21. Mucilaginous
Date: 345/1/2730
Patient: Bomoo, Oogaroob
Patient ID: 98573928
Presenting complaint: Auditory Hallucinations
The Professor solves a mystery. Sec does prefer it when their patients don’t ooze.
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Transcript
[MUSIC: The Vesta Clinic Theme]
[SOUND: Comms call]
AERGLO
Absolutely fascinating! [To the unanswered call] Come on, Dr Adra, I have something very interesting for y-
[SOUND: Comms call connected]
XAELEST
Hi Prof, sorry, I was just away from my computer.
AERGLO
Not to worry, Dr Adra! I’m sure you’re hard at work.
XAELEST
Do you need help with something?
AERGLO
Not urgently, please finish whatever you’re doing. But I would be grateful of your assistance when you’re free. I have just met a very interesting patient indeed and I’m looking forward to discussing it!
XAELEST
The Oogaroob?
AERGLO
The oogaroob! I think you’ll be pleasantly surprised.
XAELEST
I’m sure I will, Prof. I’ll be in soon.
AERGLO
Take your time! Sec and I will get our thoughts in order. Speak soon!
XAELEST
Thanks, Prof. Bye.
[SOUND: comms call disconnected]
AERGLO
Right!
[SEC: typing on screen]
I know! This has very much turned my morning around! You know, when I first started working as a doctor I’d complain that it was always the simple jobs that caused me the most grief - you know, you’d go to extract someone’s serum and notice that their temperature was excessively high and they were leaking all over the bed and had twelve angry relatives who wanted to speak to you -
[SEC: affirmative ping]
But now, I find it most exciting when something you expect to be dull turns out not to be.
[SEC: typing on screen]
Oh, good. Marvellous. I do try to make things interesting for you, dear.
Shall we get started while we wait for Xaelest?
[SEC: affirmative ping]
Date: 345/1/2730
Patient: Bomoo, Oogaroob
Patient ID: 98573928
This patient presented with a most unusual symptom for their kind: internal auditory hallucinations. Fantastic stuff.
Sec, dear,
[SEC: questioning ping]
Please could you remind me to send a copy of this letter to Xaelest? It really should be written up for publication and . . . well, I suspect I shan’t have the time to do it myself.
I have simply never heard of something like this before! For an oogaroob to have such an affliction! The wider medical community was of the opinion that their lack of organised nervous system protected them from any kind of mental disturbance! Oogaroob are, in essence, sentient collections of gelatinous tissue, how, how could they have psychoses? I was thrilled to receive the referral!
[SEC: typing on screen]
[Laugh] I suppose I rather am, aren’t I?
[SEC: typing on screen]
I - I suppose I can take my time. Yes.
It was a rare pleasure to receive this referral from my esteemed Oogarooban colleague, Dr Ryookoop My patient is Bomoo, a 14 Vesta Year old oogaroob, hailing from Nereid.
I understand that he has been suffering from auditory hallucinations for approximately one Nereidan orbit, erratic though they are, with no medical professional on their home moon able to satisfactorily diagnose the issue or provide symptomatic relief.
[Slight pause]
The hallucination, perceived as the voice of a fellow oogaroob, came on suddenly. Bomoo recalls first hearing it clearly following a communal feasting. The voice is heard internally and there is no pattern to the person used.
[SEC: questioning ping, typing on screen, questioning ping]
Ah, hm. In this case, I mean ‘person’ in a linguistic sense. Perhaps, I should clarify and say that: The perceived voice will use “I”, “you” or “Bomoo” interchangeably with no appreciable pattern.
[SEC: affirmative ping]
The typical contents of the hallucinations include odd words and phrases. The voice frequently comments on the patient’s appearance, choices and experiences with a critical tone. This led to an initial diagnosis of anxiety with psychosis.
It is important to note that the voice never made reference to Bomoo harming himself or others and my patient has suffered no other thoughts to this effect.
The patient, in their slow gurgle, described no other symptoms including visual or tactile hallucinations, no memory disturbance, no thought disturbance, no self-reported mood or behaviour changes.
On my assessment, there was no speech anomaly. The style and content of Bomoo’s speech was as one might expect, though he was occasionally distracted and lost his train of thought. He attributed these events to hearing the voice.
The patient has no other significant past medical history. What a mystery!
[SEC: typing on screen]
Marvellous, do let her in, please.
[SOUND: Door opening, footsteps as XAELEST enters, door closes]
Dr Adra! Wonderful to see you, please take a seat.
[SOUND: footsteps, chair]
XAELEST
Everything okay, Prof?
AERGLO
Absolutely wonderful. How is your workload this morning?
XAELEST
Fine, thank you. I have that themite coming for her injections but otherwise I’m free.
AERGLO
Good. Wonderful. I didn’t get the opportunity to catch you yesterday, but I thought the workup you did for the young Martian girl was spot on. I was very glad to see that you’d checked her urine before referring her to the nephrologist. We often do get referrals rejected if due diligence hasn’t been performed.
XAELEST
Thank you.
AERGLO
Now, this wonderful oogaroob I called you about. Take three guesses as to what they presented with?
XAELEST
Colour change?
AERGLO
No!
XAELEST
Post-viral hypoviscosity?
AERGLO
No - thank stars! Sec does prefer it when our patients don’t ooze.
[SEC: affirmative ping]
XAELEST
Um, I don’t know. Perhaps some . . . feeding issues?
AERGLO
Auditory hallucinations.
XAELEST
. . . What?
AERGLO
Auditory hallucinations, Xaelest! They are the first known presentation of psychiatric illness in oogaroob medical history! The hallucinations were the only symptoms, no other hallucinations or thought disorder. Other than the voice in their being, they were completely well! An absolute marvel! I have identified an area of tissue which I believe to be the source of the problem and was hoping to rely once more on your surgical skill - I was hoping that you could take a - sample - an excision biopsy - from the oogaroob in the waiting room and then - transfer the sample down to the lab for - Goodness me - for - for - for Dakarai.
XAELEST
Are you okay, Professor?
[SEC: questioning ping]
AERGLO
I appear to have come over quite dizzy. One moment, I - I’m sure I’ll be fine.
XAELEST
Do you want to get on the examination bench?
AERGLO
No, no - No. Thank you, Dr Adra, I’m alright.
[SEC: typing on screen]
I’m alright! No need for alarm.
XAELEST
Prof . . . did you sleep here last night?
AERGLO
No!
. . . Not quite. I had a late case and then Sec and I were . . . discussing it. I suppose I may have dozed off for a few hours.
XAELEST
How many hours?
[SEC: typing on screen]
Prof! You can’t sleep in a chair all night!
[SEC: typing on screen]
It doesn’t matter if it’s a sufficient amount for an adult human, Sec! They -
Did you have your feed last night?
AERGLO
I think . . . I may have forgotten.
XAELEST
Professor.
Calyxy and I have been talking -
AERGLO
Later, Xaelest.
XAELEST
She agrees with me - you’re -
AERGLO
Xaelest.
XAELEST
You look worse every day!
AERGLO
Dr Adra! We agreed the boundaries of this conversation!
[SEC: typing on screen]
She simply means that I look more tired than usual.
XAELEST
If I could just read your letters, I know several people who could offer a realistic second opinion.
AERGLO
Xaelest -
XAELEST
You look very tired. The tiredest I’ve seen you look.
AERGLO
That’s because I have been working very hard with Sec here. Everything is under control.
XAELEST
I’ll come round and help you down to the lab once I have the sample.
AERGLO
That would be lovely, thank you. If you could please also ask Calyxy to kindly help me empty my stoma bag before she goes home?
XAELEST
And put your feed up.
AERGLO
Yes.
XAELEST
Fine.
AERGLO
We can discuss ‘the case’ later.
XAELEST
[Sigh] I’ll be in the lab.
[SOUND: chair]
AERGLO
Thank you, Dr Adra. Don’t hesitate to call if you need anything.
XAELEST
I will, thank you.
[SOUND: footsteps, door open, door close]
[SEC: typing on screen]
AERGLO
Oh, stop it. I very much enjoy staying up with you. You’re excellent company.
[SEC: typing on screen]
Ah, but you didn’t keep me up all night. I slept for longer than I would have if I’d gone back to my pod.
[SEC: typing on screen]
I certainly do not snore.
[SEC: typing on screen]
Ah. I see. Hah. I’m glad it didn’t disturb you. You know, Sec, you’re welcome to play some music or whatever you like whenever the room is empty.
[SEC: typing on screen]
Hm. Maybe you will sleep - dream, even, when this plan comes to fruition. I must admit, it’s often a dull experience. I went through a phase when I first graduated where I completed another shift in my sleep, except I could never get my cannulas in . . .
[SEC: typing on screen, questioning ping]
I do. People keep trying to unplug you. [Laugh] It’s very stressful!
[SEC: laugh]
[Laugh] You like my snoring. I like your laugh.
[SEC: typing on screen, affirmative ping]
Oh! I forgot to ask Bomoo if the voice caused any disturbance to his sleep. [Tuts at self] That’s irritating.
[Sigh] Shall we continue, dear?
[SEC: affirmative ping]
The patient is otherwise well and has no sign of systemic illness. He has no past medical history. He did not take any medications prior to this, but has been trialled on a range of anxiolytic and anti-psychotic medications as per the referral letter.
Bomoo denied the use of any psychoactive recreational drugs.
I am willing to admit that I was at a loss at first. His fluid analysis was normal and the initial scan appeared homogeneously Bomoo. He rippled with irritation as I perused the scan images, complaining to me that it seemed that he’d come all this way just to have the same tests done. He made a good point.
I asked Bomoo to show me exactly where in his body the voice was coming from. He folded and coalesced into a long, thin tendril of semi-transparent goo -
[SEC: negative ping]
[Brief laugh] - and tapped at a spot along his inferolateral border. I noted from the referral, that functional scanning had not been performed. When I added the functional sequences and, with consent, infiltrated radio-opaque glucose into the tissue in the area, I was astounded. There was a small patch of metabolically active tissue at the site Bomoo indicated to me, which lit up in startling shades of fiery orange at the times when he could hear the voice.
But what could it be? A neural tumour? A particularly dense section of Bomoo’s conscious cells? Something else entirely, its relation to the voice mere correlation?
Bomoo returned mucilaginously to his seat and, together, we returned to the history. Bomoo reported first hearing the voice during a communal feasting. For clarification - which may be of use to non-oogaroob physicians who come across this case - oogaroob are ecologically valuable scavengers whose main nutrition source is . . . recently departed lifeforms who passed from other, usually natural, causes.
The oogaroob use chemolocation to gather as a group and overwhelm other scavengers by coating the deceased until it has been consumed entirely. They have no ‘mouth’ as such, but release acidic secretions and enzymes to liquefy their meal before reabsorbing the nutrients.
[SEC: negative ping]
Ah, Sec, we have talked about this! Medicine is not glamorous. It is mushy and sticky and smelly, and that is on a good day.
[SEC: typing on screen, questioning ping]
Out of love, of course!There’s nothing else like it.
My leading hypothesis is that in the scramble to cover their meal, Bomoo may have overlapped with a neighbouring oogaroob and accidentally absorbed their tissue as well as the meal beneath. Once absorbed, the other oogaroob’s cells reorganised into a lump of tissue which retained its ability to think, and this wobble of consciousness synapsed with Bomoo’s own cells in order to communicate.
[SEC: typing on screen]
I couldn’t agree more! Though it would have made larger ripples in the medical community to provide evidence of psychiatric illness in an oogaroob, the suggestion that oogaroob can . . . absorb one another is also important to share!
[SEC: affirmative ping]
For . . . personal reasons, it is also very exciting to have discovered a tissue that can share spontaneous thought once separated from its whole . . . It is generally accepted that most lifeforms can imprint memory on an electronic network, but this does not give rise to sentience within the hardware! A ceresaur’s ship doesn’t become sentient while they fly!
I had always thought that a computer system would be the only option to store and support my consciousness. I hadn’t considered that a - a hybrid system might be feasible; using a tissue with the ability to keep my core engrams functioning while linked to the computer network as a whole.
[SEC: typing on screen, questioning ping]
Yes. We would be . . . linked. As opposed to myself becoming fully virtualised. It will still take rigorous investigation, of course.
[SEC: affirmative ping]
But now we know that there’s a precedent! Oogaroob tissue can hold a non-native consciousness and said consciousness can grow within it!
[Pause]
What? What are you thinking?
[SEC: typing on screen in stops and starts]
Oh, Sec. Please. Yes, it was an unexpected surprise to . . . meet you inside what would have been -
The place I expected to program into a comfortable afterlife. But you have been the happiest, happiest accident of my life. There’s a reason I brave the trip down here from my pod in the depths of the night! I crave our time together.
[SEC: typing on screen]
And I, you.
[Pause]
Goodness! What a distraction you are!
[SEC: questioning ping, negative ping]
I wouldn’t have you any other way.
[SEC: typing on screen, affirmative ping]
Let’s wrap this up, dear.
Bomoo has kindly agreed to allow my colleague to take a biopsy for further study at the clinic and I will refer them for surgical removal of the functional tissue. Please attach the investigations performed at the clinic today.
[SEC: file attached]
Thank you kindly.
[SEC: affirmative ping]
If my proposed theory holds true, surgical excision of the foreign tissue should be curative. It may be prudent for the treating team to seek to contact the GMB for advice on what should be done with the tissue following excision . . . the ‘donor’ oogaroob may wish for it back. It is unlikely that the tissue will survive independently, but given its signs of sentience, it may qualify for medicolegal protection against destruction as any other oogaroob would.
[SEC: typing on screen]
[Laugh] Yes! I don’t envy the junior clinician who gets lumped with that conversation.
[SEC: typing on screen]
[Remembering] Yes! Thank you. The patient has also given permission for staff at the clinic to write up this case for scientific publication.
Have I missed anything?
[SEC: typing on screen]
Shameless flattery! I just nearly forgot something!
[SEC: laughs]
Signed,
Professor Aerglo Rae,
The Vesta Clinic
[MUSIC: The Vesta Clinic Theme]
This episode ofThe Vesta Clinic was created by AMC. It starred Christopher Stoops as The Professor, Ruby Campbell as Xaelest Adra and Sec as himself
Music by AMC and Ruby Campbell. Please check out our show notes for content warnings, transcripts, and your prescription of: vitamin T. If you enjoyed this episode and would like to help the show reach more ears, please tell someone who loves podcasts to check into the Vesta Clinic. You can also follow us on your social media of choice at @vestaclinicpod!
A huge thank you to our Patreon supporters. We hope you enjoy this week’s bonus story and bloopers like this one:
AMC: a hawk with ears. What’s an ear hawk? A bat!
Chris: Do bats have ears?
AMC: [stunned laughter]
Chris: Wait . . . what? Oh! Of course they do! Of course they do! Do bats have ears? I wasn’t sure -
AMC: Oh my god.
Chris: COURSE
AMC: Yeah!
Chris: Oh! Wow!
Content Warnings: Discussion of symptoms of psychosis including hallucinations, thought disturbance, and mood changes; brief mention of harm to self/others (of which there is none); terminally ill character ignoring medical advice; euphemistic discussions of illness and death; stoma mention; non-oral feeding mention
