Chapter 21: Visions, Nightmares, Sickness and Hope

"Well, I guess it's time to get down to business, huh?" Alex asked as he pushed his plate away. Breakfast had been a dour affair. None of those in Alex's group felt like talking, given what they knew they'd be dealing with later. Their Native American hosts were, as ever, aloof and taciturn, and today they were even more serious, now that their entire future rested in Alex's nervous hands. Or at least that's how Alex viewed it. It was hard to tell what the mostly silent village residents believed.

"Yeah, that's a good idea." Simon wiped his mouth and stood too. "There's no sense putting off the inevitable."

Alex and Simon walked out together, not bothering to wait for the others who trailed behind.

It was a hot, dry oppressive day and the sun blazing overhead baking their skin wasn't making things any easier. The conditions were hardly alleviated in the non-air conditioned hut they were using as a makeshift clinic.

"You specified you wanted the worst cases first. Though I question the wisdom of that approach, I accept it since I have no idea how you operate. This case, though, is a tough one," Simon said, as they entered the dark interior where Alex could see an older woman lying there, obviously quite ill and looking uncomfortable.

Gail stepped up, looked her over and turned to Alex.

"There are a couple of major tumors, fairly well advanced." She turned to Simon. "I'm surprised you haven't tried to remove them."

"Ah, but that's the rub," Dr. Reinhart explained. "While a simple removal is cheaper than chemotherapy, it isn't an option in this case. The central tumor resides next to a major artery, which is why it's managed to grow so fast. It's getting more than enough blood flow to feed it's never ending growth. That's why this is such a difficult case. We've got to find some way of removing the cancer without surgery."

Alex and Gail spoke silently together, while Gini listened in, trying to learn how to interpret what she saw. Finally Alex turned back to Simon.

"It's going to be difficult. These are all major growths and I can't drain the energy from them without destroying the flesh and organs in the way. While I may be able to help with the tumors, I'd have to kill off the healthy tissue around them."

"Well, there's an easy enough solution for that," he responded, calling to Jennifer. "Could you get her ready?" Turning back, he told Alex what he planned. "I'm going to put her under quickly, and then I'll cut her open. We aren't really operating in a pristine environment, but since you simply need unfettered access it should be OK. I'll cut as close to the tumor as I can, and you can treat it without worrying about anything getting in the way."

As much as that disturbed Alex, he couldn't see any reason to object. It would solve his problems, and it would give him access to what he needed to do.

"You do realize I can't do what I need to do with gloves on?" he asked.

"Are you planning on manhandling her tumors?" Simon asked.

"No, but still..." Alex replied, not able to explain his fears.

"Then it should be fine. Both Jennifer and Dr. Ryan explained how you operate, so I don't see any problems with it."

It took a moment for Simon to put the woman out using a crude anesthetic, applied with a simple air supply mask. He then motioned Alex near him as he made a couple simple incisions, working quickly. Jennifer, standing on the other side of the patient, wiped the blood clear, and Simon waved Alex forward.

Alex had never had much experience with blood, aside from his own when he was shot, so he felt a little queasy looking at the woman sliced open like she was, but he put those feelings away. He had more important things to concentrate on, and this woman's life depended on his not getting sick just then.

"You realize what I'm going to be doing will make her blood thinner, making her bleed—"

"I'm perfectly aware of how you work," Jennifer assured him. "I'll keep the blood stanched, you just do what you need to."

"Do you actually thin the blood?" Simon asked. "If so, I'd love to know how you accomplished that."

"We're not exactly sure what causes it," Cate explained, "this is just something we've observed over time. We're not even sure it thins the blood, but it increases bleeding, whatever the causation behind it."

Alex saw he couldn't use the more efficient forehead approach, since the incision wouldn't give him enough room to stick his entire head into her body, thus he'd have to do this the old-fashioned way, by using his fingers. Jennifer pulled the skin apart, giving him more room while still keeping the incision clean of excess blood.

Alex reached in, moving his hands as close as he could without actually touching anything. He could easily access the tumor now, and it was clear what it was, as it appeared hard and dark, like a mottled mass of destructive growth. Using just his finger tips, he tried to drain the energy from it at a slow but consistent level. Gail advised him how he was progressing, once again showing him what he couldn't see.

Alex had to make several passes at it, keeping each one short, since he wasn't actually doing anything physical with the tumor. But he had to get in at different angles to reach the different areas of the tumor. He knew it wasn't necessary to get it all. Simply draining much of it would sap the rest of its life sustaining energy, and without that it would slow down substantially. What's more, once the affected areas of the tumor died off, they'd slough off. Simon could either remove it later, or hopefully her body would be able to dispose of it naturally.

He worked on it a little longer, trying to reach the areas he hadn't been able to reach yet, instructing Jennifer where he needed access to, when suddenly the woman's incision began to fill with blood. It quickly filled and the blood began running out, streaming down her side. Alex stepped back in alarm.

"Doctor, we have a situation," Jennifer said, as she hurried to clean the wound enough for him to see what had happened.

"Damn, her artery burst. You didn't cut anything, did you?"

"No, I didn't touch anything. I don't even have a knife on me."

"Well, excuse me, but this is going to be difficult to stop. Could one of you give me some more light, please?"

Alex retreated, and Cate came up to reassure him, as Simon and Jennifer worked frantically to save the woman's life, knowing he'd blame himself for whatever occurred.

"Damn, I don't know what's happening. Every time I try to sew her artery up, it falls apart on me. It's crumbling like a sand sculpture."

"I think what's happening is Alex drew too much energy from the artery walls, effectively killing the cells making up the artery. Thus it's disintegrating as you pull it tight trying to sew it up," Gail explained. "At least that's what Liv is telling me. I'm giving her a live feed on what's happening."

"Does she have any suggestions on how I can save this woman's life?" Simon asked in desperation. This should have been a serious but easily treatable complication, but instead he found himself unable to stanch the flow of blood.

Gail simply shrugged her shoulders, but since he couldn't see her she answered verbally. "She says no. Without a viable artery, there's no way to make the repairs you need."

"I don't suppose draining energy from her would help slow her bleeding?" Simon asked, never looking away from his task.

"Sorry, but it doesn't work like that," Alex replied. "The effect on the blood is secondary, a byproduct, and I don't look forward to draining more energy after what I've already done to her."

"Damn," he swore again as he continued to work. Jennifer continued to mop the freely flowing blood, but she was having little effect, as the blood was getting everywhere. Cate had to turn away from the scene, but everyone else had seen enough blood to not react negatively, whereas Alex felt he had to look on in consuming dread.

"8:12. I'm calling time of death. She's gone. She's lost too much blood and there's nothing else I can do. Her heart's stopped and with nothing to pump, it doesn't make sense trying to restart it," Simon said, finally stopping. Jennifer continued to work, since without a blood pump like most hospitals have on hand, the blood continued to flow even though it was no longer being pumped. Seeing Cate was having trouble, Gini stepped up, took Alex by the hand and forcibly led him outside.

"It wasn't your fault," she insisted.

"No. You're wrong. It was entirely my fault. I drew too much energy away and it destroyed the very tissue keeping her alive. That's why I shouldn't be doing this. This is a force which can't be controlled, and we don't know enough about to use safely."

"That may be so, but until you learn more about it, you'll never be able to use it successfully. You've got to expect the occasional failure. After all, think of how many people died when they first discovered anesthesia, and how many people still die of adverse reactions to it even now. This is the same thing. You couldn't account for it."

"She's got a good point," Simon said, walking out into the sunlight, peeling his gloves off as he approached. Alex glanced around, noticing several people around them, none of whom approached, but who continued to look on, trying to determine what had happened. "That was a completely unexpected accident. I'm sure you didn't intend to weaken the artery, and I'm also sure it isn't as easy to control this energy as it seems. While unfortunate, you did the best you could."

It was then Alex noted another older woman, quickly shuffling to the hospital cottage, pausing at the door, then entering. Curious, Alex followed her and watched what she did.

She entered, took in what was happening, and then approached the body.

"I'm sorry, but there was nothing we could do," Jennifer told her.

The woman said nothing, though Alex could hear a quiet sob. She tried to hold back her tears as she reached up and closed the woman's eyes.

"We need to clean the body up. It would be better if you didn't see her like this," Jennifer continued.

"Believe me, I've seen her at her worst. This is nothing. This is just her end. I've seen death before, and I'll see it again. She had a good life. We both hoped Ada could help her, but we knew it was unlikely. There was too much damage done. We were already resigned to this. I'll get her burial shroud for her," she said, before turning and leaving the hut once again, tears quietly streaming down her face. She walked by Alex without saying a word to him.

"As she said," Simon continued once she'd gone, "they knew how sick they were, and how risky this was. Don't feel like this was your fault. You were her last hope, and I'm sure you took more chances than you normally would in trying to save her."

Alex wasn't sure how to respond. His heart felt like it was being ripped out. He'd injured people before, but only in self-defense. He'd caused someone in the Emergency Room to bleed badly, like this, but the emergency room staff had managed to stabilize him, and he'd also shattered Jennifer's arm, though indirectly, but here she was, almost whole and doing better than when he'd started. But this was the first time he'd unintentionally killed someone while trying to help them, where he'd used his abilities not to inflict harm, but ended up actually taking someone's life. He'd chosen to end Mary Taylor's life in Carbondale, but that was different. That had been a mercy killing, and while it had hurt him tremendously, she'd asked him to do it.

"Alex, you shouldn't be here," Cate insisted, physically pushing him away from the hut as she exited it herself. "Remaining here is just going to make you obsess about what happened."

"She has a point," Gini added. "And you can't take this personally. While this is unsettling, there are too many people depending on you for you to lose your nerve now."

This last statement stopped Alex in his tracks, and he turned and regarded her. Turning slowly, he took in everyone standing around, observing them, their number having increased over the last several minutes. Strangely, no one seemed to be judging him, holding him personally responsible. Instead, they seemed sad but resigned. They seemed to not be taking this personally. But Gini was right. This wasn't about him, this was about helping the people here, who without him would die soon anyway. His only hope, no, their only hope, was if he could slow the spread of their cancers, giving them a little longer. Otherwise they had no hope at all.

"OK, I'm fine. Are we ready to continue?"

"It'll take Jennifer a little while to clean up, and then the members of her family will remove the body," Simon explained. "They have their own rituals for the body, and their own burial customs.

"I'll tell you what; I'd thought starting out with the worst case was a bad idea. How about if I select a couple of people to focus on instead, covering a variety of situations? That way we can see what you're capable of, and you can get used to treating these people."

"That makes sense," Alex replied, as Gini handed him a water bottle to wash down the bile in his throat. "Call me when you're ready. I think I need to walk this off for a little while."

"OK, I decided to start off a little easier this time. This one isn't quite so far gone, but he's also a difficult case. His tumor is much smaller, but it's in his lung, so it's very difficult to operate on, and it would be highly risky in even the best of conditions, which these clearly aren't."

'What do you see, Gail?'

'Like he said, it's a tumor to the front side of his right side lung, right about here, ' she said, pointing to where it was.

'What do you see, Gini?'

'The same thing, I guess, but it looks like it's got a healthy supply of blood feeding it, as the tumor, although an odd color, is still fairly bright.'

'Very good, you're learning, ' he replied.

"So what do they say?" Simon asked, having watched Gail pointing out where the tumor was.

"Yeah, is that the only one?" Alex asked the room in general. Simon answered before anyone else could respond.

"He's got a couple of smaller ones, but that's the most important one."

"That's what I thought," Alex replied, even as Gail gave him a brief image of what his aura looked like so he could see where they were. "Does everyone here have such widespread cancer? Doesn't anyone have a case that hasn't spread?"

"They've got a very high incidence of it here, and when they get it, it spreads quickly. Again, we think there are specific reasons why they're more susceptible, although the results aren't conclusive enough to pinpoint it, I suspect the water."

"And you can't get enough water here to support the community?"

"You've seen the road into here, and there are a lot of people. What's more, the water seems to seep into everything. The local plants which the locals eat draw water, putting down deep roots. They draw whatever is causing these problems to the surface. It's not as easy as buying more bottles of water. And don't forget, these people can't afford to buy thousands of bottles a year."

"OK, I think I understand the problem," Alex replied, "and they absolutely refuse to leave?" Simon simply nodded his head with an unhappy but resigned expression on his face.

Seeing the discussion was over, Alex stepped up to the man. He'd been lying down, so Alex got him to stand, then leaned in and rested his forehead against his chest. Then he stood up and pointed his finger at a couple of areas surrounding it, always pointing towards the tumor.

"That's about all I can do without causing other damage. I'll look at it again later, maybe I can do a little more, but this should restrict the growth and cause it to diminish a fair amount."

"How do you feel, Al?" Simon asked. Alex noted the use of names varied here. Some people used their native names, while others chose to use their American names, but Alex couldn't see whether anyone held either choice against the people who chose them.

Al just twisted his head a little, considering the question. "Frankly, I don't feel any differently."

"You wouldn't," Alex answered. "I didn't give you any energy, I just took away a small amount from a very small area, so you'd be unable to feel it. Just as you never felt the tumor growing, you're unlikely to feel the changes to it now. It's not completely gone, but it's better. Not a lot, but it's better."

"That's all we ask," Simon assured him. "I'm just looking to improve their current conditions, and slowing the growth of their tumors is even better." However his words didn't make Alex feel much better at being unable to help them more.

"Thank you, Ada," the man said, bowing slightly.

Alex was surprised, but merely nodded in response, after which Al turned and left the room. As he did, Alex noticed another woman standing there, awaiting her turn.

"This is your next case, she's got uterine cancer," Simon told him.

"Uh, I'm not sure I want to risk playing around with someone's—"

"Alex, just think of it this way, what good are her sex organs going to do her if she's not around to enjoy them?" Simon asked, guessing Alex's reservation. "Besides, if we can't do anything with it, her reproduction capabilities will be seriously diminished. As much as I'm sure she'd like to maintain her fertility, I'm sure she'd rather live long enough to take care of children instead."

Alex considered that, then shrugged, stepping up to her. He glanced at her and then motioned for Gail, who approached with a smile on her face and knelt in front of her and examined her from close up. She couldn't see anything risqué through her clothing, of course, but Gail found the situation humorous, if nothing else.

"Well, it looks quite nice," she said, turning to cast him a knowing smile, but then turned back, "aside from that little spot right there. I can't tell what it's near, though, since I can't really differentiate the internal organs."

"You should be ashamed of yourself, Gail," Simon chided her. "It's right in the uterus, in case you can't remember where that is. It's to the front left portion of it, if that helps."

"How big is it, and can I access it from different directions without getting into trouble?" Alex asked.

Simon started to answer when Gail simply held her fingers up, showing how wide it was with her fingers. Simon just shrugged. "Yep, that's right. You know, if you had a scale model of the human body, you wouldn't even need me here."

"I wouldn't say that," Alex said with a frown. "You get to clean up the mess whenever I screw up."

"I'd suggest you do the initial attempt using your forehead, going directly in just because you have access, then try it from here, here and here," she said pointing out the best lines of approach.

"All right, stop sniffing around down there and let me give it a try," Alex told her. When Gail stood up and moved back, Alex took the position she'd just abandoned. He just touched his forehead to her pubic area, then pressed his finger against each of the points Gail had outlined for her. It only took a couple of moments, and then he turned to check with Gail.