30. How Blue?
Date: 64/1/2733
Patient: A'oo'da, Troglodan
Patient ID: 9583928
Presenting Complaint: Difficulty vocalising
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Transcript
FAYE
Ou - Ou - Ooowaah . . . Like that?
[SEC: affirmative ping, typing on screen]
Ou - Ou’a’da - Ou - ah - dah. This is hard for me. I’m glad Xaelest is with Rai. Ou’a’da.
[SEC: typing on screen]
As long as you write what I’m meaning to say and not what I actually say then we’ll be fine.
[SEC: affirmative ping, typing on screen]
[Laugh] Yeah, it’s like the anth - stars - anthophiloid thing again.
[SEC: typing on screen]
Thanks. Shall we?
[SEC: affirmative ping]
Date: 64/1/2733
Patient: A'oo'da, Troglodan
Patient ID: 9583928
It was a pleasure to review A’oo’da, a 10 Vesta year old troglodan who presented to the clinic with her bonded partner Ou’a’da. Both, I understand, are members of the Martian Diplomatic Service, with my patient, A’oo’da, working as a translator for her partner. [Laugh] She actually offered to have the consultation in Quotidian, Martian, modified Martian, several Earthen dialects or another language of my choosing.
[SEC: typing on screen, questioning ping]
It was tempting, but I actually haven’t done a consultation in Earthen in, pfft, um, too long -
[SEC: typing on screen, questioning ping]
[Laugh] My dad asking me about his various scrapes and sneezes definitely doesn’t count!
Um, we opted for quotidian as we were both comfortable using medical terminology in that language and it allowed for Ou’a’da to follow along also.
Though troglodan are infrequent visitors to the settlements around the Asteroid Belt, A’oo’da and her bonded were returning home to Mars after a meeting of planetary representatives on Titan.
A’oo’da presented with concerns regarding her ability to vocalise. The typically sonorous call from her skull throat was diminished to a hoarse rumble which tended to crack and trip up over note changes - uh - A’oo’da taught me a new phrase, actually, in Modified Martian, uh, kallopackda which is the unstable feeling of going down uneven steps. She said that’s what using her voice felt like - untrustworthy and a bit of a health hazard. In addition, her skull throats felt sore when attempting to vocalise and she was experiencing a new difficulty in picking out the harmonies required to compliment and complete Ou’a’da’s song.
This cluster of vocal symptoms started on the first day of their return journey, following a night of celebrations during which A’oo’da and her bonded performed a matahane thanaitu - a resyn, actually, so a matahane thanaiitu -
[SEC: typing on screen]
Yeah, I know. But when a troglodan says it, particularly if they’ve had like 4 or 5 resyns, it makes a beautiful trilling sound. Thanai-i-i-i-tu.
[SEC: typing on screen]
I say so.
Um, A’oo’da and her bonded performed a resyn, their first renewal of the matahane thanaitu bond. I congratulated the couple and felt an earnest wash of melody from Ou’a’da spill from her skull and soothe the rasp of A’oo’da’s attempted harmony. My patient shifted, her claws appearing and disappearing in a flash of bronze, and the chair moved to shift around her. She looked distinctly uncomfortable but I couldn’t tell if that was the throat or the topic of conversation. Of course, while happy for them, I paid close attention to the little voice in the back of my head which popped up to say: ‘Oh. Oh dear.’
A’oo’da had not noticed any new coughing or shortness of breath. Neither she nor Ou’a’da thought that her cranial orifices had been runny. She had no chest pain but she did report a persistent headache, described as a bilateral aching pain around the skull throat. She reported occasional stabbing pains on the side she leaned towards if she tilted her head.
During the rest of the history, Ou’a’da emitted - without even realising, I think - long, mournful notes. A’oo’da turned to knock their beaks together and rested a paw on Ou’a’da’s elbow to help calm her bonded down. It was unusual to see this amount of physical contact from troglodan and it became clear that A’oo’da’s difficulty singing was causing issues with communication and emotional regulation between the pair.
A resyn should release a whole storm of endorphins and excitatory neurotransmitters. Afterwards, a bonded pair is meant to feel incredible. Invigorated and insufferably content with each other. It - um - it didn’t exactly seem like this was the case for these two.
[SEC: affirmative ping]
Um, I also confirmed that there were no abdominal or joint symptoms and no issues with excretion. A’oo’da has suffered from fatigue since the symptoms began.
I rechecked the timing of the symptoms. A’oo’da had been fine until 3 Martian sols ago - that’s the day cycle they’ve been using on the ship. Everything began the day following the resyn. In a way, this was reassuring. The symptoms likely represented an acute issue we could get to the bottom of . . . once we’d excluded an association between the resyn and the vocal issues.
[SEC: typing on screen, questioning ping]
Uh, yeah, yeah. It can be immediate even. There’s a whole set of syndromes relating to incomplete or otherwise altered matahane thanaitu - most of them include some kind of vocal disturbance. I think it’s a biological safeguard against, um, incompatible or even forced bonding. It takes a few sols after the initial bonding for the synapses to fully grow and that process is, um, fed - I don’t know if that’s the right word but we’ll use it - fed by singing together. If you can’t vocalise then the bond isn’t going to form properly.
[SEC: typing on screen, questioning ping]
Good question, um. Yeah. Complications are less likely with a resyn because the neural pathways already exist - it’s like . . . revising rather than learning, if you get me?
[SEC: affirmative ping]
But they can still happen and it’s . . . it can be tragic.
[SEC: typing on screen]
Um. I asked A’oo’da directly about the resyn. She told me that it was unplanned and self- um - self-conducted. A group at the gathering, mostly humans, were talking in general terms about their understanding of matahane thanaitu and Ou’a’da offered to show them exactly what it was like. A’oo’da shifted again and paused, a momentary silence which didn’t go unnoticed by either myself nor Ou’a’da who wrapped her neck around A’oo’da’s upper arm and blinked up at her bonded with a low hum. A’oo’da responded with several slow pecks which may have represented an apology being accepted.
A’oo’da reported that she felt the resyn had gone well, despite her initial anxiety and misgivings about the sudden and public nature of the display. I expressed that it can’t have been easy in a room full of strangers. The matahane thanaitu puts one in a few intimate and vulnerable positions. A’oo’da agreed with a rap of her claws and Ou’a’da distangled herself with a mournful chirruping sound. My patient looked pained at the whispered squeak she mustered in response.
[SEC: typing on screen, questioning ping]
Oh. They make us memorise the steps from a video in med school - sometimes the union needs to be medically supervised so you need to know what happens at each stage. There’s, um, obviously, the song which, if you understand the language, actually describes the steps. It starts with pressing their claws into certain points over the other’s body. Like acupuncture, almost. If done properly, it releases certain neurotransmitters and growth factors in a set order which allows for new plasticity and the formation of the new joint network. There’s a similar thing with the biting. Then, um, there are a few elements which make for uncomfortable viewing for 19 year old humans. There’s, uh, it’s like a right of passage, having to look your examiner in the eye and explain why it’s neurologically imperative that the troglodan kind of pose like that.
[SEC: typing on screen]
It’s - um - beautiful in its own way. But I wouldn’t watch it with my parents. [Hastily] Or alone! So . . .
[SEC: typing on screen]
Good idea.
I gathered some more information about the ceremony itself. The pair had asked a colleague to read the necessary words from a holo-screen they projected. Their singing was resonant enough to crack several glass vropper tanks - which the hotel were thrilled about - and they attracted such a large and noisy audience that they were eventually asked to take it outside. So, they did. They took half the party guests and stirred patterns into the mist with their voices until the shuttle came to collect them.
So, we know that A’oo’da was in fine voice immediately after the resyn.
[SEC: affirmative ping, typing on screen]
Ou’a’da told me that, though she was aware of A’oo’da’s initial shyness -
[SEC: typing on screen]
Yeah, I think that it’s a gentler way of saying that she noticed her partner’s discomfort and pushed on anyways, but, you know.
[SEC: typing on screen]
Despite her initial discomfort, the resyn led to so much interest in their culture that she’s very grateful A’oo’da came out of her metaphorical cave to do it. A’oo’da said nothing, but covered her beak with her third paw.
I enquired about their first methane thanaitu and, for a pair that had recently demonstrated a resyn in front of a group of strangers, they came over all reserved. From what I could gather, there were no issues with their first bond and they had enjoyed many harmonious orbits together.
‘Despite . . .’ Ou’a’da said before halting. I looked to A’oo’da quizzically.
A’oo’da’s past medical history includes an overactive hygroid and cerebral nutritional syndrome. The latter would explain their heightened concern about the integrity of the bond.
[SEC: affirmative ping]
For the benefit of other health-care professionals who may read this letter before A’oo’da reaches home, Cerebral nutritional syndrome is a congenital condition affecting a troglodan’s nervous system. It’s thought to be caused by poor parental nutrition during gestation. A’oo’da’s age would put her birth slap bang in the middle of the Martian triatic famine. Um, it’s commonly appreciated that certain nutrients and, uh, vitamins are required for successful neuroplasticity and the syndrome can present in a variety of ways and a range of severities: learning difficulties, language issues, harmony problems -
[SEC: typing on screen]
Amusica, yes, thanks - amusica, and, in later life, issues with matahane thanaitu.
I am . . . fairly confident that the cerebral nutrition syndrome has not impacted on A’oo’da’s ability to learn, converse or sing - as demonstrated by her role as a translator. If their first matahane thanaitu was successful, the syndrome shouldn’t affect a resyn because the effects of the condition are permanent but not progressive.
Um, do you think that explains it well enough? The reason she came to the clinic was because their ship doctor didn’t feel confident assessing and treating her so I want to make sure everything’s clear.
[SEC: typing on screen, affirmative ping]
Thank you.
A’oo’da manages her hygroid issues with weekly self-drainage and the mineral sachets she takes - I think for the cerebral nutritional syndrome, but there’s no actual evidence for that - um, the sachets are not known to cause issues with resyn or other vocal issues. She has no known allergies.
I asked Ou’a’da to leave the clinic room for the examination.
[SEC: typing on screen, questioning ping]
Um, I mean, the reason I gave was because Ou’a’da’s vocalisations might confuse the exam . . . but it was really because I wanted to ask A’oo’da some safeguarding questions.
[SEC: questioning ping]
I felt a bit bad in retrospect, it’s uncomfortable for bonded troglodan to be separated for long. But something wasn’t sitting right about the whole resyn business and, um, it’s more than just due diligence, I wanted to be sure.
[SEC: typing on screen, questioning ping]
Well, I think . . . it’s like all things in medicine, you have to be open and ready to hear what they might tell you and you have to have the ability to support them afterwards. It’s . . . yeah.
Fortunately! A’oo’da denied feeling any pressure from her bonded to perform the resyn with a strong, if hoarse, conviction. She told me that she appreciated why I was asking the questions but she had no concerns about her relationship or the way Ou’a’da treated her. The resyn was a wonderful moment to share with everyone, she just wished that she didn’t feel so unwell now.
[SEC: typing on screen]
[Laugh] Yeah. Phew.
I proceeded to the physical examination. A’oo’da has two skull throats, present on the para orbital ridges of her cranium. They appeared adequately lubricated. I could convince myself that they were, maybe, slightly more red that might be expected.
[SEC: typing on screen]
[Laugh] yeah. Fine. It just - it always feels like cheating when you know the diagnosis at the end. I feel like I’m editorialising.
[SEC: typing on screen]
Fine. The skull throats were mildly erythematous bilaterally.
I performed a basic tonal assessment. A’oo’da’s attempts at matching pitch came out as a thin crackle, the kind of emission a physicist would have you believe is the mumble of a distant star. Her lower paws beat against the metal grille of the flooring in a frustrated discomfort and I stopped the assessment before its usual conclusion.
There were no audible abnormalities on auscultation of the posterior thorax.
Um, maybe you should put this bit back up with where I was talking about her skull throats? I palpated her skull through the rough scales of her scalp and there was marked tenderness around the opening to the skull throats and the along the sinal cleft, running from the apex to where her sandpaper skin met the gleam of her beak.
Her, um, you can put this back at the end from now -
[SEC: affirmative ping]
Her eyes appeared to be functioning normally. There was no discharge or other abnormality noted from the auditory foramen.
I was at a bit of a loss. I felt that it was unlikely from the history that the issue was due to a damaged matahane thanaitu, but I needed to bring Ou’a’da back in to the room to test harmonisation. A’oo’da really struggled with this, throats twitching soundlessly in response to the balm of her bonded’s calls.
Then,
[SEC: typing on screen]
[Laugh] I don’t want to say that you weren’t built to be a medical secretary . . . but, like. . .
[SEC: negative ping]
Then, by some stroke of luck, the right-sided skull throat spasmed and widened into a silent scream before expelling a string of sticky, blue phlegm onto the side of her face. The pair erupted into panic. I’m glad it happened here and not on their shuttle . . . Though, even their ‘under confident’ ship doctor should know exactly what was going on from this new finding.
[SEC: typing on screen, questioning ping]
How blue was the phlegm is exactly the right question, Sec! What if I tell you that it was a shocking, electric blue, shot through with branching strands of indigo. Bestlegel, we call it, because, through some bizarre coincidence - at least, I hope it’s a coincidence -
[SEC: affirmative ping]
The colour of the sputum is the exact same as the bvomp drink you can get exported from Bestla.
[SEC: typing on screen, questioning ping]
Oh, yeah, a few times. You can’t get through med school without about six lecturers shoving it in your face and telling you: DO NOT forget this colour.
[SEC: typing on screen]
You’re right, I never did forget the colour. It’s too spicy for me, bvomp, but, uh, I think Xael and Rai like it. I can’t imagine the phlegm would have tasted too good though.
[SEC: an eruption of negative pings]
[Laugh] I just say these things to get a reaction, you’re too easy.
[SEC: typing on screen, negative ping, typing on screen]
Yeah, yeah, sure.
[SEC: questioning ping]
What?
[SEC: typing on screen]
Seriously?
[SEC: affirmative ping, file open]
You’re sure it’s from her?
[SEC: typing on screen]
No, let’s - let’s look now before Xael’s brought back. Stars, I thought - I thought Adrastos had deleted the message, or it had never reached her.
[SEC: affirmative ping, typing on screen, file open]
Wait- wait - it takes me longer than 0.5 seconds to read the whole thing!
Dear Dr Underwood,
Thank you for reaching out to me. We have been in an anti-comms zone for a number of tendays now, I hope this message reaches you before the next black-out. I must apologise, I cannot provide any substantial input regarding the matter you contacted me for.
[Disappointed] Oh.
[SEC: typing on screen]
Um? Oh.
However, as you may have found out, my wife was a close confidant of Aerglo’s. I have attached a message from her also. I have told Thea that you will not contact us again without, how shall I say, ‘unimaginable’ news.
Oh, stars, Sec, they know. They totally know.
[SEC: affirmative ping]
Okay, so this is from Thea, then?
Dr Underwood,
Firstly, thank you for looking after my wife last orbit. She does not often take to medics but she spoke very highly of you.
[SEC: typing on screen]
I’m blushing.
I’ve been hoping to hear from someone at the clinic for longer than I dare admit. I trust you’ll understand my reticence to divulge too much to a stranger, but if you are who you say you are and if you’re looking into what I hope you are, I can tell you to try spending some time in their pod . . . and remember me and the numbers they loved -
[Pause] Is that it?
[SEC: affirmative ping, typing on screen]
Really? That’s it? What? What is she talking about ‘numbers’?
[SEC: typing on screen]
Their pod is my pod! I don’t know how much more time I could have spent in there!
[SEC: typing on screen]
No, no. Come on. It’s something. We can work it out! We’ll - work it out.
[SEC: typing on screen]
I -
[SEC: typing on screen]
Okay, yeah. Okay. I have it still, the metal thing we found in the vent. I’ll - wave it around in there and see what happens.
[SEC: typing on screen, questioning ping]
Uh, usually collapse asleep and wake up when the bleep goes off?
[SEC: typing on screen]
Don’t judge me.
[SEC: negative ping]
Listen, let me finish this letter and I’ll check on Xael and go.
[SEC: typing on screen]
Unless a patient comes in, of course.
[SEC: affirmative ping]
Uhh, where did we get up to?
[SEC: typing on screen]
Oh, of course, the Bestlegel. Um.
A’oo’da was not suffering from a neurochemical impairment associated with a renewed synaptic commitment to her bonded. She was, however, suffering from a viral infection - likely titasix given her travel history and the presence of Bestlegel - a viral infection of her skullthroats and sinuses and a viral-induced headache.
A’oo’da and Ou’a’da had done a whole night of the most intense karaoke this side of Pluto, all the while mingling with a crowd of aliens in an alien place. No wonder she had a pair of sore throats!
I was able to reassure A’oo’da that her voice will recover in time. The most important thing to do at the moment is get adequate vocal rest. Soothing skull throat lubricants can be obtained from most troglodan-serving pharmacies if her throats are still causing issues by the time they get home.
I informed the pair that the virus is contagious and for Ou’a’da to try to avoid contact with A’oo’da’s secretions as much as possible. If the current symptoms get worse or if A’oo’da develops extremely high temperatures or difficulty breathing she needs an urgent medical review. I have provided the clinic’s bleep number to the ship’s medic in case they need verbal advice about the case for the remaining leg of the journey.
Happy?
[SEC: affirmative ping]
Right, let’s go.
[SOUND: chair]
[SEC: typing on screen]
Signed - I hadn’t forgotten -
[SEC: typing on screen]
Signed -
[SOUND: bleep, pockets zipper, button beeps]
Oh, you’re joking. I’m sorry, Sec. Whatever it is, I’m sure it won’t take long.
[SEC: typing on screen]
Signed,
Dr Faye Underwood,
The Vesta Clinic
[Credits]
Content Warnings: Phlegm; viral illness; alien bonding rituals with reference to human sexual encounters; concern about coercion with reference to domestic violence (this is excluded); reference to perinatal famine affecting character’s health; co-dependency; reference to known character death
