Medicine

An overview of medicine in the Alliance (and other nations).

Alliance Medicine

Alliance medical technology is marked by its advanced technology, extremely tight privacy restrictions (due in part to the fact that the original Pelted on Terra were sometimes used as essentially lab animals), and a higher number of healers than doctors.

• Medplexes

Alliance Medical Technology

Medimage platform

Medimage Platform

"He was no mechanic but the set-up had come with a basic repair manual; it had contained a long block of explanation on how the Pad technology had made the Medimage platforms possible and then a smaller set of pages instructing Pad technicians on the differences and similarities between the two. He’d glanced through them, picking up several bits of trivia about lights and quantum tunnel disruption before flipping to the troubleshooting sections."

While traditional modalities of surgery are used in the Alliance, the most advanced surgical platform available is the medimage, which uses a variety of technologies (including the breakthrough that made Pads possible) to continuously scan the interior of the body, build a solidigraphic image of it for gross manipulation by surgeons, and then duplicates their motions, in miniature, inside the body. This solves several problems: it allows far more precision in technique, since surgeons no longer have to work directly on a body part; it minimizes invasiveness and injury, while results in patients recovering faster; it allows multiple surgeons to work on the patient without crowding; and it reduces surgeon fatigue, since it allows them to use more of their bodies, in a more natural way, while working.

A surgical theater outfitted to use this technology is a significant piece of technology, consisting of a lower platform (the bed and its emitter); an upper platform, usually mounted in the ceiling (the upper emitter); and side installations for monitoring and power. A minimal medimage platform will allow a third of the body to be addressed at one time, but these small installations are rarer than full body platforms.

The minimal (typical) team for a medimage surgery consists of an anesthesiologist, who monitors the patient’s status at the patient’s head where the displays are mounted. The anesthesiologist is in charge not just of the drugs used during the surgery, but the use of the paralysis field (which is generated by three bands, one at the head, one under the medimage arch, and one at the ankles). The engineer tracks the equipment power and status, and oversees the backup generators; the engineer also addresses any technical issues that might arise during the use of the platform. Larger hospitals assign banks of engineers to their surgical wards, who sit outside the operating theater; smaller locations might seat their engineers inside the theater, depending on their design and procedural preferences.

The minimal surgical team is one principal surgeon and one surgical healer-assist, but some operations may call for more participants. A medimage surgery can be undertaken with a single surgeon but this is not encouraged except in emergencies.

While the Pad technology made the medimage platform possible, there are significant practical differences between them. Pads can operate with only a base station; medimage requires both the base and head stations to generate and maintain their field. Because the surgical platform must remain in operation and stable for continuous periods, its power needs are far greater. Pads have a limited number of functions, all of which can be performed by its single base; the medimage platform is actually a constellation of functions, undertaken by separate modules, all of which must be functioning in order for it to work.

There are multiple failsafes programmed into a medimage platform to reduce the frequency of errors, the most notable being that the manipulative element will be locked out if any of the other technologies fail (power, visual/monitoring, drug delivery, etc). Medical professionals call this the ‘all but, no cut’ principle, based on the frequently repeated line that if ‘all but one thing is operating, you still can’t operate’ made popular in the Tam-leyan hospital that pioneered the technology.

A medimage platform is the preferred vehicle for the procedure that extracts reproductive assets from women for use in float chambers, or for storage.

Halo-arch

Halo-arch, retracted.

The most ubiquitous of medical devices in standalone facilities is the halo-arch, a piece of monitoring equipment capable of minor intervention (in most models) and more complex intervention (for models intended for serious injuries or maladies, Faith in the Service, Chapter 14). Smaller, less feature-rich halo-arches may not be capable of the same tests that larger ones intended for broader applications will. (Earthrise, Chapter 12). Halo-arches can be manufactured as separate add-ons for existing medical beds, but are usually sold as units. The (larger) medimage platform uses a special halo-arch to perform the functions of monitoring and manipulating the patient, and medical personnel will often refer to the patient being under the halo-arch when they are in a medimage theater (since the halo-arch is the pertinent part of the technology, in terms of positioning the patient). Patients coming out of surgery (particularly Medimage surgery) are usually placed in (non-surgical) halo-arches for secondary care/monitoring. (Earthrise, Chapter 8)

Vital data gathered by a halo-arch is usually called a halo scan. (Mindline, Chapter 15)

The emitters are on either side of the bed. Beds that mount a halo-arch (if they don’t come as a single unit) require a stasis tray base, since halo-arches can also hold bodies in stasis. (To Discover and Preserve, the Mayer Directive).

They generate suppressive fields to keep patients from rising; this field can be manually controlled (Alysha’s Fall: Cold and Gentle Dark) or it can be set to automatically generate based on measurements of the patients’ vitals. The suppressive field also generates a shield over the patient to prevent anyone from disturbing them; this field is solid to the touch, though invisible, and “tickles.”(Either Side of the Strand). If the patient is spastic enough that they might injure themselves against the suppressive field, as a last resort the halo-arch will withdraw. (Dreamstorm, Case Study: Wet)

It can also generate a numbing field. (Alysha’s Fall: Cold and Gentle Dark)

There is a call button on the halo-arch, accessible to the patient and to the observer (to summon other medical help). (Mindtouch, Chapter 20). There are alarms (audible to the patient and in the room and that show up on panels elsewhere). (Faith in the Service, Chapter 18). They are also programmed to initiate lifesaving procedures automatically, on being triggered by a critical event in the patient (To Discover and Preserve, the Mayer Directive). Falling vitals are usually signified by a wail (unless this default is changed) (Mindline, Chapter 16). The default sound generated by a halo-arch when a patient’s vitals collapse into a non-viable status is a whine. (Mindline, Chapter 5)

Halo-arches can dispense pharmaceuticals, automatically or ad hoc as directed by a medical technician. (In Good Company, Chapter 16). They handle anesthesia, and also IV functions, using force fields to drop fluid into the body in the location chosen by the physician; this is called halo-pushed fluidics, and it defaults to enteral feeding (through the gastrointestinal tract) rather than parenteral (via bloodstream).(Some Things Transcend, Chapter 2)

An open halo-arch is indicative of a patient out of danger/whose vitals don’t need measurement or who doesn’t need any fields applied. (Alysha’s Fall, Blood Money). The default sound of an opening halo-arch is a rising arpeggio (Mindline, Chapter 16), and the default sound of one closing is a descending arpeggio. (Earthrise, Chapter 26). An experienced enough person can read the musical and aural cues of a halo-arch and determine the status of the person under it. (Laisrathera, Chapter 17) Halo-arches can use a variety of interfaces; the default (as with most alliance devices) is touching or tapping, but it can be reset to work with a particular person’s preference (and it can store multiple preferences and switch between them based on the ID of the person). For those who prefer it, the halo-arch can generate holographs and respond to kinesthetic movements. (Farmer’s Crown, Chapter 8)

Biobed heads can be raised. This does not interfere with the halo-arch, if properly designed. (Faith in the Service, Chapter 18)

• • Chimes with vital signs when active
  • Capable of generating numbing fields, as for wounds.
  • Closed when needed for monitoring vital signs or maintaining fields; open when not
• A steady light at the base of the bed indicates that it's active.
• Has a call panel.

Float Chambers

• embryo flotation: a field holds the fetus suspended as it develops; a monitor in the mother's uterus records body temperature, metablic changes, and heartrate, as well as all the noises the baby could hear, in order to create a real-time portrait of the birth environment. A very old and much iterated technology in the Alliance. Babies born this way still hit the same developmental milestones as their natural born peers.

The sound that generates the data to simulate the birth environment is implanted in the mother's uterus, a procedure that takes less than twenty minutes.

Stasis Chambers

• Cryogenic suspension

"The halo-arch can serve as a stasis unit,” Cecil said. “The only reason we transport bodies to stasis trays is because a halo-arch is a complicated, multifunction device that we need for various procedures, and a full stasis chamber intended for a living body is extremely complex. A tray with a stasis field for a dead body is a simple matter. Less energy intensive, more margin for error."

Other Technology

• That thing that hopefully makes higher gravity not kill you
• Skin sealer

An AAP.

• AAP, sometimes AAP syringe. Stands for Air-Assisted Pump; is essentially a futuristic hypodermic. Makes an assortment of quiet chirps as status responses, unless it is in silent mode, at which point the feedback is haptic. Normal operation of an AAP is not painful or even noticeable. It does hiss.
• Accelerated healing clamps?
• vials of antiseptic bandage--smear it on and as it dries it seals wounds and sterilizes them. It grows cloudy as it dries
• Shock blankets

Procedures

Surgery takes place in an operating theatre, which is encased in a decontamination field. (These are alternately called 'sterile fields', even though technically they're not the same thing. People still use them interchangeably.) People at work in them wear face shields (generated force fields).

• Phobia desensitization therapy

Birth Control

• Birth control does not work reliably for Malarai.

Alliance Medical Personnel

• Healers and healer-assists, trained in the Alliance. Most Pelted are healers or healer-assists.
• Doctors and nurses, trained in the human medical fashion. Less common in the Alliance than healers, but some humans and Eldritch, and even a few Pelted, living in the Alliance are doctors.

Alliance Medical Oaths and Privacy Protocols

• Kelienne (Earthrise, early chapter)

• The Gordon Protocol ensures the privacy of Pelted medical data.

Alliance Medical Insignia

• At least some Healers wear a DNA cadeuceus patch on their arms (unclear if this is specific to Fleet, or not, or something else).
• Nathan and Laelkii Lifeweave's home is marked by a sign of a healer's staff.
• In Sword of the Alliance, part of what makes Laelkii blend in as a medical professional is a medical apron with deep pockets.

Alliance Pharmaceuticals

Legal pharmaceuticals used in medicine. For illegal drugs, see Controlled/Illegal Substances

• anti-nausea patches
• day-after - this is slang for a cocktail of drugs that take care of hangovers and the effects of poor sleep; also known as an 'after-all-nighter' and 'carousing shot'
• erylliacoronade
• mellifleurin - not sure what this is for, but Hirianthial uses it on Reese
• slowsleep
• a synthetic hormone for Karaka'An developed from the firebird trumpet plant.
• A drug for allowing people to operate with thinner air/lower atmospheric pressure than they're used to
• "Wooly blue," a topical anesthetic that dyes anything it touched a fixed ultramarine ("dyed in the wool"). In the Alliance, is only used in cheap emergency kits.

Anesthesia

" ...nepenthe, a rarely used surgery prep cocktail; its narcotic component was unpredictable in Pelted subspecies who had genetic markers in common with the original Terran experiments, compared to other, more broadly useful anesthesia combinations. It had functioned as expected in Acron, as a paralytic, and then the narcotic would have altered the man’s sense of time… at least, until hypoxia had set in, and with it, perhaps, paranoia—a common side effect of the interaction between nepenthe’s constituent drugs, which was why it was administered with a mild sedative like tricodelerine. When it was administered at all."

Chatcaavan Medicine

Females do not merit the services of surgeons or medics, as they are considered replaceable.

Chatcaavan Medical Technology

• Flesh-sealers
• Gel-tanks:
  • Contain a translucent green substance that can be breathed. It heals injuries and numbs and soothes those immersed in it. The tanks themselves are transparent, so the gel (and the patient within it) can be seen from outside.
  • Works better on Chatcaava than on others.
  • Can cause an intermittent state in which the patient suffers pain, fever, delirium, and unconsciousness. This is due to the conflict between the body's memory of injury and the body's healthy state. The effect is very unpleasant, but wears off every time.
  • Is not used for minor injuries (and "minor" to a Chatcaavan inside might be "devastating" to a non-Chatcaavan).

Chatcaavan Medical Personnel

• Chatcaavan surgeons, who are Outside, and who have leeway in their behavior and level of respect because they are so sorely needed by males Inside.
  • Medical personnel Outside are not politically obligated to anyone and are not subject to the duels and honor wounds of those Inside; their properties include similar protections (which extend to those sheltered within them). However, they also must maintain strict neutrality to politics, and cannot maneuver for political gain. To become partisan or seek political power is to become Inside. The power that they have is due to their skills, which are especially needed by males Inside, making them valuable members of Chatcaavan society Inside.
• Triage, a male who sits at reception in a clinic and directs patients according to need.

Chatcaavan Pharmaceuticals

• Hekkret, a medicine and recreational drug for Chatcaava (and a poison for most members of the Alliance)
• Bit (pronounced 'biht'), a euphoric that can be blocked from action by a different drug prior to ingestion/inhalation; this chemical acts as a soporific on Pelted and human-based species; scent is lighter and more acrid than hekkret, and the smoke is thinner, more liquid.