“Scalpel,” you say, your voice laced with concern. You should be kinder to Cynthia. She’s doing her best to assist, her face pale with the gravity of the situation before you.
She tentatively hands you the scalpel, and you begin to draw a linear incision around the wound.
Valya just had to go and get themselves shot. Probably while running a multiverse errand for you. You’re just thankful they had the good sense to travel back to a medical specialist they could trust rather than trying to perform yet another amateur surgery.
Speaking of amateur surgeries, Valya’s body is layered with cookie-cutter scars. Like a child took scissors haphazardly to their torso and back.
“Cyn, can you note that the patient has assorted scarring to their abdomen? I’ll check their back when all is said and done.”
“Got it, doc,” she says with a flirty wink. You blush but avoid letting her catch your eyes.
You’ve finally gotten the incision open between the fascial layers. Now, you need to extract the foreign body. The bullet, really.
The ultrasound showed hypoechogenicity in this region, but the depth is questionable. You would get extra imaging, but that would require bringing in someone else, which Valya refused. Prior to passing out, of course.
You quickly glance up to the medical bay window, catching sight of Julia. Valya’s Julia. She looks terrified. Which is odd given how much Sidesteps like you, Cynthia, and Valya have been through.
Now, you turn your attention to the open wound. Suctioning the blood as it obscures your line of sight. You need to be quick.
“Cyn, can you ask Julia-V if we can give a tetanus vaccination?” You see her nod out of the corner of your eye, not letting your concentration wane from the current task of bullet retrieval.
Your forceps dully tap a solid object in Valya’s lower abdomen. You decided not to go through the initial entry site as it had already barely missed vital organs. There is no need to open the area up further.
Slowly, carefully, you extract the bullet. You know Valya’s armor took most of the force from the impact, but it’s still a large caliber. Idiot nearly got themselves killed.
The metallic slug clinks along the surgical tray beside you.
A sigh of relief escapes your lips. The difficult part is over.
Now, to close them up.
You’re not a surgeon by any means. But you taught yourself the basics. Enough to survive shootings, stabbings, and bludgeonings. Your sutures won’t be plastic surgeon-level, but they’re not going to be the crazy-scissor-induced mess that litters the rest of Valya’s body.
The mattress suture will induce the least amount of trauma to the skin. And you know Valya won’t rest after they wake up, so you’ll need to ensure it’s tight and secure. And you’ll probably need to restitch it a few more times in the near future.
“Cyn, note that the exploratory incision required 7 sutures in a linear pattern. Used monofilament nylon.” Cynthia nods, and you hear her nails flying across the keyboard. She’s a great assistant.
“Are we good?” She asks tentatively, eyeing the unconscious Valya.
“Yeah, we should hang another IV drip. Need to get their blood pressure stabilized,” you nod to the monitor. They’re certainly hypotensive, but it’s to be expected after the blood loss. “And we should get a unit of blood on deck for transfusion if necessary.”
Cynthia nods, “And Julia-V okayed the vaccinations. She wants to come to see them, though.”
“Alright, you can let her in. And go get a first-round dosage of Tdap.” You nod to Cynthia, who darts out of the room to collect the supplies. Julia-V pokes her head in and waits for you to address her before she slowly inches into the room.
You don’t need to worry about sterility anymore. The bullet and exploratory wounds are closed.
“Are they okay?” She asks, looking down at her lover. You note the same crinkling around her eyes. The same with which your Julia always has when she looks at you.
“They will be. The rear plating of their armor caught the bullet. But it didn’t ricochet off anything vital. And it didn’t nick any of the colon or other organs. So, all in all, very lucky.”
She nods, looking pensive. “I don’t know what they were doing when they were shot, but they refused to go to anyone but you. Thankfully, we’d had a portal gun on hand.”
She taps the small pistol-like object at her belt. A design of your Mortum’s. The method of multiversal travel.
“Well, they’ll need to take it easy. But I’ll explain it all to them when they wake up.”
She nods and returns to watching Valya, her eyes flitting between their pale face and the slowly beeping monitor.
They’ll be fine. Some bed rest and fluids will do wonders.
You hear the clinking of vials as Cynthia rolls a cart through the door. You turn to her and give her shoulder a soft squeeze as you examine the kit in front of you.
Taking the dosage of Tdap, you inject it into Valya’s left deltoid, being careful to avoid the nervous structure under the muscle.
You’d love to give them the rest of their missed vaccinations, but you suspect you should discuss it with them first.
“Okay,” you say, sighing and stretching. “I need to write my note, but we should be ready. Cyn will wait around to make sure everything goes smoothly. I’ll be back when I’m done.”
Julia-V nods, her eyes not leaving Valya.
Cynthia gives you a swift peck on the cheek as you pass.
You reach your medical office desk and sit down on the ergonomic swivel chair.
You usually don’t write notes for your procedures as you are usually operating on yourself. But you know this won’t be the last time Valya needs an operation, and you’d like to keep a record. Never can be too careful.
***
Note: These records are for internal use ONLY. Disclosure of these forms will be met with swift recourse.
Date: 10/20/21
Facility: Heartbreak Medical Facility
Patient: 0002
Patient Name: Valya Galdin
Sex: AFAB
Gender: Nonbinary (they/them)
Attending: Arya Skovsgaard
CC: GSW
HPI:
Valya Galdin is a 38 y.o. AFAB nonbinary person who presents following a GSW to the lower left abdomen. The patient arrives around an hour after the inciting incident. They present with a significant other who reports they were in an unknown altercation. Their partner states the patient has a previous history of bilateral lower leg complex fractures. She also notes the patient has a history of self-harm.
HPI and ROS are limited due to patient status.
ROS:
Head: Positive for trauma
ENT: Negative for dental trauma
MSK: GSW entry wound in the left lower abdomen
Integumentary: Positive for abrasions, lacerations, ecchymosis
Psych: Altered mental status
Neuro: Loss of consciousness
Physical Exam:
Head: Atraumatic, normocephalic.
Neck: No signs of trauma or misalignment.
Lymph: No acute findings of lymphadenopathy.
Musculoskeletal: 3mm wide entry wound in the left lower abdomen.
CV: No murmurs, rubs, gallops. Tachycardic. Blood pressure depressed.
Respiratory: Some wheezing.
GU: No abnormalities noted.
Integumentary: Lacerations and healed cuts to the patient’s wrists and torso.
Psych: Unable to assess.
Neuro: Unable to assess.
Assessment:
GSW to left lower abdomen.
Plan:
Immediate surgical attention is required.
Procedures:
Laceration Repair:
Location: Left lower abdomen
Size: 3 mm in diameter
Anesthesia: None used
Suture: Monofilament nylon, 4 used
Laceration Repair:
Location: Left lower abdomen
Size: 3 inches in length
Anesthesia: None used
Suture: Monofilament nylon, 7 used
Progress Notes:
0100: Patient arrived at Heartbreak base. Significant other reports history while triaging.
0110: Patient placed on IV fluids and given vasopressin 0.5 mu/kg/min to maintain blood pressure.
0130: Skovsgaard removed a foreign object from the patient’s lower abdomen and sutured it.
0135: Tdap vaccination given
0140: Significant other in the room with the patient.
Disposition:
Remain in the facility for recovery.
Electronic Signature:
Arya Skovsgaard
This report is to remain within Heartbreak Medical. If it is found outside of these servers, it should be destroyed, and the aforementioned party should be warned.
***
Good. That will suffice for now.
A message pops up on the corner of the screen. From Cynthia.
They’re awake.
Time to talk to the idiot.
When you return to the surgical center, you find Julia-V holding Valya in a tight embrace. They groan slightly at the pressure.
“You need to stop getting shot,” you say as you sanitize your hands. “You’re lucky the bullet didn’t nick anything vital.”
“I… uh…” Valya looks out of it. They’re barely keeping their eyes open.
“Looks like the pain meds are kicking in,” you say with a chuckle.
“They’re good, yeah,” Valya says mildly.
“Listen. I’m not a doctor,” you say, taking a seat on the roller chair by the room’s computer. “But you’ve got to stop doing surgeries on yourself.”
“Valya?” Julia-V looks down at them, a spark of worry lighting her face.
“All I need from you, Julia,” you address her now. “Is for you and Valya to use that fancy little teleporter and come here for regular checkups.”
Valya had a smattering of dangerously sutured scars across their body. It’s clear they have no idea how to stitch themselves up.
“We… we can do that,” Julia-V says, looking back at Valya.
"Good. Because you need to stop f*cking trying to stitch yourself up. You look like a patchwork quilt.”
“Alright…” Valya says slowly, the pain meds clearly working wonders.
“So, all I did for you was pull out the bullet and stitch you up,” you say, gesturing to the small metal caliber in the plate next to them. “Otherwise, I gave you a tetanus vaccine.”
Valya’s eyes widen slightly.
“Don’t worry, it’s a safety precaution. If you get tetanus from a bullet, there’s no amount of medicine anyone can do to save you.”
“…Thanks,” Valya mumbles.
“Alright, I’m gonna go get some sleep. You’re both free to hang out and stay the night if you wish. Call me before you head out, alright?”
Both nod. Julia-V looks less anxious than she did earlier.
“Cyn, will you show Julia how to unhook them from the I.V. when they’re ready to leave?” You look to the dark-haired woman. She nods. “Just finish the bag, and you’ll be ready. And take it easy, okay? I don’t want you back here tomorrow because you tore your stitches.” You address Valya.
They nod again, and you take one last look around your filthy operating room before leaving through the medical bay doors.
Before heading back to your bedroom, you stop at the computer again.
***
0150: Spoke with patient and S.O. about taking it easy and to f*cking stop doing major surgeries on themself. They’re agreeable with the plan for discharge after finishing their last I.V. unit.
***
Before long, Cynthia joins you in the bedroom, and you finally get some sleep.
