Solo [Job Thread] Persistence

[Nathaniel Deveraux]

Day 39, Season Fall, 513 AV

Nathaniel Deveraux was not usually a man given to a quick temper. It did not serve a hunter out in the field very well when they got angry easily because there was a lot of to get angry at. Anger, perhaps, at how no animals show up despite bells of waiting, or perhaps frustration at the fact that one could hit a deer three times with arrows and have it running off as though nothing happened.

So yes, plenty to get angry at, and if a hunter lost his cool while out in the field that pretty much resulted in death. Because anger clouded the mind, but worse, anger dulled the senses and one's skills. So Nate had learned not to let himself get angry if he could help it. One needed a clear head out in the woods, if one had any desire to stay alive.

But this wasn't the middle of the woods. It was the middle of Endrykas, and Nate was standing here, in front of the Opal clan tents, wondering what the petch he was doing back here. Well, he knew what he was doing, he just didn't want to admit that his shocking lack of ability to navigate pretty much relegated himself to this sort of work. On the one hand, he'd far rather be hunting, but on the other hand learning to navigate the Sea meant he was accepting his new life here, which was most emphatically not the case.

Striding through the flaps of the tent, Nate looked about at all the hustle and bustle and trying to see if he couldn't snag someone's attention. It didn't take long for somebody to come by. A lean, rather severe-looking Drykas man with his windmarks peeking out from under his white smock came over and gave Nate a once-over before snarling something in Pavi that Nate, of course, did not catch.

The man's hands flew in a flurry of Grassland Sign, which Nate equally failed to understand, but the man's tone and entire demeanor was one of dismissal. He did not want Nate there, it was obvious. Whether it was because he thought Nate was wasting people's time, coming in clearly uninjured, or he was busy and didn't have time for new recruits, or simply because he was a stranger, he could not tell. Nor did he really care.

But before the man could simply move on, Nate took a sidestep to his left to block his path, eyes blazing but jaw set firm.

"I don't understand your language," He nearly growled in the man's face.

"I'm here to offer my services as a medic," Nate continued. The other man just looked at him for a good chime or two, brown eyes boring into his skull like as though he could set Nate ablaze if he stared hard enough. It wasn't that Nate even particularly wanted to work as a medic here, but at least it would put his skills to use and he wouldn't be standing idle for days on end waiting for something to do.

The Drykas man, however, looked unsure. As though he did not really want to hire him on but of course, like any other medical center, could really use the help. He remembered encountering similar resistance when he was last here with Waisana, and this time he did not have the Drykas girl to vouch for him. Fortunately, this man seemed a lot less full-on prejudiced than the other.

"You work. We watch. You do harm..." The threat implicit in the man's eyes was not needed. Nate had no intention of causing harm to the injured. He took his sacred oath seriously. No medic would ever deliberately harm a patient. Well, no medic worthy of the title, anyway.

"I understand. Where to I start?" he asked, and the man just motioned for another one of the healers to come over to take the reins. Clearly, he himself had no time to be teaching the newbie the ropes of how things worked. The more things changed...

"This Atine Stormrun," he introduced, brusquely. "You work with. She teach, you follow. Know?"

Nate assumed the man's last word was intended to be "understand", but nonetheless he nodded quietly, glancing over at this "Atine". He wondered how well he and his apparent new partner was going to get along. She was a slight woman, probably only around twenty or so years of age, with a clear complexion and large, expressive brown eyes. Her dark black hair was done up in the intricate braids typical of her people and she either had her windmarks on her back or chest because he could see no direct evidence of it on her at all.

She turned to regard Nate for a brief moment, placing one hand on her hip while pursing her lips and cocking an eyebrow at him, before crooking her finger to indicate he should follow her. Nate sighed, and complied with the instruction. He had, after all, offered to do this job, so he might as well not piss off every single co-worker her got assigned, or this was going to be one hai of a season.

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[Nathaniel Deveraux]

It was to Atine's credit that she started off right away with having Nate do something that was actually useful. Perhaps that was the advantage of having a mentor; he suspected Waisana may not have and that was why they had stuck her doing bandage duty. Though, Nate was not fooled. The man had stuck him with Atine not because he wanted him to learn more but because he didn't trust him and wanted someone to keep a close eye on him.

Which obviously annoyed Atine, who despite her relative youth moved the the calm, seasoned movements of someone who had at least a few years' experience doing this sort of work. She did not turn green when both their noses were assaulted by the odor of injury; the sickeningly sweet smell of blood or the stench of injured flesh. Nor did she turn green when she saw the injuries that were clear to see in the tents. If she was this used to the sights of a hospital then it was equally obvious and clear that she had better things to do than babysit him.

"So do you know any Pavi at all?" she asked, in surprisingly good Common. She had a fair bit of accent; a flowing lilt that reminded of the manes of the Cyphrus Striders the Drykas were so attached to. But her words, unlike the broken, disjointed phrases of the man before her, were actually understandable. Perhaps that was why she was chosen to chaperone him around.

"Oh yeah. Sure. I'm just not saying it because it's so much more convenient to talk in sentence fragments," Nate replied somewhat hotly. Atine just raised an eyebrow at him.

"Good, because that's all you're going to be hearing from now on. I hope you pick it up fast, or you're going to be getting lost on just about everything," Atine fired back. Nate was fairly drawn up by the comment. Wait... what? She was going to be speaking in nothing but Pavi and the Drykas hand signs from now on? That wasn't fair! That was, until he saw the sly grin on the woman's face. He almost slapped himself.

It had been the first time anyone had really fired back on his sarcasm and teasing. Some people came close, others wholly misunderstood and assumed he was being flip or even insulting. Few truly understood the purpose behind his sarcasm, as a way for him to ease into uncomfortable situations. But Atine seemed to understand. She was the first person who seemed to actually know how this particular game was played. The only people who ever did that was his sisters. Well, mostly Kat. Lea just tended to get annoyed and try to hit him with that frying pan of doom of hers. Despite himself, Nate couldn't help but grin back.

"Yeah, that's gonna work real well," he tried. He didn't make light of injuries, especially not here where the patients could hear them. It wasn't the best retaliation, and his opinion of the woman rose several notches when he realized she was disappointed he didn't have the imagination to come up with a creative comeback. He'd have to redouble his efforts. Atine, though, just shook her head. Play time was over.

"Place your hand here," she instructed, without preamble, and Nate immediately complied, pressing his hand against a cloth held against a wounded Drykas' right thigh. Something large and jagged had cut a rather severe gash into the man's flesh, and if Nate had to guess he'd say it was either a jagged piece of rock or a really dull knife.

The injury was just a singular gash, so he doubted it was caused by animal attack, since their claws tended to leave multiple gashes. He knew that one from painful personal experience. And if it was an attack by a human, they usually wouldn't go for the inner thigh, so it would have had to have been a very unusual fight. No, this was probably him falling into a stream of some sort and forgetting that streams tended to have sharp rocks at the bottom.

"HEY!" Atine was shouting, almost in his ear, and Nate stopped his internal diagnosis to glance at her wildly, wincing a bit at her volume. She didn't have to shout... "Would you mind terribly leaving your daydreams for your tent? Now is the time to pay attention," she admonished, and Nate nodded sheepishly. He really did know better than to lose focus in a medical situation. Paying closer attention, Atine instructed him to lift the bandage off, which he did, exposing the angry wound to their inspection.

Atine got to work immediately, and Nate was pleased to see that she followed the same precepts he had learned. Namely, the first thing she did was soak a clean cloth in water that had been boiled with some unknown herbs steeped inside, and then daubed the wound to simultaneously sanitize and sterilize it. Those herbs must have been natural antiseptics, though he didn't recognize them and knew the middle of treatment was not the time to ask.

Atine motioned that Nate should watch closely, as she quickly and deftly held down the man's leg, instructing that Nate assist her in doing that, before taking a needle and thread and quickly inserted it into the flesh. Nate did not wince as the instrument went to work sewing up the wound; he'd seen this done many times and in fact, it was one of the things he himself needed to learn how to do. However he did not dare attempt sutures of his own, not until he picked up more skill in medical techniques.

Once she was finished with her suture, Atine's hands stopped moving. Nate looked up in confusion, only to have her say something in Pavi, her hands moving with the usual signs he couldn't understand. He looked blankly at her. She knew he couldn't speak her language, why was she being difficult? Atine repeated the phrase, slower this time, before giving up and simply saying in Common,

"Take over. Since you're here I assume you know at least some medicine?" Nate barely understood. She... wanted him to take over? He stared dumbly at her and she began to tap her foot impatiently against the ground. The sharpness in her eyes spurred him into action. Right. They had a patient. No time to dally. So, what was next?

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[Nathaniel Deveraux]

Nate had never actually sutured a wound before, so he didn't know what the next steps were. In fact he didn't know anything about medical sutures at all, so this was definitely a new experience for him. After about a chime of indecision Atine grew impatient and grabbed a nearby cloth to soak in the sanitizing agent before wiping off the blood from the now-closed wound.

Like the medical professional she was, Atine quickly and efficiently removed the last of the potential infectious agents before motioning for Nate to release the patient. He immediately removed his hands from the man's chest and arms, allowing him free movement again, and Atine gently rubbed his shoulder and spoke gently in Pavi, occasionally signing, her voice soft and reassuring. Though Nate had no clue what the woman was saying he could guess at it; he'd heard nurses speak in that tone many times.

It was a precept of good medicine that practitioners should always present a calm and steadying face to the patient regardless of circumstance. It was called bedside manner and it was common to all medical personnel from nurses to doctors to medics. And Atine was presenting perfect bedside manner, her face gentle and voice soothing and he could imagine she was telling him that he would be fine.

And the man would be. His leg, however, might not. The injury sustained would put him out of action for at least several days, and even when it healed it might leave him with a limp, and certainly with a scar. But that was not something the healer ever tells a patient. Not unless they were directly asked about it.

Once she was done consoling the man, she indicated with her head that Nate should follow her. Under other circumstances he'd find it funny, that this smaller woman was ordering him about like he was her underling. Though in a sense he supposed while he was still working here, he was her underling. She led him past rows and rows of bedspreads with patients on them until she reached an area behind the tents. Striding through the flap, she held it open and indicated Nate should go through.

When he did, the sharp odor of preservatives assaulted his nose as he realized he had stepped into what looked like a slaughterhouse. Several pig carcasses were lying about in various stages of dismemberment, the parts in neat boxes scattered around the cordoned-off area and a few mobile tables were set up in the middle. There were surgical instruments on one of them and the other had half a pig lying upon it. Clearly this was where the Drykas practiced their techniques. It made sense; you would not wish to do so on a live patient. That would not be... wise.

Atine quickly went over to the pig carcass and picked up a nearby scalpel. With practiced ease she drew a sharp line across the flesh, making a vertical incision across the pig's leg similar to the one the man in the tent earlier had suffered. Indicating with her hand, she raised an eyebrow at Nate.

"I assume you were watching earlier?" she queried. Nate nodded, and went over to the pig carcass. There was a significant difference between watching something done in real-time once, and doing it oneself in quarter-time later. He himself did not appreciate being thrown into the deep end like this, but then he figured that living in Endrykas was pretty much all about being thrown into the deep end.

The incision was about three or four inches long, and Nate decided he probably needed that amount of string. As he reached over to the thread Atine slapped his hand away, and he drew it back with a glare at the Drykas woman's direction. Seriously? Despite the action, her face was as bland as it was before, giving no indication she'd done it at all. Nor any indication which thread would be appropriate for the incision she'd made.

He tried to remember the suture she'd used on the patient from before. It was a fairly thin string, not much thicker than a human hair. So his hand went from the thicker thread, which he thought would be stronger, to the thinner one. No slapping of the hand this time so he seized it along with a mid-sized suture needle approximate sized to the one he'd seen Atine use before. When he went to cut off a length, Atine stopped his hand for a moment, looking him in the eye before taking the thread away.

"When sewing up a wound, you want to use as little thread as you can get away with," she explained, measuring out the length of the incision she made with the thread. "You usually want to use about four times the length of the wound itself in terms of thread," she added, as she proceeded to do just that, folding the thread three times, then cutting on the fourth to have exactly four times the length of the wound, and handing the thread to Nate.

This was definitely a new experience for him, though. Besides never having actually sutured before, he had never actually even sewn before. He had no clue how to do it; and while he knew that it was basically the needle pulling the thread and one needed to insert the needle into the flesh, he didn't know where to do it, or how to do it, how much force was too much force, how deep can the needle go before it's too deep... he didn't want to make a mistake and have a patient's howl of pain be his first indication he'd done something wrong.

"You do realize if this had been a real patient, he'd be dead by now, right?" Atine growled out, eyes furious. Nate sighed and plunged the end of his needle into the flesh of the pig, hoping he'd done it right, when a sharp rap on his head from Atine told him he had not.

"What are you doing?!" she asked incredulously. "Are you trying to look like an idiot? Because you know if you are, you're doing a fantastic job." Nate wasn't sure whether to be angry or chastised. Or both. He wasn't used to being addressed in this way, except perhaps occasionally by senior staff at a hospital. And although Atine was clearly a far more experienced surgeon than he was, that didn't mean she had to act so high and might about it.

Before he could muster up a retort, Atine continued. "The suture needs to be evenly spaced across the wound," she explained, removing the needle and handing it back to Nate. "And don't stab it into the flesh. You're suturing a wound, not sticking a pig."

Except, of course, he technically was sticking a pig. And the joke was confirmed when he looked up to see Atine grinning at him. He smirked back and returned his attention to the incision she'd made on the pig's flank, ready to try once again to suture it.

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[Nathaniel Deveraux]

Nate's fingers did not dance across the flesh of the pig like Atine's had. In fact, he was pulling the thread very, very carefully, and every so often his instructor had to correct his technique. The hardest part of it was that apparently, the suture technique was not in fact the same as actual sewing. Beyond the fact that suture needles were actually curved, something that Nate was chagrined to discover he didn't actually know before, but there were certain techniques that did not exist in traditional sewing.

Atine described the stitches one by one, showing him on other carcasses then making him do it himself. The simple interrupted stitch was the first technique he was taught, and he spent a few chimes carefully pulling the thread over once, over twice, before tying it off with a simple knot.

That was another thing he was taught, how to tie a suture knot. Apparently it was not the same as a normal knot. It was a simplistic-looking but surprisingly strong double overhand knot, where there would be an extra twist above the main one, to give the knotting the stability needed to withstand the force of the body moving about.

The 'interrupted' suture was apparently so named because each stitching was interrupted. That was to say, each time one of the sutures was tired off, it was then cut, and the next one would be spaced evenly away from it, until the entire wound was closed. The advantage of the interrupted suture was that the failure of any single suture did not reopen the wound, but it was also slower and had that much more chance of potential infection in case anything went wrong.

Atine mentioned the existence of the faster running or continuous suture. As its name implied, it was a suture that was not interrupted; each stitch was attached to the next one and no cuts were made. The advantage was one of speed, and Nate tried his hand at that one too. It was much faster, as advertised, as he did not need to bring the shears to cut the thread each time he completed a knot but could continue on to the next one.

But Atine displayed the downside to such a suture quite dramatically by tugging hard on the 'wound' Nate had just stitched up, popping one of his knots and causing all the rest of them to unravel. And so that was the weakness of such a procedure; the failure of one suture meant the failure of all of them. Still, Nate was intrigued by the speed with which such sutures could be performed.

Speed in the field was crucial, after all. Even though it was the less efficient technique overall, the fact that it could be completed faster, and without the need of any shears, made the continuous stitch a technique Nate made sure to remember to practice later. Atine, meanwhile, had moved on to other things, now indicating that Nate should follow her back out of the surgical practice area and back to the main ward.

Oh goody. Perhaps he'd stop being treated like a first-year healer's assistant and finally be put to work actually helping people. Though if he was being honest, Nate would admit that he did appreciate the lesson in suturing. If he'd had that knowledge a decade ago... but no. No use crying about that now. With a grunt, Nate put down the suturing needle next to the now very odd-looking pig, covered in gashes that were rather haphazardly sewn up, to follow her back into the tent.

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