TITLE: Make Me an Instrument


SUMMARY: Dr. Kate Pulaski assists in a massive humanitarian effort on post-war Cardassia.

DISCLAIMER: Paramount owns the Star Trek universe and all it encompasses. This is a work of fan fiction, and as such intends no infringement.

NOTE: This story was first written in 1999 for a printzine that disbanded before it could be published. It has not undergone any significant changes since then.


The stench was enough to reawaken long-suppressed, long-forgotten gag reflexes. Doctor Pulaski was no stranger to field medicine--as a Starfleet officer, she had spent enough time on deep space missions and remote worlds to qualify as a hands-on expert--but she had never imagined such extensive devastation could be possible in an era of such advanced civilization. Although she was not a religious woman by any stretch of the imagination, Pulaski prayed she would never again have to witness the carnage that unfolded before her on Cardassia Prime.

Two figures in familiar grey and teal stepped out of the haze at the edge of the landing pad and approached her. Pulaski immediately recognized the woman from her brief stint aboard the *Enterprise* over a decade ago. She adjusted the shoulder strap of her duffel bag and advanced to meet them halfway. "Deanna, it's good to see you again after so long."

"It's good to see you, too," Troi replied warmly. "Thank you for coming. We could use all the help we can get." As if in response to Pulaski's unspoken question, she half-turned to her companion. "Doctor Kate Pulaski, meet Doctor Julian Bashir, CMO on Deep Space Nine."

Pulaski could not help registering her surprise. She had heard so much about Doctor Bashir back in San Francisco, she had assumed he would be much older. This young man looked as if he had only graduated from the Academy last week. Nevertheless, she knew appearances could be deceiving--and Bashir's record in the field spoke for itself. She accepted his outstretched hand. "Doctor, it is an honor to meet you. Your reputation precedes you."

"The honor is all mine, Doctor," he replied with a shy grin. "I can't begin to tell you how grateful we are to have you here."

Pulaski gave him a tight-lipped smile, already preparing herself mentally for the grim task that lay ahead. "How could I possibly turn down a personal appeal from Brother Manny? Beside," she said, wrinkling her nose, "if I'd known the situation was this dire, I'd have been here a month ago."

She followed Troi off the landing pad. On the far side of the tarmac a complex of cobbled-together structures bearing the red and white Doctors Without Borders emblem beckoned the trio closer. Within the field hospital lay what would no doubt prove to be a living--and dying--hell. If the stench and the haggard expressions Troi and Bashir wore with the ease of broken-in jeans were any indication, the worst was yet to come.

"The problem is that we didn't know the situation was so dire until only recently," Bashir explained. "The Protectorate was determined to convince everyone they had the situation under control. We were all so distracted with rebuilding the Federation, no one had any idea."

"How did you find out, then? I can hardly imagine any Cardassian government asking for help under any circumstance."

"You're right. I only found out when a friend contacted me personally. Believe me, Doctor," he said, his prematurely aged face clouded with misery, "Garak wouldn't have said anything himself if he hadn't felt it absolutely necessary."

"Unfortunately," Troi said, "they may not have come to us in time. Excavation teams are still finding bodies in the rubble left during the final hours before the armistice. The air, land, water--it's all hopelessly polluted. Diseases are spreading faster than we can identify and treat them." Her sadness seemed to emanate from every pore. "We've lost over 100,000 people since we arrived."

"We should concentrate on getting those corpses properly disposed of," Pulaski said matter-of-factly.

Bashir nodded vigorously. "We'd love to, if the Cardassians would only let us."

Pulaski came to an abrupt stop and spun on her heel to confront him. "What? Are you telling me you're trying to treat infectious diseases while the source of the infections is still out in the open?"

Before he could reply, Troi came to his defense. "We've been doing the best we can, but the Cardassians have very elaborate burial customs that slow our progress."

"The hell with their burial customs!" Pulaski almost shouted. "People are *dying* out there."

"Kate," Troi said in that deceptively soft voice of hers, taking hold of Pulaski's arm and forcing her to stop and listen, "they've lost so much already. We couldn't bear to deny them this one small concession to who they once were."

Pulaski shook her head in frustration. "I hear you, Counselor, but this 'one small concession' is being made at the risk of thousands of lives. Have you made that clear to them?"

Bashir nodded. "They're aware of the danger. They don't care."

Pulaski threw up her hands in disgust as Troi resumed walking toward the hospital. "Then what are we doing here? If they want to expose themselves to contagion for the sake of clinging to archaic superstitions, why should we bother?"

Troi had no answer, not that it would have mattered; Pulaski had little patience with any behavior that impeded the advance of public health. She followed Troi and Bashir in irritated silence, formulating a plan to impose better conditions, local traditions be damned.

A tall, gaunt man dressed incongruously in a long brown hooded cassock, heavy boots and red surgical mask stepped out of the hospital. Before he had even removed his mask Pulaski recognized him as her childhood friend Manuel Ruiz, Franciscan friar, head of Doctors Without Borders, and, in her unbiased opinion, one of the best damn medics never to set foot in a properly sterilized surgical ward. Pulaski stepped up her brisk pace, her gloomy mood quickly evaporating at the sight of her dear friend and respected colleague.

"Manny!" she shouted, her arms already spread in preparation for his embrace. "I see you still haven't given up that habit of yours."

Thick, coarse wool smelling faintly of antiseptic and sweat enveloped her as Ruiz pulled her to his chest in a powerful hug, almost suffocating her. "How's my favorite godless infidel?" he boomed in a stentorian voice that seemed almost too big for his slight frame.

"Still as righteously atheistic as ever," she managed to reply after he loosened his clasp, allowing her to breathe freely again. "And you?"

"Still praying for your eternal soul."

"I see no introductions are necessary," Troi said from behind.

Pulaski laughed and extracted herself from Ruiz' arms. "Brother Manny and I go way back--so far back I knew him before he got religion."

"I, on the other hand, have never known Kate without a tricorder in one hand and a hypospray in the other, even if the first one were just toys. Speaking of hyposprays," he said, sobering, "I have to inoculate you before I can let you inside." Before Pulaski could protest, he had retrieved a hypospray from within the folds of his habit and pressed the instrument against her arm, injecting what was no doubt a highly complex cocktail into her bicep.

"Let me know if you start to feel nauseous or your vision blurs," Bashir said. "The pathogens responsible for this epidemic are so potent, we've had to up the dosages to near-dangerous levels. I've got counter-agents handy, if you need them."

"No wonder the pathogens are so strong, considering the ideal conditions you've left for them to grow and thrive in," Pulaski said, rubbing her arm where the skin tingled from the injection she had just received. She turned on Ruiz. "Is it true you're actually letting local customs override the interests of public health? That's not just unlike you, Manny, it's against the most basic principles of Doctors Without Borders. I can't believe you would be so foolish as to let sentiment get in the way of common sense like this!"

Anger flashed in Ruiz' eyes, but his expression remained maddeningly placid. For a moment, Pulaski envied his simple, contemplative life. As a Franciscan, he had renounced all worldly possessions, living only by the generosity of others as he traveled from world to world, trying to bring healing and comfort wherever he went. As Manuel Ruiz, however, he gave ten times what he received. Despite her feelings about his dalliance with religion, Pulaski could not help admiring his boundless philanthropy.

"Don't lecture me about principles, Kate," he said with quiet force, "or about this group. You're a volunteer. This is my *life*."

"Spare me your "poor friars" platitudes," she shot back, recovering from her momentary lapse of sentiment. "I don't fall for it as easily as some."

"I should hope you at least remember the oath you took: "First do no harm"? Are you so eager to irreparably harm the Cardassians' mental health by stampeding over their long-cherished mourning rituals? As you well know," he continued, gesturing toward Troi, "and as Counselor Troi can tell you, mental health is a vital facet of public health as well."

"Crap, Manny. What good is their mental health if they're all dead?"

"Doctor," Bashir said, "everyone who comes to us is already dead, or very nearly so. Our greatest concern is making their death as easy and as comfortable as possible."

She wanted to scream and pull her hair out. Instead, she asked, "And what of those who haven't come to you yet? Don't you have an obligation to them?"

Ruiz clapped a heavy, callused hand on her shoulder. "That's why I asked you to come, Kate."

She scowled at him, suspecting she was about to let herself in for more than she had anticipated. "Care to explain, or are you just going to let me find out for myself?"

"Oh, I'll explain soon enough. First, though, I want you to come in and see what you're up against." He pulled a surgical mask from his cassock and handed it to her. "Here, put this on," he instructed, raising his own to cover his mouth and nose.

Pulaski turned to see Bashir and Troi following suit. Somewhat perplexed, she asked, "Why cloth masks? You know they're not nearly as effective as the shields."

"These are less intimidating," came Troi's muffled explanation. "Many of our patients are young children." Biting back yet another angry complaint about the risks they were taking, Pulaski tied the mask around her face and followed her colleagues inside.

"My God." The words escaped her lips before she had even finished the thought.

"Don't blame God for this," Ruiz said, his voice muffled by the mask. "God doesn't exist, remember?" Pulaski glared at him, for once unable and unwilling to retort in the face of such tragedy.

The hospital was packed to overflowing with wretchedness. Beds were arranged in deceptively neat rows, just far enough apart to allow the overburdened medics from worlds all across the Alpha Quadrant room enough to pass between them. Pulaski saw with interest that many of the Human medics wore the heavy brown robes of the Franciscan order. If she knew Ruiz, he had personally harangued them until they agreed to join him on Cardassia just to shut him up. He had used the same tactic on her, with the same results.

She looked around, trying not to let pity get the best of her. She needed to be strong, to be dispassionate and objective, if she was going to help. The reality of the situation, however, was almost overwhelming. Not a single bed lay empty, and many, especially those holding children, claimed two or three occupants. The place reeked of death. "My God," Pulaski repeated.

Ruiz led them down the nearest aisle, stopping at each bed to review each patient's chart. Those strong enough to do so acknowledged Ruiz' presence with a weak smile or slight jerk of a hand. Only the very healthiest managed to speak a greeting.

Pulaski glanced at several of the charts as they passed down the rows, horrified at the details. Dysentery, typhoid fever, smallpox, tuberculosis, tetanus--all diseases that had no place in the 24th century. She saw Cardassians of all ages covered in lesions, their scales mottled with jaundice, blood trickling from their ears and noses, their chests rattling with each labored breath. By all rights, this planet, and everyone on it, should be incinerated. Pulaski wondered if even she would ever leave this place alive.

Ruiz stopped at the foot of one bed and leaned heavily on the metal railing. As if on cue, Bashir went to the occupant, a girl not yet into adolescence, and swept his tricorder over her. The child's skin was so pale and drawn she almost blended into the stark white sheets. Only the oval depression in the center of her forehead, stained and swollen by illness, revealed any sign of color.

"How is she?" Ruiz asked, his voice that could silence a Klingon suddenly as quiet and gentle as a Vulcan monk's.

Bashir shook his head. "Not good. Her fever's spiking again. I could give her an anti-convulsive, but..."

"...she needs to fight off the infection. Counselor, can you tell me anything?"

A shadow passed over Troi's face as she concentrated on the girl. After a moment, she too shook her head. "Her coma is too deep for me to even penetrate it."

"Well, at least she's resting." He turned to Pulaski. "She came to us last night, conscious and alert with only a slight fever. That's typical for many of our patients when they first arrive. Within twelve hours, their systems begin to shut down, one by one. Within 36 hours, the disease has run its course." He sighed and turned back to the girl. "Only two out of every ten of our patients come out of the coma. She'll probably be one of the lucky ones."

"You actually think she'll pull through?" Pulaski asked, feeling, for the first time, hope that they might actually defeat this blight.

Ruiz hung his head. "No, I don't," he said quietly. "That's what makes her lucky."

Pulaski's heart sank. At the gentle pressure of a hand on her shoulder, she looked up to see Troi's astonishingly expressive gaze exuding warmth and compassion. "If it's any comfort, she's not in any pain," she said.

Pulaski found little comfort in Troi's reassurance, but accepted the gift of her empathy anyway. "What of her family?" she asked. "Surely there must be someone out there, worried about her."

Ruiz shrugged, his gaze still concentrated on the girl. "Who knows? She came to us alone--for all we know, her family may have already succumbed to the epidemic, or they may have died sometime during the war." He looked up at Pulaski. "You've been at the front line before, Kate. You know what to expect."

With a deep cleansing huff, he smacked his palms against the bedrail and pushed away. "Come with me, Kate, Counselor. I want to talk to you about your assignment. Doctor," he said to Bashir, who had already moved on to the next patient, "don't hesitate to call me if you need me."

* * *

Four hours later, Pulaski found herself, Counselor Troi and Doctor Bashir crammed into the cargo bay of a ground transport packed floor-to-ceiling with tricorders, antibiotics, vaccines, hyposprays, air filtration units, water purifiers, blankets, antiseptics, dermal regenerators, synthetic blood, field rations, and anything else that might come in handy in the field. Ruiz, as she should have expected, had pulled his trump card on her and put her in charge of a proactive mission to halt the spread of the epidemic. To her relief, he had even given her his imprimatur to encourage the Cardassians as much as possible to relinquish their traditions and concentrate on more immediate, life-threatening matters.

Even with Ruiz' blessing manifested in the cremation unit she leaned against for support as the truck swayed through the crowded streets, however, the blunt force of his reminder for her to be compassionate and sympathetic to the Cardassians' misery hung low and heavy over her head. "Convince them, Kate," he had argued. "Don't intimidate them. Not everybody is as enlightened as you." Then he had cracked a grin at her and said, "And if you succeed, I'll put in a good word for you with Saint Peter." Thirty minutes later, the truck came to a jolting, grinding stop. Pulaski heard voices outside, and realized the truck's arrival had been expected for some time. Mindful of what she had seen in the clinic and expecting far worse out here, she replaced the surgical mask, Bashir and Troi doing the same.

With a clatter and a series of bangs, the rear doors opened, revealing the two burly Klingons escorting them and a mob of filthy, diseased, half-starved Cardassians beyond them.

Pulaski looked at Bashir. "You ready, Doctor?" The young man nodded, his haggard expression fading away as he readied himself for the task he had been called to do. Pulaski nodded in return, then looked to Troi. "Counselor?"

Troi straightened her posture. "They need our help, Kate. Let's give them all we can."

Pulaski snorted mildly in agreement as she crouched to jump to the ground, then turned back to reach into the nearest case for a vial of antibiotics and a hypospray. "We've got a job to do, so let's do it." She faced the crowd, determined to succeed at any cost. "All right, who's first?"

* * *

Twelve days passed in the blink of an eye. In that time, Pulaski, with Bashir's and Troi's tireless assistance, had inoculated so many people against so many diseases she suspected she continued to do so even in her sleep. She took rations in through one side of her mouth and announced diagnoses out of the other. At times she had even found herself conducting triage on three people at once. Sleep, such as it was, consisted of little more than brief dozes every now and then, when she was so tired she could not hold her head up any longer.

In the end, though, she felt pride in the success of her mission: according to Ruiz' most recent status report, not only were fatalities down by five percent, but even those who survived the critical stage did so with better results. For the first time in two months, she learned, he had more beds than patients.

Her greatest accomplishment, however, was in convincing the Cardassians who came to her to give up their traditions and make public health their highest priority. The stench of rotting corpses still filled the air, and the groundwater would remain polluted for years to come, but at least the people consented to burning what new bodies they unearthed rather than let them lie undisturbed until surviving relatives could be located and the elaborate interment rituals could be performed. The cremation unit Pulaski brought along had not stopped humming for a full week.

Now, thanks to the progress she had made, Pulaski had been given a short reprieve. She would be able to take a real sonic shower, wear clean clothes, eat replicated food, sleep on an actual bed and have 78 hours to rejuvenate, before she had to go back out into the field and wage hand-to-hand combat with the epidemic.

At the sound of an approaching vehicle, she crept to the edge of the cargo bay-cum-clinic and jumped to the ground. It was nearly dark, and with the twilight-to-dawn curfew imposed by the Protectorate in an effort to curtail looting, only sanctioned relief personnel had permission to travel after dark.

Two beacons of light pierced through the thick haze, followed soon thereafter by the inelegant hulk of an armored groundcar, its hood emblazoned with the Doctors Without Borders symbol. Pulaski switched on her wristlamp and held her arm high in the air, signaling the driver. The vehicle slowed as it neared, then stopped.

Pulaski was surprised, but nonetheless delighted, to see Ruiz himself climb out of the driver's seat. A Cardassian girl exited from the passenger side. Pulaski hesitated; she did not recall having seen any Cardassians amongst the medics at the hospital.

"What's the matter, Kate?" Ruiz called out with a laugh. "Think you've seen a ghost?"

"What?" she asked, genuinely confused now. Ruiz gestured toward his companion. Pulaski scrutinized the girl under the glare of the groundcar's headlights. After a moment or two, she realized the joke: it was the same child she had seen so close to death almost two weeks ago. "Congratulations, Doctor," she said with a smile. "Looks like you've pulled off yet another miracle."

Ruiz harrumphed. "You're the miracle worker, Kate. I knew that if anyone could convince the Cardassians to see the light, it'd be you, but I must admit, I had my doubts."

Pulaski pressed her hand to her chest in mock outrage. "You doubted me?"

"Me? Not for an instant."

At that, Pulaski laughed and retrieved her duffel bag, eager to leave this hellhole, even if just for a few days. Before she could sling the strap over her shoulder, however, the girl, who until now had only stood in silence, her gaze darting back and forth between the two riposting friends, claimed the bag for herself with a barely audible, "Thank you for all you've done."

Pulaski paused, startled. The Cardassians were not inclined to express gratitude, behaving instead as if they were entitled to the enormous sacrifices of time, manpower and resources being made on their behalf. She could recall having been thanked for her hard work only once before.

On that occasion, it had been an elderly woman who defied the outrage of a group of young veterans offended at Pulaski's presumed disrespect for the dead. Heedless of the clubs they brandished as Pulaski, Bashir and Troi cowered behind a stack of supply cases, the woman had stared them down, then lectured them at length about the stupidity of their "flat-ridged machismo," as she had so eloquently phrased it.

"I lost a husband, two sisters and my only son to the Dominion," she said. "But I lost all twelve of my grandchildren after the war ended. If dishonoring my husband would have saved my grandchildren's lives, then I would have been the first one to spit on his grave!" Then she turned her back to the gape-mouthed youths, walked toward the cringing Starfleet officers, and said, "Thank you for all you've done. Most of my people may be too thick-scaled to realize it now, but you've done us a great service. Why bother with fancy memorials for the dead when most of the living are still homeless?" With that, she tottered off, the browbeaten gang following sullenly in her wake.

Pulaski smiled in fond remembrance of the old woman's courage and wisdom, and, above all, her gratitude. "You're most welcome," she said, resting her hand on the girl's shoulder. Then, in what she would later insist was a moment of temporary insanity aggravated by extreme physical and psychological fatigue, she pulled the girl to her chest and hugged her tightly, squeezing her eyes shut against the impending tears.

Two wool-covered arms long enough to embrace the world encircled the pair as a deep, gentle voice said, "God may not exist, Kate, but in your case I think He'll make an exception."

***** Medecins Sans Frontieres (Doctors Without Borders) is an international relief organization dedicated to providing medical assistance to war-ravaged and poverty-stricken countries all over the world. MSF volunteers work with the national health ministry to rehabilitate hospitals, vaccinate people in remote areas and improve sanitation, as well as train local health care personnel. MSF is also concerned with raising public awareness about crisis situations, speaking out on the behalf of those in suffering. MSF was awarded the Nobel Peace Prize in 1999. For more information about MSF, go to: http://www.msf.org