoes. Now, the ideal situation is to stop wearing them altogether, but I have met too many hyperfixated teenagers in my time to suggest that that is the only option. What Hafín and I have been able to agree on is that she needs to limit wearing them and take regular breaks, especially if they are hurting. I have also recommended cutting some holes in the shoes to prevent trapped gas - she could even cut out the sole of the shoe and slide it above her blower membranes to prevent blocking the flow of gas. She can use sticking plasters to prevent the formation of blisters where the shoes rub her skin.
It will likely take some time for her body to get used to this new adjustment, but I hope she will reach a happy equilibrium in time. I have not made any adjustments to her medications today, but I suggest she sees her regular doctor for a review when she arrives home.
I - um, in fact - We would be happy to review her again if she requires further medical assistance prior to her trip home.
[Cough]
[SOUND: objects removed from drawer]
Um. . .
[SEC: typing on screen, questioning ping]
Yes! Yes, I’m fine. I just need to . . .
[SOUND: chair hover, vent opening, objects placed]
Sort out the temperature in here.
[SEC: typing on screen]
It’s okay, I’ve sorted it. Thank you.
[SEC: affirmative ping]
[Pause]
Thank you.
[SEC: typing on screen]
No, I said, ‘If that was my last consultation’.
[SEC: typing on screen, questioning ping]
Oh. Hm. It wouldn’t matter. I . . .
I loved all of it.
Uh, I, um . . . I’m going to go down to the lab. For a short while.
Will you - uh - will you be okay without me?
[SEC: typing on screen]
I’ll miss you too.
Happy with the letter?
[SEC: affirmative ping]
Right. Good. [Laugh, sigh] Ill-fitting footwear.
Signed,
[Pause]
Signed,
Professor Aerglo Rae,
The Vesta Clinic
[MUSIC: The Vesta Clinic Theme]
This episode of the Vesta Clinic was created by AMC. It starred Christopher Stoops as The Professor and Sec as himself. Music by AMC and Ruby Campbell.
Please check out our show notes for content warnings, transcripts, and your prescription of: nutritional yeast.
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:
Chris: but nothing overtly patholo-[fumbled]. I’ve seen that word before, I don’t know why I’m pretending, of course I’ve seen the word pathological before I’m like - googling things about myself [Laughs]
AMC: [laughs]
This episode was inspired by submissions from our wonderful listeners. Thank you to Shelby and Leon Egan - whose new book Listen Closely is something you should buy and read right now!
Content Warnings: Reference to syringe pump; Reference to feeling nauseous; Reference to perceived medical negligence; Reference to overstimulation; Lying
