37. Solari
Date: 89/1/2733
Patient: Dakarai Solari, Human
Patient ID: 5318008
Presenting Complaint: Seizure
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To avoid spoilers, content warnings are available at the bottom of this page!
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Transcript:
[MUSIC: The Vesta Clinic Theme]
[SOUND: door open, footsteps door closed]
[SEC: negative ping]
[SOUND: chair]
FAYE
Don't 'nuhuh' me,
[SEC: negative ping, typing on screen, questioning ping]
Yep. It's half four in the morning.
[SEC: affirmative ping, typing on screen, questioning ping]
I was trying to sleep. Then someone called the clinic and started screaming at me because they want someone to look at their hoof and we're closed.
[SEC: typing on screen]
I know - I just - I really think they would just keep calling if they got an automated message from you. They seem to like using me as a punching bag for their grievances. What they don't know is I wouldn't even trust myself to be their doctor given the current state of things. I’m so tired and so emotionally drained and I don't have the mental or physical energy to give to someone's hoofache.
I've already got a patient here who I'm meant to be fixing and I don't even know if ze's alive! I can't even look after my friends! Rai's been having seizures for months - right in front of me - and I didn't even notice!
Is that the doctor you want? In fact, yeah, Sec, let's give the people an automated message. Don't come here. The doctor is shit -
[SEC: negative ping]
she might not even know if you're alive or not.
[SEC: negative ping, typing on screen]
It would be easier if Xaelest were here or, stars, if the professor were here! All of this could be solved if only I had the guts to plug in this chunk of metal Rai sent. But I don't and here we are.
[SEC: typing on screen]
Sec -
[SOUND: incoming comms call, accepted]
DAKARAI
Hiii - what are you doing up? Oh. Oh dear.
FAYE
That bad?
DAKARAI
I've had my skull opened and somehow you look worse?
FAYE
Thanks.
DAKARAI
Did you get, uh, get the thing I sent you?
FAYE
I have it. Thank you.
DAKARAI
Can I know what it is?
FAYE
Um . . . not yet.
[SEC: typing on screen]
I don't think - I - I’d rather tell you when I’m sure.
DAKARAI
Okay . . . Is there a chance I might be able to have it back one day? I'm thinking of making a dust-globe out of it.
FAYE
Um. . . I don't know yet. Maybe.
[SEC: typing on screen]
DAKARAI
Can I ask how the - uh - how’s baby doing?
FAYE
Uh . . . No. Don’t ask that either. Not yet. There’s nothing new to tell you.
[Pause] How are you?
DAKARAI
I'm feeling a lot better, honestly. They suspect that my seizures might stop altogether now that thing’s out, but they're going to keep me on antiepileptics for a while. Oh, um, did you also get those records from Elysis General?
FAYE
Yes. They came through. I obviously haven't -
DAKARAI
Please do. The staff here want to know everything and, I'm not gonna lie, they could do a better job at hiding the fact that they're taking everything I'm telling them with a pinch of sodium chloride. Which is stupid, I’m hardly manic right now, am I?
I know it's weird . . . but is there any chance you could write me a letter explaining what happened and, um, just summarising the other stuff on my file. I have notes on the system from the Prof too. They let me pick my own patient ID number.
FAYE
Oh, Rai -
DAKARAI
I know. I know, I'm sorry to ask. And I'm sorry for not telling you about it all. And I am especially sorry for how I treated you when I was post-ictal.
FAYE
I’m sorry too. Just in general. And for not noticing you were having absence seizures for like half an orbit.
DAKARAI
You’re forgiven.
FAYE
[Sad laugh]
DAKARAI
Have you spoken to Xael?
FAYE
She called me - uh, a unit of time ago, I don’t know anymore.
DAKARAI
Did she tell you that she’ll be bringing NOSL11 back soon? They’re aiming to time it so they can collect me on the party shuttle to Vesta. Then we can collectively put Dr Underwood to beddy byes.
FAYE
NOSL11 and Jien might prefer to Space me -
[SEC: negative ping]
DAKARAI
Faye. If nothing else, it is blatantly obvious that you’ve been trying your best.
FAYE
[Choked up] Thanks.
How long do you think? Before you’re back?
DAKARAI
Um, it’ll be a few more days before I’m discharged, then a few days for the return journey. Not too long!
FAYE
Yeah. Yeah!
I’ll get right on that letter for you.
DAKARAI
Thank you. We’ll be home soon, honey. Hang on in there.
FAYE
Aye, aye Captain. Miss you already.
DAKARAI
Miss you already!
[SOUND: comms call ended]
FAYE
[Sigh] This feels . . .
[SEC: typing on screen]
Yeah. Intrusive.
[SEC: affirmative ping, typing on screen]
I know. I know he gave me permission but . . . Still. Will you help me?
[SEC: typing on screen, affirmative ping]
Date: 89/1/2733
Patient: Dakarai Solari, Human
Patient ID: 5318008
[Laugh] Star’s sake, Rai.
[SEC: questioning ping]
The number - it - doesn’t matter. [Laugh] Um, how should I - ?
[SEC: typing on screen]
Yeah, except, it wasn’t a pleasure to review him, was it?
[SEC: typing on screen]
Please will you send him a message and ask how hurt he’ll be if I don’t say that it was a pleasure to review him.
[SEC: typing on screen]
[SOUND: message sent]
[Pause] I really miss them.
[SEC: typing on screen]
I know. I’m really glad you’re here. Just so you know.
[SEC: typing on screen, questioning ping]
It’s, um, part of the reason why, yes. I . . . I know you want me to just do it. I’m sorry - I just - What if something happened to you? Or to the rest of the satellite’s computer systems? Xaelest isn’t here to bail us out if I break the life-support.
[SEC: negative ping, typing on screen]
Can we talk about it later?
[Pause]
[SEC: affirmative ping]
Thank you.
[SOUND: message received]
[Laugh]
[SEC: typing on screen]
To be fair, I’d feel the same way. It’s important to get the best grade in patient.
[SEC: affirmative ping]
Stars. Okay.
It was an honour to provide medical assistance to my esteemed colleague Dr Solari, who is an 8 Vesta year old human from Mars. Dr Solari is the head of research at the clinic and, indeed, was in the laboratory at the time of his . . . seizure.
Um, his collapse was captured by the security sentinel software which triggered a clinic-wide alarm. Um, due to recent malfunctions within the alarm system, and the perceived lack of patients on the satellite, there was a short delay in responding to the alarm -
[SEC: typing on screen]
Thirty seconds is a long time when someone's seizing!
[SEC: typing on screen]
I do feel guilty about it.
[SEC: typing on screen, more typing on screen]
Fine, fine! Take it out.
[SEC: affirmative ping]
Upon realising that Dakarai was the cause of the alarm, I made my way immediately to the lab. I had seen a brief flash of the sentinel feed which showed him on the floor of the lab, surrounded by blood. Um, it was my first concern that Rai had fallen and hit his head or somehow had sustained another form of massive haemorrhage.
It was only on my run down to the lab that I realised that the blood I had seen had distinct differences to human blood and therefore was unlikely to be Dakarai's. We'd had a haemorrhaging patient in the laboratory recently and it appears that Rai was trying to clean the area when the attack occurred.
Um -
[SEC: typing on screen]
Thank you.
[Breathes] On arrival to the main laboratory, um, Dr Solari was displaying unmistakable signs of a generalised tonic clonic seizure - with bilateral jerking of the limbs. I started a timer and mentally added about a minute to account for the time elapsed since ictus.
Initial A to E assessment was as follows: the airway appeared patent. His breathing was irregular and fast, and his sats were in the low 80s. These improved with rapid application of oxygen via a face mask.
Honestly, Sec, we're lucky that we'd just had NOSL11 down there. There wouldn't have been any clinical equipment otherwise. . . Rai can do many wonderful things with a microscope, but even he wouldn't oxygenate himself with one!
[SEC: affirmative ping]
I had forgotten my stethoscope in my haste, but thankfully there was one discarded on one of the lab benches.
He had bilateral air entry. I couldn't hear any added sounds that would raise concern about aspiration or some other issue with the lungs.
The monitoring I attached told me that he was tachycardic, but there was too much interference from the muscle spasm associated with the seizure to get a good trace.
Don't put this in the letter, Sec.
[SEC: affirmative ping]
I thought he was in VF at first. Like, my own heart nearly stopped, thinking that his had. But the isoelectric line was just so wiggly from the interference. There were a few actual QRS complexes in there - thankfully.
[SEC: typing on screen]
Ha. Don't joke. Because I was about three seconds away from starting chest compressions.
The seizure had also put Dakarai's blood pressure up to about 140 systolic.
I thought about cannulating him so I could give IV drugs if it came to it but, honestly, I was never very good at them and he was still seizing. There was no-one else around who would have been able to help me hold his limb still to try.
His eyes were open - which was awful, um, for me.
[SEC: typing on screen]
Uh, yeah. I mean to say: his eyes were open, gaze fixed laterally, which allowed me to ascertain that his pupils were equal and reactive. Which was good, because, stars, between the heart monitor and a blown pupil, I actually would have passed out. I did my 6 months mandatory ICU time and I would quit medicine before going back.
[SEC: typing on screen, questioning ping]
No, that's not true. But it was awful.
Dakarai had quite obviously passed a large volume of urine.
Um, at this point the timer I'd set was approaching the 4 minute mark and there was no sign of seizure termination. We don't tend to keep patient drugs in the laboratory, and therefore I had to balance the risk of leaving Dakarai alone against the risk of not treating the seizure.
I decided to, uh, cushion his head with a spare lab coat and run up to the pharmacy store. On the way, I was able to contact the clinic's secretary bot via the main computer and request that an emergency transfer to the nearest hospital was arranged.
[SEC: typing on screen, questioning ping]
Uh. [Sigh] Was there a method for how I picked which drug to give Rai? No. Um, no. I grabbed the first few boxes I could find and raced back to the lab with them. Luckily most of them would have been appropriate to use.
I arrived back in the lab and found Rai virtually unchanged. Still seizing, but with stable observations. The timer was at approximately 6 minutes total.
With Rai seizing and without IV access, I opted for buccal administration of imazolam and was able to avoid his teeth with the tip of the syringe as I squirted the medication against his lower gums.
A single 4mg dose of imazolam was able to terminate the seizure.
[SEC: typing on screen]
Yeah! You'd think it would be starlight and rainbows from then on but - uh - no.
Dr Solari had, um, quite profound post-ictal confusion and, um, personality change. At first he became fearful and agitated because of the blood on the floor. Which was understandable. He had developed what I later diagnosed as a post-ictal hemiparesis - a Todd's Palsy - and he found the inability to move the left side of his body distressing. Which, again, I would too.
I tried to comfort and reassure him. Um, and with time, his confusion abated and he was able to tolerate a more thorough assessment. Um, don't write this, I don't want to upset him, but at one point he physically shoved me away and told me to eff off and find Xaelest.
[SEC: questioning ping, typing on screen]
Well, people get confused and sometimes angry or sad when they've had a seizure. It wasn't unexpected . . . but it was upsetting. I think that's what he was apologising for. About five minutes after that, he started crying and begging me not to send him away to hospital again which -
[SEC: typing on screen]
Yeah . . . also upsetting.
[SEC: typing on screen]
Ah, it's fine.
Um, once he was stable enough, I persuaded him into a chair and brought him up to the clinic room. It was vital that I scanned his head - it could have been a stroke that caused the seizure and subsequent weakness. Or, as he collapsed, he could have hit his head so hard that it caused a bleed.
However, as the scan images loaded on the screen, they did not show the black bloom of ischaemia, or a bright flash of acute blood. Instead, the scan revealed a previously unknown foreign body.
[SEC: typing on screen]
Oh, I knew. I've spent so long thinking about this weirdly shaped hole in the connector. I've been seeing the silhouette of it in my dreams. . . when I used to sleep long enough to have a dream, anyway.
I wasn't sure at the time how likely it was that this unexpected gleam of metal in Dakarai's head was the cause of the seizures. The foreign body appeared to have been inserted into a gap in the skull, such that it lay in continuity with the bone. Honestly, if it had just been embedded in the scalp tissue, I think I would have tried to remove it at the clinic. It, um . . . given that it wasn’t, I didn’t want to risk any damage to Rai’s brain.
[SEC: typing on screen, questioning ping]
Ha. Um, it was a bit naughty. I told Rai that you thought it was an important, missing piece of your operating system so we absolutely needed it returned as soon as possible after removal.
[SEC: questioning ping, questioning ping]
Hey, come on! I just used the first computer words that sprung to mind.
Rai was on board with getting it back from the outset, probably because he likes the idea of finding out what on Earth has been renting out space in his skull for the past however long. He managed to convince his surgeon - a really sweet Themite, according to Rai - that it was, uh, an important human custom to have all foreign bodies returned to us ASAP for ritual purposes.
[SEC: typing on screen, questioning ping]
No! No, absolutely false. In fact, I can’t think of a single human that I’ve removed a foreign body from who should be allowed to have the thing back.
But! [Sigh] We have it now.
[SEC: affirmative ping, typing on screen]
Maybe.
I also performed some bloods on Dakarai which were entirely normal. I had no reason to suspect intoxication, so did not perform a general drug screen. I did, however, check a lithaplex level and confirmed it was in a safe range.
Given his ongoing state of confusion, I deemed it in Dakarai’s best interests not to immediately tell him about the results of the scan. He was drowsy, but appeared to recall and understand the reason for transfer to hospital.
[SEC: typing on screen]
Ugh, yeah. Um, Dr Solari has recently requested his medical notes from Elysis General Psychiatric Hospital and has given me permission to view these in order to provide a more complete summary for his current hospital team.
Sec, I - really don’t want to read all of them, is there an admission or discharge letter with a good summary on it?
[SEC: affirmative ping, file open]
Oh, okay, thanks. This looks like a discharge letter?
[SEC: affirmative ping]
Um, okay. So -
[SOUND: scrolling]
Past medical history: bipolar disorder, first diagnosed at age 19 Martian years. Um, with a manic episode requiring hospitalisation in 2731, thought to have been triggered by traumatic circumstances surrounding a bereavement.
[Breathes] Poor Rai.
[SEC: affirmative ping]
Apparently work and previous university-related stresses have been the triggers for previous manic or depressive episodes and, as such, Dr Solari was supported by the psychiatry team and his employer in his decision to step down into a solely research role at the clinic.
Um, and he’s had his tonsils out as a kid. Which doesn’t feel particularly relevant.
Huh.
[SEC: questioning ping]
There’s no mention of any foreign bodies in Rai’s head. Or even any imaging of his brain during the entire admission. . . That’s bad!
Can you open his admission document?
[SEC: file open]
Thank you.
Uh . . . Oh, look! There, in the examination. The receiving medical officer noticed a scalp wound . . . and did nothing about it.
[SEC: typing on screen, questioning ping]
Well, I mean, it’s anyone’s guess. I don’t think Rai remembers. He makes a lot of jokes about ending up in the vents -
Oh. Sec -
[SEC: questioning ping]
He went into the vents. Thea was told to tell him that he’d find what he was looking for in the vents! He must’ve gone looking!
[SEC: typing on screen]
Yeah. Stars, he - he was close.
[SOUND: incubator beeping]
[SEC: questioning ping]
[SOUND: chair, footsteps, buttons]
It’s nothing exciting, just a reminder to check the settings. I’ve been fiddling with the temperature for the last few days but it doesn’t seem to affect anything.
[Whispers] Hi, baby NOSL11, please wake up.
[SOUND: footsteps, chair]
Where was I?
[SEC: typing on screen]
Oh, right. Yes. Dakarai takes 1 gram of lithaplex daily. He has not had any recent dose adjustments that I’m aware of.
Do you think that’s enough of a summary? I don’t know what Rai was hoping for by getting these sent over.
[SEC: typing on screen]
I guess, I could mention that, in his confused state, Rai mentioned several times that a patient had told him he was buffering. I’m not sure what that means, but I personally have noticed a few instances where Rai appears to have lost focus for a few seconds as though daydreaming. It may be worth, if the treating team haven’t already, asking Rai about any previous seizure or other neurological activity.
[SEC: typing on screen]
Well, I do. I do feel guilty.
[Pause]
At the time of departure, Rai had mostly recovered. He was off oxygen, was moving both upper and lower limbs with equal power - though, he was globally weaker than usual - and could walk unaided. His pupils were normal and he was oriented to time, place and person. Only his mood remained a little more sullen than usual.
He asked me if I could go with him. And I felt so awful saying no.
[SOUND: chair, footsteps]
All because I have to be here monitoring this egg that I am becoming more and more convinced is never going to hatch. I know there’s someone in there! I’ve seen zir on so many scans!
[SEC: typing on screen]
Ugh, I don’t like it when you ‘Dr Underwood’ me. What?
[SEC: typing on screen]
[SOUNDS: footsteps, pacing]
Yeah, I know what I said. It would be great to ask them for advice, but I can’t - it’s just wishful thinking.
[SEC: typing on screen, questioning ping]
If they’re anywhere, I think they’re going to be in there. Yes.
[SEC: typing on screen, affirmative ping]
I can’t! I told you, what if it knocks out other systems?
[SEC: negative ping, typing on screen]
How can you be sure? How do you know that damaging you isn’t going to upset - I don’t know?! My oxygen supply!
[SEC: typing on screen]
Okay. Yes, you were switched off when I first arrived. . . Okay, but . . . What if we put this chip into the connector and . . . something happens to you?
[SEC: typing on screen]
I know. I know you have. And I’m on the same moon as the Professor, I’m not going to risk your -
[SEC: negative ping, negative ping, negative ping, negative ping, typing on screen]
That’s not true! I always read what you have to say and you - you help all the time!
[SEC: negative ping, typing on screen, questioning ping, typing on screen]
I don’t know if I’m okay with that! What if it was the other way round, Sec, I like to think you wouldn’t be happy with me taking silly risks in the chance that it might help a patient!
[SEC: typing on screen]
That - that doesn’t count. Venocrafts are safe and nobody died!
[SEC: typing on screen, questioning ping]
I get it. You want - you deserve agency. But how do you think Professor Rae would feel if I woke them up and you weren’t there?
Ah.
[SEC: typing on screen]
[SOUND: footsteps, chair]
[Sigh] Of course you know how that feels.
[Pause, thinking] Are you sure this is what you want?
[SEC: affirmative ping]
And you understand the risk.
[SEC: typing on screen, affirmative ping]
Even if this thing is blank, it could still cause damage.
[SEC: affirmative ping]
You have to promise me -
[SEC: questioning ping]
If you think you’re about to be deleted, you have to stop the process. If you can.
[SEC: typing on screen]
They’re already dead, Sec. You’re not.
[SEC: typing on screen]
Promise me, or I’m not doing it.
[SEC: affirmative ping, typing on screen]
[Pause]
Okay.
[SEC: typing on screen, questioning ping]
[SOUND: drawer open, connector plugged in, metal clack, scrape of receiver]
Yep. I’ve got them both.
[SEC: typing on screen]
Yeah. I will - just -
[SEC: questioning ping]
Thanks for looking after me.
[SEC: negative ping, typing on screen]
[Tearful] Cool.
[SEC: typing on screen]
Yep. Yeah. I’ll tell them.
[SEC: affirmative ping]
Don’t forget.
[SEC: typing on screen, affirmative ping]
Ready?
[SEC: affirmative ping]
3, 2, 1 -
[SOUND: click, electric buzz, whoosh]
AH! OW! Sec! I think you just electrocuted the entire damn room!
Sec? Sec?
[SOUND: awful computer noises]
Sec! Sec!
[SOUND: incubator beeps, cracking sound]
Wha- Oh, no, no, no. Whoa there, okay! Okay!
[SOUND: footsteps, more cracking]
Sec! Please say you’re there! Oh, shit! Ah! Oops! I mean, poopy! I think - I think ze’s -
[SOUND: alien crying]
Stars! Okay! Hello! Hi! Wow, look at you! Um, welcome - um, oh my stars. Where are my gloves?
[SOUND: Sec start up noise, ongoing crying]
Sec? Sec! Hi! The baby! We have a baby!
[Pause, more fearful] Sec?
AERGLO
Hello?
[MUSIC: a variation on The Vesta Clinic Theme]
For the final time this season:
This episode of The Vesta Clinic was created by AMC. It starred AMC as Faye Underwood, Kamen Cooley-Greene as Dakarai Solari, Christopher Stoops as The Professor and Sec, as himself.
Music was by the incredible Ruby Campbell and me!
Please check out our show notes for content warnings and transcripts.
Thank you so much for all your support during this season! We’ve loved seeing your thoughts and every one of the fan creations you’ve been kind enough to make and share!
A huge thank you again to the people who submitted ideas for this season of the show: Boombox-fuckboy, Beka Terrier, Exal None, Leon Egan, Shelby, Mad, Colin Arnott, Aster, and Arian Wells. If you want to submit an idea for season three, now is the time! Go to thevestaclinic.com/submissions to send us your ideas!
We are hard at work writing season three and would love your continued support in helping the show reach the ears of other audio drama lovers! You can support us on Patreon and catch up on the bonus stories for the last two seasons and lots and lots of bloopers. Or, just find a friend and tell them all the things you love about checking into The Vesta Clinic! As always, you can find us on social media at @vestaclinicpod.
That’s all for season two, folks. In the words of the eminent Dr Dakarai Solari: miss you already.
Content Warnings: Swearing; seizures; reference to bleeding; mental health issues; reference to previous psychiatric hospital admission; reference to discrimination against patients with mental health conditions; uncertain clinical outcome of newborn patient; reference to dead character
