Part 17: Episode 3-5: The Deputy Secretary

Episode 3-5: The Deputy Secretary



Markus: She seems to be recovering well, but it's unclear how the disease was transmitted in the first place. We should continue monitoring her for at least another month.

Irene: I see. Well, it's safe to say that the treatment was successful. How about the pathogen itself? What have we learned? And please keep it brief, Robert.

Cromwell: My pleasure, although our analysis is only partially complete. First, the biopsy: Stigma did not match any known organism. Meaning, it's a new species, so we'll have to come up with a name for it. How about it, Dr. Everett? You'll be a grandfather one of these days…

Everett: My son's only twelve. All he thinks about is football.

Once again, I'm not totally clear on the connection between naming an organism and grandkids, so I just shrug and move on.

Cromwell: Oh, well. In that case, I'll ask someone else. Now, in regards to the spectral analysis: our attempts to determine its structure resulted in failure.

Tsuji: What? How is that possible? I've never heard of that happening before.

Cromwell: We tried a different machine, but the outcome was the same. We screened for nucleic acid, proteins, glucose, lipids and ATP, but there were no matches. Stigma consists of an organic compound that is complete foreign to us.

There are a lot of words here that I'm going to leave alone, but proteins and nucleic acids, for example, are essential parts of life, so not being able to find any is absurd. Which is the point of this speech, I guess.

Everett: What? This will change the way we think about life itself!

Cromwell: Whoever is credited with its discovery will surely make history. From a medical perspective, it's fortunate that Stigma's infectivity is weak. We're trying to culture it, but so far, there's no sign of growth or multiplication. It's going to be difficult to determine the means of infection, as well.

Irene: This is worse than we thought.

Leslie: Madame director, we have an emergency! Deputy Secretary Marshall has collapsed! He may have intra-axial haemorrhaging!

Everett: George Marshall? From the Department of Homeland Security?

Irene: All right. Let's adjourn the conference. Leslie, I want you to prep operating room 3 for him. Vaughn, Blaylock, you two will be performing the procedure. I'll explain the details before the operation, so please go make the necessary preparations.



Tachypnea is characterized by rapid, shallow breathing. More importantly, intra-axial means within the central nervous system. In other words, we have a brain operation coming up.

Valerie: We're waiting for the CAT scan results, but it's most likely a case of subarachnoid hemorrhage.

This means it's actually an extra-axial hemorrhage, despite the initial report.

Irene: This is a chart from his previous admittance. We performed deep brain stimulation to treat his dystonia.

Markus: And he was able to recover from that? That's incredible. Looks like the system's produced by Columa & Cornix, the same company that made Elena's pump.

Irene: Yes, it's not a subsidiary of Humani. If you have any questions about it, you can ask Isabella.

Dystonia is a disorder causing involuntary muscle contractions, which can lead to repetitive movements, weird postures, and pain. There is no existing treatment as effective as the ones in Trauma Center.

Valerie: Director, what's the shadow on the X-ray?

Irene: It's a hippocampus chip. We implanted it at his request.

Markus: He didn't want to forget anything, so he opted to have his memory augmented, huh? I assume they're keeping it quiet. Do we have to worry about being in violation of state law?

Irene: We don't have time to discuss that. Now, the hemotoma is far enough away from the electrodes, but take care when using the thrombolytic.

I probably don't have to tell you that this part is pure sci-fi.

Valerie: We'll head over to the O.R. then.



Here we go again: the aneurysm operation in Under the Knife was one of the more difficult operations in the early game, and was a significant jump in difficulty. For those still unaware, an aneurysm is when a weakening of a blood vessel wall causes a ballooning of the vessel. If this is left, the vessel may burst.

Elena: Here is the results from the CT. Please take a look. A number of aneurysms have been detected. First, we must clear the excess blood from the area, then we need to treat the aneurysms. Remember, this is brain surgery. Please be extra careful when performing this operation.



Markus: Even a tiny mistake could debilitate his brain. We need to be careful.

Valerie: This will require extreme delicacy and dexterity. We need to do our best.

Well, he's not very delicate, but we know that this one goes to…



Markus!



OPERATION VIDEO

Viddler Backup

This is the first operation in a long while that I managed to screw up enough to warrant re-recording it. You're not required to open him up when dealing with the brain, so you can jump right in.



Firstly, you'll need to drain this blood.



This is an aneurysm. It will bulge more and more until it explodes. Since vitals drop quickly on this operation anyway, and explosion is most certainly not what you want. Thus, you use this sedative to shrink the bulge until it's small enough to cut out and remove.



The broken vessel will be bleeding a great deal, so you need to drain the blood, pull the vessel closed with the forceps, and then suture. I usually try for 4-5 sutures as a rule. So long as they're the right size, that should get you a Cool.



After the original aneurysm, you need to deal with three more waves of two at once. The trick here is the fact that once you've used the scalpel on the bulge, it can't grow anymore. This means you can immediately go to the other one without worrying about a burst vessel. However, the untended aneurysm will be draining vitals, so you can't afford to waste time here.



Another word of caution: the game will spawn the next wave as soon as you've pulled the previous two shut. In other words, it won't wait for you to suture.



After the last wave of two is completely eliminated, you need to deal with four at once. As Elena helpfully points out, having more than one of these explode at once would be very fatal, which is why you'll want to use the Healing Touch. Either character is fine, but I happen to like Markus, since he gives you more breathing room.



Just to be a dick, two more will appear once you've closed three of the original four. Your HT will be wearing off around that point, but it's not too hard to handle if you've made it this far.



No need to close up this time.



OPERATION END



I messed up and got a Bad when suturing, so I lost the chain bonus. Without that mistake, you'll get at least an A from this. A little care and vitals-raising should take it even higher.



This rank is about right, though.



Markus: But it won't be long until they're available to the general public. Just like the pacemaker. Professor Wilkins had one. Everyone who's contracted Stigma has had some sort of artificial agent in their body. Even that one patient who was transferred here had Synteq's Q-Heme blood. I was using artificial blood with my test mouse, too. I wonder if there's a connection.

Irene: Dr. Vaughn, can I trouble you for a moment? I wanted to check on the Deputy Secretary's condition.

Markus: I doubt I can tell you more than you already know, Ma'am. Since he was brought here promptly, cerebral ischemia was kept to a minimum. And there were no signs of paralysis, so we shouldn't have to worry about any aftereffects. We can't use the MRI, so we'll take another CAT scan tomorrow. Will you be advising his rehab, Ma'am?

Irene: Yes, I will. I'll also need to administer a personality test. Because of his implant, he must be closely monitored. It's sad, really. He's such a talented man.

Markus: Yeah, I feel sorry for the guy. But I'd like to leave him in the hands of others so I can concentrate on Stigma.

Irene: Agreed. And, Dr. Vaughn, it's a shame that you feel the need to keep secrets from us, but I'm hoping that will change.

Markus: What makes you say that?

Irene: your cutaneous muscles seem a little more tense than normal. I'm out of practice when it comes to reading faces. Was my assessment accurate? You're a critical part of the Caduceus team. I hope you're not thinking of leaving.

Markus: Of course not.

That's all for chapter 3. Chapter 4 is my personal favorite. Thrill as our doctors take on rich people, road trips, and the heart of western culture itself in New Blood chapter 4: Miracle Surgery!