Episode 6 - Growth
Date: 580/1/2732
Patient: Sida Cupress Pinoles. Arbolite
Patient ID: 00952604
Presenting Complaint: New Growth
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To avoid spoilers, content warnings are available at the bottom of this page!
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Transcript:
[MUSIC: The Vesta Clinic Theme]
[SOUND: Door opening, footsteps through dry leaves, chair]
FAYE:
I need to sweep up in here.
[SEC: affirmative ping, typing on screen]
Oh, stars. What has she sent me now?
[SEC: typing on screen, file open]
Have you read this? [Imitating Dr Adra] Dear Dr Underwood, Thank you for your interesting referral, I have completed my assessment and excised the aberrant tissue.
So far, so good. Right?
I have noticed that you are yet to start your clinic letter for this case. Could you please add the following addendum . . . when you get round to it.
[SEC: negative ping]
When I get round to it?! Forgive me for needing both the toilet and a drink. Oh, and I checked that Calyxy's okay after that whole thing with the counterslug this morning.
[Sigh] When I - [sigh] when I get round to it.
[SEC: typing on screen]
No, I'm - It's fine. It's hardly the most passive aggressive message we've had from her, is it? It's just . . .
[SEC: questioning ping]
[Sigh] It’s just -
How long do doctors usually last here?
[SEC: questioning ping]
I know Dr Adra and Dr Solari, Rai - they've been here ages but Rai’s been very cagey about when he stopped seeing patients outside of the research setting and - I don't know. The whole set up of this place is . . . Not what I expected. Like, Dr Adra has been acting senior since the Professor -
[SEC: negative ping]
Sorry. It's just, this exam she's prepping for, Interspecies Management 4? I thought you had to have it before you could have a leadership position.
[SEC: typing on screen, questioning ping]
What I'm asking is . . .
I'm not . . . the job's not cursed, is it? I'm not being . . . Set up to fail?
[SEC: negative ping]
So if I lose my job, it's my own fault?
[SEC: affirmative ping]
Cool, well. Guess there's only one way to find out.
[SOUND: glass against the desk, sipping noise, disgusted noise]
Ugh! While we're complaining about Xaelest. She might know everything, but she is definitely wrong in thinking that this tea is palatable.
[SEC: typing on screen]
Well, I keep drinking it because I'm trying to - like it.
[SOUND: sipping noise, disgusted noise]
[SEC: typing on screen]
Oh, shush. We should do this letter before she comes down here to watch me do it. Ready?
[SEC: affirmative ping]
Date: 580/1/2732Patient: Sida Cupress Pinoles, Arbolite Patient ID: 00952604
[MUSIC: begins]
It was a pleasure to meet Sida in the clinic today. They are a 73 year old Arbolite from the planet Kepler 186f. Sida joined us on route to the Transgalactic Tourism Safety Conference in the - er - where did they say?
[SEC: typing on screen]
Of course it's in the Silicon Towers, where else would it be?
Sida presented to my clinic today concerned about a new lump they’d found on one of their branches. According to them, they had been fit and well prior to departure into our Solar System. Specifically, they hadn't noticed any changes to their bark such as shedding, mottling or thickening - uh - lichenification, that's the word. They reported no branch snapping or a change in the direction of growth. Actually, I could tell that this was an Arbolite who travelled a lot from the way that the leaves sprouting from their sturdy branches grew in different directions, catching light from all angles.
The way we were taught to spot a sedentary Arbolite is if they have a spot you can stand in where every leaf is pointing its verdant fingers at you. It means that they haven't thought about moving from one direct light source in a good long while. Sida described no excessive leakage of sap either. So . . . we don't need to get into what might cause that to happen.
[SEC: typing on screen]
By all accounts, Sida's bark used to be the endlessly rich umber of a young arborlite with no root-partners to share the soil with. However, since arising from the preservation chamber they used to keep them sane and sedated for the long journey over here, they’ve noticed that their bark is now a much greyer, murkier brown. They feel as though the nutrient syrup in their pres-chamber has robbed them of vitality instead of ensuring it.
[SEC: typing on screen]
You thought that they were being dramatic?
[SEC: affirmative ping, typing on screen]
I'm going to be . . . Diplomatic and say that they seemed acutely stressed on a background of already being highly strung.
[SEC: typing on screen, questioning ping]
That is my professional assessment, but it has no place in this letter, okay? Sida also complained of shedding leaves wherever they walked, the shifting movement of their branches enough for the newly weakened stems to bow and release the hard-grown leaves to gravity's whims. . . . Or, even, lack of gravity’s whims. Apparently, the Main Chamber of their shuttle looks as though someone made Autumn into a physical playground with the floating spectrum of orange-brown leaves hanging mid-air in the hub. I got the impression that these physical changes were concerning them more than the lump itself. Perhaps, it was simply bravado -
[SEC: typing on screen]
- Or vanity, yes - but they barely mentioned the new protrusion from their branch in the first few minutes of the consultation. In fact, when I first enquired about it, they kind of ignored me and, instead, reiterated that it was absolutely vital that they looked their healthiest for the conference if they wanted a chance of securing the Visitor Grant.
[SOUND: picks up cup, drinks, places cup back down]
[SEC: typing on screen]
No! I was genuinely . . . Concerned! It was Kepler 186f that destroyed the first colonisers from Earth.
[SEC: typing on screen]
No - they said that applying for the Grant was still a 'topic of controversy' within the settled Arbolite communities, but that the majority believed that visitors who didn't hold 'misguided notions of owning whatever land their boots touch' should be allowed to appreciate the natural splendours of the planet.
[SEC: affirmative ping]
Yes, that was me told. Um, for the letter, let's just say . . . Let's just leave it at, um: Sida felt it was vital that they looked their healthiest for the Tourism Safety Conference in order to impress the committee there. I questioned them about whether or not they had noticed any changes to their health before departing from Kepler and Sida shook their branches at me, scattering a handful of golden leaves to the floor of the clinic room.
The only thing they could think of was that they had to spend a few days without their cricocicadas as the bugs - ah, um, I probably shouldn't call them that - um . . . As the symbiotic insect species departed Sida's branches a few day cycles before they ventured into the preservation chamber. For the uninitiated, cricocicadas are a domesticated pest species on several of the planets in the Kepler system. Through the insects' uncanny vocalisations, the Arbolites can converse with other species in an astonishing range of languages and dialects. 'But you're talking to me now?' I questioned, confused and jumping to a worrying conclusion about the nature of their lump.
[SEC: questioning ping]
Well, there have been reports of the cricocicadas burrowing into Arbolites and -
[SEC: negative ping, negative ping]
- I couldn't agree more. However, they informed me - via the hoarse buzzing of cricocicada - that they had hatched new larvae when they docked with the clinic to avoid any communication issues. I'm struggling to piece this information in with the rest of Sida's presentation, but have included it in the letter in case it becomes relevant in the future. Perhaps, Xaelest will have some thoughts to share.
After much scraping of twigs and rustling of faded, delicate leaves against the ceiling, Sida was able to twist themselves into a position in which I could examine their lump. They explained that their pilot had noticed it when freeing them from the soup inside the pres chamber. Of note, they reported that it seemed to have grown in size in the ten or so hours it took to contact the clinic and point the shuttle over to us. I pulled over the examination light from by the bench and directed it at the spot their long, finger switches seemed to be pointing me to.
This - not for the letter, Sec, but I think you might find this amusing. In a way, it was a relief to finally have somewhere to look. I - really struggle with, uh, anocular populations. I want to show them that I'm listening, that I give a damn about what they're telling me . . . It's hard to do that without eye contact! My eyes snapped to the lump immediately, drawn in by the unmistakeable bulge outwards from the otherwise still fairly glossy bark of the rest of the branch. It looked . . . Fleshy.
[SEC: negative ping, negative ping]
It did! It didn't look like wood at all. It was as though the smooth bark had been peeled away to reveal the wet irregularity of damaged subcutaneous fat underneath. Except, instead of the egg-yolk orange any physician would expect from mammalian tissue, the lump was a rich, glistening collection of peat. A mound of waterlogged soil clinging to their body by a smoother base of flaking bark.
Before I could excuse myself to grab a pair of gloves, I stopped still, fixated on the mass. It moved. I was sure of it. I apologised to Sida as I almost tripped over one of their trailing roots in my efforts to get to closer. It was moving. I could see the moist surface of the mass start to tremble, to pulse and bulge as though shifted by movement underneath. For a queasy second, I thought that my earlier suspicions were about to come true and the clinic was about to be swarmed by the shrieking wings of hundreds of newly-hatched cricocicadas. I held my breath on instinct, and I could sense Sida holding themselves in an unfamiliar, anticipatory stillness too.
The lump continued to twitch, the rhythm too irregular to be secondary to the steady circuit of sap inside them. I exhaled a startled 'what?!' as the uneven face of the lump shifted to allow the eruption of fresh, green stems out onto its surface. I struggled to reply to the worried hiss of Sida's cicadas as the new shoots wriggled free from the mass and twisted until they were facing the light. One by one, too fast to predict which would go next, the protrusions split down the centre, unfurling into twin pairs of delicate, many fingered leaves like each stem was extending a hand to wave at me as it came into being. The growth didn't stop there. The bifurcated stems kept reaching out towards the light, swelling at the point where two apical leaves kissed into a darker bulb. The bulbs continued to expand, revealing a tease of waxy, white petals guarded inside a tight fist of dark green leaves.
'What's happening?' Sida asked.
'It's okay - it's - just . . . . Growing.'
'Just - keep still. Relax.' I told them. In hindsight, I probably could have sounded more relaxed myself. The sight had put goosebumps all over my arms, as though there were hidden shoots beneath my own skin trying to burst through in reply.
I shifted closer still, gasping as the writhing leaves matured right before my eyes - the veins forming lacy networks to deliver water and nutrients to the lush patches of chlorophyll between them. 'It's beautiful.' I whispered, my face casting the mass in shadow as I craned even closer. It . . . It seemed like it heard me. As my words blew through this new network of xylem and phloem, the straining bulbs burst into bloom. The white petals twisted into complex, fragrant spirals, mere centimetres away from my face.
[SEC: typing on screen]
I did not fall. I just . . . Jumped back in surprise.
[SEC: typing on screen]
Even if I did trip a little, it's not clinically relevant and it doesn't need to go in the letter.
[SEC: typing on screen]
[Clears throat] Sensing my patient's discomfort, I sat slowly and gently and very carefully back down in my chair, trying to process what just happened. Stars, Sec. I - I have never seen a tumour behave like that. It was like . . . It was like it had been waiting for an audience. I established with Sida that they were not usually a flowering tree - further confirming the suspected malignant nature of the mass.
For all its beauty, its sudden presence and rapid growth were highly concerning, and Sida seemed relieved when I assured them that we'd be removing it from their branch as soon as possible. Many thanks to my colleague Dr Adra for seeing the patient at such a short notice. She has excised the mass and I will attach her report at the end of this letter.
[SEC: typing on screen]
Oh, come on. If you were Sida, who would you rather did your surgery?
[SEC: questioning ping]
There's a whole thing with excision margins and it was right by a branch junction which makes it even more cosmetically challenging. Like, for all I complain. Xaelest will have done a perfect job. This Arbolite has Board snobs to impress, remember?
[SOUND: picks up cup, drinks]
She has awful taste in tea though.
There's something weird, though. They're 73 vesta years, right?
[SEC: affirmative ping]
How old is that in Earth years? . . . Like . . . 260ish?
[SEC: affirmative ping, typing on screen]
260 years old as an Arbolite equates to about 20 years as a human -
[SEC: affirmative ping]
- Which really explains why Sida Cupress Pinoles is defying half of his community to invite the universe to come party.
Arbolite very rarely get tumours unless they're little baby saplings or actually ancient. We're talking thousands of Earth years old. Which means . . . There must have been something that triggered this. I mean, they probably got a whacking great dose of radiation on the way here. I saw their shuttle and . . . I wouldn't send a loved one on a spin through Space in it. No way. The radiation could have caused enough genetic damage to cause a tumour. But you'd expect their whole body, roots and all, to have been irradiated. Why would they have a single, solid tumour tucked away between their branch and trunk?
I know they said they started dropping leaves after they came out of the pres chamber, but, I do wonder if it all started before then and the stress just masked a few symptoms. Leaves don't tend to drop overnight. In fact, it's known to be one of the hardest parts of being a chronically ill Arbolite: one day, they see the first splash of yellow at the tip of a leaf and they know that eventually every last one will crisp up and float away on the breeze. Oh - and - AND the cricocicadas! They often evacuate a host when they become unwell . . . Am I onto something here?
[SEC: questioning ping]
We know that radiation can cause cancer but what else do we know causes cancer?
[SEC: typing on screen for a long time]
[Sounds of Faye trying unsuccessfully to interrupt him] Yeah - mhm - mhm - yeah. Well, yeah. Um. Yes. Well [sigh], actually, that one's never been proven. Viruses. I was thinking, viruses.
[SEC: questioning ping]
If the Intergalactic evolutionary census can be trusted, Arbolites were once very similar to the trees we used to have back on Earth. That is - not sentient exactly. Then there was a mutation - well, a series of mutations, let's be real, um - a mutation in a virus which had infected half of the Pre-Arbolite population and bam! Sentience.
But what if the tumour on Sida's branch was caused by another mutation of this virus and it too was sentient? What if the mass did know I was looking at it and that's why it responded so . . . Overtly? What if it sensed me somehow? I'm gonna have to call Dr Adra. Can you patch me through?
[SEC: affirmative ping]
[SOUND: outgoing comms call, comms call connected]
XAELEST:
Dr Adra speaking, how can I? - oh. [Concerned] Dr Underwood?
FAYE:
Hi! I, um - was wondering - if the biopsy results had come back yet? From the patient. The - um - gentlefrond from Kepler? It's just that I had a thought about the tumour - what if it's -?
[SOUND: unhappy alien]
Oh.
XAEL:
Let's not break confidentiality. [To the patient] Excuse me, madam, I'll be with you in a second.
[SOUND: footsteps]
FAYE:
Sorry, is this a bad time? Do you have a patient?
XAEL:
I usually do.
[SOUND: door opening, footsteps, door closing]
Continue.
FAYE:
Are you sure?
XAEL:
[As though her patience is being tested a little] Dr Underwood.
FAYE:
Right. Um. So, I was thinking of reasons why such a young Arbolite might have a tumour and I was wondering if it could have been caused by a mutation in the uh, the virus, um, I, uh, can't remember it’s name. But the lesion seemed to react to my presence, so I thought it might be worth investigating that if we still have the tissue sample before they head over to that conference. I mean, if it is a virus, we have no idea what the virility is. They could end up infecting another species!
XAEL:
[Pause] Did you listen to the addendum I sent?
FAYE:
I - uh - I was going to add it to the end of the letter as you suggested.
[SOUND: footsteps, door opens, alien noises]
XAEL:
Call me back later if you have more questions.
[Tired] Madam, please don't chew on those cables.
[SOUND: comms call ended]
[Pause]
FAYE:
So, um, Sec if you wouldn't mind pulling up that addendum?
[SEC: affirmative ping, file open]
XAEL:
Please see attached letter for patient details. This patient was referred to me for the excision of a likely malignant growth on their branch which was first noted after a prolonged Space journey in a preservation chamber.
Examination revealed a sizeable mass on the right ventrolateral branch. The mass had previously flowered when examined by my colleague and, indeed, displayed further phototrophic growth for me. I was unable to elicit any growth in response to my presence alone, despite my colleague's assertions that this occurred. It may be postulated that the tumour was actually reacting to the shadow cast as my colleague's head blocked the light.
I have researched the flowers and found a likely match in the Rosa destiglinosa, a night-blooming flower . . . Which further supports this hypothesis.
The tumour was excised with a 1.5cm margin in an attempt to maintain a satisfactory cosmetic result. I have cautioned Sida that further excision may be required in the future and they have accepted this.
Preliminary histological investigation has revealed a Stage I phloem tumour. I have explained to Sida that this is a malignant tumour, but given its low stage, it is unlikely to recur in the future.
As my colleague will have no doubt explored in the letter above, an Arbolite of this age presenting with cancer warrants further investigation. I suspect that the underlying cause is multifactorial. The biopsy shows evidence of ZMV, a non-sentient viral infection of the phloem. The presence of this virus alongside the prolonged exposure to radiation and the nutrient-rich media in the preservation chambers was likely enough to tip the cells into carcinogenesis. The otherwise normal scan and sap analysis has been attached.
Attach signature.
FAYE:
[Thinking] She has a pretty signature. [Pause] So what I'm getting from this is that Sida is good to go get their grant money and I was right about there being a virus.
[SEC: typing on screen]
We're ignoring the part where I thought the tumour was reacting to me complimenting it, actually. Maybe it was sentient and it just liked me better.
[SOUND: mechanical sounds from outside, alien vocalisations]
[SEc: negative ping]
Let's wrap this up, yeah? Sounds like Calyxy’s got a new patient for us.
Er. Sida has been advised to inform their physician on Kepler 186f of their consultation and to return to clinic if their condition deteriorates before the return journey. They have been provided with leaflets on how to reduce radiation exposure on long-haul travel and how to care for their bark wound.
I - we wish them all the best in their endeavours.
Signed, Dr Faye Underwood and Dr Xaelest Adra The Vesta Clinic
[MUSIC: The Vesta Clinic Theme]
CREDITS
This episode of the Vesta Clinic was created by AMC.
It starred AMC as Faye Underwood, 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: access to hidden memories.
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Content Warnings: Cancer, mentions of colonialism, historical interspecies tensions
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Sound Effect Attributions:
Spaceship compartment door.With pneumatics(8lrs,mltprcssng).wav by newlocknew at Freesound.org
Typing metal plate(reson,rev,DTBlkfx,Eq,Extr,sat,dcmtr)12.wav by newlocknew at Freesound.org
Connect2 by RICHERIandTV at Freesound.org
Critical Stop4 by RICHERIandTV at Freesound.org
glassbottle on wooden table fx.wav by jammaj at Freesound.org
Wounded Alien by Airborne80 at Freesound.org
