In the Balance

Posted on Wed Sep 30th, 2026 @ 7:14pm by Lieutenant Mahkato Elkhorn DAOM, MD & Lieutenant Commander K’Var & Lieutenant JG Jarin Alexander, MD

2,497 words; about a 12 minute read

Mission: Echoes in the Triangle
Location: USS Arcadia | Sickbay

Doctor Oscar McDonald and his medical staff had been swift. They had acted on instinct and relied on their medical knowledge to do what was needed in the moment as soon as Lieutenant K'Var arrived aboard via transporters, bleeding all over the place. She had been mortally wounded by a Klingon blade sent hurtling toward the away team, and K'Var had taken the hit directly in the chest. The transporter operator had been able to recognize a foreign object and removed it through the use of the technology, but it had already done its damage. It had made contact with a target, and it had ripped through the Caitian with ferocity.

There was no hesitation. They knew they could not wait for medical teams to arrive at the transporter room. A call was made for an emergency site-to-site transport. Lieutenant K'Var was beamed directly from the transporter pad to Sickbay and loaded onto a bed where she was quickly tended to by Dr. McDonald.

Oscar had worked frantically to keep the Caitian from bleeding out, and the USS Arcadia was rushing towards the nearest starbase, but Lieutenant K'Var did not have the time. She did not have hours. A medical distress call was made. They were just fortunate enough that the USS Sutter was within range, and aboard was a surgical specialist. Dr. McDonald was a miracle worker at times, but surgery was not something he specialized in. What he did do was keep his patient alive for thirty-six minutes.

Thirty-six minutes that gave Lieutenant K'Var a chance. The doors to Arcadia's Sickbay opened before Dr. Mahkato Elkhorn was suited up for emergency surgery.

“Trauma case over here!” shouted a nurse near a bed where several people stood around covered in blood. Elkhorn turned sharply toward the biobed.
Lieutenant K'Var lay there motionless beneath the surgical lighting, her fur matted dark with blood. A section of the front of her uniform had been cut away during transport. The wound in her upper chest was ugly and deep, surrounded by torn fur and rapidly spreading bruising. A Klingon blade had entered between the ribs and been driven inward before the transporter beam finally caught her.

He was immediately flanked by a fresh set of eyes, ears, and hands. Some of them, medical staff from the USS Sutter that had come aboard with Dr. Elkhorn.

“Status?” stated Mahkato.

“Blood pressure sixty-eight systolic. Oxygen saturation eighty-one percent and falling. Significant hemothorax.” The nurse glanced at the monitor. “She's tachycardic. We're having trouble maintaining her rhythm, Doctor."


Elkhorn stepped to the table. “Where's the blade?” he asked, not noticing it. He was concerned that the patient or someone in their haste had pulled it out before medical could tend to her.

“She was transported in with it inside of her, but the transporter operator used the transporters to remove it mid-transport. The weapon is in the pattern buffer."

“Good," replied Elkhorn. That was a better way of removing it than he had braced himself for.

Dr. Elkhorn then placed a tricorder across K'Var's chest and studied the rapidly updating anatomical display. “What do we know about the blade's trajectory?”

Another physician who served aboard the Arcadia under McDonald spoke up, “Anterior-left thoracic cavity. It passed through the fourth intercostal space.”

Elkhorn's expression tightened. That was not the best news, but it was an assessment that he needed to hear. “That's close to the left cardiopulmonary bundle" stated Elkhorn. He looked at the monitor. “Lieutenant, can you hear me?”

One of the Caitian's ears twitched, but she said nothing. “Good. Stay with me, Lieutenant.” Her eyes fluttered open for half a second.

Elkhorn looked directly into them and tried to reassure his patient. “You're in Sickbay, Lieutenant. My name is Mahkato Elkhorn, I'm a doctor. I'm here to help.”

Her eyes closed again. Elkhorn immediately looked toward the surgical display. His voice was even-keeled, but there was urgency in his tone. “She's bleeding into the thoracic cavity. We need to decompress the hemothorax before we lose her.”

One of his nurses moved into position. “Starting thoracic drainage, Doc.”

Mahkato nodded. “Do it.”

The catheter was inserted beneath the fourth rib. Dark blood immediately flooded through the line. “That's more than I wanted to see.” The monitor screamed. K'Var's blood pressure dropped drastically.

“Damn it! She's crashing!” shouted the nurse who had started the drainage.

Dr. Elkhorn shook his head. No, he was not going to quit now. “Push adrenaline, two milligrams. Prepare transfusion. Caitian-compatible whole blood.”

The surgical team moved with practiced precision. Elkhorn stared at the anatomical projection. The Klingon blade had missed K'Var's heart by centimeters, but the damage was worse than the initial scans had suggested. One of the secondary vascular structures supplying the Caitian thoracic musculature had been severed, and blood was continuing to accumulate around the lung.


“Her left pulmonary sac is collapsing,” Elkhorn said. “We're losing ventilation.”

“Can you repair it, Doctor?”

He looked at K'Var. “We're going to find out.”

A beat passed. “But she's going to need an open thoracotomy.”

The nurse hesitated. “Doctor, her pressure...”

“I know. I know, but if we don't attempt it, then we're going to end up moving her to the morgue for cold storage until we reach the starbase.”

Elkhorn reached for the surgical instruments. “Let's keep her alive long enough to complain about it at the starbase. I need all hands in here and scrubbed up, now. Pull Arcadia's medical staff, Doctors, Nurses, get McDonald back in here if you can find him. We wouldn't be doing this if he hadn't bought her time."

K’Var woke on the hard and dusty floor, a fire crackled and the light from its flames reflected off the rock wall. Pushing herself up off the ground K’Var felt something warm soaking her fur. Her eyes widened with fear when she looked diwn and saw the wound in her chest. The fire glistened off the blade that was next to where she laid before. Checking her wound she figured the bleeding had stopped, when her paw came back clean and it appeared the wound was closed up.

Glancing toward the light at the entrance of the cave, there was a figure. At first it startled her but she realized she couldn’t see their face because the sun was shining behind them. “Come child” came a familiar voice, a shaky and elderly voice, but a familiar voice. “Come to my voice, young one” it felt warm and safe to K’Var and she started taking a step toward the cave entrance.

—

K’Var woke on the hard and dusty floor, a fire crackled and the light from its flames reflected off the rock wall. Pushing herself up off the ground K’Var felt something warm soaking her fur. Her eyes widened with fear when she looked diwn and saw the wound in her chest. The fire glistened off the blade that was next to where she laid before. Checking her wound she figured the bleeding had stopped, when her paw came back clean and it appeared the wound was closed up.

Glancing toward the light at the entrance of the cave, there was a figure. At first it startled her but she realized she couldn’t see their face because the sun was shining behind them. “Come child” came a familiar voice, a shaky and elderly voice, but a familiar voice. “Come to my voice, young one” it felt warm and safe to K’Var and she started taking a step toward the cave entrance.

Another voice caught her attention from behind and when she turned to see who was behind her a rush of fear crawled up her spine and throughout her nervous system. It was then that from out of the shadows, the shadows that were created by the caves fire pit, crawled a strange looking creature. In the low lighting of the cave it looked as it was made from shadow. A form of primitive Caitian from long ago, that crawled on all four. Its face much more ferocious, it appeared to have horns and the longer K’Var looked at it the more she got the sense of evil. “It can all be over” a whisper came creeping from the shadow “I can take away all the pain girl.”

Taking a few steps backward K’Var started screaming “NO” at the creature. In real life on the bio-bed the wounded Caitian moaned a soft and painful sounding “no.”

—

“Stay with us my friend” Jarin said as he was gowned and gloved so he could help try and save one of the officers aboard the Arcadia he had become pretty good friends with. “Just stay with us buddy” the human said agaij, slightly lower volume. “Where do you want me doc” he would do everything in his power to save K’Var as with any patient.

"Here," replied Elkhorn. "Our patient has stabilized, for now, but her condition could worsen at any moment" explained Elkhorn. "I have done what I can with what we have aboard the Arcadia, but a starship Sickbay is no surgical suite aboard a starbase. We need to monitor her 'round the clock, a physician on stand by. Once we arrive at the Starbase, we can repair more of the damage done to her. We are going to need a lot of blood."

—

K’Var had turned and was making her way toward the exit of the cave, one of the logs from the fire being used as a torch to light her way. The Caitian was moving as fast as she could with her injury, it was hard to breath and she felt so weak. It now sounded like there were two familiar voices mixing and calling her toward the light “K’Var come on you can make it.”

Glancing back K’Var noticed the creature had grown bigger and was following her. It was in no hurry to catch her or surly it would have as slow as she was moving. “Leave me alone” she cried out at the creature trailing her.

—

Dr. Elkhorn stood beside K’Var’s biobed, one hand resting against the edge of the diagnostic console as the USS Arcadia continued its steady course toward the starbase. The worst of the hemorrhaging had been controlled, her damaged pulmonary tissue repaired, and her oxygenation had begun to stabilize. Still, the Caitian remained unconscious beneath a web of monitoring leads. Elkhorn studied the neural display as a constantly shifting pattern of electrical activity moved across the screen.

“That's encouraging,” he murmured. “Her cortical activity is remarkably strong.” Despite her unconscious state, K’Var’s brain was working intensely, cycling through periods of heightened activity. Whatever was happening inside her mind, she was still fighting.

“Come on K’Var stay with us” Doctor Alexander was getting one last transfusion bag ready. “She’s pretty strong willed.”

Her physiology, however, told a different story. Her heart rate remained elevated, her respiratory pattern irregular, and subtle muscular contractions continued beneath her fur. The Caitian autonomic response was showing significant sympathetic activation. Her body was still convinced it was in immediate danger.

Elkhorn adjusted the sedative infusion by a fraction. “Easy, Lieutenant,” he said quietly. “Your brain knows you're safe. Your body hasn't figured that out yet.” He watched the neural pattern for another moment before looking toward the stars beyond Sickbay's viewport. “Come on, K’Var. You've survived the blade. Now let your body catch up.”

He looked at Dr Alexander "Doctor, do you know the lieutenant well?"

“Pretty well, doctor” Jarin looked up from his scan. “We’ve spent some of our off duty time together and my son loves K’Var.”

—

K’Var was getting closer and closer to the exit of the cave. Closer and closer to the light, to a presence that felt warm, almost like a mother’s love. Be just a few feet behind her was the cold, dark, scary feeling that she knew she had to get away from. “K’Var” the trailing presence whispered, she pushed her tired legs with everything she had. Reaching for the familiar presence waiting for her at the exit of the cave.

The dark figure swiped its gnarly claws at the fleeing woman’s back, barely missing by a few inches. “You belong with me K’Var” it growled and it seemed as if the cave shook around her causing her to stumble slightly. It was at that moment the creature got the upper hand and pounds K’Var. they rolled on the sandy cave floor, K’Var fighting with everything she had. The creature slashed with its claws and got the Caitian across her chest. Pain lit up every nerve in her body and she cried out in pain.

Just when k’Var was losing consciousness there was a warm light enveloping her body and when she cracked her eyes she saw her grandmother, her mother’s mother. K’Var stood and watched her grandmother hold her as a child. Another memory was their trip to the opera house. She watched several of her memories play on like a movie and the last one was the day her grandmother passed away. Before slipping away she told K’Var how much she loved her and how proud she had made her.

Ir was her grandmothers loving reminder that would help her fight her way back to life, back to her duty and friends. “I love you, Mar Mar” she whispered as the pain in her own body went away with the memory of her grandmothers last hug.”

—

Jarin noticed K’Vars eyes flicker a little bit and heard her let out a moaning almost mumble of the words “Mar Mar” and called for his superior “Dr. Elkhorn I think she’s waking up” he said excitedly but not to loudly, after all it was a sickbay.

"Caitians make for a stubborn physiology at times," Dr. Elkhorn said as he approached loaded another vial of a medical cocktail to administer it. He found an ideal site and pressed the device against K'Var's flesh. "Best to keep her sedated for now. We'll be arriving at the starbase shorty. From there, she will undergo additional surgery and need time to recover. We've done what we could here, Doctor Alexander," he said to Jarin.

He placed a reassuring hand on the man's shoulder. "I have full confidence in the starbase' medical staff. She will pull through. We did our part well."

—

K’Var was at peace and was getting the rest she would need to allow her body to heal. In the physical world she had been moved to the starbase for further medical treatment until it was time for the Arcadia to depart. Of course that was if the medical staff thought it was safe enough.


Lieutenant K'Var
Security Chief
USS Arcadia

Dr. Mahkato Elkhorn (NPC - Abernathy)
Surgical Specialist

 

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