Trauma Team: Equestrian Chronicles

by ThatCanadianDude

Twilight Sparkle Part 1: Fallen Athena

“Alright, do you have the file?”

The purple dragon threw the file down on the library table. “Don’t I always?”

The book flying in front of the purple unicorns face flew over to the messy pile of books to her right and stopped glowing. The glow then came to the file, which rose up and floated in front of her face. She read it aloud as she started walking towards the library exit. “Berry Puncina. Is she in yet, Spike?”

As she walked, Spike always stayed a foot ahead, opening each door in her path. “She’s waiting in examination room as we speak, Dr. Twilight,” he announced, waving other ponies out of Dr. Sparkle’s path as she walked on, face engrossed in the file.

“Excellent. My second official diagnosis. This shouldn’t take long. I can be back in the library in no time at all,” Twilight remarked, narrowly missing running into her own office door before Spike gently nudged her in the direction of the door next to it.

“Dr. Twilight...”

“Be quiet, Spike, I’m trying to get all the information down before I get to the examination room.”

“But Doctor... you’re in the examination room right now.”

Dr. Twilight raised her head from her file to find herself right where she had been told; standing in the middle of her examination room. The room itself had a desk; a small examination bench; a small counter with some basic medical tools including syringes, bandages, and a stethoscope, along with a few larger machines; and a couple of small, relatively comfy chairs.

Sitting in one of these comfy chairs was a purple pony, a red flush in her cheeks as she leaned back. She looked at Twilight. “You the doc?” she half-mumbled.

Twilight blinked a few times before nodding an affirmation and taking a seat in the other chair. “That is correct. My name is Dr. Twilight Sparkle.”

The purple dragon stepped up, pointing to himself. “I’m Spike."

The purple pony suddenly shocked forward, looking intently at Spike. Spike stared back with a nervous look in his eyes before the pony sat back up in her chair. “Uh... am I the only one seeing this... purple... lizard thing over here?”

Dr. Twilight chuckled. “No, Spike’s quite real. He is my assistant and will be helping me in your diagnosis.”

The purple pony sighed in relief, hiccupping in the process. “That’s good. I was afraid somepony had slipped me something. Never know what’ll get into your drinks at the pub.”

She suddenly clapped her hooves together. “Alright, doc, let’s get this done with. I got pain I want gotten rid of so I can get back to the bar before Happy Hour is over.”

Laying the file down on the desk, Dr. Twlight turned towards the pony. “Alright, Ms. Puncina. We’ll figure out what’s bothering you. Ready, Spike?”

Spike reached behind his back and pulled out a clipboard and a quill. “Ready, Dr. Twilight.”

“Very well. Starting diagnosis.”

Using her magic, Twilight opened a drawer in her desk, pulling out a pair of red reading glasses. “Alright, Ms. Puncina. How about you start by telling me what brought you here today?”

Berry sat back in her chair again, thinking. “Well, I’ve been having a couple problems off and on for awhile. They weren’t really bothering me until recently, though. I kept getting this pain in my lower back and my abdomen, but over the last couple days it’s gotten really bad. Oh, and I’ve been losing weight constantly. Normally I’d be thrilled, but there comes a point when skinny stops being attractive, no matter how drunk you are.”

Twilight nodded, before glancing over at Spike. “Spike, did you get those?”

“Way ahead of you, Doc. Abdominal pain, back pain, and weight loss. Check.”

Twilight turned back. “Those are good reasons to bring yourself in for a check-up, but I’m going to need more if I’ll be making a accurate diagnosis. Anything else?”

Berry rubbed her chin. “Well, I’ve been feeling nauseous lately.”

Spike chimed in. “You sure that’s not the drinking?”

Twilight shot him a glare before Berry responded. “Hey there, pip-squeak, I know how to handle my alcohol. I ain’t ever lost my lunch from a couple of drinks.”

Dr. Twilight chimed in. “What exactly constitutes a couple of drinks?”

“Oh, you know, 2 or 3.”

“Glasses?”

“Liquor bottles.”

Dr. Twilight stopped for a moment, taken aback at the comment. “Um... ok then. Spike, make a note of it anyways.”

Spike sighed. “Alright, alright. Nausea. Check.”

Berry sat up. “Anyways, that’s all I can think of off the top of my head. So, what do I got?”

Twilight stood up and walked over to Berry and began to look her over. “I’m afraid I don’t have enough information at the moment. I’m going to collect further data, and then I’ll be able to give you my diagnosis.”

Twilight looked over at a counter. Concentrating on the stethoscope, Twilight magically brought it over, placing it into her ears. “Now, Miss Punchina, I’m going to take a listen to your organs to see if I can find the problem. Hold still, please.”

As Twilight pressed the end of the stethoscope to Berry’s chest, she suddenly jerked away. “Ack! That thing is c-cold! You mind warming it up first, Doc?”

The doctor pulled back the stethoscope. “Oh. I’m sorry. Um... Oh, I know! Spike?”

Spike looked up from his clipboard. “Yes, Dr. Twilight?”

The stethoscope floated over to him as Twilight spoke. “Would you mind warming this up for Ms. Punchina?”

Spike shot back a glance of concern. “Doctor, don’t you think that’s a bit mu-“

“Spike. Hurry up. We have a job to do.”

“Alright, but I still say this isn’t a good ide-“

“Spike!”

“Fine!” came Spike’s final reply. He took a deep breath and exhaled, green flames encompassing the stethoscope.

“Good. Now let us...” Twilight began to speak. Her words cut short when she noticed that the end of the stethoscope had fallen off, the fire having melted the rubber holding it in place.

“I told you, Dr. Twilight.”

Twilight grinned nervously as she magically opened one of the counter drawers and pulled out a spare stethoscope, rubbing the end of it with her hoof to warm it up. “Ok, with that out of the way, please hold still, Ms. Punchina.”

“Hmm... Heart sounds good... breathing is normal... Ah. I think we have something. The bowl sounds are quieter than normal. Spike, record subdued bowel sounds.”

“Subdued bowel sounds. Check.”

A magic aura enveloped a small collection needle and a small container of antibiotic gel. “Now, we’ll need to run a diagnostic, so I’ll need to collect a little blood. Hold still, please,” she mentioned, dipping her hoof in the anti-biotic gel before bringing it up to Berry’s flank, an action that resulted in Berry jerking away.

“Whoa, Doc! Watch those hooves!”

Twilight stopped for a moment before responding. “Oh, are you sensitive there, as well? Spike, are you getting this?”

Spike blinked for a moment. “Um, Dr. Twilight, I don’t think that’s what she means...”

“I’ve seen enough late night television to know where this is going! I may be inheb... inebre... drunk, but I’m not that drunk.” responded Berry in an agitated tone.

“I’m sorry, but I don’t quite get what either of you mean,” came Dr. Twilight’s rebuttal.

“Oh, the doctor seems nice. She’s speaks sweet, she says she wants to help you, she gives you candy, then the next thing you know, she’s greasing up her hooves for some-”

Spike suddenly jumped in. “What she’s trying to say, Dr. Twilight, is that it’d probably be better to get the blood from... somewhere else. Like the shoulder, perhaps.”

Twilight looked puzzled. “But the flank is the location of the largest muscle in the equine body. It’s got heavy blood flow and is easy to acquire blood from. I don’t see why...”

“Dr. Twilight, come here for a moment,” responded a somewhat-aggravated looking Spike. She approached him, at which point Spike whispered something into her ear. A deep flush came to her cheeks.

“... Oh.”

“Yeah. Might want to work on your bedside manner. These are patients, Doc, not the lab rats you’re used to.”

Twilight cleared her throat. “Uh, yes. Sorry. Anyways, blood.” She quietly took the gel and needle and collected her needed blood from Berry’s shoulder.

Plugging it into one of the machines on the counter, she magically flicked a switch. “Now, we give that machines a few minutes and we’ll have the necessary tests done.”

Berry looked a tad confused. “Admittedly, I’m less than alright at the moment, and I never went to any fancy medical school, but aren’t there, like, dozens of tests to do?”

A wide smile came across Dr. Twilight’s face. “You are correct, Ms. Punchina. There are dozens of tests needed to be done and, thanks to this little machine, the latest in cutting edge medical technology developed in the labs of the Equestria Centre for Disease Research and Control, all of those tests can be finished up in mere minutes, saving valuable time in the diagnosing process. Valuable time you can use to get better.”

Twilight stood, a beaming smile on her face, before Berry responded, cocking an eyebrow. “Well, Doc, that’s great and all, but I don’t think I’ll be buying one for my house, so you can cut the pitch.”

Twilight’s smile quickly left her face, and she blushed once again. “Oh, my apologies. I just...”

Twilight stopped. The cocked eyebrow had opened one of Berry’s eyes further, and Twilight didn’t like what she saw. “Spike, I have another symptom to report.”

Spike tilted his head to the side. “What is it?”

“Jaundice in the whites of her eyes. I must have missed it earlier.”

Spike nodded. “Alrighty. Jaundice. Check.”

Twilight’s attention was torn away by a prominent ‘boink’ emanating from the machine.

“Wait a minute. Did that thing just ‘boink’?” Berry inquired.

Twilight approached the machine, which had begun printing out a piece of paper. “Yes. It’s designed to get the doctors attention when the tests are finished so they can retrieve the print-out.”

“Huh. So cutting edge medical technology goes ‘boink’.”

Twilight couldn’t stop herself from giving Berry a dirty look, but quickly returned her attention to the paper. “Spike, you ready to take this down?”

“Ready, willing, able.”

“Alright. The tests show that the blood serum shows high levels of amylase and lipase, we have an elevated elastase level, and the total bilirubin is up, which explains the jaundice.”

“High Serum Amaylase and Lipase, High Elastase, and High Total Bilirubin. Check.”

Berry raised a hoof. “Hey, Doc, that sounds thrilling and all, but I don’t know what emil-lace or Billy’s rubix is, so can you give me the short version?”

Adjusting her glasses, Twilight turned to Spike. “Spike, head down to the X-Ray and CT rooms. Tell them I want scans done on abdomen, sector 3.”

Giving a salute, Spike quickly headed out the door.

Turning her attention back to Berry, Twilight began to elaborate. “Amylase and Lipase are digestive enzymes secreted by the pancreas. Elastase is an enzyme that’s commonly found when connective tissue starts breaking down. Bilirubin is a cellular antioxidant which, in excess, causes a yellow discolouration of the eyes and, in extreme cases, the skin. Judging by all that, I believe it’s safe to say that there is something wrong with your pancreas, Ms. Punchina. We’ve ordered the necessary tests, an X-Ray, where you are bombarded with radio waves, allowing us a better look at your bones and organs, and a Computed Tomography scan, where you are bombarded by radio waves from all sides for more information. Does that make it clear?”

Berry blinked a few times, a confused look plastered on her face. “Doc, I asked for the short version.”

Twilight blinked as well, the confused look on her face neatly mirroring Berry’s. “I thought that was the short version.”

---

“Dr. Twilight! I’ve got the images from the CT Scan and X-Ray of Berry Punchina.”

“Excellent work, Spike. Now let’s take a look...”

Spike held up a pair of manila envelopes, which Twilight took one of and opened, placing the image onto a viewing box. She flicked the switch and the box lit up.

“This is the CT scan, correct?”

“Yep. That’s the one.”

Twilight examined the picture while taping her chin. “Well, this one is clear.” Looking over, she magically picked up a tongue depressor and brought it up to the image, indicating a large blob in the middle. “The pancreas is roughly 30% larger than normal. We have pancreatic swelling.”

“Swollen Pancreas, check.”

Twilight quickly pulled the image down, grabbing the second envelope and placing it’s contents on the viewing box. “Let’s see... here,” she mentioned, circling the tongue depressor around a shaded area. “Calcification in the pancreas. This could be serious.”

“Calcifi-wuh?”

“Calcification. It’s when calcium builds up in the soft tissues, hardening it. Typically caused an excessively high calcium/vitamin D ratio.”

“... I’m going to pretend I understand that and write it down. Calcification in the Pancreas. Check.”

Twilight smiled as she brought the image down and flicked off the viewing box. “Well, Spike, I think I have enough to make a diagnosis. Back to the office.”

“Right behind you, Dr. Twilight.”

---

“Alright, I have a good idea what we’re looking at. Spike, retrieve me the file with the pancreatic diseases, A-D.”

“I’m on it!” Spike replied, a smile on his face. He quickly went to grab his step ladder as Twilight took a seat behind her desk. It took him a bit, but Spike eventually had the ladder in place and retrieved the file and placed it on the desk. Twilight once again readjusted her reading glasses before removing them completely.

“Um, Dr. Twilight, I keep meaning to ask; why do you wear those glasses anyways? You never use them when you’re reading in the library.”

“Hmm? Oh, it’s for appearances. Studies show that a patient is 23% more likely to trust a doctor if the doctor looks smart, so I brought these from Canterlot when I got this job. Now, onto the file.”

The file magically opened and began flipping pages. “Let’s see... Acute pancreatitis... close... Annular pancreas... no... Benign neoplasms... I doubt it... Ah-ha! Here we are. Spike?”

“Yes, Dr. Twilight?”

“I’m going to start reading off this entry. Please check-off any symptoms that match up, alright?”

Spike pulled out his checkboard and pen. “Sounds like a plan.”

Twilight cleared her throat and began. “Patient will complain about pain in the abdominal region and lower back.”

“Check and check.”

“Weight loss may be noticeable, and in certain cases where the liver is also affected, jaundice will be noticed in the eyes.”

“Double check.”

“Auscultation will turn up subdued bowel sounds caused by reflexive bowel paralysis. This may also lead to nausea as digestion ceases and food builds up in the stomach.”

“Second verse, same as the first.”

“Blood tests will show an elevated amylase and lipase levels in blood serum, as well as high elastase and, if the liver is affected, high total bilirubin.”

“Super check.”

“An X-ray will show calcification in the pancreas, and a CT Scan will reveal a swelling of the pancreas.”

“That’s two more checks. That’s all the symptoms.”

Twilight smiled. “Wait, I have one more.”

Spike gave her a confused look. “One more?” A nod was his answer. “What is it?”

Twilight held aloft the file, clearing her throat before continuing. “Most commonly associated with alcoholism.”

Spike blinked a few times, before responding. “I’ll add that as a check.”

Twilight grinned enthusiastically. “Great! We have our culprit.”

Spike flipped the page on his clipboard. “What should I book her for?”

“Patient: Berry Punchina. Diagnosis: Chronic Pancreatitis.”

---

“So that’s it, Ms. Punchina. Chronic pancreatitis. The nausea is caused by your digestive system shutting down, and the pain is due to the enzymes activating at the wrong time, thereby dissolving your pancreas, intestines, and liver. We believe it was brought on by your excessive drinking habits.”

Berry rubbed her chin. “Well... that sucks. So what now, Doc? Am I gonna live to see my next happy hour?”

Twilight’s smile beamed once again. “I do have some good news on that front. Last year, the Equestrian Center for Disease Research and Control made a major breakthrough in the suppressing of digestive enzymes. The medication can be applied through a simple endoscopic procedure, and the damage that is done should be repairable as long as it hasn’t progressed farther than we suspect it has. With any luck, we can have you in surgery within a few hours. For now, I’d like to check you in to keep an eye on you.”

“Well, I suppose I don’t have much of a choice, do I? Alrighty. Sign me up.”

Twilight nodded in approval. “Very good. Spike? Go tell Nurse Hooves to get a bed ready for Ms. Punchina.”

“On my way,” Spike said, saluting before heading out the door.

“Well, Ms. Punchina, I’m glad we have that all sorted out. Just wait here till the nurse comes to show you to your room.”

“Alrighty. Thanks a bunch, Doc. We should go out for a drink some time.”

“I thank you for the offer, but I don’t drink.”

---

Twilight sat in her office, writing up the forms necessary to take Berry into surgery. She hummed a little to herself when a knock came from the door. Magically, she turned the handle and Spike entered the room. “Dr. Twilight. I’m pleased to report that Ms. Punchina has been officially checked in.”

“That’s great news, Spike. Now I just have to focus on finishing these forms and we can be well on our way to helping Ms. Punchina recover.”

Spike smiled. Walking over to the couch, he hopped up. Pulling out a small device from his pocket, he flipped a few nobs until a quiet white noise began emanating from it.

“Spike, how many times have I told you not to bring your pocket radio on the job?”

“Come on, Dr. Twilight. It’s just a little distraction. Besides, it’s not like I have much to do. I’ve already organized the office... twice... this afternoon...”

Twilight chuckled. “Oh, alright. But remember, you always have to ready to spring into action.”

Spike nodded and returned to fiddling with the dial.

At first, there was only static, but soon, a voice came on. “-Listening to 97.3, Scalez Radio, all dragon metal, all the time. And now, for the 2 o’clock news.”

“Aw man... I hate it when the interrupt the music for this stuff...”

The voice on the radio changed from a scratchy voiced DJ to a much more sophisticated female tone.

“Hello, I’m Hedrina L. Newsworth, and this is Ponyville Daily News. A recent accident at the Flim Flam Brothers Amusement Park in neighboring Fillydelphia left several ponies in serious condition. Due to the sheer number of those injured, Fillydelphian General had become overstocked and many of the injured were rushed to our own Granifred Pie Memorial Hospital. Sources state that all the patients arrived safely and are now in stable condition.”

Spike chuckled. “Guess Rainbow Crash is finally starting to pull her weight.”

“In other news, Ponyville PD has an APB out on a currently unnamed gryphon, wanted for questioning in a suspicious death that occurred during the accident in Fillydelphia. Police are not giving a name or reasoning, but state that the gryphon is a 4’5 foot tall female with short head feathers and a nasty disposition.”

Spike looked up. “Hmm... Nope. Can’t say I’ve seen anygriffon matching that description.”

“Now, for National news. It was a happy day at the Equestrian Center for Disease Research and Control as they swore in their new Head of Research. Dr. Trixie Lulamoon, a researcher of 4 years, has become the second youngest pony in the history of Equestria to receive this honour, a record only broken by her pred...”

“Spike. Turn it off.”

Spike looked at the radio for a second, then looked back at Twilight. “But Dr. Twili...”

“Spike. I said turn it off.”

Spike sighed, turning the switch and deactivating the radio. Twilight sighed, standing up from her desk. “The paperwork is done. I’m going to go find Dr. Kindred and see if she’ll be available for this procedure.”

“Right, you do that...” Spike said, his voice trailing off. Twilight walked towards the door, only for Spike to speak up.

“Twilight?”

“Yes, Spike?”

“You know it wasn’t your fault. You can’t stay mad forever.”

“I’m not mad, Spike,” Twilight’s response came as she opened the door, closing it behind her.

“I just don’t like being reminded.”

Comments

[Chaos Light]

SCIENTIFIC PROGRESS GOES "BOINK"? C&H FTW

EDIT: Aha, Spike is RONI.

[MrBrawler18]

825684
Perhaps maybe in this case BRONI
(shot)

[Cellin]

The medication can be applied through a simple endoscopic procedure,

Endocopic procedure eh? I think we'll be seeing Berry later.