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Tweak says, "SANCTUARY!"

Leon Vance (leon_vance) wrote in omega_reality,
@ 2013-03-27 14:10:00

Entry tags:

*complete, 2013 03, character: maura isles, dead: leon vance

RP: Leon and Maura
Who: Leon and Maura
Where: the safe house
When: Wednesday, March 27, 2013
Summary: Leon and Maura discuss duty

When Doctor Isles asked for some time, he made sure to tell Deeks and Reese that he had some work to do that required the doctor. That gave them some privacy when everyone was training.

Leon stayed inside. He knew that the house provided little privacy from people like Renko or surveillance equipment, but then if someone was eavesdropping, they had much bigger problems.

"How can I help you, Doctor?" he asked when they were finally alone.

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drmauraisles
2013-03-27 10:11 pm UTC (link)

"Thank you for seeing me, Director." Having thought about the situation over night, Maura had come to the decision that if it was the expectation of her position, she would have to devise a way out of this mess and learn to deal with what was being asked of her. As much as she held some very strong opinions about some things, Maura had always been one for rules and upholding the standards of her position, regardless of her own distaste for some aspects of the job.

"It has come to my attention that I may not have understood exactly what the expectations were regarding my ability or requirements to offer medical care and I wished to clarify those expectations. I had been under the impression I was not to do anything unless specifically requested, such as when Callen asked for confirmation someone was field ready shortly after I arrived, or without clearing it through you first, such as with the physicals. It seems, however, that at least some have the expectation that it is my job to make decisions regarding everyone's health whether asked to or not, regardless of whether the individual has come seeking my assistance.

"If, as it has been suggested, it is truly my place to be suggesting individuals who have specified a desire to not be placed under my care should not be allowed in the field, or that such desires are to be ignored, then I fear I may have unknowingly created a problem, but would like to have confirmation as to what exactly my duties are outside specific medical requests made of me."

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leon_vance
2013-03-27 11:03 pm UTC (link)

This wasn't a discussion that he'd ever had with Kepner, because at the beginning, it was necessary for them to keep their cover, and later, because things were already set a certain way. It had never really occurred to him that he should have that discussion with Isles. Then again, Callen and Morgan were not Deeks and they would be ready to ban people from the field even without doctor's order if they thought it were necessary.

"Your duties would include consist of treating any injury. If there are things like the medicals or the vaccines, then you are to administer them. You also decide if someone is field ready because of medical reasons," Leon said, trying to limit the scope, not because he didn't trust her, but because obviously she needed guidelines. "We've always tried to use federal regulations in defining medical reasons, and even then we'd had to play around a little since they don't cover things like superpowers or their effects on the body. We used modified military rules for the pregnancies, because they made more sense. Technically federal rules in most jobs say that you can't discriminate based on that, but in the military, you can have modified service starting the fifth month. You're also responsible for letting us know when someone is fit for duty once again. We've had blind men, and it didn't take a doctor for us to know that they weren't fit. Regaining their sight or at least partially is something that would require your input."

He sighed. "I'm afraid that I can't be very specific, because past circumstances have presented us with situations that aren't covered by any laws, but we had to adapt. Generally speaking, if it's not serious enough to effect training or field work, then it's up to the people to come to you. If it is serious enough, then it is up to you to bring it up if Deeks or I haven't done anything about it already."

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drmauraisles
2013-03-28 05:16 pm UTC (link)

Maura listened to his description in silence and then nodded. "Alright. I can look up the federal and military guidelines to get an idea of the differences and nuances, unless there is something drastically different about policies here than in your dimension? So, let me ask you about the specific problem I believe I may have caused and perhaps that will help make things clearer regarding my expected role in making sure people stay on top of their own health because that is where I find I'm having the most difficulty -- knowing where the boundaries are between when I need to intervene and when to leave well enough alone. As Chief Medical Examiner, I get to pick my cases and assign the rest to others. Had I gone into a more patient-rich field, there would have been more regulations, but if a person chose to no longer put themselves under my care, I would have no further right to an involvement unless it was an emergency. Here, it seems as though there is the expectation that I either am at the beck and call of those who wish for my services or I keep track of everyone at all times because they will never come to me and I need to do it for them.

"As I'm sure you're aware, I was seeing Savannah regularly for prenatal check-ups. The visits were more frequent than normally required because I wish to keep an eye on her weight, which is much lower than advised and, while I understand there are mitigating factors such as the high level of training done here, it is still a concern I did not want to ignore just because it seems normal. The baby is healthy. It was simply a precaution and one with which she did not seem to agree to the necessity of taking. Savannah came to me to explain she did not think she would continue the visits and was considering finding someone else to assist with her delivery. She did say that her reasons were mostly out of concern for my comfort as this is not my area of expertise and it seems she had been given to believe this was a problem for me. However, it was clear to me that she did not trust that I would be capable of handling it and I informed her, I now believe erroneously, that it was a very ill-advised idea for a patient to rely on a doctor she couldn't trust and, if that was the case, she should terminate her agreement to my care.

"The conversation devolved into some personal issues between us; however, based on my experience the recommendation I no longer serve as her doctor did remain valid at the time, given my lack of understanding as to my role here. The problem I believe I may have created is that since then it seems she has returned to a level of training no pregnant woman, no matter how in tune with her body or how good her physical shape, should be partaking in for the sake of the baby she carries at the very least. She had slowed down prior to this disagreement. My concerns now are that I was unaware of the fact I should have been reporting to you or Deeks that she really should no longer be doing any strenuous training at all and that it seems I was incorrect in allowing her to remover herself from my care."

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leon_vance
2013-03-28 07:59 pm UTC (link)

"Don't bother. Things have evolved past those regulations. You can keep it simple. If you think they will die out there, whether because of illness or a bullet, then you speak up. No one Margaret's age would be allowed in the field and Bud could suffer another heart attack at any moment. In the past, Sam would have tailored their training. Derek shows a little less... restraint. If you think a particular exercise is a problem, talk to him, but be prepared for the common answer that they won't have much of a choice where we are going. It's a balancing act, Doctor, and you'll have to use common sense when to stop an activity or not, knowing full well that neither option will be the right choice, just the less harmful."

He had noticed a slight chance in Savannah, but he figured that Deeks was keeping an eye on that front. "Pregnancy is a tricky thing. It's not exactly an illness that needs to be cured and I can't force her to see you, but I can keep her out of training until she does, which is probably the best outcome if what you're saying is true. The same will apply after birth. She will have to see you to be cleared for training and field word. There is one thing that you should keep in mind. People can do all sorts of things and they might not always disclose the full extent of their powers. I don't ask, because I believe it's a bad idea for one person to know everything, but that doesn't mean that I don't know that people hide things. Savannah was fully cleared within weeks and she was doing backhand springs and standing tucks, not that I know the difference, but she spoke at great lengths about them, a week or two after the twins were born. What that means? I'll leave it up to you to decide."

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drmauraisles
2013-03-29 06:12 pm UTC (link)

"She needs to restrict her training whether or not she's seeing me, Director, at least until she gives birth and for some time after. This isn't a matter of needing treatment, but that the exercises in training are a danger to her baby. She may indeed be very capable, but it isn't about her. It's about the baby she's carrying." Savannah had even said it herself. She didn't care about making the pregnancy easier, just protecting the baby, her family.

"Whether they disclose the effects of their power is also not an issue. So, long as it's clearly understood that not disclosing those things that could affect their health means I cannot do my job properly and I will not risk treatments or patients on guesswork unless absolutely necessary. I can only go by what evidence is present. If there is no evidence of a problem, I cannot treat one. If there is evidence of a problem, I can only go by what I see combined with what I know to treat it. Withholding information that could change my diagnosis will only hinder the process. As has been pointed out to me repeatedly since I arrived here, medicine can do as much harm as it can good. Not having all the facts means putting them in my care puts them at risk.

"And this is again, why I am asking specifically how far I am expected to push. You say it is up to them if it is not serious enough to affect training, but up to me if it is serious enough. But, my question is how I am expected to determine something is serious enough when I'm told not to expect them to tell me the entire truth and also that they will never seek me out and it's up to me to pay attention to everyone and all times and guess whether or not something is wrong. Without examining them, I will never know. Unless what you are saying is that I should simply inform you any time I suspect a problem and require an examination before they are allowed to continue training, I do not see any way to meet those requirements accurately."

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leon_vance
2013-03-29 07:49 pm UTC (link)

"And as I said, I can't force her to see you, but I can keep her away from training and the field. The fact that I do that doesn't mean that I can stop her from training at home or by herself," he said, knowing very well that Savannah trained when Savannah wanted. She had done it at the ranch and he didn't think he had half the chance that Callen and Kepner had had to make her slow down.

Leon nodded. "I understand, but you also have to understand that if they look ready to serve, regardless of medical recommendations based on guidelines that don't apply to us, I will send them out."

He looked at her. "Bullets, blindness, pregnancies. If it's obvious, then they should be declared unfit. If it's not, chances are they can still fight. Doctor, I'm not interested in every illness they might have, but you can spot things that I can't. That's all I'm asking you to do, because there's no way to do this accurately. They are much like servicemen on deployment. They go to sickbay when something goes majorly wrong and if not, everything is fine. But the bottom line is that unless it's something as obvious as Savannah's pregnancy, you will be guessing. You tell us and we can ask them to have a medical to confirm your suspicions if it's serious enough."

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drmauraisles
2013-03-30 03:56 am UTC (link)

"Looks can be deceiving," Maura pointed out, wondering if anyone truly understood that it wasn't about taking them out of the field but making sure they were in the top form they could be while out there. She wasn't trying to bench anyone unnecessarily. Yet, they all seemed to have certain flawed ideas about what medicine could and couldn't do for them. Still at least he was willing to give her an out on guessing, a way to verify the accuracy of her diagnosis. Jane would be laughing herself silly if she could hear this.

Maura supposed they would finally put to the test Jane's theory that Maura's guesses were more accurate than most other people's facts.

"I supposed that's as much as I can ask of you." Or at least, as much as she was likely to get at this stage. "Thank you for explaining things more clearly."

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