33. Buffer
Date: 80/1/2733
Patient: Exal None, Human
Patient ID: 5681938
Lab ID: γΩ90-W1-ENH-38
Presenting Complaint: Headache
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Transcript
[MUSIC: The Vesta Clinic Theme]
[SOUND: door open, footsteps]
XAELEST
What do you want?
DAKARAI
I have a proposition.
XAELEST
I’m listening.
[SOUND: door close]
DAKARAI
Your computer for uninterrupted lab access. There’s a surgical bot with your name on it.
XAELEST
Deal.
Computer. Log out.
[SOUND: Computer logs out, chair footsteps]
Have you seen Faye? She wanted to do my repeat post-altiraans exam.
DAKARAI
Have you two made up now?
XAELEST
We didn’t - Yes. We’re fine.
DAKARAI
I'm glad to hear it. Is she alright?
XAELEST
I think so. I know what you mean, though.
DAKARAI
She's seemed a bit . . . low.
XAELEST
Since Jien and NOSL11 last came.
DAKARAI
When you snapped at her.
XAELEST
I apologised. I think she's anxious. She should be anxious. We should all be anxious.
[SOUND: footsteps, chair]
DAKARAI
I take too many psychoactive medications for that.
XAELEST
[Little laugh]
DAKARAI
If you see her, can you tell her I have some poop for her?
XAELEST
What?
DAKARAI
Fertiliser. My guy gave it to me.
XAELEST
Ew. Sure. Let me know when you need your lab back. Call me if you need me.
[SOUND: footsteps, door opening and closing]
DAKARAI
Computer?
COMPUTER
I'm listening.
DAKARAI
Hi, sweetie. Can you log me in, please?
COMPUTER
Logging in user.
DAKARAI
Thank you. Any time today would be perfect. Open lab notes - Mod Study - um, γΩ90-W1-ENH-38 - New record.
[MUSIC: begins]
[SOUND: opening program]
I need to backdate this. Let me see . . .
[SOUND: typing]
Great.
74/1/2733
Screening call made to patient Exal None. Confirmed participant ID and my name and role. As part of the study, participants are aware that they will be called at orbital intervals to discuss their body modifications.
However, when I asked Exal if he knew the reason for my call he said: To be honest, mate, I don't have a clue. He said that he recognised my name and voice though - which, I should hope so! We've been in contact for years! With a little bit of prompting, he recalled the Body Modifications Study and was happy to answer my questions.
Exal reports having one INC upgrade and a replacement uroseal since our last conversation in 2731. I asked him if he had any new symptoms or health conditions and was startled at the sudden burst of frustration from the other end of the line.
'Right, mate, this is what's really grinding my gears at the moment.' He said. To my knowledge, Exal actually has very few gears as part of his mods. 'I've been having these headaches for months, right. But every time I try and speak to someone about it, they tell me to go to the biotics engineer.' I hummed to indicate I was listening and he continued, 'A biotics engineer! Like I'm a pigging hover bike or a computer. I'm still a person!'
A headache could easily be attributable to one or more of his many body modifications. I asked Exal if he might be able to join me for a review at the clinic and, as luck would have it, he was already planning on travelling out this way for LutMod Fest. I assured him that I'd find time to review him whenever he made it here.
[SOUND: clicking]
Um, right. Has that worked?
COMPUTER
I’m sorry. I don’t understand the command.
DAKARAI
Oh, don’t you worry. Let’s just try it.
Date: 80/1/2733
Patient: Exal None, Human
Patient ID: 5681938
Lab ID: γΩ90-W1-ENH-38
It was a pleasure to see Exal None at the clinic once again. I knew he had arrived because all of the scanners at the docks went mental. He has so much metal in him, the bioscanners have never known how to cope with it. Nurse Calyxy very kindly agreed to search him on entry. Fortunately, Exal and Calyxy have built up a good rapport over the years and he didn’t take issue with this. He seemed happy to see her, actually, it was quite sweet.
Exal was brought to the clinic for a check-up as part of the Body Mod Database Project, the Clinic's ongoing study into the changing prevalence of body modifications over time and associated complications. Exal has been experiencing headaches and . . . hm. And several medics have declined to review him in favour of primary input from a biotics engineer. Mr None has refused this but agreed to speak to me today.
Since his last review, there have been some changes to Exal's body modifications and therefore I will provide an updated summary here. From the top, Exal has several cerebral implants - one linking to his INC. A new INC was implanted around 4 tendays ago following a connectivity failure in the one he’s had for the last 3 Earth years. This matches our current findings that INCs tend to become unusable after 3-5 years.
I suspect that his are less - come on, Rai, what’s the word you want here? Umm. [Sigh] I should have asked for Sec. Healthy? Durable? Enduring! That’ll do.
I suspect that his are less enduring because the INC units are not embedded into osseous grooves in the skull, but, instead, rest atop his cranioplasty plate. It’s actually a miracle that he doesn’t get a brain infection every time he has them replaced.
Exal had orbital - meaning eye this time - damage during a previous shuttle accident and also wears a specialised monocle over the left eye to enhance what he’s able to see and provide specific visual overlays such as maps and other media. This connects to one of the cerebral implants near the occipital lobe. To Exal's knowledge this has not been altered since the last review. You think you'd know! Right?!
You think you'd know. . .
Exal has a previous history of spinal injury at C5. This leaves him with motor weakness bilaterally. He is able to mobilise and use his right arm through the use of motorised braces which also connect to a central processor implanted in his brain. The left arm was amputated after the same crash in which he sustained the other injuries, and so he uses a bionic prosthetic to achieve a similar degree of function as the right arm.
Given the level of spinal injury - C5, if I haven't already said - there was some damage to the nerves supplying his diaphragm and therefore he uses a Diaphragm-assist device which hooks around his middle and, through negative pressure, helps to expand the chest and simulate the movement of the diaphragm. It's not a perfect solution, but Exal has told me previously that it's improved his stamina. None of the above have been altered since the last review.
Exal has . . . uh, a difficult history with pain following the accident, but generally seems to be more comfortable after the insertion of several nerve root simulators across his spinal cord. The last time I saw him, they had been implanted but not yet programmed, so I was glad to see that he was getting some pain relief from them.
Exal also has an implanted cardioversion device. He - to my knowledge - has no history of cardiac disease but he did have a traumatic cardiac arrest at the time of his injury. It seems that he has decided that safe is better than sorry. It is not my place to comment on the appropriateness of this in my current research capacity. But I can't wait to see Faye's face when I tell her about it.
The spinal injury has left Exal with no sphincter control and he has been using a coloseal and uroseal system to collect his biological waste. The uroseal system leaked last week and he had a new one inserted. He'd had the last uroseal for . . . hm, only half an orbit. Though the one before that seemed to last for the standard 2 orbits. I wonder what happened there.
Finally, given all the maintenance required for the various co-existing machines inside Exal, he was given a long term femoral nano-port on the right side. This . . .
So, on my last review, there was some discussion about whether that should be removed as Exal was struggling not to access the port to take off-label nanobots and other illicit substances. Exal told me that he's had several discussions with his regular doctor about it and they are leaving the port in place, pending further discussion, until they are confident that the newest uroseal has grafted well.
I think that's it.
Today, I welcomed Exal down to the Laboratory interview rooms and asked him to tell me about the headaches.
There used to be only like ten classical headache syndromes in humans . . . that was before people started shoving tech in between their sulci.
The headache Exal described was intermittent and tended to come on over a couple of minutes. There was no aura described - no flashing lights, auditory issues, nausea etc. He remained able to control his limbs and other mods throughout the attack. The pain was worse on the right side and was a sharp, constant pressure that tended to last for about ten minutes before subsiding.
Exal told me - and, honestly, fair - that the first time it happened he stood up and swung his bionic arm into the space behind his pilot seat because he thought someone had snuck aboard his shuttle and stabbed him in the head.
Pain killers had not been doing anything for the pain. I delicately asked Exal if he had thought about trying some of the other drugs he used to take to help and he very sternly informed me that he 'doesn't do that shit any more'.
Aside from the headaches, Exal has no new health complaints.
His past medical history is unchanged from previous reviews and includes a previous traumatic brain injury, spinal injury at C5, left arm amputation, PTSD and a history of substance misuse.
He is not currently taking any medications. Occasionally, he told me, he'll take a laxative if his stool is too hard to easily be collected in the coloseal.
Exal is meant to have regular updates to his medically acquired tech - the arm, the braces, the nerve root stimulators and the uro and coloseals. However, he has missed his last two nano-bot appointments due to issues travelling to specialised clinic.
'I was spatially displaced, Doc.' He told me. A quiet hum followed as he folded his arms and leant back in the chair.
'Why's that?' I asked.
'I move where the work is. Innit.'
'What's the work?'
'Oh, you'd like it if I told you that. You'd love to know. Everybody wants to know about the work.'
I wasn't sure what kind of game Exal was trying to play, but I remembered this kind of thing from previous reviews. It's like he wanted to cultivate an air of mystery but was making his smoke screen out of water vapour and a rough almost-charisma. I wish the Prof could have met him. They would have gotten along, I think.
'Yeah, I would like to know.' I told Exal. Bracing for whatever hoops I'd need to jump through to get a clear answer.
'Alright, Doc, I'll tell you.'
And he did? he told me that he's still Running - moving cargo from one place to another. Only now, the cargo he's running is a little different to the drugs and weapons he used to cart about before. I assured him he didn't have to tell me what it was before he incriminated himself.
'All I can say is that it makes a lot of people very happy indeed, Dr Solari.'
My problem is. . . that I do really want to know! I'm not Xaelest, I can't put on a show of utter neutrality in the face of exciting secrets. That's not and never will be me. I wanted Exal to tell me. He could see it on my face, too. His grin made me grin.
In terms of changes to his social history, um, Exal currently has no fixed abode and mainly lives on his shuttle when it's not full of whatever mysterious things he transfers between whichever rocky surfaces and space-ports will have him. I asked if the tech had caused any issues with his employment and he found that hilarious. The answer, I think, was no.
As part of the screening questionnaire, I asked Exal about how the body modifications affect his relationships with others. Exal was more than happy to tell me, in detail that would put hairs on Sec's chest, about his new boyfriend on Lutetia. I made reference to Exal's reason for being over on this side of the belt being the festival and he actually went a little coy. Apparently the new partner is a fan of body mods.
I am - a little . . . concerned that Exal appears not to have met this person or even seen them yet . . .
You hear all sorts of stories about people meeting up on forgotten asteroids only to find that their girlfriend is actually there to nick their shuttle and their pet qog. I asked Exal how sure he was that the person he was talking to was genuine and I seemed to have touched a bit of a nerve . . . Exal's brace whirred as he sat upright. I saw the light inside the monocle lens flash. Maybe he was better taking me in. Maybe he was pulling up his conversations with his unknown partner.
I backtracked - trying to explain that I just hoped that he was being safe and advised him to make sure that he met them somewhere public, preferably with a trusted friend. But! Phobos will crash before Exal None takes advice just because it’s good advice! He waved me off. I’ll keep an eye on the news from Lutetia, if it comes out that someone’s had all their mods stolen, I won’t reach out to say I told you so.
Off the back of this conversation, Exal initially refused any physical examination. He did however, allow me to run some blood tests as part of the study. This was something that a biotics engineer would not - or, at least, should not - be doing, so he was happy to have it.
It - um - Note: edit later. I was gathering the equipment for the blood sample when I caught Exal looking at me strangely. I asked if he was alright and he gave me a half-smile, like we had a secret he wasn’t sure he wanted.
‘What have you got, then?’
I frowned at the question. I mean: perfect hair? The statistical software ability to make the boys go wild? A very soothing baritone? I genuinely didn’t know what he was talking about.
‘You just buffered, mate.’ He said. I blinked.
Computer, can you call the secretary at Elysis General Psychiatric Hospital?
COMPUTER
Let me try that for you.
[SOUND: outgoing comms call, error noise]
DAKARAI
Can I leave a message?
COMPUTER
Yes. Leave your message now.
DAKARAI
Hi, um, hello! Cynthea, Girongi, uh, Dr Hoyati, I’m not sure who’ll get this but it’s me - Rai. Um, oh, I guess, if you’re new, it’s Dakarai Solari, I’m one of Dr Hoyati’s patients. Um, I was just getting in touch to maybe speak to someone about accessing my medical records for the time when I was an inpatient. I know that it might take some time. It’s just - um - today someone - one of my patients, actually, commented that I seemed like I was buffering. You know, when someone has a cerebral implant and it’s running a little slow? You can see them pause and restart with their next thought.
I . . . I mean, to my knowledge, I don’t have anything. I’m not a huge fan. But, um, there have been some times recently when I’ve lost track of a thought midway through. It’s freaked me out a bit. And, um. . . after the consultation, I checked my scalp and um, I do - I do have a little scar behind my left ear. I’m sorry to have to ask. Um, but it’s, uh, it’s really busy here and I don’t have time to visit the hospital for an assessment. I would use the scanner here but my colleagues would get the images and - [he doesn’t need to explain why that is not ideal]
I don’t think that I’ve had a cerebral implant. But, as you know, there is that time period, um, in late 2731 where I don’t have the best recollection of events.
Um, please feel free to call me on my personal comms when you’re next open.
Thank you.
Hope your kids are doing well, Cynthea.
Bye. Um, bye.
End message.
COMPUTER
Message sent.
DAKARAI
Thanks, Computer.
[SOUND: head scratch]
Ugh! Obviously, I can’t stop scratching it now that I know it’s there!
Where was I?
The blood tests! Um, the blood tests were normal. Exal’s headaches were not being caused by electrolyte disturbances, an infection somewhere or liver issues. He seemed initially happy with this news until it was soured by the remaining confusion about the cause of the pain. At that point, he did consent to a physical exam.
I want to point out that I did tell him I was only acting in a research capacity and wouldn’t be able to diagnose anything officially. I don’t think he really believed me.
I focused my examination on the tech, rather than the human attached to it. It was obvious to me which parts had been recently replaced and which were approaching a trip to the second-hand dealer. In particular, the nanobot port looked unused for a long time - but not in a good way. I explained to Exal the importance of keeping it clean and patent to reduce the risk of infection.
I hadn’t realised that the coloseal he was using had a portable composter attached. He seemed, hah, he seemed a little taken aback and then a little smug by how cool I found it. I’ve never received a sample of someone’s faeces before and been so excited about it! [Laugh] It doesn’t even smell so bad.
I did notice that the new INC was clearly not from the same source as the rest of the body modifications. The coils had the stiff, interlocking patterns used by humans on Venus, rather than the springy coils of those popular on Earth and most of Mars.
‘You know these headaches? Are they worse when you try and use your new INC?’
Exal wasn’t sure.
Though I was kinda curious, I advised Exal not to use it until the consultation was done. I asked him where he’d got it. He told me ‘Mars’ and gave me a shifty sort of look which begged for no follow-up questions. Which I ignored. ‘But this is from Venus, right?’
Exal shrugged. He got it on Mars.
I explained that I wasn’t convinced that the INC had been properly reset . If the previous user’s neural imprinting hadn’t been stripped, there would be functions of the device that Exal couldn’t access. The brain isn’t used to being unable to explore its own circuitry, and it tends to protest, physically or emotionally, when it’s prevented from doing so - though, I guess with Exal’s PTSD he knows that better than most people. Trying to access someone else’s memory on an implanted device would certainly upset my brain.
[Unhappy] ‘You’re not saying I’ve got a seg fault.’ Exal said. I explained that it was definitely a possibility. He really should have just gone to see the biotics engineer. . . [Pause for laughter]
You know, computer, I don’t know how Xael copes with you. Sec would have had something funny to say about that.
COMPUTER
I’m sorry. I don’t understand the command.
DAKARAI
Yeah.
Um, I checked the ethics on the Body Mod Database Project and it’s mentioned in the protocol to administer urgent treatment if a complication is affecting quality of life. Which - I think it’s justifiable that this was. I gave the nanoport a thorough clean before using it, though, and I left Exal relaxing with some music playing while the bots ran their course.
The readout confirmed my suspicions - and, it seems, the suspicions of others before me - that the INC wasn’t completely wiped before it was installed in his head. It’s a shame that no-one took the time to actually check him over and help him understand why a biotics engineer was the right person for him, though. Especially given the complexity of his other mods. It frustrates me when people get flung around like pinballs between different professionals who refuse to take responsibility for their care.
Computer?
COMPUTER
I’m listening.
DAKARAI
Any new messages?
COMPUTER
You have 0 new messages.
DAKARAI
[Deep breath] Okay.
Exal was able to use his INC successfully following the update, and, so far at least, has not had any further headaches. I have explained to him that this may be correlation instead of causation and to see his doctor if the headaches persist.
I have also reminded him to be really careful when meeting his new partner on Lutetia.
Right, Computer.
COMPUTER
I’m listening.
DAKARAI
Send message to F UNDERWOOD - Hii, I’m coming to you with poop. Get Greenhouse-ready.
Sign both - Lots of love, Rai xo
[MUSIC: The Vesta Clinic Theme]
This episode was inspired by submissions from our wonderful listeners; Exal None. Whose name we also stole because it was so cool. Thank you!
This episode of the Vesta Clinic was created by AMC. It starred Ruby Campbell as Xaelest Adra, Kamen Cooley-Greene as Dakarai Solari, AMC as Xaelest’s Computer. Music by AMC and Ruby Campbell.
Please check out our show notes for content warnings, transcripts, and your prescription of: a personal gas giant
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:
Kamen: This is literally - Like that princess Leia meme?
AMC: Yes! Yes, yes.
Kamen: No! The Padme meme.
AMC: Yes, I want you to release Natalie Portman, right now, wherever she’s hiding.
Kamen: Will do [laughs]
Content Warnings: Reference to traumatic injuries; cyborg character using bionic accessories as disability aids; drug use; reference to previous addiction; drug/weapon smuggling; mental illness; psychiatric hospitals; catfishing
