It amused Rarity how similar all the huts and shelters she’d seen since ending up on the islands over a month ago were. Somehow, three groups of ponies had independently come up with the same design principles and building materials. At the very least, it meant that her and Rainbow had done a good job with their own shelters back home.
Doctor Gauze’s clinic occupied a small space at the very edge of the camp, and was oriented as far away from the pirate camp as possible. Out here in the tropic wilderness, a trained and licensed medical professional was invaluable, and so the survivors from the Concordia had taken steps to afford the doctor and his quarters a little more security through its positioning. Rarity was merely happy that there was somepony that could look after their wounds and injuries if it came down to it.
Rarity brushed aside the palm fronds covering the doorway and stepped inside. Even with the scarcity of resources available out on the islands, the small shelter still felt like a doctor’s office: neat, organized, and somehow hiding every little bit of medicine or tool a pony could possibly expect to find inside one. Four piles of fresh bedding lined the walls, though only two were in use. Coals lied on one such bedding pile, his eyes shut and a white bandage covering the bullet wound in his side. At the very least, he looked to be sleeping peacefully, and Rarity could see the rise and fall of his chest even from where she stood. Knowing that the stallion was okay, she let her eyes wander to the opposite side of the hut, where Gyro lied on her stomach while another stallion sat next to her, feeling her back with his hooves.
The stallion noticed the shifting shadows and light patterns as Rarity walked through the doorway, but other than a quick glance in her direction, he continued to focus on Gyro. “Is there something you need?” he asked in a disinterested tone. “Or is this a social calling?”
Rarity blinked, one hoof still hovering outstretched in front of her. “I… well, I wanted to see how Gyro and Coals were doing.”
The stallion slid his hooves down Gyro’s back, ending at her tail, before pulling them away and standing up. Blue magic adjusted half-rim glasses, and his focus swiveled to Rarity, giving her a good look at his features. He was well into his middle ages, roughly fifty years old, with a white coat and a graying blue mane. His face was sharp and angular, and his eyebrows almost seemed to sag under their own weight, giving him a stern resting expression. He wore a dirty and fraying white suit with blue tie that had somehow survived the chaos of the airship crash and the subsequent month and a half of being stranded on the island. Some brown stains across the chest and near the sleeves left little wonder as to what they were.
“I performed basic surgery on Hot Coals last night,” Doctor Gauze said, his voice stern and professional. “I removed the bullet and closed the wound, but I don’t have any blood packs for transfusions nor the tools for testing blood types to perform a safe donor to patient transfusion here. I expect him to be out for the count for a week as his body tries to rebuild its blood supply. Assuming he doesn’t die from the stress his blood loss is putting on his organs.”
Rarity winced. “Thank you for painting a detailed picture for me, doctor.”
“It’s my job to keep ponies healthy and keep their friends and family informed,” he flatly replied. Then he glanced at Gyro, who was watching the two unicorns with interest. “I’ve been examining Gyro’s back for the past half hour. Without x-ray machines and most of my modern tools, it’s difficult to diagnose exactly what’s wrong with her spine. From what I can tell, she’s suffering from a severely herniated disc between in her lumbar vertebrae.”
“So what does that mean, exactly?” Gyro asked, twisting her upper torso while her legs remained motionless and dead behind her. “Am I totally screwed?”
“No,” Gauze said. “Only mostly.”
Gyro frowned and her eyes fell. “Oh. Well, that’s better than nothing… I think.”
“Is there anything you can do for her?” Rarity asked, striding closer to the doctor. “She hurt her back falling out of the airship wreckage on the northeastern face of the island. I think she said she hit her back on an open bin or something of the like.”
Gauze adjusted his glasses again and advanced on Gyro without even so much as glancing at Rarity. “Yes, I’ve already heard the full story from Gyro herself. The blow to her spine damaged the disc between her vertebrae, and I believe, as I mentioned earlier, it may have resulted in its herniation. However, I believe it’s merely a severe case of lumbar disc herniation as opposed to something worse.”
“I don’t usually hear ‘merely’ and ‘severe’ go together that often,” Gyro grumbled, laying her chin back down on the bedding.
Gauze regarded her with an unamused look. “You have to consider the alternatives. You could have completely broken your back, which you miraculously did not, or you could have died. As it stands, your spine is still in one piece, if a bit mangled, and you’re still converting oxygen into sarcastic wisecracks with frightening efficiency.”
While Gyro grumbled and sulked, Rarity eyed the mare’s spine. “But there is something you can do for her, is what you’re saying.”
“It depends on how severe the underlying nerve damage is,” Gauze replied. “Given Gyro’s inability to feel anything below her waist and her incontinence, there’s some damage there. I can at least diagnose part of it as cauda equina syndrome, but it’s obviously more than just that. She would need surgery on her spine to help decompress her nervous system and allow her to use her legs again…”
The way his voice trailed off and the sigh didn’t escape Rarity. “But what?” she asked. “You can’t do it?”
“I have my surgical equipment and basic first aid with me,” he said. “I can perform the surgery. I’m not even worried about the risk of infection; we have fresh water and we have wood, so I can boil my tools to disinfect them. What I’m worried about is my lack of anesthesia equipment and other medical conveniences to simplify the surgery.”
“I mean, I can’t even feel my legs,” Gyro said. “Do you even need anesthesia for that?”
“You are currently lacking sensation below the damage to your spine,” Gauze informed her. He stepped forward and put his hoof on a bulge in Gyro’s back, sharply pressing down for a second. “Can you feel that?”
Gyro hissed, squeaked, and writhed in the sand. Even after the doctor removed his hoof, she shook and trembled. Tears of pain welled in her eyes, and she panted through gritted teeth. “Okay… I get your point…”
“Can’t you use your magic to help her?” Rarity asked. “You’re a doctor and a surgeon, I would imagine you know some numbing spells.”
“I can induce paralysis in a patient and I can apply topical anesthesia while performing surgery with ease. But I’m going to be cutting around her spine and trying to decompress her nerves.” He shook his head. “That’s much more complicated. I need actual anesthesia to fully desensitize her for the surgery. Even if I tried numbing the pain directly, I can’t perform the surgery while I’m focusing on that spell. I risk doing more harm than good if I can’t deliver my full attention to the surgery and her injury.”
Gyro swallowed hard. “But you could do it, right? You could fix my back?”
Gauze nodded. “I could fix your back without anesthesia, but the trauma and shock from the pain might be too much for you.”
“I’m a big girl,” Gyro insisted. “I’m an earth pony. What’s a little pain?”
“Your life.” Gauze sat down next to Gyro and removed his glasses, a sign Rarity knew meant he was about to tell her something serious. “The incredible pain will dramatically increase your heart rate and dump adrenaline into your blood. Considering I will have to cut open your back and carefully make my way through muscle to access your spine, there will be blood loss. On top of that, this won’t be a quick surgery. It will take a few hours. Over the course of those few hours, you run a risk of severe blood loss and suffering from shock. To put it another way, without my proper tools, there’s a nonzero chance that the surgery will kill you.”
“Then… it can wait until we get back to Equestria, right?” Gyro’s eyes took on a hopeful sparkle. “You can fix it then, right?”
But Gauze shook his head. “By that point, the nerve damage will become too severe to reverse. You will never be able to walk again. Essentially, I must perform the surgery within the next twenty-four hours if you want to use your legs again.”
“Is it really that much of a risk, doctor?” Rarity asked. “What are the odds that Gyro would die from blood loss and shock during your surgery?”
“One in five,” Gauze said. “There’s a reason corrective surgeries like these are only performed in professional and equipped hospitals. It’s too dangerous for a non-life-threatening injury.”
Rarity thought for a moment. “What if I helped you perform the surgery?” she asked. “I’m a seamstress. I work with dozens of needles and spools of thread, often at the same time. My magic is as fine and precise as anypony’s. I could do the actual cutting while you numbed her pain.”
Gyro’s eyes brightened. “Hey, that’s an idea,” she said. “The two of you together could do it. I know you can!”
Gauze regarded Rarity with a skeptical look. “I’m not sure I want to trust delicate surgery like this to an amateur. Sewing and stitching is one thing, but working with scalpel and knife is another.”
“I know I can do it,” Rarity said. “You just have to tell me where to cut.” Her eyes shifted to Gyro. “But, overall, it’s Gyro’s decision. Not ours.”
“A fair point.” Gauze pivoted to Gyro and raised an eyebrow at her. “Now that you know the choices, what do you want to do? I do warn you that even after the surgery, you will have a long road of rehabilitation ahead of you.”
Gyro thought for a moment, but as soon as her eyes made contact with Rarity’s, Rarity knew exactly what she would say. “Let’s do it,” she said. “I trust you two. I know you can do it.”
Gauze bobbed his head once. “Very well. We’ll begin after dinner. I need to make sure your stomach is empty before we start, and then you’ll have the night to sleep the worst of it off. In the meanwhile, if you reconsider, let me know.” Standing up, he nodded to Rarity. “I’ll find you when it’s time to begin. In the meanwhile, do whatever you want. I don’t particularly care.”
Rarity gave him an affirmative nod, and he walked right by her and out that door. After he was gone, Rarity looked back at Gyro and offered her a smile. “So, you’re sure about this?”
“Honestly, I’d rather die than spend the rest of my life a cripple,” Gyro said with a grin and a shrug. “It’s a win-win situation!”
The seamstress sighed and frowned at Gyro. “I do really wish you wouldn’t talk about your own life with such levity.”
“What do you want from me, Rarity? It’s just how I deal with stress.” Groaning, she pushed herself halfway off the ground with her forehooves. “Now, mind helping me get back into my walker? I don’t want to spend the rest of today just sitting around the doctor’s hut, staring at Coals. I don’t think he’d appreciate that too much when he wakes up.”
Rarity did as she asked, her blue magic quickly affixing the harness around Gyro’s body. As she helped Gyro stand, she shot her a concerned look. “If you change your mind…”
Gyro responded by putting her hoof on Rarity’s shoulder. “I appreciate it, Rarity, I really do. But I know that you and Gauze can do this.” Smiling, she added, “I wouldn’t trust anypony else.”