Oh boy! This is my first attempt at a medically-heavy fic, so I hope it worked out! This PWP is simply Shep-whump for the fun of it - and for Titan5 who requested it as her Secret Santa fic. The prompt was "a story where Sheppard gets sick, mild at first (seems like something simple), but then just continues to get worse and worse as Beckett tries to figure out what's wrong with him." I hope you enjoy it Titan5! Thank you very much to Linzi for doing an 11th hour beta, too.
A Day In The Life...
John sat in the sweltering sun, already bored with the trade negotiations between Teyla and Shannook, the clan headman. John's team and Shannook sat in the centre of a cleared area between the hatched-rooved clay huts of the village and the stockyards. John surmised that the clearing served as the village marketplace, as well as an all purpose meeting area. They were surrounded by a dozen or so dirty villagers, armed with an assortment of swords, longbows and crossbows, who optimistically declared themselves to be the headman's honour guard. More dusty and ragged men and women drifted in and around the negotiation party, displaying varying degrees of interest in the process.
He wished that he could have joined Ronon and the hunting party that had headed out an hour earlier, but as team leader the villagers expected him to participate. Not that he had anything to contribute, but they had discovered almost immediately that these rude villagers lived a life steeped in tradition, and deviation from their rituals was met with a cold disapproval and hostility. He looked sourly over at McKay, who had convinced the negotiating party that it was a part of their own ritual to record the proceedings. The scientist was now nursing a laptop and happily ignoring the entire procedure; he was immersed in God knows what, only looking up occasionally to smile and nod in order to maintain his pretense.
John slapped at a crawling insect in a vain attempt to convince it that his neck was inedible and watched a hexipedal Friesian plod serenely past them, oblivious to its importance in the negotiations of its human neighbours. He noted sourly that the cow was also seemingly oblivious to the manure-scented stench rising from the sunbaked cattle yards next to them.
John returned his attention to the matter at hand, struggling to keep his boredom from showing on his face as Shannook gravely informed Teyla that the meat and cream from their strange, six-legged cows were far too rich and flavoursome to be traded for the dubious benefit of an untried irrigation process. John scowled; these people were so backward it was surprising they didn't trip over their asses as they walked.
"Great," he thought to himself. "Now I sound like Rodney." He scowled and slipped on his sunglasses, trying to ignore the heat and stench.
The tediousness of the negotiations came to an abrupt halt however, when he found himself suddenly ringed by three sword points, and an equal number of steel-tipped arrows and crossbow bolts. He aborted the move to his P-90; the villagers may be squalid, but they had the element of surprise; in this case the hostility had come completely out of the blue. John raised his hands in what he hoped was a calming peace gesture, and looked around to discover that this aggression was obviously only aimed at him. Teyla stood next to the headman, talking in a low calm voice, but with an undisguisable undercurrent of anger.
If John wasn't held hostage by extras from the cast of Conan, he would have laughed the expression on Rodney's face. The bewildered scientist was clutching at his laptop as a burly villager manhandled him towards Teyla and Shannook. John relaxed; if they were in serious danger then Teyla and Rodney would have been taken prisoner as well. They still had their radios, and Ronon was not far away if they needed help. He tried to look harmless and inoffensive, content to keep a wary eye on his captors while Teyla got to the bottom of things.
Elizabeth sighed and leaned back in her chair. She was having a bad morning. The meeting with the Analonian ambassador had been tiring and tedious, and they had gotten nowhere. The ambassador was arrogant and ignorant; two qualities Elizabeth hated at the best of times, but acutely detested when they were combined. Trying to cast aside the disparagement, Elizabeth flipped open her laptop to review the monthly progress reports.
Elizabeth jumped as the klaxon sounded, then paused a moment to rub her temples in the vain hopes of forestalling a migraine. There was only one team offworld, and they weren't due back for another five hours. She stood up and hurried out of her office and down into the 'gateroom.
"Do we have an IDC?" she called out to Chuck. Her chest tightened as she awaited the answer. Tiny trills of fear rushed through her as each awful possibility ran through her mind. She crossed her arms over her chest, her method of warding off negative thoughts, and nodded as Chuck confirmed it was Rodney's IDC. "Lower the shield." She turned back apprehensively to the 'gate.
Five hours early. She remembered the day she had asked John to formally take command in Colonel Sumner's place, and form his own team for offworld exploration. After considering the implications of that, he had casually leaned against the balcony railing, looked her straight in the eye, and said "You realise I could get us into all sorts of trouble, right?" It was one of the few times she had ever heard hesitancy in his voice. She had never doubted her faith in John, and he had proven himself time and again. But there were the occasional moments like this one, waiting to find out what had happened this time that she wondered if she should have given his warning just a little more consideration.
The event horizon rippled and 'bloomped' three times as Rodney, Teyla and Ronon stepped through into the 'gateroom. They seemed well, and they certainly weren't hurrying through with gunfire echoing around them. Something was definitely wrong, though. They were all red-faced, and was Ronon shaking? There was an air of suppressed emotion surrounding them, and under different circumstances Elizabeth would have sworn they were trying not to…
Rodney laughed. Not a giggle, a full-bodied laugh. He clutched his sides and howled with laughter. Everyone in the 'gateroom fell silent and turned to stare at him. Ronon continued to shake in what Elizabeth realised was silent laughter. Teyla managed not to laugh, although her composure looked forced. The event horizon rippled and 'bloomped' for a fourth time, was still for a moment, then shut down behind John as he entered the 'gateroom to the unrepentant laughter of his team mates.
Elizabeth stared. After a moment of blank shock, she pooled all of the skills learnt over years of practical experience as a diplomat and ruthlessly curbed the fit of giggles she felt threatening her equilibrium.
"What happened?" she asked, the corners of her mouth twitching in spite of her best efforts. She stared across the floor at her military commander, who was currently standing ramrod straight and glaring at her pugnaciously. The affronted look was blunted by the fact that he stood there dripping a viscous fluid that looked like dark honey. Clinging to the thick, amber goo was a profuse array of brown speckled feathers.
Rodney tried to sputter out an explanation, but the words were choked by a fresh bout of chortling, and Teyla seemed momentarily lost for words. Ronon didn't even try to speak, just continued to shake silently, his normally brooding features relaxed in open amusement.
"Nevermind." Elizabeth waved a hand dismissively at them. "Go and see Carson then get cleaned up. Debriefing in one hour." Finally her own mirth got the better of her. "I can't wait to hear how you got yourselves into this sticky situation." John's eyes narrowed as he pierced her with an irritated look, then the smouldering eyes moved over the rest of the staff in the 'gateroom, silencing the giggles and whispers. Bristling, he stalked out without looking back.
Sheppard's team filed into her office, somewhat calmer than when she had previously seen them. John jogged up the steps a moment later. Elizabeth had a private chuckle at his hair; damp and spiky it was barely tamer than the last time she saw him, although it was certainly less sticky.
"Alright, what happened on P31 492? I'm assuming from the levity in which you returned that it was nothing too serious?" Although judging from John's condition, they could probably kiss yet another hope for a trade agreement goodbye. Rodney lent forward, grinning. Before he could speak Elizabeth held up a forestalling hand.
"Summarise please. John?" The last thing she needed today was to have those two start bickering. Whilst their point scoring was often amusing, she simply wasn't in the mood for it today.
"We came, we saw, we spent over two hours in their hot stinking village trying to trade with backward idiots, and then I got tarred and feathered." John said succinctly. He still radiated anger, although the dangerous look had gone from his eyes.
"Apparently, they're not Top Gun fans." John cast Rodney a frustrated look.
"Pardon?" Elizabeth gave him a mildly disapproving look, then turned to Teyla for clarification.
"The P'tarks consider covering the face and eyes to be an insult, believing that to do so implies dishonesty and lack of respect. In their culture, it is a severe breech in etiquette."
"Yes, and as it's their summer, Colonel Cool over here put on sunglasses." Rodney added cheerily, smirking as John clenched his jaw and attempted to ignore him.
Elizabeth sighed and pinched the bridge of her nose as understanding was accompanied by a dull throbbing behind her eye that signaled a return of her headache.
"And John being tarred and feathered was…?"
"Retribution." John finished tersely, scratching his neck absently.
"The villages perceived that the Colonel had insulted their headman. Under their laws, public humiliation is the required attrition for such an act." Teyla elaborated.
"We could have avoided it." That was Ronon. Elizabeth looked over at the giant Satedan. He was hunkered down in his chair, long legs stretched out in front of him. He had regained his usual stoic demeanour, but had an amused glint in his eyes.
John turned and faced him.
"We were not going to shoot our way out of that village." John stated with an air of finality, which suggested to Elizabeth that they had already debated this at least once. Elizabeth strongly agreed with that sentiment.
"Well, fortunately no-one was harmed."
"Except Flyboy's dignity." Rodney interrupted, snickering.
"Rodney!" Elizabeth shot him a warning look, which the smirking scientist dismissed with a wave of his hand, while the look the Colonel gave him held less of a warning and more of a promise of intent to harm. Elizabeth decided the conversation had run it's course, and moved in swiftly to head it off. "So what of trade? Did this eliminate our chances of dealing with the P'tark, or are they still open to negotiations?"
"They told me in no uncertain terms that I wasn't welcome back." John answered, hitching his right sleeve up and raking his nails down his arm. "Teyla managed to calm them down and organise to meet them again in two weeks." He started gouging at his arm. Elizabeth frowned at him.
"Fine. Teyla, we can discuss the trade possibilities in more detail after I've read your mission reports, if your amenable to that." She waited for Teyla's nod of affirmation. "John, did you see Carson when you got in?"
"No, I radioed him that I'd come in after debrief and went straight to my room. He said that was fine, as long as I kept some of that goop they drowned me in." His nails had finished their work on his arm, and ventured back to his neck, which now looked red and irritated.
"Dismissed then. John, go and see Carson. Now." She added, before he could add anything else. They all stood and she watched them leave, smiling exasperatedly as she noticed McKay follow up a comment by digging an elbow into John's ribs. Sheppard retaliated with a slap to the back of Rodney's head before he veered off in the direction of the infirmary. Elizabeth nodded slightly to herself, and made a mental note to check on him later. She cast a disgruntled look towards her laptop and decided that reports were more palatable with a hefty dose of caffeine, and left in search of a coffee.
John shut the door behind him and walked straight through to the bathroom, leaving his clothing in a trail behind him as he striped down. He gave the patchy rash covering his arms, chest and legs a dismayed look before giving into the irritation and scratching vigorously for a few minutes. Controlling the scratching took some effort, then he liberally lathed the corticosteroid cream Carson had given him over the inflamed areas. He went on a search for clean civvies, which lead him to a disgruntled search of his laundry basket. He finally found a reasonably clean pair of jeans, but gave up on finding a shirt and grabbed a clean black T-shirt from the pile of clean uniforms that he hadn't quite found the time to put away.
He flopped down on his bed, distracting himself from the constant itching by imagining several painful and humiliating fates for Shannook, but after a few minutes restlessness had him grumpily roaming around his room. He flipped open his laptop, then clicked it shut again. He fingered his golf clubs absently as he considered cleaning them, but he didn't feel like doing that either. After another fruitless lap of his room, he sat back down on the bed and tried to resign himself to an irritating and uncomfortable afternoon.
He was trying to decide whether the release of going for a run outweighed the added discomfort of sweat to his rash when the doorbell chimed. He jumped at the distraction and almost lunged at the door.
"Hey! How'd you go with Carson?" Rodney asked by way of greeting as he barged in.
"Why don't you come in?" John asked dryly as he palmed the door closed. "Allergic reaction to that damned sap they dumped on me. I've got a rash that itches worse than that itching powder we used to spread over the teacher's desk in third grade."
"Really? Well, welcome to the wonderful world of allergic reactions! We'll make a geek out of you yet." Rodney said with a crooked grin.
John glared at him.
"Did you just come here to gloat? 'Cause I'm really not in the mood."
"Nope." John heard a rattle as Rodney waggled the wooden box he was holding in his left hand. "Chess. Interested?"
"Not really." John responded, but he dragged the footlocker from the end of his bed to use as a table and sat cross-legged in front of it. "Pull up some floor."
Rodney sat opposite him and put the chessboard down with a noisy clatter.
"Hey, look what I found!" He said brightly, holding up a small brown feather.
"Okay, okay. Black or white?"
John would never admit it to the man sitting opposite him, but he was grateful to Rodney for coming around. The chess kept him occupied, and helped him keep his mind off his itching skin, as did the easy banter and sniping insults they traded with each other. Unfortunately it did nothing to aid the restlessness, and he was feeling increasingly edgy, his muscles twitching with it as he bounced his legs rapidly as he sat. Two particularly itchy spots on his neck and right hip seemed to be intensifying into an uncomfortable burning, which appeared to be spreading concentrically. When Rodney gleefully declared checkmate, he went to the bathroom and applied another liberal dose of the cream to neck and hip. Almost as an afterthought, he also grabbed a couple of Tylenol from the vanity and dry-swallowed them on his way back out.
Rodney glanced up at him as he sat back down, then peered at him more intently.
"You okay?" he asked with a slight frown.
"Yeah, just a bit of a headache, that's all. Probably bought on from listening to you gloat over your glorious victory in battle."
"Humph. Just getting even for last week." Rodney grunted. "Are you sure you're okay? You're sweaty."
"A little hot is all. Geez, are you and Elizabeth trying to henpeck me to death today?" He snapped, moving his king's pawn. "Your turn."
Rodney stared at him a moment longer, then turned his attention back to the chess board without commenting.
By time they were halfway through the game, John's comments had turned waspish and he was feeling decidedly unwell. His headache had gotten worse, and his stomach was clenching from trying to keep a lid on a rising swell of nausea. His face was sheened in sweat that he could no longer pass off as simply feeling hot. He slid his bishop across the board to take Rodney's knight, and was surprised to discover his hand shaking. A tremor betrayed him and he knocked Rodney's knight and a couple of other pieces off the edge of the board.
"You're definitely not okay." Rodney said as he scooped up the scattered chess pieces. "I think you should go back and see Carson." He was scowling and his voice held a note of irritation, but there was undisguised concern in his eyes.
"Yeah, maybe your right." John answered shakily. He really didn't feel too good. He started to stand up, but figured he must have stood up too quickly, because a wave of dizziness saw him stumble and fall onto the footlocker, scattering the chess pieces, board and all. A startled Rodney hastily reached to grab him and steady him before he pitched face first into the scientist's lap. John was grateful that he didn't. He was fairly sure he'd never live that one down.
"Medical team to Colonel Sheppard's quarters." John cursed himself for not being quick enough to head off Rodney's call. He hated being wheeled around on a gurney with everyone looking at him as he rolled past. He slapped his hand to his radio.
"Cancel that medical team, just tell Carson we're on our way." He turned and looked sourly at Rodney, who heaved a suffering sigh and stepped closer to offer any support that might be necessary on the way.
Carson eyed the wobbly Colonel in front of him suspiciously.
"Well, at least he's ambulatory," he thought. "Well, mostly." He amended as Colonel Sheppard staggered slightly.
"Alright, lad. What didn't you tell me earlier?" Instead of the boyish look of guilt he was expecting, he received a baffled shrug. Carson sighed and indicated to a nearby infirmary bed.
"Well, up you hop. Let's have a look at you." John sat on the bed with a quietness that told Carson louder than words that the man wasn't well.
"What's wrong with him?" Rodney queried, looking from John to Carson, and back again.
"Rodney, I haven't even looked at him yet. It could be a reaction to the resins in the sap those bloody idiots poured on him, although he only presented with allergic contact dermatitis. I've got a sample of it anyway, so I'll get tests run on it. He could also be having an adverse reaction to the antihistamines I gave him, but that's not likely, as previous adverse reactions should have been noted in his medical file." Carson trailed off as he realised he was thinking out loud and started to shoo Rodney out of the way. "Look, I'm sure it's nothing too serious. Why don't you go and grab something to eat and by time you get back, I'll have had time to look him over."
"Hey Doc." John smiled blearily at him as he turned his attention to his patient.
"Okay, Colonel. Why don't you tell me what's been happening to you since I saw you last." As John filled him in on the details in short, clipped sentences, Carson ran some preliminaries, checking his chest and temperature.
"So this pain you had in your neck and hip, has it cleared?"
Colonel Sheppard shook his head. "Worse. Hurts nearly all over now." Carson looked at him sharply. He examined the indicated areas, but the rash appeared as he expected. There was some underlying tension in the muscles, but that could just as easily be the body's reflexive reaction to the discomfort.
"Did you eat or drink anything while you were off-world?"
"Nothing. We were only there for a few hours, before…"
"Aye." Carson murmured as Colonel Sheppard trailed off. He picked up the sphygmomanometer and inflated the cuff around John's arm. He frowned at the elevated blood pressure reading. As he let his stethoscope fall and reached over to detach the cuff, John suddenly curled up and rolled on his side, face near the edge of the bed. Carson made a desperate grab for a kidney dish, but he wasn't quick enough. He sighed as he looked down at the vomit that was dripping off the edge of the bed and liberally coating his shoes. John managed to groan out an apology.
"Well, it looks like you'll be staying here with us for a little while, Colonel." Carson told him, and gently palpitated his stomach. It revealed no tender areas, which helped eliminate a few possibilities, but unfortunately didn't immediately help him with a diagnosis. He looked up and saw one of the nurses heading over, and signaled her.
"Rebecca, can you get the Colonel settled in please love. I want obs every twenty minutes for the time being, and keep a close eye on his vitals. His temperature and his blood pressure are both higher than I'd like. It's probably only a response to the malaise, but alert me if they continue to rise. It's not problematic yet, but until we know the cause, I'd like to play it on the safe side. Also, get me a complete lab work up. Include blood count, blood urea nitrogen, serum electrolytes and an electrocardiogram. " He unabashedly left her with the mess on the floor, and headed off to freshen up and get a clean pair of shoes.
Carson sat on the edge of the bed next to Dr. Hernandez, gently probing the young zoologist's arm. He glanced up when the infirmary door opened, and returned a nod of greeting to Elizabeth and Rodney.
"Okay lad. You'll be wanting to treat this arm gently for another few days. Angela will be over in a moment to give you some physio exercises that you can take with you, then you're free to go. And remember this next time you challenge marines to a soccer match, try not to let it denigrate into a brawl. You might be good at soccer, but when it comes to brawling, they have the upper hand." The lithe man nodded with an impudent grin and thanked him cheerily. Carson left with the sinking feeling that his advice had fallen on deaf ears, and made his way over to Colonel Sheppard's bedside where Rodney and Elizabeth sat, the latter with a worried frown.
"Elizabeth. Rodney." He said by way of greeting. "Colonel Sheppard, how're you feeling?" he asked as he checked the Colonel's charts. He frowned at what he saw. The Colonel was now borderline hypertensive, and his temperature was still too high. He was also still vomiting, which was a concern, as there was no obvious cause for it. He jotted down an order for 10ml of calcium gluconate to be added to the Colonel's IV line when Rebecca did her next round of obs.
"Not good, Doc." Colonel Sheppard replied. He was still perspiring excessively, and the now pervasive pain he was feeling left him looking pale and weak. Carson found it difficult to see him looking fragile; the man was normally so vivacious and he exuded a strength that was all to easy for others to rely on as being permanent.
"Aye, I'll give you something for the pain. It should take the edge off it for you." Carson walked over to the huge glass-plated fridge and took out a small vial, which he injected into John's IV line.
"There you go, son. You just lie back and take it easy." His eyes sought Elizabeth's and he nodded in the direction of his office, a silent request for her to join him. They left Rodney to keep Colonel Sheppard company, and Carson couldn't help but have a private chuckle at the litany of complaints that started issuing from the prickly scientist as they moved away.
Elizabeth followed Carson into his office.
"So have you determined what's wrong with him yet?" she asked. Carson sighed deeply as he sat down.
"Not as yet." he answered, giving her an almost apologetic look. "I'm still waiting for the lab results, but they should be coming in any minute."
"Could it be a result of the disciplinary action he received on P31 492?" If it was, Elizabeth would have some rather sharp words for the village headman before she ceased negotiations and banned anyone else from going to that world. She wouldn't go as far as retribution. Theoretically, she had no problems with another government enforcing their own laws. However these people obviously didn't extend any diplomatic leeway, and in spite of the humourous aspects of John's penalisation, if his illness was a direct result of those actions she couldn't ignore the possibility of a recurrence. Not to mention that if they reacted this way to John wearing sunglasses, there was no telling what else might trigger an even stronger response.
Carson gave a faint smile at her phrasing.
"No. I've got the lab results from the sample of the sap that they used. There is nothing abnormal about it. It is responsible for his rash, but that is a simple allergic reaction, and unrelated to his other symptoms." Elizabeth nodded in relief. One less trouble to worry about, at least. Before she could follow up with another question, Carson's radio crackled to life.
"Dr. Beckett? You wanted to be notified when Colonel Sheppard's lab results were finalised? I'm just sending them now." Carson quickly tapped his laptop keyboard.
"Aye, got them. Thanks Robert." He started scanning the file. Elizabeth watched him silently for a minute, then she noted his eyes widen in surprise.
"Acetylcholine!" he exclaimed.
"Did you find something?" Elizabeth leaned forward intently.
"I think so, but I'll need some confirmation first. Excuse me Elizabeth." He tapped his radio. "Dr. Symes, can you please report to the infirmary?"
"Well, I should probably leave you to it. I'll check in later." Elizabeth stood up. She'd just reached the office door when she saw Rodney racing over to them, calling for Carson. She found herself gently but brusquely pushed aside as Carson came racing out. She followed over to John's bedside, where Carson and a nurse were bustling around their patient. John, at the centre of the activity, was arched on the bed, his back bowed and his heels digging into the bed. His hands were clenched around fistfuls of sheet, and his face was thrown back in a grimace.
Elizabeth hurried over to Rodney, who was standing next to Teyla and Ronon. She assumed they must have come in while she was in Carson's office.
"What's happening?" she asked, making no attempt to hide her concern.
"I don't know. We were just talking to him, then…" Rodney trailed off, waving his hand in John's general direction.
She turned her attention back to the bedside, and the four of them watched forlornly, trusting Carson to ensure their friend's safety. Elizabeth felt helpless. She'd seen John injured many times, and each time brought home to her how much they – she – relied on him. She was honest enough to admit that this time was worse, because she was feeling the guilt of laughing at his misfortune earlier that day. She found it baffling that he could be healthy that morning, then becoming increasingly more ill after a few short hours. And how could Carson fix this if he still didn't know the cause? Elizabeth clung to the promising clue Carson had found in his office, hoping desperately that it would lead to a cause, then a solution. Looking at John's rigid, bowed body, she wasn't sure how much time they'd have to discover one.
After maybe ten more minutes of hectic activity centred around John, Carson came over to them. Elizabeth looked at the three faces mirroring her concern, then looked back to Carson, silently waiting for him to speak.
"He's okay for now. We've given him some diazepam for those muscle spasms, and some nitroprusside to help with the hypertension."
"Hypertension?" Teyla shook her head, lack of understanding evident from the furrows on her forehead.
"High blood pressure. We're also hooking up to an EKG to monitor his heart, as his heart-rate is continuing to increase." Carson rubbed his hands wearily over his face. "These bloody symptoms are increasing so rapidly."
"So is that what caused the seizure?" Rodney asked, his voice slightly shrill. Elizabeth put a calming hand on his arm. She imagined he must have got quite a shock to be talking to John when this had happened. It was certainly shocking to walk out and see him in that state.
"It wasn't a seizure. His body has released an abnormal amount of a natural chemical called acetylcholine, but something is inhibiting him from using it. Acetylcholine is a neurotransmitter which, simply put, allows the nervous system to effect muscle control. As a result, he suffered some prolonged and painful muscle contractions."
Rodney didn't look reassured. "So what can you do to fix it?"
Elizabeth felt a pang of empathy for Carson; he shrugged slightly and his face held a look of mixed sorrow and frustration.
"At the moment Rodney, not much. We're just treating the symptoms, not the underlying cause." Carson gazed sympathetically at his friends. "Look, there's really nothing you can do here. You can stay if you like, but I'll keep you informed of any further developments."
As the four of them turned back towards John's bed, Elizabeth felt a hand on her shoulder lightly restrain her. She turned back to Carson with a raised eyebrow.
"Could you stay for a moment?" Elizabeth tried to ignore the momentary panic that settled in the pit of her stomach, and nodded to Carson. They waited for another few moments while a short, balding man in a science blue uniform entered the infirmary and hurried over to them. She approved each personnel file before they were submitted to the SGC, but as the separate department chiefs were responsible for choosing their staff, she had trouble recalling who this man was. As he scurried into Carson's office with them, Carson introduced him as Dr. Symes, and she was surprised to discover he was Atlantis' resident entomologist.
After the preliminaries, Carson addressed Dr. Symes.
"Carl, I was wondering if you could help us out. Colonel Sheppard is quite sick, and I've a suspicion that it's your area of expertise. He's presenting with a rapid onset of clinical symptoms concurrent with latrodectism."
"Really? Well, what a thing! How severe is the envenomation? Has he had tetany or any myocardial symptoms?" The strange little entomologist was enthusiastic, showing little concern that he was talking about a person. Elizabeth pursed her lips in an effort not to comment while Carson answered.
"Yes, to the tetany, and he's also got mild tachycardia and hypertension. I haven't been able to find any bite marks or erythema, though, which is why I wanted to get your opinion." Carson handed over what Elizabeth presumed was a copy of John's file.
One of the drawbacks of working with so many experts in a wide variety of fields, Elizabeth had discovered early on, was that in spite of her own inherent intelligence, she often found herself partaking in a conversation like this that seemed to her to be half conducted in a separate language.
"Carson, can I have the English translation please?" she interrupted. Carson gave her a slightly apologetic smile.
"Sorry, love. The acetylcholine imbalance that I mentioned before, combined with the other symptoms the Colonel is exhibiting are synonymous with latrodectism, which is the scientific name for the bite of a spider from the black widow family."
"More precisely, the severity of the symptoms is more appropriate to a bite from a redback spider, a cousin of sorts to the black widow." Dr. Symes added. Elizabeth was startled by the news.
"But we're in the Pegasus Galaxy. Do they have redback spiders here?" It was a comment born out of surprise, and she mentally kicked herself as soon as the words had left her mouth, because she could already surmise the answer. The odd little Dr. Symes provided confirmation.
"Well, it's possible, but not too likely. However there are only two major groups of venom, and they have similar toxins and victim reactions. Dr. Beckett has only matched the symptoms to the closest category in our galaxy. I suppose it's possible that there are more than two major groups in this galaxy, but I haven't found any…"
"Thank you, Dr. Symes." Elizabeth cut him off. She didn't really want a lecture in comparative venomous species of the Pegasus and the Milky Way galaxies. "Next question. What can we do about it? Do you have any antivenom here?"
Dr. Symes shook his balding head.
"No. Even if I did, it wouldn't necessarily be effective. The symptoms may match latrodectism, but the toxicity of the venom is most likely different. The only way I can make an antivenom is to capture the spider or insect responsible and milk some of the venom. Once we've done that, making an antivenin should be reasonably simple."
"That's why I asked you to stay, Elizabeth." Carson interjected. "We'll need to send a team back to the planet and try and get one or two of these little buggers. I can't do much for Colonel Sheppard without an antivenom. And given the aggressive nature of the venom, the sooner the better." Carson looked worried, and Elizabeth didn't need him to verbalise what they were both thinking. John was only going to get worse, and who knew if they would even be able to discover what it was that had bitten him, much less how long it would take to capture one and make an antidote.
"Okay. Major Lorne's team went off-world two hours ago, but one of the other teams should be able to accompany Ronon and Teyla. I'll talk to them and see if they noticed any insects around John. They can also talk to the villagers. They might have a history of the insect or spider responsible for this." Carson nodded and gave her an encouraging smile.
"Sergeant Rouse's team have escorted me a quite a few times, and their getting to be somewhat competent. If they come with me, it'll most likely be more efficient." Elizabeth nodded consent, and the short scientist stood up and headed to the door. "I'll just have a talk to the patient if he's responsive. He might have noticed something that didn't seem relevant at the time."
"The patient's name is John Sheppard." Elizabeth told him coldly, finally loosing patience with the man's chipper attitude towards John's condition. The balding little man stammered an apology and scurried over to John's bedside.
"We can do this Elizabeth. He'll be alright." Elizabeth would have felt more comforted by Carson's words if they weren't weighted by concern and worry.
John watched Elizabeth talking to Carson. He fervently hoped she had some good news about the team. They'd told him what was going on, but he was in so much pain that he only registered about half of it. He did know that Ronon and Teyla were off-world on that damned stinking planet trying to help him, and he was stuck in the infirmary and powerless to help himself. The thought had been burning in his mind for the last hour or so, as he lay there in agony, unable to control his own body. It felt like a betrayal, and it was galling. If his friends were hurt trying to help him, he'd return to P3-whatever and reduce the place to a smoking cinder. Well, okay, maybe not, but the thought was awfully tempting.
Carson had given him something which had stopped a majority of the convulsions, although he'd still had a few episodes. Unfortunately the medication only went so far, and his muscles were still coiled and bunched tightly, causing a deep ache that rode the waves of pain and wore down John's resistance. Every time a muscle spasmed it would send another excruciating wave of agony shooting through his body. The whole process left him with a deep weariness, but the hyper, restless state of his body wouldn't allow him to drift off to sleep. Thinking about it only rekindled his anger, and he struggled to draw in a breath deep enough to help him calm down.
Another bout of nausea had him reaching for a kidney dish, hands clenched into fists from the contracted muscles fumbling the small tray as he curled the rest of his body inwards as the force of vomiting triggered yet another fiery explosion of torturous pain as his stomach muscles cramped.
He straightened up slowly, and discovered Elizabeth had come over and was standing next to him. Oh, great.
"Here, let me take that." She took the kidney dish and it's unpleasant contents before his shaky, clenched hands betrayed him and he dropped it on himself – again. She put it on the small table next to the bed and signaled a nurse to remove it. John felt the twin burn of humiliation and anger; frustrated once more to find himself in this position. He was relieved that Elizabeth was a gifted diplomat; she picked up on his embarrassment and promptly tried to divert him.
"So, Carson says you're holding level. That's something anyway." She placed a gentle hand on his arm, but rather than being comforted, he cringed at the feel of slick sweat between them.
"Something." He appreciated the effort, he really did, but his muscle spasms were becoming increasingly frequent and more intensely painful, and he'd overheard Carson telling the blond nurse that his heart rate was becoming problematical. Even through the hurt-fueled haze in his mind, he had enough wits to know that he was still getting worse.
"Well, I have some good news." Elizabeth chirped in her best 'bedside manner' voice. "Ronon and Teyla are back. They'll probably be into visit you soon, if they haven't been in already. They found the bug responsible for your present predicament. Apparently the villagers knew exactly what they were talking about. This is a frequent problem for them. In fact, they're even willing to trade for the antivenom if Dr. Symes is successful. He's working on it now."
"Great." John answered through gritted teeth, gasping through more muscle spasms. He lay there panting, considering throwing in his commission as military leader of the expedition and taking up a new career of pest exterminator. The Pegasus Galaxy sure could use a few less bugs.
Elizabeth started talking again, but her words were ephemeral, and he couldn't quite follow what she was saying as he was carried away on a rising wave of pain. John gritted his teeth as more waves of nausea and agony washed over him. Pain. Painpainpainpainpain. It was god-awful. It attacked him as if it were a conscious entity; it ripped into his abdomen and up through his chest and arms. It clawed his head from the inside, ripped along his neck and invaded his brain with the intensity of a small-yield explosive detonation. His already laboured breathing hitched as he gasped his way through the wracking torment. He dimly heard alarms blaring and Elizabeth's voice rising in panic, but the wave broke over him and he was carried away by the undertow.
Carson heard the alarms go from the heart monitors.
"Oh, bloody hell." He dropped what he was doing and raced over to Colonel Sheppard. He'd been increasingly worried about the Colonel's ventricle tachycardia, as the venom's toxins continued to turn his body against him, and his body was struggling to cope. Something had to give eventually, and Carson's growing concerns had matched the pace of the steady rise of the Colonel's blood pressure and heart rate. He almost collided with a nurse as they both reached Sheppard at the same time. A quick glance at the monitor confirmed myocardial infarction.
"Get the crash cart. Now." Rebecca grabbed the cart, while Jason efficiently prepped the Colonel for defibrillation. When Rebecca slid the resuscitation cart next to him, he grabbed the defibrillator paddles and stepped forward. Jason stepped forward with a resuscitation bag and fitted it to Colonel Sheppard's mouth and nose.
"DC shock, 200 joules." He placed the paddles on the Colonel's chest and depressed the trigger, eyes on the waveform on the monitor. When there was no change after thirty seconds, he indicated to Rebecca to recharge the paddles and depressed the trigger again.
"Increase to 360 joules and prepare 300mg of amiodarone – wait!" The waveform on the monitor fluttered erratically for a moment, then strengthened into a pattern. Carson unconsciously let out a sigh of relief at the reassuring sound of the beeps, and checked the Colonel's pulse, then commenced a full vitals check. Finally he lifted the Colonel's eyelids and flashed a penlight, relieved to see the pupils were responsive, though Colonel Sheppard remained unconscious. As Rebecca cleared away the crash cart, Carson issued Jason with a terse order to check on Dr. Symes progress. Finally, he turned to where Elizabeth stood quietly out of the way, pale faced with her arms wrapped tightly around her as if she could ward off what she was witnessing. Best put a stop to that, at least.
"He's okay for now." Elizabeth's face remained impassive, but her shoulder's almost slumped as they released the fear-fueled tension. "We need that antivenom soon, though. I've sent Jason to harass Dr. Symes." He added, not quite able to smile. Rebecca came over and handed them each a cup of coffee.
"Lord bless you, lass." He said with heartfelt gratitude as the nurse grasped his elbow and gently turned him to face his office, before unobtrusively assuming care of Colonel Sheppard. Elizabeth followed him wordlessly; there wasn't much to say. It had come down to a race against time and he knew, baring an even more serious emergency, she'd wait it out here.
The passage of little over half an hour saw Carson and Elizabeth sitting with the cold dregs of their coffee and passing the occasional comment to fill in the silence. Elizabeth knew Carson would prefer to be actively doing something, but he would not refute the kindness of his nurse's offer of time out, nor leave her waiting alone, at least not yet. She felt a warm rush of endearment for the Scot, whose heart at times seemed to large for his body to contain, and his care and kindness literally shone through his soulful eyes and expressive face. At the moment, the expression on his face mirrored her own feelings; worry, concern, and frustration at his inability to take further action unless –when- Dr. Symes was successful.
John occasionally teased her about her poor bedside manner during these times, and it was true. But she knew that it stemmed from her discomfit around any illness, regardless of the cause. She hated it, was unnerved by it. Illness wasn't something she could reason with. It wasn't interested in negotiation or trade-offs. It wasn't willing to open lines of communication, at least not in any language she could speak. It left her powerless; helplessly watching people she cared about fading away before her. And in too many cases, the stakes were just too high in the end.
She was snapped out of her morbid thoughts by the arrival of Dr. Symes, who was excitedly waving around two small vials of opaque liquid.
"Is that the antivenom?" It was her own question, and she had a passing sense of disorientation when it was Carson's voice, not hers, that sounded in her ears. Dr. Symes nodded cheerily.
"That's it. Have you administered antivenom before?" He asked Carson, handing over the vials.
"Aye. I've already got some epinephrine on standby in case he goes into anaphylactic shock." Carson stood and took the vials, talking as he walked rapidly over to John. Elizabeth and Dr. Symes followed him.
"One vial intramuscularly, and then observe him for an hour for response. If it's necessary, give him the second ampoule then. You're not likely to need a third, but I can make more within half an hour if he's still not improving after the second. Just let me know." He looked at the antivenom with satisfaction, and then turned to leave. Elizabeth stopped him quickly, feeling guilty that she had taken a disliking to the man for no other reason than he caught her at a bad time.
"Dr. Symes, thank you." She said warmly, smiling at the odd little entomologist.
"No problem, Dr. Weir. Glad I could be of assistance. Very glad, actually." He smiled back and then left her alone. She resumed watching Carson administer the antivenom. She knew it wouldn't be an instantaneous solution, but she watched John with hope of a response anyway.
Rodney, Ronon and Teyla entered the infirmary and quietly moved to stand beside her. She wondered how they knew the antivenom was ready, then considered that Rodney had probably been keeping an eye on Dr. Symes. His quietly protective stance over his team mates, so often at odds with his brusque manner and poor people skills, never ceased to astonish her. She'd observed it before, but each time it struck her as something wondrous, like finding an object of sentimental value that she'd long given up as lost. Ronon and Teyla flanked her and Rodney in their own protective gesture; closing ranks and offering the strength of their presence, which she gratefully drew on. None of the four said anything, just stood together sharing silent comfort.
John slowly awoke late the next morning, serenely listening to the muted beep of the heart monitor without registering its significance. He drowsily pondered on the thought that something was different, but it was another minute or two before he realised that the pain was gone. The peacefulness was tinged with relief as he cautiously reached out his awareness to confirm the discovery. He ached, and regardless of his newly awakened state he felt a bone deep weariness, but there was no pain. He drew a deep, easy breath and allowed his eyes to flutter open.
He looked around him to discover Elizabeth and his team clustered around his bed, talking in quiet tones that he didn't focus his attention on. Carson hovered nearby; John couldn't tell whether he was actually doing something or just appearing busy as an excuse to loiter nearby. He suspected the latter.
"Lizbeth." He coughed to clear his throat and tried again. "Elizabeth." The others stopped their conversation mid-sentence and he found himself ringed by five anxious faces.
"I'm resigning my commission. Gonna hunt bugs." He murmured.
"Yes, well given their propensity to find you to be a tasty snack, I wouldn't advise it." Rodney snorted. John smiled tiredly.
"Rodney, shush." Carson frowned at him, then turned back to John. "How are you feeling, lad?"
"No pain. Thanks, Doc." He mumbled. Ronon gave him a happy grin, one that started in his eyes and lit up his face.
"You gave us quite a scare." Elizabeth smiled at him warmly.
"Sorry." John knew he wasn't at fault, but he felt uncomfortably guilty anyway.
"Well it is good to see you returning to health." Teyla said softly, laying a gentle hand on his arm.
John let Carson prod at him, then lay quietly listening to Rodney tell him of the Herculean effort of carrying him to the infirmary the previous day. John noticed he didn't talk about the time he spent actually in the infirmary, but was content to let it go, preferring to let Ronon's inelegant snort serve as his answer as well. He stifled a yawn as he began to feel drowsy again, then decided not to fight it as he let the sound of good-natured bickering carry him off to sleep.
Disclaimer: The copyright for Stargate Atlantis belongs to MGM studios and SciFi channel. It's their playground- I'm just playing in it.