Phillip Hughes, M.D, S.J. (fidesetratio) wrote in whatprice, @ 2009-06-02 09:00:00 |
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Current location: | London, Chelsea |
Current mood: | confused |
Entry tags: | augustus pye, phillip hughes |
doctor, doctor,
Who:Phillip Hughes & Augustus Pye
Where: A coffee shop and then Gus' flat
When: Saturday, 30 May, 10am
What: Doctors consult over patients both ways - lines are blurred and information shared.
Status: Complete
Rating: G/PG
Gus covered his mouth as he yawned widely again, his elbows resting heavily on the edge of the table. He had intended to be good and wait until the other man got there to order, but after vacant stare had gotten a bit too vacant to the point that he nearly jumped right out of his chair when someone walked by too closely, he decided that some caffeine would do him good. He just hoped he could get a decent nap before the birthday party. Taking a sip of his coffee, he brightened up a bit when he saw the familiar man come into the cafe. Waving his hand, he stood up as Phil came over to the table, holding his hand out. "Hello. Thanks again for meeting me like this. I hope you found the place alright."
Phillip shook the other man's hand firmly and smiled.
"I'm always happy to help," Phillip said as he sat down. Ordering chai for himself, he smiled. "I'm afraid I'm British through and through and prefer tea to coffee most days. Or rather, coffee reminds me of residency and all night shifts."
Like the one he'd pulled Tuesday night working on Heather.
"How have you been?"
Gus chuckled as he took his seat again. "I tend to prefer tea, but today is certainly a coffee day," he said in amusement, remembering some of the days of Healer training and then uni. "I've been alright. Busy, but that tends to be a given. You?"
"Long night?" Phillip asked with a bit of a smile. "I've been alright. Busy. Seems whenever things start to calm down, they get busy again."
"Early morning," Gus supplied. "Something came up and I had to be up before 6." He took a sip of his coffee, murmuring happily at the taste before chuckling. "I think you're lucky that things choose to actually calm down before they get busy again."
Phillip chuckled.
"Doesn't always happen, but I'll take what I can get. Not a morning person, I take?" Phil asked.
Gus laughed. "Not that early. Usually work starts at 9. Maybe 8 some days. I prefer to be sleeping at 5, not wondering about whether I should get up then or if snoozing a bit is beneficial. What about you? Your profession certainly doesn't give you a chance to sleep in much on Sundays, does it?"
"No. Usually I'm up hearing confessions before the early morning masses. I'm low on the totem pole at my church. I can't really remember the last time I had the chance to sleep in. I've learned to catch naps where I can."
"I don't know how you do it," Gus said with a shake of his head. "But then I can't fully get into the idea of confessing every week, too. My friend does it, every Sunday like clockwork. Although what you do must be a humbling experience in a way. Hearing about other people's problems every week."
"It is. It's hard at times, but it's the path I've chosen," Phillip said with a shrug.
"Quite interesting as well at times."
"And sometimes when you've chosen that path, it's hard to do anything but it," Gus joked warmly before tilting his head curiously. "How does it work out? Your two paths. Or I suppose your one path with two professions."
"Generally, it works out well. It just means I try to heal people spiritually and physically. Of course, that's the ideal. There's paperwork that at times I don't see how it relates, but what can you do? There's always paperwork, I feel. Obviously, not my favorite part of medicine. I often find myself wishing there were more hours in the day," Phillip explained.
"I agree with you on needing more hours in the day," Gus said with a nod. "And also on the paperwork. It often seems more of a hindrance than help in matters, even if I understand the liability issues and all that goes with that. Not to mention making it so others can treat your patients rather than everything resting completely on you."
"True, but it doesn't make it any more endurable," Phil said with a chuckle as he thanked the server who brought his chai and took a sip.
"Did you bring the casefile?" Phillip asked.
Gus nodded as he leaned over to reach blindly into his messenger bag. His fingers closing on the familiar feel of the folder, he pulled it out and held it out towards Phil as he covered his mouth with his other hand as another yawn demanded his attention. "Ugh," he muttered out at the tail end of the yawn, moving his hand to rub over his eyes. "Sorry about that. If I start to look as if I'm nodding off, feel free to give me a swift kick to the shin."
Phillip raised an eyebrow as he took... two.. folders. Maybe it was overflow. Flipping through them, he glanced between one and the other. They were nearly identical. Nearly.
"I'm not sure I follow your notes here," Phillip said, sliding one of the folders over and pointing to the confusing part.
His brow furrowing in confusion, Gus was about to ask what he meant, hoping he hadn't fudged up his copying last night, but then he pulled his hand away from his eyes and his face paled when he saw one folder in front of Phil and another in front of himself. His brain picking up on the colors of the sheet and the faded logo faster than the word Phil was pointing to, he reached out and picked up the file, flipping it closed and pushing it back into his bag. "Sorry. Early morning," he said with a shake of his head. "I accidently grabbed someone else's file with the other one."
Phillip raised an eyebrow, giving Gus a 'Don't give me that bullshit' look.
"Someone else with identical history and only slight variations in treatment?" Phillip challenged.
Gus rolled his eyes slightly before huffing out a tired sigh. "Same treatment," he corrected before nodding at the case file in front of Phil. "That file has the more recognized treatment names. I developed a bit of a weird slang of how I write things up. I figured a translation of my notes would suit you better."
"Careful who you show that to," Phillip said. "There are people who don't always look well on weird slang.."
Gus reached down to pick up his coffee cup, glad to have something to grip onto as he took a slow swallow. Words like that made you wonder, and considering what Sam said he was doing... Well, running wouldn't do much right now. "There are," he agreed before smirking. "Especially when people realize what TTFO stands for."
Phillip raised an eyebrow.
"TTFO?" he asked, not recognizing the slang.
Gus chuckled, his cheeks flushing slightly as he cleared his throat. "Um... well... Told To F Off," he mumbled, hoping the older man got the idea considering he wasn't sure if he could actually say 'fuck' to a senior doctor and a priest.
Phillip chuckled.
"I see. And would that be what you're doing now? I mean you no harm and I'll keep everything confidential. Secrecy of the confessional or doctor patient confiedentiality," Phillip said quietly.
"I'm Anglican," Gus said with a bit of a smirk before he studied Phil a bit more seriously. Glancing down at his coffee, he tapped the fingers of his left hand against the cup as he went over his options. "I ran into Sam this week. Do you do work with him?"
"It doesn't matter," Phil said, referring to Gus being Anglican.
Phil did his best to keep a poker face, although the news took him by surprise.
"We've reconnected again. We're considering working together again."
Nodding slightly at Phil's words, Gus kept typing out a tune against his coffee cup before he breathed out a heavy sigh. "I have your promise about the confidentiality?"
"Completely."
Phil's voice left no room for doubt as he realized his life was going to get more complicated yet again. This was certainly turning out to be quite the complicated year.
"Should we go somewhere else?"
"I think that would depend on how many questions you think you'll have," Gus admitted. "You caught a glance at the slang I use, what do you think?"
"I think it never hurts to be careful," Phillip said. "And medicine is best discussed frankly."
Gus nodded as he finished off his coffee. "Do you have a place in mind?" he asked, a bit wary to show the other doctor where he lived.
"Only place that might be appropriate would be the reconciliation room at my church," Phillip said quietly. "Your office? Although I suppose you don't want to go in on your day off."
Gus shook his head slightly. "My office is on the other side of the river and not in the best location," he admitted, even though he left out the bit about how bringing a stranger there was likely not the best idea considering everything. "Do you have an office?"
There was absolutely no way Phillip was taking Gus to MI7.
"Security. No way to get you a visitor's pass on a weekend," Phillip said as he made a face and took a sip of his chai. "Any other ideas?" Phillip asked.
Gus' eyebrows went up at the mention of security and he wondered just what he was getting into and how deep. Taking a deep breath, he ran a hand through his hair. "My flat isn't far from here..." he said hesitantly. "A good deal closer and safer than Brixton..."
"Are you sure?" Phillip asked, worried about the blond's expression. "I wouldn't want to impose."
"Not really," Gus admitted with a smirk. "But I suppose if I can trust your confidentiality enough to talk frankly about medical practices, I can trust you walking about my flat."
"I promise not to touch anything or rifle through your medicine cabinet," Phillip said with a smile as he tossed some bills down on the table and handed the manilla file folder back to Gus.
"Ready? Coffee's on me."
Gus laughed as he took the folder from Phil and put it into his bag. Standing up, he pulled the messenger bag over his shoulder as he nodded. "Thanks. Cab or walking?"
"Walking is fine. Unless you're in a rush," Phil said. "You could always blindfold me in the cab so I don't know where I'm going."
Shaking his head in amusement, Gus led the way out of the cafe. "I think I would be more worried about what the cabbie would think of me dragging a blindfolded man into his car and what he may tell other people," he joked back before waving down a cab. It was a relatively short ride to get to his flat and he was only slightly tense as he led the way up to his flat and let the other doctor in. Shrugging off his messenger bag and jacket, he went to hang the jacket up in the closet, holding his hand out to take Phil's jacket. "I know you just had some chai, but do you want anything to drink? Tea? Juice? Beer?"
"Tea's fine. It's a bit early to start on the beer," Phillip teased as he handed over his jacket and glanced around the nice flat, taking it all in.
"Nice place. Mind if I take another glance at those files?" he asked.
Gus blushed a bit in embarrassment as he took Phil's jacket and hung it up. "Thanks," he mumbled. "If you feel something hit your ankles, it's the cats, so don't freak out too much." Pulling out the files, he handed them to Phil and then gestured to the reception room. "Feel free to make yourself comfortable while I get the tea going," he said warmly as he headed to the kitchen. "Do you want any sort of biscuits to go with the tea?"
Phillip took a seat ou the sofa and spread out the files.
"No, thank you, just tea is fine," Phil said as he read over the file. "Which one of these should I be focusing my attention on? Because a GSW and a puncture wound aren't quite the same. Or rather, there might be nuances from the GSW. Can you explain some of these nuances here?"
Setting the tea kettle up, Gus breathed out a heavy sigh as he leaned on the counter so he could look out into the reception room. "The one that has all the 'slang' is the proper and original documentation of the case. The other one will provide you with good... translations for the slang you might not understand."
Phillip nodded, reading over the original casefile.
"You've done amazing work already on him. This is beyond impressive," Phillip said. Shifting so he could reach his backpack, he pulled out a folder and set it on the couch. "Here's the stuff that might be useful. It's related work, but I'm not sure if it's applicable."
"It's still frustrating," Gus said with a bit of a blush as he headed over to the couch. "Especially when you keep reading about the sorts of procedures and recovery times if you treat the nerve immediately after the injury..." Picking up the folder, he sat down on the couch beside Phil. Flipping it open, he frowned slightly as he started to read, his eyes going wide the farther down the page he went. "Holy shit..." he breathed out, his stomach doing somersaults. No wonder he had wanted confidentiality. He'd likely get shot if someone knew he read this. Well... even more likely to be shot then he already was. "This..." He cleared his throat as his eyes stayed wide. "If they could really could figure out how to reverse these chemical reactions, it would be pretty amazing..." He was pretty sure though that Percy would be even less open to using manipulated biological warfare on him than he would be acupuncture.
"Well, the key is reversing it, of course. And no one's really tried to do it. You do something like that, pharmeceutical companies lose money on painkillers. Medicine can't solve everything, remember?" Phil quipped. "I think your problem is more muscular than nervous system. Because he has sensitivity, so the nerves are working. Can the muscles be manipulated to work or are they atrophied? Is it a lack of neurological control there? It seems there's a missing link somewhere.."
Gus rolled his eyes slightly. "I would say also finding people willing to have this tested on them would be an issue as well... And our jobs would be easier if medicine could solve everything..." Breathing out a sigh, he ran a hand through his hair. "I've had him doing physical therapy since the initial injury in order to make sure the muscles don't atrophy. It seems to be a lack of neurological control. As the nerves have been regaining their functions, his muscles have been spasming during certain times of the day, usually causing pain and he mentioned the spasm being so bad it makes his elbow lock. That one seems to happen usually when he relaxes... Otherwise it's a small rhythmic twitch that is a small annoyance." Unbuttoning the sleeve of his dress shirt, he pushed it up so he could point exactly where the twitch was right now on his own arm. "It's gone down to that point. The spasms however aren't as bad as any that he had in his back when this whole thing started."
"Is he on any muscle relaxants?" Phillip asked curiously. "Is it neurological then? Or just.. sometimes I wish I was a better neurologist. What about alternative medicine? Any chance of getting him into an altered state and seeing if you can acheive different results?"
"He's in a position where it is better if he's on the least amount of medicine as possible. He has prescriptions for pain relievers and muscle relaxants, but they're more for emergency circumstances when the spasms become too much." Gus had to force himself not to laugh at the idea of Percy in an altered state and was glad that the tea kettle whistling gave him something to focus on. Pulling out the glass teapot, he poured the tea leaves into it before pouring the hot water in. Carrying the teapot and two cups out to the living room, he shook his head slightly. "I don't think it's neurological... He's progressively getting better. When the damage first occurred, he had issues moving his shoulder." He did frown in thought though as he went back to get milk and sugar from the kitchen. It might be worth having Adrian look at it though... Coming back with the milk and sugar, he set them on the coffee table before taking his seat on the couch again. "There is no chance at all of getting him in an altered state, but I think I know of some alternative medicine that can figure out if that may be the case..."
"So it's just a matter of speeding up the progress, then?" Phillip reached in his backpack and pulled out some beat up notebooks. Flipping through them, he found his notes from Brazil and flipped to some unusual herbs and berries and some of their properties.
"What about these? The only other option I can think of would be operating to try and reconnect the nerves in different places."
Gus nodded. "The current process is working, but it's been nearly a year and a half and he's only really regained muscle control of his shoulder. So what? Another year or two and he may regain everything? And even after that, there's no telling how long it'll take for him to actually have fine motor function in his hand. Anything to speed that up would be brill. Sam suggested acupuncture, but... I think it would take a fair amount of convincing to get that method used." Looking over at the notebook, he nodded slightly before looking up at Phil. "Can I take some notes on those? I have a colleague who knows a great deal about plants."
Phil nodded.
"Go right ahead. This is my own stuff. There's some notes from India in one of the other ones too," Phillip said as he reread the file. "So we need an accelerant of some kind then.."
He was thinking aloud now, murmuring under his breath as he got up to pace while thinking and making notes in yet another notebook.
Excusing himself to grab somethings from the study, Gus came back with a pen, a notebook, and a stack of herbalism books he had checked out of the library, plus a print out of the newsletter from Draco's friend to cross reference the plants Phil had written down. Jotting down the plants written in Phil's notes, he breathed out a sigh. "Something that will accelerate the healing, but won't interfere too much in the patient's life. He's in a situation where he doesn't have the luxury of taking large amounts of time off to just rest. Which is one of the reasons that I've knocked out serious surgery..."
"Ah, one of those patients," Phillip said, smiling in understanding. "I almost feel like you should make Sam and me butt heads on this and see if we can come up with anything."
Gus chuckled. "He's one of my better patients though. He just leads a busy life." He smiled warmly as he opened upone of the herbalism books to check to see if their names were in there. "I think Sam might like that. Hell, I wouldn't mind it. The more minds thinking over an problem, the more options you come up with and paths to try out." He looked up from the book to smirk. "As I wouldn't have thought of checking to see if the injury was neurological."
"True. Plus, Sam knows me well enough to know when I'm spouting bollocks and calls me on it," Phil said. "Whereas I might still be able to get away with some of that around you," Phil teased.
"I think I'm of the mindset that even if you started spouting bollocks, I'd think it over as a possibility," Gus laughed in amusement. "But then I hear a lot of crazy things sometimes."
Phillip chuckled.
"It's good to see that you ended up a doctor though, even just reading this, I can tell that you're good at your job. And calling in for a consult admits humility and that you don't know everything. Both things I respect."
He ran a hand over his hair.
"Could do a neurological scan while testing sensitivity and responsiveness, see if we learn anything from that. Acupuncture is good too. I think nothing permanent or altering should be attempted until we're positive it won't counteract what you're already doing."
"When your path starts calling, it's hard to ignore it," Gus said as he ducked his head bashfully at the praise. "I just try and do the best I can to help people..." Nodding slightly at the suggestion, he paused a moment before continuing on. "My colleague is capable of doing a neurological scan at our clinic. I'll ask him if he'll assist me next time the patient comes in. I'm sure he'll be just as curious to see if that's the problem as I am." Running a hand over his mouth, he looked curiously at Phil. "Do you know of any good places to take acupuncture classes? I'm not sure if the patient would agree with the method anyways, but I wouldn't feel comfortable trying it anyways unless I had proper training. I don't fancy doing more harm to him by accident."
"I don't, but Sam might. Sam might even be trained in it, but I'm not sure if your patient would trust other doctors," Phil said with a shrug.
Gus sighed heavily as he shook his head. "The doctors that he would trust to treat him other than me wouldn't be the sort that would know acupuncture, let alone think it a viable method. They have very particular ways at how they think medicine should be."
Phillip pushed down the curiosity to ask about how what he was fairly certain was magical medicine worked. He wouldn't use this colleague for it. Or Adrian. Even if MI7 would promote him if he did.
"That might make it a bit difficult," Phillip said, thinking of what knowledge he could impart to the other man.
Nodding, Gus ran his hands through his hair. "I know that if I need to, I can force my hand on the matter. He trusts my knowledge of my field and if I say something is necessary, he'll likely bow to my wishes." He made a face. "Needless to say, I don't want to want to resort to that unless something is really necessary... Especially if it's the kind of treatment that would require me to convince him that sticking a bunch of needles into his body is a good idea."
"Well, I think that's true of a lot of patients," Phillip said with a sigh. "Well, the neurological scan is probably the best place to start. No need to put the cart before the horse. Can I take the clean copy of the file with me? In case I think of something else?"
"Most of the time I have to convince patients that stitches are a viable method of healing though," Gus pointed out before nodding. "You can take the clean copy. It doesn't have any identifying information and as far as I remember, I cleaned up all the slang."
Phillip nodded.
"Thanks. I'll keep it secure."
There was no way that file was coming near MI7.
"Can I ask you a question? Have you ever come across a patient having a chunk of flesh missing?" he asked curiously. "Due to a sort of accident."
Blinking in surprise at the question, Gus frowned in thought. "Well, yes. Although it depends on what sort of accident it was. Most of the missing flesh that I dealt with was due to animal attacks."
"I don't think it was an animal attack," Phillip said, running a hand through his hair. "No teeth marks. Almost... like a handful.."
"A clean chunk or ragged?" Gus asked curiously. "Like was it sliced off or torn. And how deep are we talking? Just the skin flesh or going down farther into muscle and tendon?"
"Torn, more like, I think," Phillip said. "It cut through part of the muscle. We operated that night, grafted some skin from a cadaver and some muscle tissue from a cadaver as well, and the patient is walking now, but well, I wasn't sure if there was more that could be done with alternative methods."
Running a hand through his hair, Gus looked over towards the windows of his flat, thinking about how much he should say. He'd already told Sam so much and who knew how much they talked about things... Moving his hand to rub at the back of his neck, he finally nodded slowly. "More can be done with alternative methods if it's just a wound caused by some normal accident. Even more could be done if all the resources for the methods were open to us."
"I have reason to believe it was a magical accident."
"Ah," Gus said simply, shifting uncomfortably on the couch. Well, he was already in this deep, wasn't he? After all, Joe Schmoe doctors didn't just show up with files talking about reversing the effects of nerve toxins used in biological warfare. Taking a deep breath, he rubbed his palms against his thighs. "If it was a magical accident, how well it can be healed by alternative methods would depend on what sort of magic was used. There are certain magics whose wounds traditional techniques can actually heal better and more easily than alternative magic can."
"I don't know much about types of magic. At least not things here in England. It's all very confusing and bookish - nothing at all like magic in India or Brazil. At least not the stuff I encountered."
Phillip paused. He had privileged clearance about what had transpired since he'd treated Jones.
"It happened when the wizard left while holding on to the patient."
Gus made a face at what Phil said happened. That definitely sounded like a bit of splinching considering everything. "That injury could be fixed easily by alternative methods, although more so years ago. It... it's a fairly common injury. That method of leaving has its dangers, although usually more to the person leaving than anything else..."
"I'm not sure I understand," Phillip said in confusion.
"But I don't want to pry if you're uncomfortable with it."
"If we're truly keeping confidentiality in this matter..." Gus ran a hand over his face before taking a deep breath. God, he didn't even know who he was possibly helping, but... "From what you described... There is a way of magical travel that's like teleportation. It's very difficult to learn though and if your concentration isn't perfect, you may do something that's refered to as 'splinching'. Basically leaving a piece of yourself behind, or.. in this case, taking a piece of someone else with you. It's fairly common when people are first learning how to do this sort of magic, kind of like a very exaggerated skinning your knees when you fall off a bike. So needless to say, ways have been devised to heal these wounds."
"Would they work on a non-magical person?" Phillip asked. He wasn't taking notes, just committing this to memory.
Gus nodded slowly. "As far as I know, Healing is Healing, it doesn't matter who you perform it on." He sighed as he shook his head slightly. "It would be different with your patient though as the area wouldn't be the same as when the magic first affected her. Normally with splinching, people who are skilled at reversing magical effects would undo the damage rather than them immediately seeing a Healer. I think now it would just be using Healing magic to decrease the healing time between her body and the transplant."
Phillip sighed.
"She wouldn't consent. And I don't know about a secure enough location even if I managed to sedate her."
Gus chuckled softly, his stomach doing flip flops. "If she was injured by a wizard leaving in a hurry, I'd likely be in just as much trouble trying to help her from her herself as well as colleagues if they ever found out I had a hand in her being better."
"Sam and I worked in India after the riots of '92. They attacked Sam and his family, and yet my oath bound me to take care of their injured too. It's more than an oath though, and it's a decision everyone has to make for themselves," Phillip said quietly.
"I healed people who wanted nothing more than to see me tortured to death before," Gus said with a wry smirk. "I think I know the oath well. Healing is healing... it's hard to leave someone suffering when you know there's a way to fix them..."
"But I won't ask you to do this, Augustus. It's your call. I don't want to endanger you. I know what the stakes are," Phil said worriedly.
Gus thought over Phil's words, studying the other doctor carefully. "It sounds like she's healing well on her own at the moment. If she has problems with the transplant and it becomes life threatening..." He trailed off a moment before taking a deep breath. "You can contact me then if you feel like alternative methods may be the only way to fix her."
Phillip nodded.
"That's more than acceptable."
Besides, he'd sideline Jones for as long as he could.