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CHAPTER 35:
Under Pressure



Richmond Times Features @JenButler

Tonight’s stream features Mission Medical Command, the consolidated team of physicians, surgeons, and specialists serving NASA and MarsX. We’ll also dive into the training of USSF flight surgeons. Join us in an exploration of the fascinating work these highly-trained doctors bring to our space missions. Stream it now @RTFchannel11016.

ChirpChat, October 2043


Glenn felt confident as he headed into the main room to check the toxin analysis results. Something nagged at him as he closed and latched the door to the isolation room. It was something about the little room and security, but he couldn’t place it.

First, he needed to check on his patients.

When he’d dismissed Takeda to her quarters, Katou had taken her place and was currently asleep, dialysis finished for now. He checked her condition and set the treatment bed to keep her sedated for the next eight hours so that she could rest. Glenn decided to keep her catheter connected to the treatment bed to facilitate administering the sedative.

Bialik moved slightly and her eyes shifted back and forth beneath the closed eyelids. The readout on the treatment bed indicated that the medic was currently in normal REM sleep, and not showing signs of pain or discomfort. She still needed rest, and the treatment program was due to re-dose her with a sedative in ten minutes. Pancreatic failure didn’t typically require dialysis except in severe cases. He might have to surgically implant a dialysis port later, but for now he could disconnect her from the treatment bed. He programmed an immediate dose of sedative instead of waiting, then removed the tubing and capped the catheter for the time being.

He was satisfied that dialysis had been the right call. It would have removed copper from their bloodstreams, if that was indeed the culprit. At the very least, he’d taken steps to keep the deterioration from getting worse. Copper could still linger in cells and lymph fluids, but that could be handled with chelation treatment. Still, these results were one more indication that he was on the right track.

Now to confirm it.

He sat at the console for the lab wall—or rather, pulled himself to the seat and pressed his knees under the console to keep from drifting away. He reached into his belt pouch and pulled out one of his remote chips. The interface behind the analyzer panel was tied into the whole med bay informatics system. He would finally get the remote access he hadn’t been able to do while Yvette was watching.

Once the chip was installed, he pulled up the results in his heads-up display. Each of the tests—Bialik and Takeda’s dialysate, Mishra and Grigorescu’s blood samples—showed high levels of copper.

Now, where’s it coming from?

As he had just seen with Bialik and Takeda, the crew could be treated. If the source was in their food or water, it wouldn’t matter, since he’d brought replacements from Earth. If it was some other environmental source, though, he needed to find it and shut it off. The tests indicated that ceruloplasmin levels were very high, as well as unbound copper—elemental copper, copper sulfate, copper nitrate, copper arsenate, copper chromate and other salts—this was important for Mishra and Grigorescu’s diagnosis, since ceruloplasmin was the body’s carrier of copper for normal metabolic functions, as well as ridding the body of excess. Copper sulfate was a soluble component of fungicides and bactericides. He found some metal salts in the results, too, implying that the source was associated with corroded metal, but it wasn’t enough to point to the illicit still. Copper sulfate and copper salts were common in many of the agents used to keep fungal growth down in the warm, moist, closed atmosphere of a spaceship. There was still a chance that there was a solid source for the contaminant, but the mostly likely way each crewmember would have been exposed would be the water supply.

There was a water dispenser in the small room with desk and console through which one entered the med bay from the main corridor. Glenn grabbed a syringe and went to the office to get a sample of drinking water. He opened the dispenser valve for just a moment, and a small globule of water formed on the mouth of the tube. He used the syringe to suck up the water, then returned to the analysis wall, injected the sample, then waited for a result.

Copper sulfate.

Time to go looking for copper in the water tanks.

Glenn started out of the med bay, and was hit by the smell of the atmosphere of the rest of the ship. While conducting the exams, he’d increased filtration and airflow in the enclosed medical facility. With his helmet off—and now that he understood the causative agent, he could leave it off—he was hit with the bad smell of the ship’s general air supply.

It reminded him both that he had left his helmet in the isolation room where Yvette had knocked it off during their fight, and that he no longer needed his own air supply. He would need it if he planned to enter any of the huge water storage tanks, though; they wouldn’t have airflow except through the open inspection hatches. Descending into a tank would require him to bring his own air along.

Yvette was still unconscious from the sedative. As he retrieved his helmet, Glenn realized he had another problem—he was about to leave the med bay, having locked the ship’s medical officer in a room, strapped to a cot. Acting captain or not—superior officer or not—this was not the sort of action that could go undocumented. Before starting his scavenger hunt, he needed to record a report to Earth.

He wouldn’t have trouble with the diagnosis, metal toxicities had been briefly discussed during the pre-Bat medical discussions. They had only been dismissed because the teams had been fixated on bacteria or viral causes. He now had definitive tests that showed copper levels were abnormally high. He’d attach those to the report and send it along for information, but make it clear that he had the treatment plan in hand.

As for treating the crew, he planned to use the decades-old standard treatments of penicillamine and dimercaprol. Both were chelating agents to remove excess heavy metals from the body, although they had different routes of administration. Penicillamine could be taken in pill or liquid form by mouth; dimercaprol, also called “British Anti-lewisite,” would have to be administered by injection into muscle, so he’d have to call each of the crew back in for shots. There was also a newer treatment with alpha-lipoic acid—an antioxidant with good effect at chelating unbound copper from tissues. It was a common dietary supplement, and he’d brought sufficient stock in Bat to treat the crew.

No, the part of his report that would create problems would be the diagnosis of paranoia in First Officer Dvorak, debilitating OCD in Marsbase commander Taketani, and paranoid delusions with schizophrenia-like symptoms in Medical Officer Barbier. Command teams distributed authority precisely so that ultimate authority was not held by any one person. While it was true that a ship’s captain was in full command, questionable decisions could be countermanded when first officer and medical officer agreed. Glenn Shepard had been effectively made captain of Percheron and commander of the returning Marsbase crew, but the command triad was broken. He had declared both of his potential seconds-in-command—as well as the medical officer—unfit for duty.

He was truly alone, so he’d better be right.


Once more, Glenn transited out of the habitat ring to the ship’s core. For the first time since he’d started the medical exams, he realized how much time had passed. He and Yvette had done twelve exams on the ambulatory crew members, as well as two more on Bialik and Takeda. That was fourteen exams—most about thirty minutes, but several had run much longer. They’d also set up three dialysis treatments and the blood, urine, and dialysate analyses. Altogether, he could account for nine hours just on the medical procedures alone. However, that didn’t include the fight with Yvette, her exam, securing her, getting Bialik disconnected, and reading the analyses. It had been twelve hours since he’d entered the med bay, and he was feeling the strain. He should go to the bridge and make the report, then back to his shuttle to eat and rest.

The problem was Yvette—she was unconscious in the med bay, and he needed to make his report and inspect the water tank before she woke up.

All he really needed was a ration bar, some tang, and an extra oxygen canister. He’d need the air if he went inside the water tanks—which he admitted to himself was increasingly likely—but it shouldn’t require too much more than a single recharge. After all, he’d been breathing ship air for some time now. There were spare air packs scattered throughout the ship, and they were compatible with his suit. It was more important to get reports and messages sent to Earth now that he had an answer, or at least the first part of one.

He didn’t even have to go to the bridge to use the comm. The belt pouch of his skinsuit had a ration bar and couple of drink bulbs, and he’d grab an oxygen canister on the way. He dictated a report for Mission Control as he made his way back toward the cargo section. The interface chip in the med bay workstation gave him full access to the medical records and instrument displays on his heads-up display. That same system allowed him to store data and individual views, so he simply attached those files to messages sent directly from his interface to Percheron’s bridge comm console, and from there to Earth.

The eye prosthetic not only wrote visual information to an electrode interfaced to the still-intact retina of his left eye, but read information in the visual association areas of his brain. Their purpose was to help focus and refine visual input depending on where he was looking in his visual field, and on which items he focused his attention. It also functioned as a virtual “keyboard” interface in which all he had to do was focus on letters and numbers superimposed over his vision. Using the interface, Glenn’s search for files to attach to the report had also revealed time-indexed “snapshots” of his day. Each was an audio and video clip of varying length, which occurred both at regular intervals, and at events throughout the day when he’d been most stressed. He knew his bionics spied on him; after all, he’d activated the “bodycam” recording function when he boarded Percheron. This particular system had done him a great favor, though. He was able to find records of the fights with Yvette, Dvorak’s paranoia, and Taketani’s delusional OCD. He attached those records as an addendum to his original report and sent those to Earth as well.

Current communications lag was fifteen-and-a-half minutes each way, just over thirty-one minutes for a round-trip message, assuming that Earth answered as soon as they received his report. However, it would take time for the report to go from the comm station to the flight director, through MMC, and up to the director level at NASA, MarsX and Space Force. It would be hours before he could expect a response. There was no point in waiting, so he also recorded messages to Dvorak and Taketani to briefly describe his findings. He ended each message with the information that medical officer Barbier had attacked him and he had secured her in the med bay. She should be okay for the hour or two it would take him to complete his next investigation, but he wanted others to know where she was in case it took him longer than anticipated.


Glenn found himself standing in front of the inspection hatch for Internal Water Storage Three. Normally at this stage of the voyage, Percheron would still be drawing water from the second of the four large internal tanks. IWS One was meant to service the Percheron and outbound Marsbase crew during the journey from Earth to Mars. With reduced numbers aboard during the stay at Mars as the Marsbase crews switched off down on the planet, IWS Two would suffice for the entire stay at Mars and well into the return journey. The crew would use approximately half of IWS Three for the rest of the trip back to Earth, leaving IWS Four completely in reserve. However, a malfunction in the IWS Two distribution valves occurred forty-five days into the three-month Mars orbit phase.

The remainder of the water in Tank Two was still there, inaccessible until the ship returned to the dockyard at O’Neill Station. Moreover, the water intended for sterilization by exposure to space radiation had been drawn from IWS Four. Not only was nearly one-fourth of their water supply inaccessible, almost the same amount had been lost when Captain LeBlanc blew the hatch and decompressed Cargo Bay One.

There was additional water storage in external water supply tanks—EWS One through Six—but those tanks were much smaller, and were primarily “gray water” tanks, meant to store wastewater from the hygiene facilities, hydroponics, and cooling systems. It could be filtered and recycled—and was, if needed—but as is, it also served as radiation shielding for Percheron’s emergency shelters and core.

Approximately forty-five percent of Tank Three’s water remained. It had been in use full use for only three months, and partial use for a month and a-half before that, so this was to be expected. Free water in zero gee was hazardous to humans—it was possible to get trapped in a bubble and not be able to swim one’s way out. Glenn needed to move the remaining water out of Tank Two, and he had a choice of sending it to IWS One or Four. Tank One was completely empty, while Tank Four was still fifteen percent full. A control console outside the inspection hatch to Tank Three allowed Glenn to transfer the remaining—presumably copper-contaminated—water to Tank One, preserving the hopefully clean water remaining in Tank Four.


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