Practicum in Neurology

Posted on 13 Feb 2024 @ 11:31pm by Lieutenant Sahar & Lieutenant JG Hannah Wagner

Mission: M4 - Falling Out
Location: Sickbay- ACMO's Office
Timeline: TBD- 2 days prior to "Theory Testing"
1882 words - 3.8 OF Standard Post Measure

Hannah turned from one research board to another with an audible sound of frustration as she couldn't glean from the research she'd done which path was the correct one. She'd mapped her thought process in terms of the problem she had in front of her, but without further assistance she would be unable to fix the problem.

The young doctor had already determined several things from the detailed scans that she'd done on Ibis. The first was that the damage was large in area, but not as significant in severity as she'd thought. It was focused almost entirely on the telepathic region of the brain, and was more similar in appearance to atrophic damage than it was scarring or any other type of neurological damage. It pulled on the other areas of the brain, making it so that the channels that would normally carry fluids back and forth, allowing reception of telepathic communication were kinked or diverted. She imagined that the backup of the system had been excruciating, leading to her patient not wanting to use the system at all. Then, she would have been unable to do so, with the repeated traumas to her psyche. That needed to be addressed by counseling, as well as her own staff...but where to start? Chewing on her lower lip, she looked from the display of the brain scan and back to her notes.

"I'm getting nowhere with this." Throwing her head back she massaged the back of her neck with an idle hand, to ease the tension she was acquiring by thinking herself in circles. "Computer, play A Sky Sparkling by Johannes Bornlöf, and continue with related tracks for an hour of music. Maintain instrumental only."

"Confirmed"

The soft muted hammer sounds of a piano began to play in the room, and the soothing effect of the music had a physical effect on her body. She had set up the research to send to Dr. Sahar, who had agreed to assist her in at least reviewing her research. He was certainly well experienced in the arena of neurology, having a pHd in the subject.

"This music is pleasing" Sahar murmerred, as he entered the room. The stoick Vulcan's voice held a note of appreciation. He had not knocked, for her door had been standing open, and it was more than reasonable for anyone to think that she would see them, facing the door as she'd been. If her eyes had been open, she would have seen him.

A gasp of startlement escaped Hannah's lips, and her eyes flew open. They settled on the tall vulcan man, and she rested a hand on her chest. "You nearly frightened me to death."

"That is highly illogical. Fear is not something that can physically manifest" The Vulcan replied, eliciting a chuckle from Hannah.

"So you say. It felt physical to me. As for the music, I find it helps me concentrate to have such background noise. Instrumental only, as I find vocal music to be quite distracting when one is trying to think about a problem such as this." Her broad sweeping gesture included all of the research that was currently on display.

"Logical."

Oh, I've gone from highly illogical to logical eh? Wonder if I can shake him up more? She inclined her head hiding the brilliant smile that a compliment of that caliber from the respected Vulcan scientist had elicited. "What can I do for you Doctor? I was not expecting you?" her tone raised in a question.

"I have been studying your problem, with no small amount of fascination. It is unlike anything I have ever seen before and that is a rarity that I cannot allow to pass by. You requested my assistance in the matter, and I should be honored to accept that request. While the exchange of information in digital form is adequate, I should appreciate hearing your thought process in relation to the diagrams you have sent me. Some of your shorthand is elusive. "

Wagner almost laughed as she realized that all that eloquence was because he couldn't read all of her handwriting! Her mother would be so proud of that, if she would ever acknowledge her wayward daughter. Nodding her head, she indicated the first of the boards. "I had initially thought the problem would be something simple, along the lines of damage from Zanthi fever...the younger tend to have permanent damage from it, whereas the older more mature telepaths can usually regain their control. "

"Indeed, what led you to believe that it was not such a thing?"

"Well..." Hannah took a breath before continuing "Partially because of the physical changes without any significant scar tissue. The whole of the paracortex is shriveled for lack of a better term."

"An apt descriptor, please proceed."

"There was no single point of damage, nor any cascading damage from a single point. It's a much more broad area of effect than should be possible from a known virus. She doesn't show any signs that an unknown virus has taken up residence in her body. The physical scans of her and the other rescued do not show any foreign contaminants of any kind. Nor, did we bring any back on the mission that ended with their rescue. The time of year could play a part, but given the condition they all were found in I would suspect that their susceptibility to disease would be extremely high."

"Again, a highly logical and reasonable assumption."

"The transport pattern buffers also didn't find anything of note, except in some of the scilica that was brought back on our boots from the surface. That, i would expect to find traces of in the lungs or digestive tract rather than the brain. While, it could pass through the sinuses or eyes directly into the brain, I can't discount the possibility that this is a form of silicosis, which absorbed the psilosynine in her paraventricular array. That by itself, would make me think that there would be some residue left behind by the process. Dust like that in a contained system wouldn't just disappear even over years. There would be some sort of something, either encapsulated or otherwise, and it would still be irritating to the brain were it still present. The body doesn't just stop trying to rid itself of an irritant of that caliber. Since none of my scans gave any indication of that, and there was no demyelnination to indicate any autoimmune disorder, nor any current indicators of inflammation on any of the pathways that utilize psilosynine and the other neurotransmitters involved I simply couldn't think of any other possibilities. That is when I decided to bring you into the discussion, because I feel quite out of my depth." Hannah had risen from her chair to pace between her diagrams and the scans, indicating each specific topic before continuing on to the next. The highlighted sections of Ibis' brain lit up as she spoke about them. That was a feature she truly enjoyed about her own personal research setup.

Sahar paused a moment and looked at the brain scan more closely. "We can test for the latent virus easily enough, immediately. Do you have a sample of her cerebral-spinal fluid?"

"Yes, I did a standard workup for disease on the sample."

"This would be outside of a standard workup, for she shows no current signs of meningitis, nor any meningeal damage of any kind. There would be remnants of the viral matrix in the fluid, if there was any virus in the area. While it has atrophied, the fluid pathways are still patent. None of them have fully closed down. " He changed the image to the one which showed the fluid pathways of her brain. It was a sophisticated system in Betazoids, which had 6 ventricles all attached to a central channel. The whole system was closed, and had redundant structures so that the telepathic ability could be maintained. "It doesn't explain the neurotransmitter nadir, but if perhaps there was swelling at the time of injury...There is too much that we do not yet know."

"I wonder what would happen if we just refilled her ventricles...." Hannah said absently as she toyed with a strand of her hair. There was a pause as what she'd just said sunk in on both researchers.

"That's a testable theory."

"It is."

"Operating under the assumption that you can't pour from an empty cup?"

"A sound, if crude description of the theory, yes."

"We'd have to dose her with steroids to make sure internal swelling didn't affect our results, and her recovery." Hannah's hesitation showed only for a moment as she thought about the effect of simply refilling channels gone dry. She thought about what a flood of water on a dry river channel would do to the area and shivered. They would have to re-infuse her neuro transmitter levels very very slowly to avoid damaging the area in their zeal to make her better.

"I agree, and suggest that they be given directly into the cerebrospinal fluid, that way the agressive affects of steroids are mitigated, and the potency of the drug isn't reduced by metabolysis."

"I didn't think that was a safe option?" Her tone was questioning, but deeply curious, as she twisted a stylus between her fingers.

"It wasn't, until very recently. There is a specific adaptogen created by Dr. Xelios of Kelandra II, a well published neurophysiologist, He and I have exchanged research for several decades, and I am better for the pairing. Specifically, his research deals with traumatic brain injuries, but has the potential to revolutionize the subject. This formulation is safe to infuse directly, and has gone through all of the appropriate Starfleet testing. It was very effective on a group of betazoids who received blunt force injury to the area resulting in shearing of the telepathic nodes. Atrophy, is obviously a different kind of injury, but I believe the aid of the medication would be beneficial to her, as we are going to be irritating the area in question in a similar manner. " Sahar had taken on a lecturing tone, but Hannah was entranced. She'd punched the man's name into a PADD while he was talking so she could read his research in her spare time. She also looked up his known research associates, so that she too could increase her knowledge in the related subject matter.

"Would you like to observe the testing?"

"Indeed. Logic dictates that we compile as much information as we can on the effects of our treatments with the repeated scans. I am a functional telepath, and I can provide some immediate feedback on treatments should any of them prove to be effective. "

Both of her eyebrows raised as she looked at the Vulcan. He really was interested in the problem and the outcome. She supposed he probably wanted to write a paper on the subject, in both the theoretical as well as the practical. Referencing their treatment theories would be sound.



The Soundtrack (some of it):

https://www.epidemicsound.com/track/9vf2aE1hst/
https://www.epidemicsound.com/track/txj3tVqg9N/
https://www.epidemicsound.com/track/QtjtK5Rzpy/
https://www.epidemicsound.com/track/EhA1utVCb9/
https://www.epidemicsound.com/track/rIloCEYgft/