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Old August 5, 2015, 01:00 AM   #1 (permalink)
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[Ziel Aerca] Healthy workers are happy workers [Maddyn]

Autumn, Era XXII Post Fractum

For all of the people that were slowly drifting into Moonstone, there wasn't a whole lot of infrastructure actually in place to take care of them all. Most of it was centered around Ziel Aerca, but of course Sliucha was trying to get people to settle down in the lands east and south of the city proper, in the area dubbed the "Third District." There wasn't really all that much out there, and the people were mostly left alone to do what they could on their own. She had been funneling resources and funds, of course, but there was only so much money could do.

So! She decided to make routine trips out into the countryside to assist, personally. A powerful thaumaturge, not to mention a rather decent surgeon and grafter, surely there was plenty of help she could provide? Most of her services were free or absolutely dirt cheap, so as to not further burden the people. Healthy workers were happy, efficient workers, no? This was more about building up a reputation than anything, really.

So! Out she went. Let the problems come to her.
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Old August 5, 2015, 10:09 PM   #2 (permalink)
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Problems! Agriculture was a lifestyle fraught with dangers that were considerably rarer than life within the city or towns. It was rare that one encountered an enraged wild oxen in the middle of Ziel Aerca. To the south of the Great Centripax Basin, it was just one of the hazards that came from introducing rice fields to the area. Snake bites were but a side effect of there being so much food available for their chosen form of prey – rats and mice were in abundance.

So too was there the dangers that came from constructing shelters, houses and barns and storage areas. The risks that came from travel from Centripax to Ziel Aerca and the prospects of banditry. Those that were in the midst of trying to clear old wells of the contamination of the Xet’s Fog, or trespassing far too far south and west where the Principality of Moonstone bordered against one of the entrances into Fae’rel and Kel’rondar.

Those that antagonized the Seelie and Unseelie creatures of Faerie? There was little Sliucha could do for them beyond advising not to be so stupid. But there was no shortage of ailments, only the time she had available and a decision on what she would focus on.

Never mind the other complications that could come from pregnancy, flu, rashes and broken bones. There would be no shortage of work for the Elf in the Third District.
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Old August 5, 2015, 11:40 PM   #3 (permalink)
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Let's get down to business!

Sliucha more or less just setting up a mobile base of operations while she traveled around the countryside. A heck of a lot less furnished than her Apothecarion, surely, but she brought along the essentials. Surgical tools and some of the more important herbs. Most of her work was admittedly magical in nature, anyway, and the only thing to worry about there was contamination. Note to self: hire spellbreaker?

Snake bites? She had antidotes for the poison, painkillers to help deal with the pain, thaumaturgy to help flush out the venom from their bodies, and kisses to make it all better. If they'd been attacked by oxen, she could heal up their wounds and reattach body parts if they'd decided to pick those up as well. Wounds in general, she'd patch them right up!

She traveled from hamlet to hamlet, visiting all the little farms out in the countryside she could, offering her services, asking them what ailed them. Any particularly interesting cases they could bring to her?
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Old August 6, 2015, 12:15 AM   #4 (permalink)
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Dealing with the various injuries gave Sliucha a better understanding in part of the trials that faced the new citizens of the Third District. Most of the animal attacks that she worked her healing upon tended to be due to snake bites. The brown snakes and the red bellied black snakes were rather routine affairs, but amongst the attacks that occurred around the rice fields and to the west of the shore? There was one outlier. One of the snake-bites, the species unknown, had a nasty tendency to cause necrosis in the injury.

Thaumaturgy had issues when the flesh and tissue was that greatly damaged by the time she got to it. She could stave off further harm and alleviate the pain, but the damage to the skin and muscle remained intact.

Injuries caused by oxen, horses and the like? They tended more towards broken bones and deep gashes rather than anything that removed limbs. These too were to prove rather routine for a Thaumaturge and healer of Sliucha’s capabilities as she moved between the small hamlets and farmsteads that dotted the south and west of Ziel Aerca and the Great Centripax Basin.

It was on the second cycle of rather routine work, that word eventually reached Sliucha of a pregnancy gone wrong. Conjoined twins.
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Old August 6, 2015, 12:27 AM   #5 (permalink)
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Hm. There wasn't much Sliucha could do about the necrosis beyond perhaps offering grafts of new skin and muscle of the afflicted regions. Or, perhaps, there could be a campaign to eliminate the snakes. Something to ponder, certainly.

Conjoined twin pregnancy? Sliucha bade them take her to the scene, where she'd see what had happened.
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Old August 6, 2015, 12:48 AM   #6 (permalink)
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Small farmhouse out in the country where the potato fields grew. An incredibly boring environment all told, as there was only so much that one could do with potatoes throughout the Era as one awaited their suitability for harvest. That same limitation had ensured that the husband and wife had found conventional means to passing the time. It hadn’t gone well.

More hands to work the farm in future Era’s? Fantastic. More mouths to feed? Not a huge problem courtesy of the bounty that Ziel Aerca had provided when it came to work opportunities in the Third District.

A mother that had all but died in childbirth and was still bleeding out was a problem. A birth, anticipating but one child and ending up with two was normally cause for remark about one being blessed. The twins however shared a single body; born with their skulls connected at the back. A boy and a girl. Separating them was more than a little bit beyond the average healer.
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Old August 6, 2015, 01:00 AM   #7 (permalink)
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All but dead? Sliucha tried to make sure that there wasn't actually any way to save the mother as well. A mother could always make more children, after all. But if there wasn't anything she could do there, she'd turn her attention to the twins.

Conjoined at the head. Complicated. How severe was it? If their heads were fused together to a significant degree than the chances of them sharing major portions of the brain was high, and that was possibly beyond even somebody of Sliucha's expertise. If it was more minor, though? Then perhaps she could do something about it.
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Old August 6, 2015, 01:39 AM   #8 (permalink)
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Saving the mother was a hefty amount of Vis for Sliucha to expend. The brightenings spent with her continually bleeding after the childbirth had left the mother effectively upon Jalat’s doorstep. Clinging to life through more will than means given that she’d lost several of liters of the precious life force after the already straining reality that was childbirth. It was well within the Elf’s means to ensure a long and healthy future (accidents aside), but at this point? Magic was the only true means of ensuring her survival.

For the child, that complication was rather less straightforward. The combination of the two children as one, both parts of the brain appeared to be connected as well as a part of their Vis. Arcana would only prove to be part of the solution – her skill as a surgeon and the need for a Grafter’s technique as well were going to have to play a part if she was to save one or both of the newborns.
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Old August 6, 2015, 01:45 AM   #9 (permalink)
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Let it never be said that the doctor gave up on a patient for the sake of convenience, hm? Sliucha devoted as much vis as needed towards ensuring that the mother survived, if only because if she failed with the conjoined twins? Well, um, surely they could just go at it again and pop out some more. Yes?

Right then. Her analysis of the children told her that while a procedure was definitely going to be difficult it certainly wasn't impossible. Her only fear was that the separation of the brains would result in drastic consequences for the children, even if the split was clean. She informed the father of such, that the possibility of complications in this matter was high. The intricacies of the mind were beyond Sliucha, quite frankly, and so she didn't know whether removing one child from the other could potentially negatively impact either of them. Even assuming everything went correctly, of course.

How likely was it that the father would refuse to go forward with it at this point, though? It wasn't like he had anything to lose.

They'd start slow, then. A room with a table would be requested, or at least somewhere where the children could lie down. Everybody else was asked to leave. Now then! A careful incision upon the scalp with a sharp scalpel, opening up their heads from the top, so she could see what state their joined minds were in.
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Old August 6, 2015, 09:55 PM   #10 (permalink)
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The mother would survive! It also ensured that Sliucha didn’t have to deal with the husband hovering about and getting in the road now that he could actually be of assistance. Brightenings spent trying to care for the conjoined children and watching his wife slowly bleed out had been more than trying when the family lived in such an isolated region of the Third District. If nothing else, Sliucha had won the gratitude of some for her efforts.

When it came to the children, matters were less than straightforward. A side effect of Sliucha striving to find unique and rare cases rather than being content with the mundane ailments and troubles that was centric to the regions around the rice fields.

Space! A slow start, and an assessment obtained amidst the surgeons work. Their minds were joined, there was no doubt in that as some of the brain appeared to be fused. The connection though was minor (insofar as such a thing could be deemed so) in that it seemed to be superficial rather than complete integration. A separation was possible, if bloody.
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Old August 7, 2015, 01:16 AM   #11 (permalink)
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Hm, yes. This was workable.

A sharp scalpel and a steady hand. She had made sure that both of the children had been put under anesthesia, unconscious so as to try and avoid them moving around during the operation. Now, poking around in their brains could also potentially cause them to flail around, but there wasn't really anything Sliucha could do about that. Note to self, more experiments involving the brain.

It was all experiments within experiments, trials within trials. What she learned early on in the operation could help her later on in the operation. Ha! This was what made this exciting. Mundane operations were safe, but Sliucha was anything but complacent!

So, then, she'd identify an area which seemed to require the simplest, shortest amount of work, and start there. Careful and precise cuts with the scalpel to try and separate the brains, utilizing thaumaturgy only to quickly reduce bleeding so as to avoid flooding, and dabbing grafter's glue here and there to help in that regard as well.
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Old August 8, 2015, 12:22 AM   #12 (permalink)
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It was tiresome work, especially so soon after having invested in the healing of the mother. A slow and steady task as more and more of Sliucha’s Vis was necessitated in staving off the bleeding as she concentrated upon the scalpel’s precise nicks and cuts. Most of the brain matter looked alike, leaving the Elf with little to differentiate between what was needed in one of the child’s skulls and what should have belonged in the other. Only that the thin membrane that linked the two was the most obvious cut off point. Tinkering further was probably only going to end poorly for one of the newborn children.

The Grafting glue helped set the foundation of her work, the revelation that she was probably going to require Grafting when it came to replacing the sections of missing skull likely. In the short term however, such an undertaking would only increase the risks of the children’s untimely death. An operation for the future given that the combination of life on a farm and having an exposed brain pan made for a rather poor combination.

After what felt like a good candlemark or two of work, Sliucha had two separate children on her hands. And a lot of blood. More so than should have been, and after treating the mother? It appeared that haemophilia was in the family tree.
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Old August 8, 2015, 12:36 AM   #13 (permalink)
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They weren't out of danger yet. For now, though, at the very least Sliucha had managed to separate the two of them. She had a few herbs on hand that helped rejuvenate blood in the patients, rich in iron, stewed into a broth for them to drink. Hopefully that would be able to help some. At the same time, a recommendation would be made to the family to try and feed the children foods that were rich in iron to assist in getting blood back into the kids. She'd be willing to donate a few coppers and silvers if necessary if the family was too poor to afford such things - or even send such supplies their way if there wasn't anywhere around for them to get such things.

Not to mention she'd schedule an appointment soon to properly close up the childrens' heads. Not something she could do now, when they were so weakened. Their strength needed to be rebuilt, and in the meantime, the parents would have to be careful about keeping the areas clean until then, yes?
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Old August 8, 2015, 01:49 AM   #14 (permalink)
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With the children, separated as they were, being newborns; the prospects of an iron rich diet seemed unlikely. As it was, the instructions with the herbs and the possibility of a broth to supplement the recovery process was taken as being absolute gospel. Sliucha’s role in ensuring the possibility of lives saved (and not having to lease out the territory to a different farmer, which would surely have only added to the Aedile’s troubles in the Third District), had won her no small amount of gratitude.

Little though they had, it was a safe bet that the farmstead would always offer Sliucha a bed and a meal when she passed through the lower south-western region in her travels.

Only time would tell how well the husband and wife followed Sliucha’s directives; with any assistance being something that was claimed. The combination of humility after everything the Elf had done for them at was at odds with the knowledge of how greatly in debt they were, and knowing that they would require assistance in the future too. A future appointment that would fit within Sliucha’s own schedule - it wasn’t as if the farmers were going to be relocating again anytime soon.
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Old August 8, 2015, 02:02 AM   #15 (permalink)
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Sliucha made sure to deposit what rations of the herb she could spare with the farmers, telling them how to make the broth in question. It was rather simple, mostly steeping the plants in hot water... hopefully that would assist the newborns on their way to recovery. She had done what she could, the rest would be up to them.

Multiple checkins would likely be necessary given the precarious situation, especially given the incredibly young age of the patients. She'd stop by in a cycle's time and see how they were doing, and go from there.

As it was? 'Tis time to move on. More patients and all, after all. She bade them farewell and best of luck in their endeavors. Glory to Moonstone!
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