Gill's Surgery (Day 4, Late Afternoon)

“We’re ready,” Dorian answered as he lifted the surgical mask over his mouth. “Sistah, would yah care tah offah a prayer before we begin?”

Ly nodded and began:
“In a ‘Verse full of pain
May we be relief.
In a ‘Verse filled with suffering,
Let there be enlightenment.
May we be the salve,
To all beings in the ‘Verse.”

“To all beings in tha ‘verse,” Adler repeated. “Let’s proceed.”

“Alright,” Batya said over the cortex link. “Dial your mixture up to forty percent.”

Dorian touched the anesthetic mixture regulator. “Forty percent. “Mistah Gill, tell us how yah feelin’?”

“Okay,” the boy’s voice was muffled by his breather mask. “Doc, am I s’posed to go to slee……”

“And he’s out. Sleep cycle vitals established.”

“I concur,” the anesthesiologist replied. “Clear to begin.”

Dr. Palmen nodded. “Good. Tissue debridement first. Dr. Adler?”

Dorian leaned over the wound. “Sistah Lyen,” he said, “take a scalpel. Yah’ll begin. What we want is fah yah tah trim away all those bits of his torn skin an’ dermal tissue. We need tah expose tha damaged muscle.”

The blade in her gloved hand felt heavy, though the steel weighed almost nothing. Adler had prepped her with what to expect, but the nun was still contemplating the healing in cutting. She remembered how steady her hand had felt in Dorian’s eye surgery. Debridement seemed such a different form of healing. She was to cut away, to make clean the torn tissue in Gill’s leg, but it didn’t look like Gill’s leg at all.

There was a surreal nature to the operating field before her. The human was draped and covered and only the sterile field remained; it was as if this young boy were detached from what she was doing as she cut into his skin. The blade followed an arc around where the wolf’s teeth had broken the skin. Not only was it wide, but also deep. Thankfully, there were words and jargon to distance the one holding the knife from the act they were actually performing: ‘Dermal tissue’ was flesh and skin, another means of distancing the wielder of the blade from the human into which she cut. ‘Scalpel’ was the razor that could just have easily torn the skin they were now trying to heal. ‘Debriding’ was the act excising dead, contaminated, or damaged tissue, so sterile in its pronouncement.

Lyen finished her ambulatory cut, forming a neat oval around the wound. She looked up from her work, unsure how she had worked her way around the bite with such gentle lines.

Dorian tapped the freshly excised area with a sponge to mop away a slight ooze of blood. “Looks good tah my eyes,” he observed of the work. “Dr. Palmen?”

“Good. Yes. We’ll require diametric measurements of the dermal opening..for the tissue graft. But now, let’s debride the Soleus.”

“Yeva?” Dorian asked. “Yah up.”

“Yes, Doktor. “

Palmen spoke. “Ms. Schnabel, there’s not so much debridement of the muscle needed, as the attacking canis lupus was exerting maximum pressure to incise. Also, note the grain of the muscular tissue. We’ll be able to save more damaged tissue, provided it’s in sufficiently large pieces.” For the next half hour, Yeva’s movements were directed by a man who sat at roughly a month’s flight time distant. “Not that one,” he said. “Not enough venous network remaining. It’ll go necrotic. That next piece? Yeeesss, nice, fat chunk of healthy tissue. It’s still bleeding. Good.”

As Yeva worked, Dorian quietly guided his newfound assistant. “Sponge that,” he whispered. “”That piece Yeva just worked...match tha tissue grain tah tha underlyin’ muscle an’ lay it down..”

At Dorian’s direction, Ly’s small hands articulated the instruments to sponge and line up the tissue. It was like a jigsaw puzzle of muscles and tendons. When she took a moment to watch Yeva work as she removed the necrotic tissue, Lyen found herself imagining all the different ways that this muscle was moved or how it might have appeared when tensed. She imagined that she could feel the way the veins and muscles and nerves bound together--how they worked in harmony. And so, as Yeva moved, removing one piece of tissue to the next, Lyen followed behind where necessary to reset the healthy tissue.

Once the last of the muscle tissue had been arranged, Palmen instructed, “You’re doing well, Lunar Veil. Now, cut a piece of Biomesh Number Six to cover the exposed muscle. Doesn’t need to be perfect...we just don’t want it to overlap the dermis.”

Dorian took this chore upon himself, trimming a sheet of the biodegradable saline mesh into a rough oval shape. He laid it upon the open site, lifted it to make some small adjustments, and then set it down again. “Sistah,” he lifted his eyes toward Lyen. “Tha heat gun. Kindly run it ovah tha mesh.”

This part felt particularly strange, planting a synthetic mesh within the body to bind it all together. In her hand, she felt the trigger of the heat gun gingerly before arching her wrist to achieve the correct angle. She had so many questions about this process, but seeing as the entire surgery was on display, they would have to wait until after their guests had quit the channel. The gun moved with ease around the mesh, but Lyen’s wrist trembled at the effort of following the clear lines.

With each pass of the gun, the mesh softened and adhered to the underlying tissue. Both teams watched as the sheet took a topographical appearance , it’s crosshatching rising and falling to reflect the surviving muscle.

“Good!” Palmen declared. “Who is doing the painting?”

“Yeva will apply, but Ah was thinkin’ Sistah Lyen might paint.”

“Great,” Lao chuckled. “She’s got quite the following here at VMC. We’ll be publishing this capture, too.!”

Dorian cast a mischievous glance toward Lyen. “Y’all makin’ this difficult...Ah didn’t include ‘celebrity’ as one of her job requirements.” He turned his eyes toward Yeva. “Those two squeeze tubes...labelled Rheumone...kindly empty ‘em both into tha site.”

With a nod of understanding, the widow squeezed both, releasing two thick streams of a clear gel onto the newly applied mesh. She worked to distribute the viscous application as evenly as possible, until each tube sputtered and went dry.

“Sister Lyen,” Dr. Palmen spoke next, “you should have a small brush? Like a paint brush? Please brush the gel across the entire surface. We’re looking for a smooth, even coverage of the mesh.”

Ly couldn’t decide if she was flattered or terrified that this live feed was going in the first place. To think that the entire thing was being recorded was a fear completely different. The first time around she’d known Dorian’s surgery was being recorded, but they didn’t have an audience. It was just the three of them, trapped in the black, rising to the occasion. Her temples tingled as a pink hue broke across the skin. Thankfully her cheeks were covered by the surgical mask. Ly made a slight bow to the capture instead of exhaling because she was sure it would have been a chortle or some awkward unbecoming sound.

Instead, her hands moved to the instrument Dr. Palmen indicated. Ly had painted before, but painting inside a wound was worlds apart from painting houses. The brush splayed as she exerted light pressure over the gel in short strokes. Soon, the two medicines mingled together into a single shining layer along the mesh.

“Rheumone,” Dr. Palmen explained, “is a sort of wonder drug, a combination growth hormone and a myostatin blocker. Myostatin regulates muscle growth in the body. It this case, we’re removing its’ control over this muscle, to permit accelerated regrowth of the damaged tissue. You’ll be reapplying this each day for the next seven days. The results are very exciting,” he said. “This young man should able to walk and begin exercise within three weeks post op. That’s good Sister. Very good work, team! You may dress the site now...don’t forget my dermal measurements!”

“ Two questions?” Dorian asked as Yeva began to apply a protective dressing. “”When should we attach tha dermal graft yah sendin’?”

“Forty-eight hours after the final Rheumone application.”

“Perfect,” the medic nodded. “Any side effects tah applyin’ a myostatin blockah?”

“There is a possibility of migration,” Palmen responded. “Potential muscle growth in other locations of the body. Given the hormonal processes of puberty, your patient may see minor muscular enhancement…”

“Six-pack abs,” Dorian asserted.

“Exactly!” Palmen laughed. “Or other enhancements...biceps, pectorals, difficult to say. Please keep us updated on his progress. You may dress the site now.”

“Sistah? Yeva?” Dorian smiled. “Care tah do tha honahs?”

Instruments placed down on the metallic trays, Yeva and Lyen worked in tandem to gently place the gauze and bandage around the incision site. The drape was finally off their subject, off of Gill, and the reality of what they had just done wormed its way back to reality. She’d been a part of cutting and cleaning and patching and dressing the teen, and the doctors a trillion miles away deemed it a success. Gill would run like any other child in three weeks time. Of that she was thankful. Lyen blinked as she started to feel the fatigue in her knees from standing for the duration of the short surgery.

As the pair set to work, Dorian turned toward the observation window. With a smile that caused his mask to ride up, he delivered a “thumbs-up: signal to Haddie and Serena. “Doctah Lao,” he said to the hospital team, “thank yah, This was invaluable.”

“We agree,” she replied. “You can wake the patient as soon as you’ve finished. Goodbye, Lunar Veil team!”

Once he’d seen the boy’s dressing was complete, Dorian lowered his mask. “Y’all did great,” he grinned. “Tha comin’ week will need tah see us on eight hour rotations. Gill’s gonna rest in mah quartahs,” he cast a glance toward their patient, “Marisol was kind enough tah set up a traction rig fah us tah keep his leg elevated...and yah know what that means,” Dorian quipped as he hoisted a gleaming bedpan before his two assistants. “We suffah and suffah alike.”

As the team cleaned up the infirmary around the sleeping Gill, Dorian keyed the intercom mic. *“This is tha medic speakin’. Our patient is outta surgery. Sistah Lyen and Yevah Schnabel performed about as pretty an operation as Ah’ve evah seen. We expect Mistah Gill tah have a complete recovery.”*