19. Trouble Some
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Patient: Eskae, Cress’p
Date: 663/2/2732
Patient ID: 5428930
Presenting Complaint: Incoordination
Dr Adra needs to sleep.
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Transcript
[MUSIC: The Vesta Clinic Theme]
COMPUTER
The time is 00:00 1/1/2733.
XAELEST
I didn’t ask.
COMPUTER
Happy new orbit.
XAELEST
Oh? Really?
COMPUTER
Dr Adra. You have one deadline today. Would you like to hear it?
XAELEST
Oh. No. I know what it is.
Computer, show professional communications.
[SOUND: the computer opens her email]
Search . . . Interspecies management exam.
COMPUTER
I can show you: Interspecies/4 Exam Results, Interspecies/4 Examiner feedback -
XAELEST
[Cutting the computer off, annoyed] No. Open Interspecies/4 Exam Resit Invitation.
[SOUND: the computer opens the letter]
Ugh, how do I phrase this? Computer, reply:
To whom it may concern.
Thank you for your invitation to resit the Interspecies Management Examination. As you. . . will no doubt have observed, my - my examiner feedback was particularly - [Pause]
COMPUTER
I can help with word choices.
XAELEST
No, you can’t.
My examiner feedback demonstrated that I need more time and medical experience to prepare for the resit. I would therefore like to defer the examination until a later date. I thank you in advance for your understanding. The Vesta Clinic continues to offer a high standard of patient care under my leadership.
Computer, attach signature.
[SOUND: attach signature]
Do you know what, computer?
COMPUTER
I’m listening.
XAELEST
There is no way I’m passing that exam until they bring in new examiners. But I don’t have the energy or time to complain about it.
COMPUTER
I’m sorry. I don’t understand the command.
XAELEST
[Sigh] I need to sleep.
Computer, open last patient file.
[SOUND: open]
Start dictation.
COMPUTER
Starting dictation.
XAELEST
Date: 663/2/2732
Patient: Eskae, Cress’p
Patient ID: 5428930
It was a pleasure to review the collection of beings known as Eskae in my clinic. It presented -
COMPUTER
Consider word choice.
XAELEST
What - ? No. ‘It’ refers to a single Cress’p or the biological mech and ‘they’ refers to a group of workers. Turn off language suggestions.
COMPUTER
Language suggestions off.
XAELEST
It presented with a concerning cluster of symptoms related to its ability to coordinate its workers. Rather, its workers were not coordinating themselves.
Communication with Cress’p can be more challenging than with other life forms due to the relative reliance on body language. The form and fluidity of the mech that the workers are calling home has a direct correlation with the ease of interpretation. For example, one Cress’p may not have a head to nod or a tail to wag and other forms of gesture are used instead. At any one time, a number of Cress’p workers will be sleeping inside the mech. Through this slumber, the Cress’p workers are able to communicate with one another and coordinate the larger actions of the body as a whole.
Eskae was in disarray. There was a halting cringe to their movements as they followed me into the room and I was immediately struck by the glimpses of frantic movement I could see through some of the superficial tunnels. Most cress’p will have a few visible workers on the skin, appearing to take in the outside as they catch a break. The woody outcroppings across Eskae’s torso and abdomen were empty and there were even fewer workers than expected on the tall sensory shelves protruding from its head.
The slow jerking of its movements and inability to coordinate its limbs left me barely able to parse the answers to yes and no questions. Through careful instruction, Eskae and I were able to develop a system where they would raise their left first limb above their head for yes and make no movement with that limb for no. If I was not certain of the answer I would repeat the question until Eskae gave a consistent response.
Thankfully, Eskae had pre-empted this difficulty and brought with it a tablet upon which it had written about their problem before its most recent deterioration. It was happy for me to read the message verbatim for the medical records.
Hello, doctor, sorry, we do not know your name yet. We am having trouble some and we thought it be best to write it before down it gets worse. It doesn’t seem to be working right.
I think two competing groups of Cress’p workers were trying to write at once. It gets . . . confusing.
We are not sure why but we do not seem to be we are not working able to work together. It is hard difficult to communicate talk and our it body does not work right ing wrong. They will not talk to us anymore. Do not we sleep and chaos talk. Help please help.
[Sigh] I’m glad I turned off language suggestions.
Through a careful use of questions with binary outcomes, I ascertained that their problem had an insidious onset, starting around 2 standard tendays ago. They started to feel general fatigue, though with no worker opacification or endothermia suggestive of infection.
Several sols after the onset of symptoms, Eskae noticed their memory starting to deteriorate. I could not grasp how this affected them in too much detail, but I suspect it was akin to the sensation of someone being adamant that you’ve said something when you’re certain you didn’t. Eskae was starting to doubt their reality but put this down to the stress of their work and the upcoming trip.
Next, they started noticing functional issues with their mech, including clumsiness and spontaneous movement, which deteriorated into the discoordination I was seeing today.
It showed me via the tablet its pre-flight medical assessment. The only condition of interest in its past medical history was an episode of mechrot when they first made their humanoid upper arms but this self-resolved with autocarpentry.
It does not take any medication at present and has no known allergies.
One thing that Eskae clearly wanted to bring to my attention - and succeeded at doing so through a series of bizarre movements when I reached the genohistorical section of the medical form - was that a previous iteration of its current group of workers was known to suffer from early onset dream degradation. This is a dementia-like degenerative process. Their concern was understandable. Despite the increasing availability of treatments for dream degradation, it still has dramatic effects on cress’p quality of life.
It works as a museum cataloguer, denies recreational drug use and lives with two other cress’p which - if I am understanding correctly, are its platonic life partners.
Initial examination of Eskae’s mech did not reveal any obvious abnormalities. Its current form stands at around 150 centimetres at the shoulder, though its large, flat head and pair of long ear-like sensory shelves made it seem taller. As mentioned, it had a pair of humanoid arms with four opposable digits, likely used at work to handle museum artifacts. It walked on four spindly limbs, feet made of toe-roses. It was tail-less. I shone a light into several of the tunnels where they opened out to the surface and they appeared healthy with an appropriate number of visible branches.
Eskae was clearly tiring and I decided to give it a break and examine a selection of volunteers. They marched out onto the examination bench along one of Eskae’s wood-like limbs, their legs making a hair-raising skittering sound. It appeared that they were attempting to line up for me but several of the workers seemed unable to get it right. Some of them clicked their prominent cephaloclaw or spiked, paired pedipalps in disappointment at the disorganisation.
Individual Eskae workers had an insectoid appearance, their abdomen tapering upwards behind where the grasping claw protruded from the head. Their moist skin was translucent, allowing for a rudimentary assessment of the organs within. The workers were clearly of different ages, suggesting that there was no dysfunction with Eskae’s marr’p - the organ responsible for ongoing worker production.
It seemed to me that there was little benefit in attempting to gather more information from Eskae as a whole. I needed the workers to communicate with each other.
Eskae was tasked with collecting a large sample of sleeping workers and I travelled to the laboratory to collect a hypnometer, a point and shoot EEG monitor used to measure the bispectral index and, therefore, depth of sleep of the subject.
I hate visiting the laboratory - I don’t know how Rai spends so much time down there it’s -
Computer?
COMPUTER
I’m listening.
XAELEST
Delete the last sentence. . . or two.
[SOUND: computer delete]
I spent my walk, and brief float, generating differentials as to what might be the cause of Eskae’s issues. The inside of a cress’p is made of a complex maze of tunnels, acting as a nervous, vascular and excretory system all at once. A tunnel abnormality could lead to chaos, with lost workers struggling to communicate their distress. However, there was no evidence of this on external examination. One would also not expect the effects of a mild tunnel abnormality to have such a profound functional impact.
Esake did not report any trauma - traumatic injuries - which could have hurt the workers and prevented them from communicating. It appeared that Eskae was a . . . dedicated employee. Was it possible that it was so exhausted from its museum job that sleep deprivation had caused some of the workers to become out of sync?
Cress’p reproduce in a similar way to Adrilaen, the mature cress’p grows a new line of workers from their marr’p while making a brand new mech for their offspring. I wondered if it was possible that Eskae had accidentally retained a new cohort of workers. However, it denied that this could be possible and I have no reason to doubt it.
Of course, I needed to consider whether a neoplastic process could be the cause. Often the first sign of malignancy in Cress’p is the presence of a large number of insomniac, and therefore alingual workers.
Eskae had been sure to inform me about their lineage’s history of dream degradation, but at 10.5 Vesta years, it would still be remarkably early to suffer from that condition. Even in the presence of genetic anticipation.
[Sigh] Other things crossed my mind: psychological distress, hormonal issues. I wasn’t sure.
Computer.
COMPUTER
I’m listening.
XAELEST
Delete the last three words.
[SOUND: computer delete]
By the time I arrived, Eskae had arranged a group of themselves into neat, snoozing rows and the glassy workers supervising my examination waved their claws at me in a clear gesture of ‘as you will’. The use of the hyponometer revealed two distinct populations of Eskae workers.
In a deeply sedated state, one might expect a reading of around 40 to 60 . . . around 70% of the sleeping workers I examined had this. However, there was a smaller population with readings that would not go lower than 95. At first I thought the machine might be faulty - stars knows everything else in this clinic is on its way out - but I cross referenced it with the visibly alert Cress’p workers and got consistently normal levels.
The only conclusion I could draw was that these apparently sleeping workers were not actually sleeping.
It was of little surprise that Eskae was struggling to function. The hundreds of usually coordinated lifeforms controlling it were unable to communicate because a significant - um, Rai would likely scold me for using that word. Computer.
COMPUTER
I’m listening.
XAELEST
Delete up to ‘because’.
[SOUND: computer delete]
An appreciable number of workers were not sleeping and therefore unable to communicate with their fellow beings.
They did appear to be sleeping, though. It was almost unnerving.
I returned to my original mental list of differentials. What would cause a worker to be collapsed but awake?
My . . . tutor . . . in interspecies medicine - taught me to never ignore a hunch. The best clinicians were, according to their philosophy, simply the ones most in tune with the organ that they ascribed intuition to. They said gut. For us, a hunch weighs like a mantle of aaringy around the shoulders.
I was reminded of the time during medical school that I spent a summer working on the festival circuit. It was a great excuse to be absent from home while ostensibly still gaining valuable work experience. There was one day where a particularly bad batch of fling made its way around the festival-goers. We only pieced it together when the third person turned up to our medbase, awake but completely absent. We had an antidote within the hour. [Sigh] I miss working on Paisphae. I hadn’t considered it before, but faced with the BIS findings, I wondered if Eskae hadn’t consumed something that was affecting this group of workers in the same way as those anxious party-goers back home.
I explained my thoughts to the anxiously contorted form of Eskae and it twitched in horror, rising from the examination bench without its sleeping cluster of workers as though the increase in height maximised the perceived sincerity. It stomped its fleshy toeroses in denial before seeming to become embarrassed at the outburst and sitting down once more.
I asked for a full list of what Eskae had consumed since a time just before the symptoms started. I knew that this would take time and gained consent for biochemical testing of the sleeping workers. I had to wake them for this. It didn’t feel ethical to test individual workers without individual consent. Particularly when many of them could not communicate their wishes to the rest of Eskae.
Computer, attach biochemical report for patient 5428930.
COMPUTER
No report found.
XAELEST
Computer. Attach biochemical report for patient 5428930.
COMPUTER
No report found.
XAELEST
That’s - there is a report! Stars. Fine! I compared the standard cress’p bioscreen between the sleeping and ‘not-sleeping’ workers. The most striking difference was a raised xanthine level and a low potassium in the ‘non-sleeping’ individuals.
Computer, attach scanned list.
COMPUTER
I’m sorry. I don’t understand the command.
XAELEST
Oh, for - ! Faye doesn’t have this shit with Sec, I’m sure.
Cress’p have a diet of polysyrup, hence why most cress’p tend to live on or near Mars. When Eskae realised that it was going to travel for work, it switched to a different producer of more concentrated polysyrup - Hive 12, I believe it said - so that it would be able to take a smaller volume with it.
It is my current hypothesis that there is something in the new formulation of polysyrup which is metabolising to xanthine and causing a dissociative amnesia in a certain group of Eskae. They believe that they are sleeping, but they are not entering the dream space in which they can communicate with other workers.
I have not performed a scan of Eskae’s mech as I do not believe it would add to the management of Eskae at this time.
I explained the findings to Eskae and my interpretation of the results, taking special care to ensure that the non-sleeping workers could hear me and understand what was happening to them. I could not understand its emotional reaction to the news, but it appeared to perk up when I reassured it that the affected workers should be fine if the causative agent is stopped. It might take them a few sleep cycles to start dreaming normally again.
Given the ongoing uncertainty in this case and the limitations of the clinic’s resources, I will refer Eskae to their local Cress’p sleep specialist on Mars. It may take some time for the communication and functional effects of Eskae’s problem to fully resolve and therefore I recommend that its new care provider books a double appointment for Eskae. Similarly, I have provided Eskae with a note advising time out of work until they are seen by the specialist.
[SOUND: LOUD alarm]
What? Computer! Where is the alarm coming from?
COMPUTER
Main Laboratory.
[SOUND: incoming comms call]
XAELEST
Answer!
[SOUND: comms call connected]
DAKARAI
Hi, honey! Sorry! I don’t know why it’s going off! I just need to - [Grunt as he reaches to hit the alarm]
[SOUND: the alarm stops]
There we go!
XAELEST
Are you okay?
DAKARAI
Oh, yeah! Splendid!
XAELEST
How long have you been down in the lab?
DAKARAI
Oh, you know . . . about 46 hours?
XAELEST
Rai!
DAKARAI
I’ve made a nest, it’s surprisingly comfy!
XAELEST
I was down there -!
[SOUND: incoming comms call, answered]
DAKARAI
Happy new orbit, sleepy head!
FAYE
Is everyone okay? [Yawn] Happy new orbit!
DAKARAI
We’re fine! I think the lab alarms just wanted to call in the new year.
XAELEST
Go back to sleep, Faye. I’ll call an engineer for the alarms. We’re overdue maintenance.
FAYE
[Yawn] I’ll make you both some breakfast. Rai, you need to - [Yawn]
XAELEST
Leave the lab.
DAKARAI
Yeah, yeah, sure. Ooh, I can hear my timer going! Bye, bye, bye, bye, bye!
[SOUND: comms disconnected]
XAELEST
46 hours, he said.
FAYE
Stars. Give me ten, I’ll come and grab the bleep off you.
XAELEST
Sure. [Without thinking] Call me if you - [she realises this is silly] need . . . anything. Before then.
FAYE
[Laugh] See you soon.
[SOUND: comms disconnected]
XAELEST
Computer, return to dictation.
COMPUTER
Starting dictation.
XAELEST
Eskae was satisfied with my plan and I watched the line of workers crawl back into their mech. I was confused when it extended a trembling hand to me before realising and accepting the Martian handshake. It must have mistaken me for human. I appreciated the gesture, especially with the knowledge of how much effort it took them to complete the movement.
I wish Eskae a rapid recovery. It is welcome to return to the clinic in the future if further medical assistance is required.
Computer.
COMPUTER
I’m listening.
XAELEST
Attach signature.
Content Warnings: Mention of dementia, sleep deprivation
