Flashback Life or Limb

[Orion Michaels]

Orion, Day of Spring 13, 507 AV "It's horribly infected, Orion." "Can we save him?" "There's no guarantee. We can't tell how far it has spread. I had this man in weeks ago to treat a gash he got working, but he didn't listen to me about cleaning it." "So what do we do?" "Ideally, we'd travel back in time and make this fool listen to me. That's obviously not an option, so we'll have to amputate." "A-amputate?" "Yes. Amputate. There's no guarantee he'll survive though. We'd have been able to avoid this situation if the man would have listened to me. Take that message to heart." "...Yes, father." "And Orion, you'll be performing the amputation. It's a perfect opportunity for you to learn. We won't let this man's ignorance go to waste." "...Yes, father." "Perfect. If all is understood, I'll act in an advisory role for this operation. You'll have to explain to the man just what happened. I leave it to you to be gentle or not. I wouldn't. When it comes to the operation itself, we'll do what we can to numb the pain, but there's little that can help with such a thing. Make sure you take charge of the situation. My assistants will be there to aid. You're the doctor, though. Remember that. Your leadership is..lacking. You need to be able to make others listen because you know what you're doing. Okay?" "I'll..I'll do my best." "Wasted words. If you ever do any less I'll make sure you never work in this city. The Michaels name will be known for nothing but the best. Do you understand, Orion?" "Y-yes, father."

[Orion Michaels]

Orion, Day of Spring 13, 507 AV Any expectations of an quiet day were dashed when a man was brought in to the office. Two men were dragging him, panic in their eyes. "He, he just collapsed," one of the men stammered. Jumping up from his seat, Orion rushed to offer his aid. "What happened," the young doctor inquired, examining the man as he helped the other two bring him over to the table. There was a horrible looking gash on the man's left arm. Swollen and puffy, a nearly clear pus was oozing from the bright red wound. It was clearly in bad shape, but Orion had never seen something quite this bad. "Like I said," the first man began, "he just collapsed outta nowhere. Complaining about his arm, but he came to the doctor a couple weeks ago, so he should be fine, right?" The young physician paused, trying to think how best to answer it and relieve the man's concern, but didn't have to figure it out as his father interrupted. "Orion, come back here," his father had said after spotting the man. "You, prepare my surgical tools." After ordering the assistant to get his equipment ready, the elder Michaels disappeared into the back room, Orion following soon after. A brief discussion ensued, and a quick decision to amputate was made. His father had instructed him on such a maneuver before, but there had never been a situation where he would actually be called on to perform the operation. The infection was in too deep to be treated, and the man was too poor to afford a marked healer, so it was a desperate time. Orion had to try and tell this man who was racked by pain and fever that he'd have to remove his arm. "You'll need to take the whole thing," he father had said. Unable to determine just how far the illness had spread up his arm, the only shot at saving him was to take his arm. Okay. I've got to inform him it's the only option unless he can come up with the mizas needed to pay for a healer. There's only so much I can do as a doctor. Father would tear me apart if he caught me paying for the man's expenses, too. Orion sighed. His father was a shrewd man. He believed that education was a privilege which should only be afforded to those who could, well, afford it. He also believed that those who held higher learning should profit from it. Charity work wasn't an option. Exhaling heavily before turning and heading out of his father's office, Orion walked over to the man, stopping a few feet before him. His face was flushed, his eyes opening and closing rapidly. The mangled left arm was placed at his side, with the elder Michaels' assistants laying out various tools and other such equipment. Scalpels, probes, cloths, threads, and of course, Orion noticed with a gulp, a bone saw. Looking down at the man and then up to his two friends, the physician took a deep breath before speaking. "I...I have some bad news."

[Orion Michaels]

Orion, Day of Spring 13, 507 AV "A-amputate?" One of the men questioned. A look of shock had spread over the speaking man's face. No one ever expected to hear that. Orion knew this, but it was a fact, no matter. His reaction was unsurprising, his pleading expected. "Yes, I'm afraid that's our only option." The man shook his head. "But he's got a family! He's a miner by trade! He doesn't have any other skills!" Kind of an uncommon profession for non criminals... While he wasn't caught off guard by the man's reply, his was unexpected. "It's either he loses the arm or his life. At least the knights will find a use for him if he's still alive." His own words nearly made the doctor ill. He sounded exactly like his father there. Cold, calculating, no empathy. As true as his words were, he still didn't want to be that kind of doctor. "Ah...I'm sorry, sir. i didn't mean to.." "No, no, you're correct, doctor." The man turned to his friend. "Hey, Roger, the good doctor here is gonna take care of you." Orion frowned. He was going to have to treat this man, sooner rather than later, but he wasn't looking forward to it at all. "We'll get you some work so you can take care of Jess and the little ones." The injured man's quiet moaning and the worry in his friends eyes had Orion quite unnerved. His father's presence at the entrance to the operating area did little to help. With an all too common expression, the older Michaels watched his son silently, judging his every action. It was something which happened every single day, but Orion only found it to be more and more trying as his father gave him more responsibility. He'd lost a patient the first time he'd been totally in control of an emergency, and it seemed that the worst only occurred when his father stepped back and left him to his own. He was unafraid to sacrifice someone he could save to give his son the experience of doing it himself. "Orion," his father began, "no more delaying. The man is probably lost as it is, but you don't give him a chance if you don't take care of things now." Orion nodded. He was right. Doesn't make me want to do it, though. The young doctor moved over to the patient, leaning down by his head to whisper. "I'll do my best, sir." Orion looked to his father's assistants, nodding and examining the surgical tools once again. "Get some..no, get lots of alcohol. Even if he's feverish like this, we need to sedate him as much as possible. Get him drinking." And pour one for me, too.

[Orion Michaels]

Orion, Day of Spring 13, 507 AV Orion wondered if he should feel guilty about making a feverish ill man intoxicated, but it was really the only option to put him under other than straight up knocking the man out with a blow to the head. After the assistants had aided the man in imbibing the beverages, Orion began to use a little pure alcohol on the various cutting tools he would need for the operation. His eyes lingered on the bone saw, the thought of having to use it causing his chest to tighten. Jagged metal teeth spread across the one foot length of the blade, attached to a handle made of bone itself would be the primary tool used in this event. "Orion, let's get this started. He's plenty gone." His father had walked over to the operation table, instructing his son in a calm plain voice. "I'll walk you step by step through this process. If you listen to me and act at my every command, we'll get through this as well as we can." Orion nodded. He needed to get this over with. "Yes, father. I'm ready." "Very well. Step one is to make an incision using the scalpel. There will be two in total. The first one," he said, pointing at the arm a few inches above the elbow, "will be around here. You'll cut through all the skin and the muscle completely down to the bone." He moved his finger up the arm several inches. "And you'll do the same here. You'll cut 360 degrees around the arm in both spots. Of course there will be lots of bleeding from this, so you'll have to clamp down the artery to stop him from dying of blood loss." Orion bit his bottom lip slightly, trying to take in all the instruction. It would need to be a quick procedure. Just another risk involved with amputation. The infection could have spread too much already, making it a waste of time. He could die during the surgery itself. It could end up in another infection afterwards. "After you stop the bleeding, the actual amputation can occur. You'll saw through the bone in between the two incisions. You'll need to be firm and powerful in your strokes with the saw blade. Once you've separated the intended part of the arm from the rest of the body, you'll sew up the skin and muscle over the open bone. At that point it's out of your hands. Are you ready?" I guess I'll have to be.

[Orion Michaels]

Orion, Day of Spring 13, 507 AV Cutting into someone was a feeling that Orion had yet to get used to. Keep a steady hand. Keep a steady hand. As the cold metal blade contacted the man's skin, Orion once again took a deep breath and added pressure to begin slicing. Dark red began to ooze as the steel created an opening in the patients flesh. The doctor swallowed hard as he heard the murmuring of pain from the mostly sedated man, but continued his work. The two cuts would meet at the bone in the end, to ensure that when it came time for the saw it wouldn't have to meet any skin or muscle. The cutting took a little time using the scalpel, but it needed to be done cleanly due to the artery which ran through the arm. While it might get the amputation done quicker by just taking the saw to the arm, it would only create complications. Precisely as he could, Orion worked his way through the man's skin, down into the muscle that made up his bicep. It was clear the man was a miner. The strong muscle took a little extra pressure on Orion's part to cut asunder, but it gave under the sharp instrument. His progression stopped, if for a moment, as the young doctor's eyes fixated on the brachial artery. The real blood loss would begin here. The surgical tool cut true as a bright red spurt of liquid blasted forth from the vessel, splattering against the blue eyed physician's tunic. Another ruined set of clothing. He was used to that at this point. Hand trembling ever so slightly, Orion moved several inches above his first incision, and began to cut. It became quite clear why he started with the lower incision as the blood flow continued. If he'd done the higher one first, the lower area would now be covered in crimson and likely more difficult to work with. Still, he didn't like how fast the blood was coming. I hate working with these guys, the doctor thought, looking at the silent assistants. He wasn't exactly a people person, so he had problems giving orders to those placed before him. "I..you..," he muttered, sighing. They know exactly what I wanted there, right? The young man shook his head before speaking again. "You. Could you maybe please put pressure on the upper arm. To make the bleeding slow. Now." What uneven commands those were. Orion didn't understand how his father could command a room so well. He'd always thought it was just a respect for his medical skills, but instead he had a way of making people do what they needed to do without hesitation. That was a talent severely lacking in the budding physician. Regardless, the assistant complied with Orion's request, and with the blood flow slowed, the steel blade once again met flesh, cutting slowly and exactly to the bone. The bright red didn't come nearly as quickly as he once again sliced the artery. Orion set down the scalpel, before ordering another assistant. "Umm...can you get me a clamp?" The young man glanced up to see his father still watching. It was slightly unusual, the expression on his father's face. It wasn't quite approving, but it wasn't disapproving either, which in the elder Michaels' case often meant the former. It wasn't a common thing for Orion to see. Slightly revitalized in his efforts, Orion secured the clamp on the man's artery, stopping the major blood loss entirely. Everything was prepared for the the actual separation of the bone now. "Bone saw," Orion requested quietly, looking down at his patient. The man's face was twisted in pain, but it seemed the alcohol had done it's job of keeping him under enough for the operation. Placing the saw just above the bone, Orion took a deep breath and exhaled slowly. "Ready?" the young doctor asked, recieving nods from the assistants and his father both. Alright, Orion, you've got this. With one pass of the blade up, the little confidence Orion built was shattered. The man's eyes shot open in confusion, his mouth opened, and he screamed.

[Orion Michaels]

Orion, Day of Spring 13, 507 AV Orion didn't have time to feel foolish, but he hadn't restrained this now thrashing man, and the already dangerous operation was now complicated. His voice left him for a moment, as he stood there, the scene surreal. The man was swearing up a slurred storm, trying to leap from the table; his father's assistants were just standing open mouthed, looking to Orion for direction. And Dr. Michaels. He remained on the far wall of the room, arms crossed, his cold with judgement. The man was nearly off the table, forcing Orion back into reality. "R-restrain him!" he managed, setting the blade down to offer his help in stopping the man. "He's gonna make it worse!" The two men helping him grabbed the man and forced him back onto the table. "Whut the petch are you doin to me?" he man yelled, fighting against the alcohol and the men holding him down. "You ssshum kind of monster!?" Orion shook his head. Though I wonder sometimes... "No, sir, I'm a doctor. You're badly infected, and we have to take your arm to save your life." The man let out a loud laugh as he continued twisting to try and free himself. "I'm fine you petching vagik! Lemme outta here!" "Sir," Orion began again, "please calm yourself. We wouldn't do this unless it were absolutely unnecessary. The longer we wait, the less chance of surviving you'll have!" The man replied by trying to spit at the young doctor. "Petch you. I'll be fine on my own. Once you petching fix my arm! What shyke is this, having a petching baby operating on me! I've got a daughter with more hair on her chin! Lemme go! Lemme go! Lemme go!" The man's eyes were nearly rolled back into his head, the combination of drink and fever wracking his mind. Orion wasn't sure what came over him exactly, but he knew the man needed to be silent and still. Pushing one of the aides out of the way, Orion pushed the man's chest down with his right hand, his left balling up into a fist. The fist was raised above his head and swiftly brought down like a hammer, the bottom of it crushing the side of the man's head. I'm a doctor, you petcher. Listen to me! The man was even more dazed than before, as his eyes glossed over and mouth opened to protest. No words came out as Orion brought his fist down again, the second one silencing all argument. Breathing heavily, Orion looked around the room. Plastered on the assistants' faces were looking of pure shock. On his father's, however, was an almost smug smile. "I'm sorry for that..barbaric method," he said with a chuckle, "but he insulted my facial hair." He gave his father a sheepish smile, a rare case of his father's approval being apparent. The elder Michaels had imparted a simple piece of knowledge when it came to keeping people under for an event like this. 'The cheapest, therefore best, way to knock someone out is cheap booze or your fist.' Syliras was a place of civilization, so the fist method seemed a bit out there, but a blunt blow to the would get the job done. "Now. If we may get back to work. Hold him down this time?" He spoke with a bit more confidence. How very beast like. Show a little strength and suddenly you think you're top dog. But I am, right? "Bone saw." With the blade back in his hand, Orion placed the saw above the groove he has started earlier and began again.

[Orion Michaels]

Orion, Day of Spring 13, 507 AV The teeth of the saw grating against the hard bone nearly made the young doctor want to retch. It was an unnatural sound, Orion nearly feeling the pain of such a thing out of empathy. The repeated quick grinding of metal on the man's arm nearly realized itself on Orion's. Still, he had kept at it, up, down, up down, making his way through the tough outer layer, carving a path through the organic material, severing the bone from itself as he separated the vessels and marrow which made up the insides. Orion could feel the perspiration forming on his forehead, though he couldn't say if it were from nerves or the effort it took, but regardless, his motions never stopped. After what felt like an eternity, there was suddenly no more resistance as the now detached portion of the arm fell free from the man. Was it satisfaction? Or just relief, Orion wondered. A weight was lifted off him, that was for sure. It was easy from here, right? Setting the saw down, the doctor examined the man again. Pressing his fingers against the man's neck, he checked his pulse against the carotid artery. The beats were steady, but weak. "He..he should survive the surgery..but we'll have to wait and see about the success itself..." Orion picked up the needle and horsehair thread he would be using for the final steps. His initial action was to remove the clamps of the artery. The blood began to flow again, but Orion carefully and quickly sewed the opening as closed as he could, allowing the bodies natural healing to take over from there. "Clean it, first," Orion instructed the aides, pausing to allow them to rinse the area clean of impurities. "And then please fold the skin over the bone. I'm going to stitch it up using his own skin as a natural cover." After they complied with his orders, Orion began to work. The needle pierced the skin, pulled through, back through, through, back through. This sort of suture wasn't the strongest there was, but it was good for this situation. It was fairly quick and strong enough. A more precise, more time consuming method was unnecessary because this sort of injury was unlikely to be under the pressure which would require it. As he completed, the arm had a fine row of stitching around it, creating a plain looking stub. "The arm should close itself up, and in about thirty days we'll be able to remove the stitches. For now, we'll let the man rest." Orion walked into the back to rinse his hands off and clean himself as best he could. The man's sudden outburst aside, the surgery had gone about as well as it could. Successful amputation, minimal blood loss, and only a few blows to the head. Whether or not the man would survive, he'd done what he could. "Orion," his father said, walking into the room. "You surprised me there. You actually took charge. In your own way, that is. Keep it up." The young doctor nodded, barely containing a grin. "Y-yes, father!" "Don't get arrogant, though. You're not good enough." He exited the room, leaving Orion wondering. But I will, be, right?

[Accolade]

Orion Michaels

Experience

Skill	XP Earned
Medicine	+ 3 XP
Observation	+ 2 XP
Leadership	+ 2 XP
Brawling	+ 1 XP
Intimidation	+ 1 XP

Lores

•	Lore Earned
•	How to Amputate an arm
•	Taking charge of the room
•	Proving one's worth
•	Michaels are doctors not saints

Notes :

Another fun read! I enjoy reading about Orion, and I also read the thread that you linked here. I like the way you bring scenes to life, and put the reader right in the seat of it all. Awesome job!

The Sylir has spoken

If you have any questions or concerns regarding your grade, please send me a PM and we can figure it out.