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Otana visits Dr. Marshall-Next morning

Posted Feb. 16, 2020, 5:08 p.m. by Lieutenant Commander Pilar O'Keefe (Head Nurse) (Tyra Schroll)

Posted by Lieutenant Drake Marshall (Emergency Medicine/Chief of Surgery) in Otana visits Dr. Marshall-Next morning

Posted by Lieutenant Commander Pilar O’Keefe (Head Nurse) in Otana visits Dr. Marshall-Next morning

Posted by Lieutenant Drake Marshall (Emergency Medicine/Chief of Surgery) in Otana visits Dr. Marshall-Next morning
Posted by… suppressed (16) by the Post Ghost! 👻
Pilar held her daughter’s hand as they walked back into Sickbay, she had scheduled this appointment to see if they had other options to work with besides the therapy. Pilar would do what she could for her daughter and her inner rage just simmered at the thought of what had happened to her.

Head Nurse

When the Head Nurse arrived, Drake greeted her and her daughter at the door to his office. “Nurse Pilar. Otana.” He had set up some toys for Otana while he and Pilar talked. Paediatric neurology wasn’t his specialty but a traumatic brain injury like this, he couldn’t let go untreated.

-Dr Drake Marshall, Chief of Surgery

Otana reluctantly sat down at the table to play with the toys. She was in one of her moods where she was vascilating between angry and crying. She was easily frustrated and didn’t really want to listen to Pilar’s directions, but reluctantly did so. Pilar sat down with her coworker “Well, welcome to my world.” She said “Have you had a chance to read through the files from the pediatrician?” She asked thinking about the notes that Ally had made prior to leaving the ship.

Head Nurse

“I have.” Drake said. “I don’t know if she went through the file with you and your husband, or if you read it yourself. The diagnosis is lesions on the temporal lobe as a result of TBI.” Drake was using as much medical speak as he could. Better, in his mind, for Otana to not understand than to be frightened. “I’ve been considering possibilities within my specialty. I have a possibility in mind. I could excise the lesions, and use a regenerator to restore healthy tissue to those areas. Using a tissue regenerator on grey matter is somewhat… experimental. But it could work.”

-Dr Drake Marshall, Chief of Surgery

“And if it doesn’t?” She asked “What are the complications from that?” She asked

Head Nurse

“She could continue down the road she’s on.” Drake said. “The possibility is that the tissue I regenerate won’t function properly. The same way the tissue damaged by the lesions do. If the cells are not as… open to new growth as I hope, it might leave us back here. What I’m relying on is that her brain is so young. It’s still growing anyway. A little nudge from a tissue regenerator to grow healthy cells, might not be a problem. A warning; the person who goes into the OR, and the person who leaves will be different. I’m confident that this will work.”

-Dr Drake Marshall, Chief of Surgery

Pilar sighed “I know that Dr. Marshall. It’s just different when it’s your own child.” She said “I’m hoping you can understand that. I will need to talk to my husband as well.” She said.

Head Nurse

“Of course. But Nurse Pilar, I highly recommend proceeding with treatment.” Drake stood up and rounded his desk. “There’s no way to be certain how symptoms will progress as she gets older.”

-Dr Drake Marshall, Chief of Surgery

Pilar nodded “I understand Dr. Marshall. I’ll speak with my husband this evening and get his input.” She said looking out at her daughter sitting at the small table coloring. She sighed, since her diagnosis, Pilar had not slept well. She kept dreaming and thinking about what had happened to her daughter and blaming herself because it was her actions in the first place all those years ago that had led to that moment.

Head nurse

“What would be the other options that we have?” She asked wanting to know all of her options.

Head Nurse

“Medication. Extensive therapy. There are a few medications that might stimulate her frontal lobe to function normally. Or closer to it. The thing is, as she gets older, it’s going to get harder for her to empathise with others. This, to her, is normal. She is going to start wondering why everyone is acting like she’s different. It’s up to the shrinks to guess what she’ll do.’

Pilar looked at Marshall, she trusted him, however, she also didn’t want to expose her daughter to surgery if it was possible for her to avoid it. “Let’s start with medication and therapy.” She said “I’ll discuss the surgical options with my husband tonight after I get home from work.” She said already thinking how she was going to present it to Derrick without freaking him out.

Head Nurse

Drake walked over to his office replicator. He produced a two bottles. He handed them one by one to Pilar. “A diuretic, to clear any fluid out of the tissue. Next, clobazam. She’s at risk of seizure, and it should help with mood control too. Dr Darren should be able to set her up with therapy.”

-Dr Drake Marshall, Chief of Surgery

Pilar nodded and took the two bottles “I will have an answer for you in the morning.” She said “Otana, let’s go.” She said waiting for her daughter, who looked warily at Dr. Marshall. She had been in Sickbay far too much and didn’t like being there anymore.

Head Nurse

“I’ll be here.” Drake said. He looked at Otana. ‘Such a small child for what I want to do.’

Drake would be waiting the next day for Pilar. Otana’s report and cranial scans had been an obsession of the last seventeen hours. If he was going to do this, it had to be perfect.

-Dr Drake Marshall. Chief of Surgery

Pilar arrived the next morning and sought out Drake “Okay. We’re going to go with the surgery.” She said “What do you think the prognosis is with this surgery?”

Head nurse

“I’ll give you fantastic odds she walks back out. Mental status… I think the outlook is good. She’s so young, her brain is growing anyway. Childhood is the one phase of life when healthy cells are not hard to come by. She will probably need psychological counselling. She’s not used to normal brain function. But Dr Darren can handle the psychology. Staff, I’ll have Nurse Khev in the room with me, Dr McKnight will be in the wings.” Drake paused. “This is the point where I’d ask any patient’s family if they want to know what I’m going to do.” He picked up a PaDD and stylus. “I almost never recommend it, but informed consent is the idea.”

-Dr Drake Marshall, Chief of Surgery

Pilar looked at Drake “I’m head nurse of this ship, of course I want to know what you’re going to do. If I have to I can explain it to my husband.” She said “He has a pretty good handle on medical stuff but this might be a bit over his head.” She said “Details please.”

Head Nurse

“Nurse Pilar. I don’t think this is beyond you or that you shouldn’t know. But paediatric neurosurgery can be difficult for parents to discuss.” Drake sighed. He always wondered why medical professionals involved themselves in the other side of practice. “The procedure will take time. A good deal of it. We begin with an incision-“ he pulled up Otana’s scan and indicated the area just over the lesions. “here, to allow access to the brain. Typically a craniotomy would be out of the question, but when we need to spend hours in there, it simplifies things. Once the skull is open, I’ll excise the lesions. That will probably be the longest portion. The removal will be followed by tissue regeneration. Otana has one thing going for her in her extreme youth. Her body is eager to grow and heal. So, the idea is that all the grey matter that gets regenerated is sampled and grown off undamaged tissue. Once I’m done, I’ll close up, and she’ll never know I was there. Any questions?”

-Dr Drake Marshall, Chief of Surgery

Pilar shook her head “No, no questions. When will this be scheduled for?” She asked knowing that there would need to be some preparation time.

Head Nurse


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