Log Title: Operation: Saving Ace
Location: Medical Center: The Pit - Surgical Suite
Date: July 20, 2013
Summary: Nightingale performs major surgery on Ace, in order to repair the pilot's damaged intestinal tract. Lifeline is in a supporting role in this surgery, and is also documenting the damage for Ace's medical file. After the surgery, Ace is recovering, when something very unexpected happens! Also starring the ever-lovable and aptly-named Chance.
Medical Center: The Pit
The base infirmary is a spacious room, with high ceilings, blue tile floors, and plenty of room in which to walk around. The place is brightly lit by row upon row of fluorescent lighting. There are about six beds ready for use, with fourteen more that can be readied if necessary. Each bedside is surrounded by state-of-the-art medical equipment, in addition to the more standard medbay fare like trays of supplies and such.
Beyond the recovery ward are a pair of double doors leading into the surgical ward itself, which includes six separate operating tables and the best surgical equipment the US goverment can provide. A smaller room to the side is set up as a biocontainment ward, including an armored window through which doctors can monitor the patients inside.
While not a place to set someone's mind and soul at ease...it's a place to spend time healing...to watch the large, industrial-grade 12-hour clock on the wall, and consider the virtues of being more careful.
Lifeline is prepping Ace for surgery. He's mainly responsible for anesthesia, as well as monitoring Ace's vitals. Dr. Miller will be doing the actual surgical procedure: mending the lower portion of Ace's intestines, which have been neatly bypassed by a temporary colostomy. The lower portion was, at one time, extremely leaky and badly infected, but the infection has subsided. Now, all the remaining shrapnel, anything that hasn't been removed by now, needs to be carefully excised and the entire body cavity cleansed of foreign matter. There's going to be some cutting and a lot of clamping involved -- steady work even for two doctors.
Fortunately, Dr. Miller will have an excellent, top of the line monitor and computer camera, as well as a robotic 'arm' to assist with the most careful work.
"Everything ready, Dr. Steen?" Dr. Miller asks, finishing her own preperations for the long and delicate task ahead. She almost completely obscured by her medical scrubs, and she's been disinfected from head to toe. "Crossed the 't's and dotted the 'i's?"
"Scrubbed and ready for the first incision," Lifeline says. "Have you ever used the robotic arm before? It's a fairly new piece of equipment; we were fortunate to get it. But if you'd rather work without it, that's fine too."
"I've been trained in the use of one, but I've never used a robotic arm in surgery," Dr. Miller responds, judging where the first incision should be. "I'd rather not have my first attempt be now; Ace's condition is too fragile for guesswork."
"Whatever makes you feel more comfortable, Dr. Miller. Oh, almost forgot to ask: do you work with music, or not?" Lifeline asks.
"Oh. Instrumental music would be nice; nothing too catchy though." Dr. Miller says, smiling behind her medical mask. "Dr. Lannster frowned on humming during surgery."
Dr. Steen's eyes -- which are mostly hidden not only behind his glasses, but a 'splatter guard' (awful name for a necessary device for surgeons who have to wear prescription glasses) -- are smiling. "Let me see what I can do."
After a moment, there's some soft flamenco guitar music playing in the background. "See, I'm not going to torture you with Bee Gees or ABBA," Dr. Steen says as he starts up a small device intended to cauterize bleeding veins and suction blood behind a scalpel's cut, once things get messy.
Dr. Miller -might- be making faces under her mask; it's hard to tell. "Hey, I like ABBA and the Bee Gees." she says. "God, remind me to tell you about my 'Dancing Queen' routine later." she says with a laugh. "Okay, let's begin..."
"I *will* want to see that later," Dr. Steen mentions. And then, he's all down to business. He clicks on the capture-camera-feed, which will record the entire procedure and make it simpler for Dr. Miller to do the post-up writeup.
Dr. Miller goes about her work with efficientcy and skill honed from years of experience. "Right..." she murmurs, gently opening Ace's abdomen (There's no way to say that without sounding creepy). She begins the long task of remving any remaining bone splinters from inside the chest cavity.
Lifeline has been The Guy In Charge here, for a good long while. And he still is! But this is the first surgery in a while where he isn't the lead, and it feels like someone else is driving the vehicle to him. It's strange sitting in the passenger seat, so to speak. But he's trying to avoid his natural tendency to butt in and take the lead...because that wouldn't be very nice. Especially to someone like Dr. Miller.
As the pair venture deeper into Ace's abdominal cavity, they begin to encounter bone fragments. Some of these fragments are embedded in Ace's intestines, and others are 'swimming' freely in his abdominial cavity. "...See, this is what I missed the first few times. Those fragments...are from Ace's lower ribcage. I left it alone intentionally because he was in too bad a shape to endure another round of surgeries until now. Lots of this is going to be pull, bleed and clamp. I'll just clamp them as you go along," Lifeline notes.
Dr. Miller wouldn't be offended if Lifeline wanted to take lead; she was the junior doctor here, he could pull seniority on her. As it is, she's glad he's there with her, in case something goes wrong. She frowns under he mask. "I can't imagine the force nessecary to drive those splinters in like that." she says, working gingerly to remove the bone fragments while causing as little damage as possible.
"That's -- let me get the camera on that..." Dr. Steen closeups within Ace's abdomen. "Because I want the top brass to *see* what we're having to clean up. I'm putting this in the dossier. Those white pieces are bone fragments from Ace's lower two ribs being *completely shattered* due to blunt force trauma inflicted upon him by Major Bludd kicking him in the abdomen. Those fragments lacerated his liver, spleen, pancreas -- all his major organs were lacerated to some minor degree; however, his intestines were completely *perforated* by these rib fragments. Note how sharp they are...and how many have just lodged into the intestines, that's what we're hoping to fix as completely as possible." His point made for Hawk and the other commanders, he then turns back to the procedure, quickly clamping as many bleeds as he can. "How's the bleeding on the upper left quadrant?" he asks Dr. Miller as he suctions out some blood and other debris from Ace's abdominal cavity.
Dr. Miller is professional as Dr. Steen makes his case to the camera, but inside she has some choice words to describe Major Bludd. "There's not much bleeding, thank goodness." the doctor says with obvious relief, carefully plucking out the many bone shards and dropping them on a nearby table; they'll be washed and collected up as even more evidence in the war crimes case, should Bludd ever be brought to justice.
"No, there isn't, and his vitals have been really good. I was expecting some blood pressure drops because of all the bleeding, but everything's strong," Dr. Steen says. "That's a really good sign."
Things proceed this way for some time. Quadrant by quadrant, the pair carefully work their way through Ace's intestines, trying to get every last bone shard out of the way. The process is helped by computer scans, which show the small fragments in contrast. Even so, it's a painstaking process, and every so often, Dr. Steen has to stop to give Ace a transfusion so his vitals will remain strong.
Dr Miller keeps at her work with a steady patience, blocking out all distractions so she can focus on the task at hand. "You're doing good, son..." she murmurs to Ace, affectionately. "Keep strong, we'll be done soon..."
Dr. Steen smiles under his mask, feeling a sudden warmth as Dr. Miller begins giving Ace an encouraging pep talk. He hopes that the camera's audio picks it up so the brass can see what a sweetheart Dr. Miller is. Outwardly, however, he gives no indication that he overheard her. "Got a bleed in the center quad. Some kind of...mass...? Probably infection. Not too big, thankfully."
"I see it. Looks like an infection pocket." Dr. Miller says, working to remedy the situation. "Doctor, make sure all of the pus is cleaned out; I don't want that infection spreading."
Dr. Steen once again stops his natural inclination to just...butt right in, and take over. (What is with me wanting to lead this surgery?? Maybe it's just a 'guy thing',) he thinks to himself, sweating as he closes in to suction out the nasty infected pocket. (I'll have to ask Spike about that next time we get a chance to catch up.) "Clamping." he cauterizes the resulting bleed, and hopes that the swelling in that portion doesn't give Ace a permanent tendency toward bowel obstruction.
You just not used to having someone else taking the lead, Lifeline. Dr. Miller smiles faintly under her mask as she deals with the infection. "There; one less boo-boo son." she says warmly. "Don't you fret, Ace. You'll have to watch your diet for a while." She finishes with that part, and moves on, making sure to not miss anything.
Lifeline chuckles softly. "I knew there was a technical term for that type of lesion...'boo boo'. Thank you for reminding me," he quips. Normally, he isn't at all lighthearted during a surgery, but this one has been so tedious that he felt a little levity was needed. A monitor begins beeping, and Lifeline goes to check on it. "Patient's blood pressure is beginning to drop. Do you want me to give him a transfusion and continue, or close him up?" Ultimately, he *could* make this decision, but he wants to see how Dr. Miller will decide.
Dr. Miller chuckles back at Dr. Steen. "I've never been one for technical jargon." she says, a smile in her voice. She frowns at the monitor beeping, and her brow furrows in though. She double checks Ace, and nods to herself. "We've gotten all of the bone fragments; the visible ones at least. I think we can close Ace up."
"Alright, let's do it." Dr. Steen does one final 'sweep' of Ace's abdominal cavity with the suction machine, then places a solution in there to hopefully prevent further infection. Getting 'out' of the woods is much easier than venturing in, in this case. "I'm clear in all quadrants. Haven't seen a fragment in about half an hour," he notes.
"Half an hour? How long have we been working?" Dr. Miller asks with a small bit of wonder. She -always- lost track of time when doing intense work like sugery. "I don't see anything out of sorts." She pauses. "You've been a great patient, Ace." she says gently.
"We're at the 3 1/2 hour mark," Dr. Steen notes, getting the surgical stapler ready to snap shut Ace's incision.
"Time flies when you're having fun." Dr. Miller says dryly. She moves a bit, so that she's not in Dr. Steen's way. She aids him as he closes Ace back up. "Good work, Dr. Steen." she says.
"Thank you, Dr. Miller, it's been a pleasure," Dr. Steen replies...then, once the incision is closed, he stops the video. "Procedure completed in 03:34:21 hours," he announces before shutting it off. "I'll put some bandages on so he can drain into them, and change them up every 4 hours or so."
"...Bleh." Dr. Miller says to herself, shaking her head. "Sorry; sometimes after sugeries my brain has to reboot I guess." She laughs, starting to clean up the medical impliments she used.
"It's OK, you did fantastic," Dr. Steen says. "Now, it's up to Ace. If things heal really, really well, I'm going to reverse his colostomy; if not, we'll just hold off on it, because that's the last thing before we call in the guy who's going to restore his face." He assists with the cleanup, then helps in bandaging Ace's abdomen with quite a bit of gauze. "Look, his vitals are back in normal range. We could've kept going, but with less results, and it would have put more stress on the patient."
"I'd rather not stress Ace any more than we absolutely have to; poor
boy's gone through far too much already." Dr. Miller says as they bandage Ace up. "I'm going to go strip off and clean up." she says, heading over to dispose of her dirty scrubs. Suddenly, her legs buckle and she crashed to the floor!
"Michel?!!" Dr. Steen does a double-take as he hears Dr. Miller hit the floor, and he scoops her up, quickly putting her on a gurney and checking her for signs of a concussion. After all, she just took a dive on the surgical suite floor.
Dr. Miller seems to be semi-conscious; she must have smacked her head on the floor with some force. Her eyes open and close, but her gaze isn't focused on anything.
Dr. Steen checks Dr. Miller's pupils for signs that they're 'off' or not even. "C'mon..." His normally cool demeanor is beginning to devolve into aggravation. "Damn, why wasn't I paying better attention..." He gets hold of the MRI tech. "Let's get a quick scan and see if there's a bleed."
There's signs of slight swelling in the brain, but thankfully no bleeding. Dr. Miller groans slightly, still very dazed. "...where?" she murmurs, not sounding quite all there.
"You gave yourself a concussion, hon. Just relax, you're going to join Ace in recovery," Dr. Steen says with a sigh, wishing he had actually SEEN what happened. Did Dr. Miller slip? Did she just collapse? Perhaps she had a seizure, and he was too busy to notice. Too many unanswered questions. "I think you might have fainted, but you hit the floor pretty hard."
"...head hurts. Left side..." Dr. Miller says slowly. Her eyes try to focus on Dr. Steen, without much success. "Ugh..."
Very cautiously, Dr. Steen examines the left side of Dr. Miller's head more closely, trying to pinpoint if there's a fracture. He didn't *see* one on the MRI, but he definitely doesn't want to miss anything for fear of a bleed starting in her brain.
Chance has arrived.
Chance is out in the main room, helping one of the other Greenshirts to an exam bed for the nurses to take care of, his pant leg rolled up with a rather largely skinned knee and slight swelling right now, oblivious to the kerthunk in the suite.
There's a small red mark above Dr. Miller's left ear from where she had made contact with the mean hard floor of the sugercial suite. There doesn't seem to be a fracture, thankfully. "...What.... what happened?" Dr. Miller asks, even though Lifeline had just told her.
"You fell, and bonked your head. Really hard," Dr. Steen explains helpfully. "Stay right there, I'm going to go get you an icepack."
Dr. Steen exits the surgical suite, still partially clad in surgical scrubs. He pulls off his headgear (that protects his glasses from getting stuff on them), then runs over to the freezer, and locates an icepack. He looks like he's in a hurry.
Chance looks up as Edwin runs in... out... and starts to make his way back. He frowned in concern, but also sees what the doctor was wearing (possibly a little bloody still) and decides NOT to interrupt.
Suddenly noticing Chance, Dr. Steen brightens. "Could you come back here a moment, please?" he asks hopefully, heading for the surgical suite with the ice pack.
Dr. Miller is right where Dr. Steen left her, nursing a painful injury to the left side of her head. "...ow..."
"We were *just* finishing surgery when she fell and cracked her head on the floor," Dr. Steen mentions to Chance. "I was wondering if you could just...stand right over here by Ace, and just keep an eye on him for a few minutes. Don't worry, he isn't going anywhere, he's just recovering from surgery. Just give a yell if you see anything unusual happen with his vitals -- like if they flatline or something."
Dr. Steen, in the meantime, wraps an ice pack up in a soft towel, and carefully positions it against Dr. Miller's bruised noggin. "Keep this right there, to reduce swelling," he says instructively.
Chance nods at Steen carefully as he stands beside Aces' bed, his hands behind his back 'at ease' as though guarding. Which he was in a way. He stared at Ace, then pointedly stared at the monitor instead.
"Ow..." Dr. Miller says, managing a grin. She holds the icepack to her head, just as Dr. Steen says to. "One moment, I was getting my scrubs off... next thing I know, I'm on a gurney and you're worried."
Chance wells "Concussions are nothing to get fainthearted about." in a deadpan voice from where he stood.
Dr. Steen smirks a bit at Chance's joke. "I see what you did there," he remarks. "Seriously, though, thank you for watching Ace. Post-surgery is a critical time, and I only have one set of eyes. And they're not always good!" He regards Dr. Miller on the gurney. "I think you had a fainting spell from being in one position for a long time without a break," he says, "But I don't know that for sure. Ever had spells like this before?"
"Dont you have nurses? " asks Chance curiously, still with his eyes on the monitor "And no real worries. I was just hanging about after a small accident. Nobody's dying though. Just a badly skinned knee. One of the nurses is tending to it." he guestures out there.
Dr. Miller grins at Chance's joke. "Clever, Chance. Very clever." she says. She seems mostly recovered, which is good. She ponder's Dr. Steen's question. "Have ever fainted before?" she asks, thoughtfully. "Well, yes. I must have been standing to still, or maybe I locked my knees..."
"I do, but they're not always 'in', they have rotating shifts and this just happens to be a time when none of them are around. Murphy's Law, you know," Dr. Steen says to Chance, and then peers at Dr. Miller pensively. "Could be orthostatic hypotension -- basically, if you're still for a while and then suddenly get up or move to stand, you get really dizzy and could even lose consciousness from a sudden drop in blood pressure to the brain."
"All I know is that I feel... real sleepy." Dr. Miller says, barely supressing a yawn. "And a little dizzy. Is Ace alright?" The doctor flicks her eyes over to Ace's bed.
"Now that you're back, did you want me to get her a drink or something? And uh... Ace appears to be okay yes." he nods.
"Well of course you're sleepy, you just got done with nearly 4 hours of abdominal surgery, followed by your floor dive," Dr. Steen quips to Dr. Miller. "So I think I'm going to keep an eye on you AND Ace tonight. You'll be sleeping right here." He smiles at Chance. "Actually, that would be great. Did you know where we keep that stuff? There's a cabinet right next to the fridge, that's where the glasses are."
"I think I can figure it out. Its the fridge NOT marked 'samples' " the soldier replied as he broke from at ease to go and do so "Any preferences or should I bring two of everything?"
"Oh, just some for Dr. Miller would be fine. And you can take whatever you'd like. Yeah, avoid 'samples'," Dr. Steen quips.
"You did the same surgery. Dont you need something? " double checks Chance.
"Apple juice please." Dr. Miller says, still holding her ice pack to her head. "...Now I feel silly. I feel over and got a boo-boo." Dr. Miller's pout is adorable.
"No, none for me, I'm going to go chill out for a bit once I make sure everything's alright," Dr. Steen admits. "But thanks for checking."
"Well, okay then. One AJ coming up." The Soldier departs quickly, and is soon back with a few boxes of Apple Juice, two bottles of water and some glasses carefully in a shallow cardboard tray.
"Aw, that's served up quite nice," Dr. Steen admits as he sees Chance returning with the waiter-type display. "That's class."
"Thanks Chance." Dr. Miller says. She tries sitting up, but decides that not a great idea and lays back down. "I think that feeling is called vertigo..."
Chance smirks a little bit "I did bus tables for a year to buy a bike when I was fourteen." he remarks at that as he shakes up the boxes a bit and puts the tray down "Anything else? Did Ace do well for this?"
"Slowly, Michel," Dr. Steen tells Dr. Miller, hoping she won't just faint dead away a second time. "Ace was amazing, Chance...he was so amazing, in fact, that he endured a 3 1/2 hour abdominal surgery with no complications. Usually if the patient is in a delicate condition, the blood pressure drops, or the heartbeat slows, but he is just acting like he wants to get out of this situation."
"Ace is a fighter; he'll get through this just fine." Dr. Miller says with a smile. Her smile disappears as she reflects on what exactly came out of Ace's abdomen. "He's an incredible man, and I look foward to having a two-way conversation with him."
"So do I!" remarks the Joe as he stands about mostly to talk to the two "... Is three point five a long abdominal surgery? " he asks, then listens to the rest and ohs "Well, I wouldnt blame him really! I prefer you as a conversation partner!"
Dr. Steen chuckles at Chance's remark. "I keep telling Dr. Miller she's an amazing woman...she even does her own stunts," he jokes. "...Too soon?"
Dr. Miller rolls her eyes. "Very cute, Edwin." she says, sticking her tongue out childishly. She blushes a bit at Chance's comment. "Even when I yell at you about burning off leeches, Chance?" she teases lightly.
Chance chortles himself and cracks open a water "Hey it works for Jackie Chan..." he remarks "I honestly meant EITHER of you with that comment. The old joke about how you only want to see your doctor when its lunchtime and he's invited."
"Oh. Well, thanks," Dr. Steen says. "I feel sometimes like I'm shackled to this place, but sure, we don't have to talk shop all the time!"
"Maybe I should crack my head more often?" Dr. Miller says, laughing. "But it IS nice to talk to you and the others Chance." She sits up, slowly, and takes a bottle of apple juice. "Alas, most of my off time is spent sleeping."
Chance nods at Steen "You should get out more though. But I think I am preaching to the choir by saying its good for your health eh? " he remarks with a grin.
"It is. Much like this whole...unfortunate...unfolding disaster in Los Angeles, we can't just dwell on the bad things that could happen, we should focus on the daily things and...when it comes down to it, our standing orders," Dr. Steen says. "I have no doubt in my mind that the brass are consulting the Autobots about these Quintessons."
"Yeah. I heard the airforce that did get sent in didnt last very long, even with Autobot help." remarks Chance darkly. Then he blinks and straightens "Hrm.. That gives me an idea..." he pulls out a note pad and starts scribbling.
Dr. Miller sughs. "Have we heard any news? I heard that the city..." she pauses as she drinks her juice, looking at Chance curiously.
"Communications are still sketchy. I haven't been able to download a single thing onto my phone, tablet or webpage. It's just taking too long," Dr. Steen says. "Or worse, it freezes up altogether."
"So who put in that Simpsons clip into their transmission?" asked Chance.
"Wait, what?" Dr. Miller says. She blinks, and takes a sip of juice. "I didn't see that."
"...I don't know. I saw that, but figured maybe they had picked that up from another signal, in order to transmit their own message. One of those ironic twists of fate, if you will," Dr. Steen notes, stepping over to check Ace's abdominal bandages.
Chance hrms "I suppose so. But he didnt seem happy that it happened." remarks the man as he watches, sipping his own water too "Yeah. someone put in a simpsons clip of the two aliens into their feed. A good chuckle."
"...That's humanity for you." Dr. Miller chuckles, sipping her juice with a smile. "Even when we're against a wall, we won't be beaten down for long."
Chance nods "Yeah." he was still scribbling a little bit ponderously
"Well, guys, I'm going to go to my decompression area." What does Dr. Steen do to decompress from surgery, anyhow? He's not saying. "Dr. Miller...if you feel tired, take a Tylenol-3 and *sleep*. Chance...if the world's still here in a few days, we should get out and do something. And...give me a call if you need me, I won't be going far."
"You're NEVER far. But I'll call." promises Chance as he finishes tracing "You sleep too after you decompress man!"
"Okay, Dr. Steen." Dr. Miller says, nodding. "That's... probably the best course of action." she says. "Take care of yourself." She lays back down, blinking up at the celing.
"Good night," Dr. Steen says with a smile, leaving a sticky note on Ace's IV pole for the duty nurse to translate, and then heading out to his 'decompression' routine.
Ace's Condition Update 3: Sun Jul 21
(( Restricted to those who would know! You know who you are. ))
On July 20, Dr. Miller and myself determined that Ace was ready for the most taxing procedure to date: repairing his lower intestines from tears and ruptures caused by his lower ribs shattering and being pushed into his abdominal cavity. The extensive damage was videorecorded, and is being included in the dossier to top brass documenting Cobra's ongoing war crimes to our troops. Dr. Miller will be submitting the post-surgical notes, as she was lead surgeon on the procedure.
The surgery lasted 3.5 hours, and no unusual complications were noted. Dr. Miller and myself repaired numerous tears to Ace's intestinal tract, as well as lacerations to the lining of his abdominal cavity.
A total of 46 foreign bodies were extracted from Ace's intestines. 45 of these were confirmed bone fragments from his ribs, and 1 is unidentified but appears to be an old bullet of unknown origin. Ace has some post-surgical swelling in his abdomen, but this was an expected condition and his prognosis is good. Further details will be included in the dossier.
Dr. Edwin C. Steen Lifeline