A Matter of Control

Posted on 04 Nov 2017 @ 10:34pm by Lieutenant Sterek & Lieutenant Commander Camila Di Pasquale

1,664 words; about a 8 minute read

Mission: Crossing Over
Location: Sickbay
Timeline: November 15, 2388

Once Joey had been discharged - complete with a PADD full of meal plans and a repeated recommendation to avoid sugary foods - Sterek gestured Camila into a private bay, taking his recorder with him. He pulled up her notes on the wall display, double-checking some small detail before dismissing them again.

Camila stood in the private room and debated between crossing her arms over her chest or the open relaxed arms at her side posture. Either way, she had an idea of what the Doctor wanted to talk to her about and she didn't have much of a plan in mind.

"Lieutenant, I observe that your body mass index seems to have reduced significantly since your last physical, with no obvious cause noted in your file. This severity of weight loss is concerning." His gaze moved from her hair to her face, clinical and assessing, and then his voice took on a slightly gentler tone, slightly unusual for a Vulcan.

"Is there anything you need to disclose before I initiate scans? Any unusual symptoms, or... other concerns?"

"The obvious cause, Doctor Sterek," she said. "Is a lot of long, hard hours spent on Deep Space Eleven. I requested to go there after the enforced shore leave from when the Black Hawk went down on New Bajor. I helped to destroy part of it when me and my personnel went in, so I volunteered to go back to help restore it."

Sterek's expression didn't change, but he clearly wasn't convinced. "Extended duties are insufficient to explain the severity of physical change in this case. Please lie down; I will need to run a few scans." He tapped in a few commands in preparation as he spoke. "Are you experiencing gastrointestinal symptoms? Elevated stress levels?"

"No," Camila replied. Other than blaming myself, but that's not unusual.

Sterek raised an eyebrow and gestured to the biobed. "It will not take long, Lieutenant, but I do have a duty of care in this situation, and your physical state is cause for concern."

She suppressed a sigh but knew a word from Medical would be all it took to take her off duty and she couldn't have that, so she laid down on the biobed. "I'm a functional officer, Lieutenant," she said. "I fail to see how my perceived physical state would affect my ability to carry out my job."

The Vulcan activated the scanner. "I disagree, but the reasons behind your weight loss are a more immediate concern. Your last weigh-in was at 65.7 kg; this has reduced by approximately..." He paused and looked at the screen. "Seventeen percent. Which could be symptomatic of a serious illness."

"You're welcome to check, but I'm sure I don't have any illnesses, Doctor," Camila said.

Sterek looked at the biobed readings again. His expression shifted almost imperceptibly.

"Are you currently seeing a counsellor, Lieutenant?" he asked, his voice a little gentler now.

"No, and I don't have a need to see one," she responded, wondering at his tone. This was a Vulcan and he was acting anything but a Vulcan.

Sterek seemed to consider her response for a moment. Then he deactivated the scanner and moved over to the medical replicator, typing in a command with deft fingers. "After my extraction from captivity on Aidoni IV, I was unable to consume solid food for three days. It was partly psychological, partly physical - extended periods of reduced intake can affect one's capacity to cope with normal portion sizes."

"Being captured and held against your will is never a good thing and I can understand that you've have a psychological aversion after being limited," Camila said.

He took the cup that materialized inside the replicator and brought it over to her. "I can detect no signs of any illness that may have caused such rapid weight loss. Given that you report no psychological concerns, I can only conclude that the problem is logistical, as you claim. I am therefore recommending a partial regime of high-calorie meal replacement beverages, which will not only save you time but should also help to increase your appetite to a normal level."

The Vulcan eyed her expression carefully as he offered her the drink, as if watching for something in particular.

"Thanks, but I prefer solid foods," Camila said. "In fact, I ate at Talon's last night with Lieutenant Geisler and had my meal at lunch today." Which the replicator records would show was true that she had ordered a meal, but it wouldn't have said that she only ate part of it.

Sterek kept holding out the cup to her. "An encouraging start," he said, eyes still on her expression. "Can I assume, then, that you will be in slightly better physical condition for your mandatory check-up appointment with me in a week's time?"

She took the cup and took a drink of the liquid within. "What's the ancient saying?" she asked. "Rome wasn't built in a day, I believe. If you can reasonably expect someone to change in a week regardless of what you give them, you must be expecting them to push themselves beyond their boundaries. That doesn't seem healthy to me, Doctor."

"Interesting." Sterek's factor was calm. "What boundaries might those be, in your case? It was my understanding that your weight loss was a result of your extended work hours on Deep Space Eleven, which have now ended. Is there another factor I have not taken into account?"

"If I were to push myself to eat say, five meals a day, would that be healthy for me just so I can meet your desired target of what my optimal weight should be in one week?" Camila asked.

Sterek looked momentarily weary.

"To be candid, Lieutenant, I see insufficient evidence that you are even managing three."

"How did you come to that conclusion?"

"You have a number of minor nutritional deficiencies, Lieutenant, as well as evidence of intermittent fasting along your GI tract. You deflect and become defensive when your eating habits are questioned; you insist that a reduction of 17% body weight can have no clinical cause. All the evidence is highly suggestive of a very specific conclusion." His voice softened again. "There is no shame in receiving psychological assistance."

"I have been back on the ship for exactly three days, Doctor," Camila said. "In that three days, do you honestly think that I can get back up to where I was before? Or in a week that you're giving me before a physical? What happened on Deep Space Eleven isn't happening here. Now you can make all the suggestions you want, but as a Doctor, you have to know that not everyone is the same and with that in mind, what is your logic telling you?"

"That if what you are saying is accurate, at your appointment in a week's time - which will not be a full physical - your scans should show that you are in marginally better health. I am not," he continued firmly, as if to prevent interruption, "expecting you to regain ten kilograms in a week, or even two. What I am expecting is that you will cooperate with the medical professionals whose job it is to safeguard your health, rather than react with hostility to any suggestion that you may be ill."

She looked at him as if he had revealed he was Klingon when he accused her of hostility when all of her responses had been calm and logical. "I never said that I wouldn't cooperate and I certainly don't recall being hostile, Doctor," she said as she took another drink from the cup he had given her. "Nor did I object to anything you've said so far, have I?"

"Your body language and speech have been consistently defensive; your reaction to my suggestion that you return in a week's time, almost disproportionately so. I am acting out of concern, Lieutenant. If I have drawn the wrong conclusion I will adjust my behaviour accordingly... but I do not believe I have." He looked at her searchingly. "Can I assume that you have now significantly reduced your intake of alcohol, as your liver enzyme levels suggest?"

"As a matter of fact, I have no consumed any alcohol in just over a month," Camila said. Not that it hasn't been tempting, she mentally added. "I know you are concerned, and you have every right to be. I am going to follow your recommendations and work on getting myself back up to optimum physical health again."

She paused, then gave a rueful chuckle as she realized something. "As for the defensiveness you may believe you perceive, I take it that you've not interacted with many Security personnel before. We're trained to be offensive and defensive in almost all situations, so anything that you believe may be hostility on my part isn't actual hostility."

If Sterek was in any way sceptical about this, he didn't show it. "I see. As a matter of fact I worked closely with many security personnel in previous postings - but perhaps they were more accustomed to interacting with medical staff." He moved back over to the wall console.

"Everyone has their own methods," she said.

"I will book you in for an appointment this time next week. Should you experience any difficulties in the meanwhile, you are welcome to contact me." The Vulcan glanced back at her, eyes inscrutable. "Anything you disclose will of course be treated with confidence."

"Of course," Camila said as she came to her feet and finished the liquid in the cup he had given her. "I'll contact you immediately, Doctor."

Sterek nodded. "I will not detain you further, unless there is anything else you wish to discuss?"

"Not that I can think of, Doctor," she said as she handed him the cup. "I'll see you next week."

Sterek watched her leave, silent, and deep in thought.

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