Episode 8 - Test Tube Baby
Date: 604/1/2732
Patient: Novel Organic Sentient Lifeform Eleven.
Patient ID: 77347785
Presenting Complaint: Nausea and vomiting
If you’ve never seen a patient like zir before, it might be because there’s never been a patient like zir before.
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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]
FAYE:
See - see this!
[SEC: questioning ping]
This is why I wanted this job so badly. Oh my stars, you can't tell me that you've ever seen anything like that before, Sec. I just refuse to accept it.
[SEC: typing on screen]
I - I do know what Dakarai would say - what's he's going to say when I tell him - and I bet you it involves certain body parts and certain Martian monuments.
[SEC: affirmative ping]
You know, when you told me that Do'oo'too had finally been accepted into that community near Aurore Planum, I was utterly content with that being the best thing that happened today. But this . . . This is something to write home about!
[SEC: typing on screen]
Okay! [Amused] Okay, I will. But I'm telling you, there won't be anything more interesting than this in the waiting room. We should savour it.
[SEC: negative ping]
Date: 604/1/2732
Patient: NOSL11 - that's uh, Novel Organic Sentient Lifeform Eleven.
Patient ID: 77347785
Um, the clerking sheet says 'no fixed abode' but I think we can be a little more accurate than that and state that the patient has asked for this information to be withheld.
[MUSIC: begins]
It was truly a delight to meet NOSL11 in clinic today, who attended with zir partner Jien. Jien is a human from Io and currently works as a lab assistant in the Hygianine Industries food production facility on the nearby asteroid of - well, I shouldn't say, should I? Scrap that last bit, Sec. Please?
[SEC: affirmative ping]
NOSL11 is a 4.5 Vesta year old . . . being.
Sec -
[SEC: questioning ping]
- Let me tell you, it has been a minute since I've had a patient whose species I didn't recognise at first glance.
[SEC: typing on screen]
[Embarrassed] Was it that awkward?
[SEC: affirmative ping]
I usually start with a: 'Hi, come in' and I think I got that out okay. I remember flashing Jien a smile as he crowded through the door and getting a slightly nervous one in return. Then, my eyes landed on the peculiarly asymmetrical ones of my patient as Jien led zir in and the 'Please, take a seat, can I take your full name and date of birth' kind of died in my throat.
'Jien, I don't know if this is a good idea.' NOSL11 mumbled in an airy vocalisation that I couldn't pin on a particular population. I noticed the way Jien's large arm was wrapped tightly around zir shoulders, half shield, half ballast.
At that point, I apologised profusely, trying to be more sly as I looked zir up and down. As they shuffled into the offered seats, I was almost settled on the idea that ze must be Themite, with some kind of congenital dysmorphism that I hadn't ever come across.
Jien apologised to me, explaining with a tone laden with meaning, that NOSL11 had not had good experiences with doctors in the past and so ze was very nervous to be here. He linked their fingers together, mumbling something supportive that wasn't meant for me to hear.
So then, I apologised again, and said that I'd love to help zir. If I seemed off, it was only because I didn't know how I was gonna help yet, because I didn't know what ze was.
'Not that I'm trying to pigeon-hole you.' I amended, to the general confusion of the rest of the room.
[SEC: typing on screen]
Yeah, I keep forgetting that some phrases don't make it through Earth's atmosphere.
What I was trying to say, is that, throughout my training, I was taught to think about patient presentations in a specific, organised way. For example - ooh, let's think of Do'oo'too - for example, when a Troglodan presents to the clinic, I have, like, this expansive imaginary flow chart of all the things that could likely be wrong, and I start trying to move through it the minute I lay eyes on them. It's impossible to do that when you have no idea who you're looking at, and it really threw me off.
'The reason you haven't seen anything like me before,' NOSL11 told me, 'Is - Is because there's only one of me in existence.' There was something in zir voice . . . Like ze was almost proud and found that same pride had a sour taste.
I must have looked baffled. Jien squeezed zir large hand and NOSL11 blinked twice in what must have been some kind of silent acquiescence.
'I assume you've heard of the SwiftSwitch Laboratory at the University of Waltraut over in Eos?'
Immediately, a number of things made much more sense. I clarified that the lab he was referring to was, in fact, the same one that had been completely shut down after an insurmountable amount of evidence surfaced regarding generations of illegal science. Stuff like conconting the next Venusfire, messing around with banned poisons and . . . It would seem . . . Creating brand new lifeforms.
All considered, it's not surprising that the place burned for so long -
[SEC: questioning ping]
- Given just how much of the Universe's most dangerous explosives were being stored there. Jien looked like he'd watch the laboratories burn a hundred times over. But . . . Um, you can leave my speculation about that out of the letter.
[SEC: affirmative ping]
The reason for NOSL11's attendance at the clinic despite zir understandable mistrust of, uh, healthcare professionals, is because ze had started vomiting regularly since settling into zir new life elsewhere on the Belt. Jien had begged zir to seek help, and I sensed that their real fear was that this was the start of a slow and inevitable decline in NOSL11's health now that ze was free of the laboratory.
I admitted to the pair that the case was, um, very unusual and that anything NOSL11 could tell me about zir biology would be incredibly helpful. NOSL11, as it turned out, knew quite a lot. Ze said that ze is a carbon-based organism who primarily uses aerobic respiration, but can switch if needed. Ze has 48 chromosomes, but ze doesn't know more about zir genetic make-up than that.
It transpired that Jien was also a font of knowledge about NOSL11's biological make-up as he had been a post-doc student in the very same laboratory in which ze had been created. I like to think that he was one of the whistle-blowers but, again, that's just speculation.
[SEC: typing on screen]
Thanks.
According to Jien, NOSL11 was designed by SwiftSwitch herself to be the new ideal of sentient life: smarter and faster and better than anyone else in the Belt and beyond. NOSL11 screwed up zir face at this. It was strange, seeing such a human expression on such an inhuman face. But it makes sense if all zir companions so far had been human.
[SEC: typing on screen]
I didn't want to say, but that's exactly what I was thinking! What a narcissistic oversight, to create a 'perfect' organism and then just teach it how to be human.
[SEC: affirmative ping]
In terms of what finally brought NOSL11 to the clinic, zir vomiting first started around 8 weeks ago, which was, uh, 10 weeks after settling down into zir new life with Jien.
[SEC: affirmative ping]
The episodes have been occurring up to three times a day and tend to affect zir more in the morning. When asked about the consistency and contents of the vomitus, NOSL11 replied that it was usually just their breakfast, and occasionally some blue bile but ze had never noticed any blood. I felt the need to clarify what breakfast actually was for zir. NOSL11's needle-like teeth didn't seem particularly designed for toast, but apparently ze can tolerate a fairly standard human diet, alongside a range of other foodstuffs.
I attempted to question NOSL11 about zir bowel habits, but ze either didn't understand the question, or was too embarrassed to answer. Jien was able to step in and explain that NOSL11, like a bird, produces solid stools and uric acid crystals instead of liquid urine.
[Sigh]
[SEC: questioning ping]
The pair of them were so cute. Honestly, I don't think there is a single person in the universe who would talk about my pooping habits with that much tenderness in their eyes. I can't even get my girlfriend to call me back sometimes.
[SEC: typing on screen]
[Arguing] Sometimes.
[SEC: typing on screen]
Well, you're not putting that in the letter.
[SEC: typing on screen]
NOSL11 reported no fever, myalgia, weight loss, weight gain, fatigue or abdominal pain. After asking those questions, I realised that I was still trying to force the consultation to fit into the neat little paths I've created in my head for other species. There was such a risk that I'd neglect to ask something crucial. So, like every good medic -
[SEC: typing on screen, questioning ping]
- No! I didn't do a blood test, I did a top to toe assessment.
[SEC: negative ping, typing on screen]
Hold the derision, please. I thought that this letter could now act as a new record of NOSL11's existence given the destruction of everything else.
[SEC: affirmative ping]
Starting with the head, then. Zir pointed, brachycephalic skull houses a brain, two ears and three eyes. Ze has one larger central eye with a distinctive turquoise iris for colour vision and two, smaller, black eyes either side, one higher than the other, which apparently aid with night vision. Ze has only two diagonal slits for nostrils, but ze reliably informed me that zir sense of smell is far superior to a human's. NOSL11 reported no headache, no issues swallowing, no apparent neurological changes, no visual disturbances, no fits, faints or funny turns and no changes to zir cognition.
Oh! Jien interrupted here to insist that, if anything, NOSL11 had become even more intelligent since zir new freedom given the vast amount of new stimuli ze came into contact with each day.
Um, moving on, NOSL11 has a thin torso, with a set of . . . Fourteen -
[SEC: questioning ping]
. . . I’m counting them in my head. . .
Yeah. Fourteen ribs - uh - protecting a pair of lungs and a pair of hearts.
'We don't know why they gave me two hearts.' NOSL11 said.
'Two hearts has got to be better than one?' I suggested.
'Twice as much love to give.' Jien nudged zir and, though nauseating, the comment did help me figure out that NOSL11's blood must be red, because the greenish hue of zir skin became the first blush of a ripening peach.
When questioned about chest pain, NOSL11 said that ze occasionally had a burning sensation in the chest after vomiting, but denied any other chest pain. Ze also denied shortness of breath, cough and any palpitations.
Having already asked a number of questions about NOSL11's GI system, I also clarified that ze hadn't noticed any bleeding or any new lumps.
From a musculoskeletal point of view, NOSL11 has four limbs, which appear to function equally as well bipedally and quadrupedally. NOSL11 had no complaints about any of zir joints.
[SEC: typing on screen, questioning ping]
Okay, yeah. I can summarise. [Clears throat] In summary, NOSL11 presented today with 8 weeks of non-specific nausea and vomiting. There were no other concerning features within the constraints of my current understanding of NOSL11's underlying physiology.
[SEC: typing on screen]
Thanks.
Despite my best efforts at history taking, I knew we were going to need to get some imaging if we wanted to know what was going on inside NOSL11's unique body.
However, it became immediately and abundantly clear that my patient would not tolerate the usual scanner. The reason for this was two-fold. Firstly, the scan makes a very distinctive set of noises as it works through its imaging sequences, noises that NOSL11 has panic-inducing associations with. Secondly, NOSL11 is not yet convinced that ze wants any medical or scientific organisation holding records about zir which could easily be shared and exploited.
While this will no doubt be a source of frustration for the rest of the medical team who could not be present for the consultation today, I was able to make a compromise with NOSL11. After a lengthy discussion, ze agreed to allow an ultrasound scan of the abdominal area as the image alone wouldn't be enough to identify zir, but still had the potential to identify the cause of the vomiting. Most importantly, Jien would be able to hold zir hand throughout the entire scan.
Off record,
[SEC: questioning ping]
I'll admit that this was a pretty long shot on my part. Ultrasounds have their uses, but the detail they show is no better than screen static compared with the images from the main scanner.
[SEC: negative ping]
I was really hoping to find evidence of something going on that I could confidently diagnose or . . . Use as leverage to convince NOSL11 of the need for further scans. Of course, given what we did find . . . It's probably a good job that I didn't whack zir full of ionising radiation . . .
[SEC: affirmative ping]
Back to the letter . . .
I examined NOSL11 before setting up the ultrasound scanner, hoping to correlate what I could feel with the scan images. On inspection of the abdomen, there was the distinctive pale line of a laparotomy scar stretching from the tip of zir sternum down into the pelvis. I think - despite all the talk about zir nerves regarding coming to the clinic and how much ze was benefiting from being away from that awful place in Waltraut -
When I saw that scar, that's when it properly hit me . . . This person . . . This delightful person had spent most of their life as a - a playground for that group of people who do not deserve the title of scientists. NOSL11 must have seen the shadow on my face because we shared a long, wordless look before ze tapped my hand with the back of zir's and asked me to get on with it before ze changed zir mind.
The examination didn't reveal anything of particular clinical relevance. The abdomen was soft throughout, with no areas of tenderness or obvious masses.
I proceeded with the ultrasound scan, using the settings I would use for a human of about 60kg, given NOSL11's size and humanoid frame. Pressing the probe into the area beneath the rooftop of the ribcage revealed a number of irregular, fluid filled circles stacked next to each other. I determined that they were nothing more sinister than a procession of bowel loops and could not see any areas of dilatation or inflammation.
NOSL11 winced as I smeared the cold goo further down the line of zir scar. Jien had dropped into a squat by the bench, half-watching the shifting greyscale on the monitor as he murmured to NOSL11 about how the jelly acted as an acoustic couplant to give us the best view possible. It was . . . Kind of endearing and I was grateful for his calming presence. At least . . . I was grateful until he . . . Stopped being a calming presence.
Can you pull up the images, Sec?
[SEC: affirmative ping, file open]
Stop! There it is.
[SEC: affirmative ping]
With the probe scanning the area between NOSL11's hip bones, an enlarged, fluid filled sac came into view. Inside it, a jittery swirl of silver pixels formed a stumpy but unmistakable mass. One that swayed slightly in the currents of amniotic fluid surrounding it and kicked out with the blurry protrusions of what looked like legs in response to all the attention.
My excited inhalation was completely drowned out by the shrill demands from Jien to know what it was and why it was moving. I hadn't realised that NOSL11 had a set of retractable claws until ze punctured the plastic coating of the examination bench, leaving a set of circular holes which, to be honest, balance out Ikogrisk's graffiti quite nicely.
We found ourselves in a sort of stand-off, NOSL11 and Jien becoming more frantic in their cries to know what was going on.
In an ideal planetary system - [sigh] Look, it's not how I would have chosen to deliver the news that the most singular lifeform in the Universe was about to become less so . . . But -
Top tip: if you need someone to stop screeching at you, shouting: 'you're pregnant!' will probably do the trick.
[SOUND: scrolling]
I always think that looking at a baby on ultrasound is a lot like stargazing.
[SEC: questioning ping]
Stare long enough at it, and you can connect the white lines of light into just about anything you want to see. That being said . . . I think that
[SOUND: scrolling]
There - is a big, wide eye. Just like NOSL11.
With everyone finally settled and the remnants of gel wiped off NOSL11 and all the things ze managed to touch in zir panic, I delicately turned the topic of conversation to 'how might this have happened?' I don’t know what was suddenly so interesting on the screen, Sec, but they both stared at it, or the floor, or the ceiling, until I asked them directly if they'd been having any kind of sexual contact.
In fairness, NOSL11 admitted that ze had no idea that ze even had a reproductive system, even less so one that would be compatible with human gametes. Ze turned the question to Jien, who told us in a flustered sequence of stops and starts that looking into that aspect of your crush's lab notes is not the done thing.
Jien needed several rounds of reassurance that the moving mass inside NOSL11 was a baby and not some kind of parasite causing zir to vomit. I stopped myself from reminding him that it really all comes down to how you think of foetuses.
The shock gradually ebbed away and was replaced by a flood of barely restrained delight.
[SEC: typing on screen]
It was. It was so nice. So much of this job is the medically mundane consultations that keep people ticking over as they jet across the galaxy. Sometimes it’s a day of bad news after bad news. But, being able to be a part of something like this? Like I said, it's why I really wanted the job.
Eventually, the conversation turned to what needed to happen next. We know that zir foetus appears to be alive and happy right now, but with its surprising genetic cocktail, unfortunately, there's no way to predict what might happen further along in the pregnancy. I wish that I could offer guarantees to the young couple, but I think it's vital to acknowledge that there are risks that we can't even imagine yet. In light of this, I explained to NOSL11 and Jien that I think this case would best be managed as a team effort with the joint experience of myself, my senior, Dr Adra and Dr Solari, who would be able to provide invaluable scientific support from the Clinic's Research Facility.
[SEC: typing on screen]
[Sigh] Ideally, we would have gone straight down there for further investigations but, given NOSL11's past, it was foolish of me to even mention the Research Facility and not expect the colour to leech out of zir scales as though they’d been delicately painted in ink and I had just dumped a bucket of water over zir.
There was a loud, insistent part of me that wanted to keep pushing, to protest that it was impossible to feel uncomfortable around Dr Solari once you’d met him, or that Dr Adra was the safest pair of hands in the Asteroid Belt but . . . I imagine it wouldn't have made a difference. I was sure that there was far more to be gained through a gentle compromise than by pushing NOSL11 into a stressful situation.
Considering this, we agreed that I had NOSL11's permission to discuss the case with my colleagues and ze will contact the clinic in a few weeks when ze is feeling more ready. I really cannot express how seriously the couple should take this news, and they must seek urgent medical attention if anything at all changes.
In the meantime, though, we discussed some practical things they could be doing to increase the chances of a successful pregnancy.
Firstly, they need to prevent further pregnancies with barrier contraception or complete abstinence from penetrative sex. Let's not complicate an already complicated situation. No smoking, no alcohol, no drugs. Try to avoid any trauma to the abdomen.
I am unsure what is safe to offer NOSL11 for zir hyperemesis gravidarum - the Morning Sickness - but I have suggested that ze tries to get hold of some Earthen ginger as, while the evidence into its efficacy is sparse, it's highly unlikely to cause any adverse effects if NOSL11 is already tolerating human food.
The pair were adamant that all of NOSL11's records had been destroyed but, if it's safe for them to do so, any information they can gather would be a huge help in our understanding of how to best support NOSL11 going forwards through zir pregnancy.
On a similar note, every member of medical staff at the clinic will be required to help during and after the birth. I took a moment to link NOSL11 to some resources for expectant parents with anxiety as ze refused a referral for psychological support at this time.
I -
[SOUND: incoming call]
Sec?
[SOUND: call answered]
XAELEST:
What's this on your list here?
FAYE:
Hi?
XAELEST:
You have a patient that has been coded as 'unknown'.
FAYE:
Oh! Yeah, I was just doing zir letter. You know the SwiftSwitch fiasco?
XAELEST:
Excuse me?
FAYE:
I know! And - you won't even believe it - ze came to us with vomiting and ze's pregnant! I was literally just about to -
XAELEST:
Where are ze now?
[SOUND: chair through the call]
Faye?
FAYE:
I can explain . . .
XAELEST:
You let zir leave?! Stars -
FAYE:
Well, yes! Ze was terrified! Ze didn't even want to come into the room with me!
XAELEST:
Have you lost your mind?
FAYE:
Look, I know this isn't what you need with all your revision at the moment but I really think -
XAELEST:
You should have escalated this to me immediately.
FAYE:
I tried. Ze was shaking. I think the pair of them would have run out of here and then any semblance of trust that I'd built would have been broken.
XAELEST:
No, this is [sigh], stars, this is incredibly complex. Sometimes it's got to be more about safety than trust.
FAYE:
Ze seemed to trust me more than you do.
XAELEST:
That's not -
I am seeing an alarming amount of self-confidence developing in your practice, Faye, and it needs nipping in the bud before it becomes recklessness.
[SEC: negative ping]
FAYE:
What?
XAELEST:
I know that you're trying to impress Dr Solari and I, but that can't come at the expense of patient safety.
[SEC: questioning ping]
FAYE:
You know what . . . I think . . . I think you should read the letter. And then . . . If . . . You can't - If - If I don’t see you then . . . Good luck for your exam.
XAELEST:
Faye -
[SOUND: Sec ends the call]
FAYE:
Sec! She's going to think I hung up on her!
[SEC: typing on screen]
Yeah, I know she shouldn't, but have you seen her lately? She's . . . just very stressed about this exam.
[Pause]
This is the thing that pisses me off!
[SEC: questioning ping]
There's just - Phobos will crash before Xaelest Adra fails an Interspecies Management exam. She knows more medicine than Rai and I put together. And we know enough to keep people safe. Stars.
[SEC: typing on screen]
You don't have to say that.
[SEC: typing on screen]
Still got that letter open?
[SEC: affirmative ping]
From a clinician's point of view, this case is easily the most interesting one I have seen in my admittedly limited career but I caution other team members in the future to be careful in their approach with regards to invasive investigations and treatment. It clearly took a great deal of bravery for NOSL11 to visit us today and it would be detrimental for that trust to be misplaced.
As it stands, I truly expect to hear from NOSL11 in the next few weeks to arrange a follow-up appointment, hopefully with the involvement of my colleagues.
Happy with that?
[SEC: negative ping, typing on screen]
[Laugh] No, she can read it as it is.
[SEC: typing on screen]
Yes, I am aware that I complimented her.
[SEC: typing on screen]
Signed,
Dr Faye Underwood
The Vesta Clinic
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: teeth whitening! But not the teeth you’d expect. . .
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! We'd love to see you there!
Content Warnings: Experimentation on a sentient being (presumed without consent); Surgical scars; Contraception; Anxiety with panic attack symptoms; Pregnancy; Vomiting mention (no sound effects)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Sound Effect Attributions:
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