Closed [Sanctuary] Diagnoses (Vanator)

[Elem Bree]

40th of Fall, AV 512

It had been a few days since Elem had trained with Vanator, the new Armsmaster and his newest friend. Much of his training had helped the Zeltivan in his boxing spar as well as the conditioning. He had taken to not healing his muscles when they were sore, as all it did was ruin his progress. it also made Elem feel more alive to hurt when the pain was the result of strengthening his body. Now it was his turn to return the favor by honoring Van's request and teach him some basics about medicine.

He had chosen the Clinic building, which still stood on the grounds above, to do the work of training on that day. It provided elem with the privacy he needed to aid him in training the Drykas. Van had told him that he knew about field dressing and not much else. This did not surprise Elem , as while that was a necessity, he was starting to guess that much like the culture of the Akalaks, the Drykas might also expect women to do the bulk of the mending. while in Zeltiva, this would not be an acceptable way to think, he was no longer in Zeltiva and had to accept things the way they were in his new home.

Before him at the table were a few items of use. A curved surgical needle, thread, some leather scraps, bandages, a mortar and pestle, as well as a bottle of alcohol. He didn't want to drown the man in knowledge, but he did want to make sure that he would pass along vital information that could save his own life or others. Besides, with all of the resources available at the Sanctuary for healing, it didn't make much sense for Van not to know how to use them.

Elem had the foresight to slide a piece of parchment under Vanator's door a bell earlier, written in Common, which would tell him to meet Elem in the Clinic for the medical training. having everything ready, he would now just attend to organizing the Clinic itself, taking care to clean out any leaves or rubbish that may have blown in over the last week.

[Vanator]

Vanator indeed found Elem's invitation, dressing and grabbing something to eat quickly. Van had washed his hands, profusely. He knew that he wasn't actually going to be treating anyone, But Kavala had drilled into her brother that if he was going to go into the clinic, or even through it, he better not show up with dirt under his fingernails, or touch anything with grubby hands. All the healers reminded the non-healer that cleanliness was vital to a proper clinic.

So with sparkly clean hands, Vanator made his way up Top and into the clinic. The Drykas was excited for the lesson, anxious to expand his knowledge, to become a more integral part of the Sanctuary. He had no idea what the future would bring, to him, his family, or to those that lived her with them. Personal development was a key to readiness.

As he entered the clinic, Van found the Zeltivan healer ready for him, array of items laid out. "Alright, I am ready..." he lifted his hands to show Elem, "...and my hands are clean!"

[Elem Bree]

Elem was looking for a book like the laboratory had for notations but couldn't find any. He suspected they were around but he was just having no luck finding them. He was a little anxious about teaching someone about medicine, mostly because Vanator had no knowledge of it and whatever Elem showed him could save or kill someone, depending on Elem's accuracy. He wanted everything to be perfect, but he also wanted to keep it light.

Standing from his searching crouch, there was Vanator, brimming with enthusiasm. The man's smile and good nature set Elem at ease, calming some of the anxiety. Maybe he was as nervous. Even if not, Elem would pretend Van was to make it easier on himself. "Clean hands are an excellent start, Van. We Rak'keliansd often overlook the importance of good hygiene when it comes to treating wounds. Rak'keli's mark allows us to sanitize wounds that could otherwise go sour. That one thing alone has probably saved half of my patients, so don't ever knock clean hands. An excellent start!"

He could tell that Van was eying the many items he had laid out to work with, but Elem had something else in mind first. "Before we get started with these things, I wanted to point out the number one tool of all medical practice. The diagnosis! Asking the right questions and forming an idea about what your patient's concerns are helps with the time of the healing, the efficiency and most of all the effectiveness. So, always remember, before you bother with any bandages or herbs, ask, ask ask!" He smiled, adding, "Of course, if someone is shooting blood in a manner of a pulse, you should probably guess that they need a tourniquet." He laughed, as grim as the topic might be.

"What have you learned already before coming here? You had said you were familiar with field dressing. Could you tell me what that entailed? Then we can get to the items I have here." Elem's hand automatically flourished over the array of medical implements.

[Vanator]

Vanator nodded at Elem's first point. To the Drykas, it was an obvious step, or so he thought at first. You see a gash, you know what is wrong, stop the bleeding, cover it up. But he realized medicine, and what they did at the Sanctuary, was more than treating visible wounds. Not all ailments were so easily identified. It was like any important problem that needed solved, you needed to determine the cause before you can resolve the issue. Ask questions to make a diagnosis. Got it, made sense. It was something he should probably remember in particular. You could not swing a dead snarlwing in the Sanctuary without hitting a Rak'keli-marked healer. Van had no such divine blessing, and would have to rely solely on traditional medicine if ever faced with a medical situation.

Then Elem asked for his experience. Vanator shrugged. "I really know little more than what the average person would know, how to tell if you have a fever, you wrap up a cut, that kind of thing. I did have to treat a serious wound once, out in the Grass. My friend Hex and I were..." Van didn't want admit he and the half-blood woman were foolish enough to try to steal a glassbeak egg, so he jumped forward in the story, "...were attacked by a glassbeak. She had a bad claw gash in her forearm. Hex was able to instruct me on what to do. She was marked by Rak'keli, and had some basic medicine skills, but she was barely lucid, and could not heal herself. I cleaned the wound with some stuff she carried with her mixed with water, then I cleaned a needle and had stitch up the wound."

[Elem Bree]

Elem nodded as Van spoke, listening closely to his story. "Oooh, glassbeaks. I've yet to see one, strangely enough. I suspected there were some near the caravan that brought me here, but it was just strange movement in the grass. Very eerie. I would suspect that the stuff mixed with water would be alcoho, which I have brought along." He picked up the flask and shook it, the liquid making a sound inside.

Elem plopped the leather scraps down before Van along with the surgical needle. "I'm glad to hear you have some experience already. This should be easy for you then. Sew these two scraps together in a straight line. We wouldn't want to give the patient a crooked scar, or any scar if we can avoid it. Clean the needle and thread it. Are you familiar with a square knot? That is the knot I use to insure the thread doesn't come out. While you are at it, I'll explain some basics after the asking." He felt that Vanator was smart and he knew the Drykas was adaptive and quick.

"After we have a good guess at the condition of the patient, there are a few things we should check. Let's start with a person that is unconscious on this imaginary battlefield. The first thing you should do, of course, is place your head to their chest and make sure their heart is still beating. If its, great! If not, clasp your hands together like so." Elem placed one palm over the other, clasping the fingers. " You will want to begin compressions over the heart to aid it in starting. Without a heartbeat, the rest is pretty useless." He watched Van's progress with the stitching. "How's it coming?".

[Vanator]

Vanator nodded in understanding as Elem set the strips of leather, needle and thread before him. He picked up the needle, pretending to clean it with the liquid in the flask. No sense in using valuable supplies for training. Then the Drykas took up the thread, and moved as if to put it in his mouth, to pull the end between his lips to make it more pointed, and easier to thread. But the man paused, eyes darting to the healer. He supposed that was not sanitary, so Van rejected the idea and instead held the needled up before his eyes in one hand, the end of the thread in the other.

After a couple attempts, he got the thread through the needle hole and ran it through. Van's gaze lifted again to Elem as he continued the lesson, nodding to ensure the Zeltivan that he was following his explanations. The horseman managed to tie the knot at the end of the looped thread, and picked up the pieces of leather. He hesitated a moment, trying to remember how he had run the stitches in Hex's arm. Then he set the point of the needle near one end of a strip, trying to find a point not too far into the piece to cause a puckering when laced to the other strip, and not too close to the edge that it might tear when pulled snug. Finding a place he thought was good, Van pushed the needle point through the thin leather. It felt a little like Hex's skin when he punctured it. Pulling the thread through, Vanator found a spot on the underside of the other strip, poked it through and tugged the two pieces together at the stitch, allowing the edges to overlap just a bit to avoid bunching. The Denusk had made another stitch when Elem paused to give visual demonstration of how to give chest compression.

Vanator watched, then looked at Elem quizzically. "Pushing on the chest like that could start the heart again? But if their heart is not beating, aren't they already dead?" The Drykas and never seen the technique used, or thought that a heart could be restarted.

[Elem Bree]

Elem looked over Vanator's progress, nodding with a satisfied look on his face." Very nice. I might let you stitch me up sometime. Hopefully, with Rak'keli's grace, I won't need it though." Elem's finger followed along the seam of the stitch. Very even and straight. Just as Van had said, it wasn't his first time. "I had a small advantage, as my father is a cobbler, so I had some experience with stitching leather." He gave a small wink and then continued on with his lesson. It occurred to him how strange that sounded. He was giving the lesson. Another satisfied smile.

"Indeed, the heart can be restarted.", Elem said, moving on with the lesson. "Not all the time, but I would say half. Which I would definitely be grateful for someone trying should I be that unfortunate imaginary warrior." He smiled, not wanting to hover on the grim details. He suspected Vanator had probably been in this situation with others, where Elem had not. Not with anyone he cared for anyway, short of his fellow Zeltivans.

"Sometimes it can be shock that leads to it, when the body takes too much damage all at once. Drowning is a common cause for heart stoppage as well. Which reminds me, you want to check and make sure that this person's airway is clear so that they may breathe. Sometimes there is blood or spittle. In the case of drowning, kelp or other foreign objects may be in the throat. Always good to check, but be very cautious about putting your fingers in the mouth. The bite reflex can be quite painful, not to mention the infection that a human bite can bring." Elem realized he was getting off on a tangent like his professors at Zeltiva often did. He tried to rein himself back in.

"So, when I had mentioned a tourniquet before, did you know what I meant? Tying above a wound in order to slow the bleeding? Also, should you find yourself in a situation like the night the Zith came and there are no healers with scrolls of bone mending, we should probably cover how to splint a break. Had to do either of those in the field? How do the Cyphrus handle that sort of thing? Injuries in the Sea of Grass? Is there a common rule to go by? Just curious." Maybe Elem could learn something as well..

[Vanator]

Vanator felt a measure of satisfaction when Elem praised his stitching, though, to be honest, he hoped he never had to use it on Elem, or anyone for that matter. But the fact that he had already had to use it once in his life indicated it was a skill worth having.

The whole concept of starting the heart again stirred other questions in his mind, though they were more esoteric than medical, like, 'what if Dira had already reaped their spirit?' or 'If they were dead, why would Dira let them come back?' and 'What if where they were was better than here, would they want to be alive again?' Van knew these were not questions for Elem to answer.

The Denusk nodded again in understanding of the concept of clear airways and the danger of being bitten. Funny, he had been bitten by so many things, but not a human. Then Elem made inquiries about the Drykas' knowledge of how his people treated injuries. "I have seen healers tie bands around a limb that was bleeding badly to stop the loss of blood. But it seemed that arm or leg always died and had to be cut off. Splints are used to keep broken bones in place, though I have never done either of those things myself, or had them used on me." Vanator looked down on the counter at his sewing project. He laid his hand on it and drew it closer to him. He wanted to keep it.

[Elem Bree]

Elem sucked at his teeth while Van seemed to mull something over during his lesson. Listening to his responses about the Drykas, he wondered even more about the customs of their people. It was his turn to mull. Were they really so severe to let a limb go untreated for so long? To kill without question? It seemed strange to the Zeltivan that although the Sea of Grass was so close to Riverfall, the customs that passed out there were so different from the Rivarians, much less Elem's.

"That's really terrible. About the limbs dying. It sounds like either the tourniquets were too tight or left on for too long. Or both. I suppose that your people are always on the move, so losing a limb would be nearly a death sentence for the one afflicted. A real shame. As far as splints go, all that is required is to set the bone, splint it and give it time." Elem knew this was a very basic summary, so he expanded on it.

"Setting the bone is important so that the bone grows back in its proper place. You can usually just run your fingers along it to tell if it is in the right place or not. If it is off center, as painful as it is for the patient, you have to manipulate the bone inside the body and line it up. Some initial pain is always better than a lifetime of disability." Elem's mind went back to some of the older sailors in Zeltiva, whose pronounced limps and gnarly limbs were surely the case of seaside doctoring, with no doctor present. " Then you take some sturdy sticks and bind them around the bone, preferably laterally, or on either side, should it be an arm or leg. it helps to keep the bone in place. After that, it is just healing and doing one's best not to strain and rebreak."

Looking down at Van's hand over the leather, Elem smiled. "Feel free to keep that. You can have the other strips too if you want to work on your own. I just thought it would be a good practice material. It's very good work."

[Vanator]

Vanator nodded as the Zeltivan commented on the Drykas treatment he described, Then interrupted. "I should say, that is out in the grass away from the pavilions. We have healers, just like you. The Opal clan is know for their healers. In fact Kavala's mother was a wonderful healer, just like she has become. but when on a hunting trip, we don't always have the luxury of a healer with us."

Having made his clarification, the Drykas turned his attention back to the lesson and Elem's explanation of how to set a splint. He had seen the process of setting a bone after a man was trampled by an olidosapux, the man screamed when they set his leg. Van had never considered how it was really done, but what Elem described made sense. Then he posed a question. "When Kav and I were attacked by the Zith out on the grass, They dropped her. She fractured her thigh, and the bone was sticking out of her leg. She was able to use her magic to heal it, but what would you do if you had to treat it traditionally, still try to put it into place and splint it?"

"Oh, thanks." Van added, taking the extra leather strips.