2024-09-23: Early Intervention
- Log: 2024-09-23: Early Intervention
- Cast: Rikka Takarada, Akane Shinjo, Hinoki Sai
- Where: Bay Tower - Medical
- Date: U.C. 0099 09 23
- Summary: After being directed to the person who can best connect them with health resources, Akane and Rikka get some checkups and imaging done after everything that's transpired with Galactron, Break the World, and the Mu Gundam. The two of them get some scary-sounding news, but rather than flinch from navigating it, they handle it on their own.
While 3G's medical facilities have significant infrastructure for cyborgs and other posthumans, there's also a pretty broad swath of normal (and extremely fast-operating) medical equipment. After all, most 3G personnel are human.
Accordingly, the wait time for most imaging results is measured in hours, not days or weeks.
Akane's the first one called in, and her discussion with the doctor (with Rikka present) is mostly unremarkable; she's asked about a handful of potential symptoms, all of which meet a 'no' or a 'ehhh, kind of...?' and that seems to eliminate the doctor's only potential concerns. Her issues most likely fall under the stress umbrella rather than something physiological related to Galactron use.
She does also get a stern reminder that the workup indicates something else that she needs to address: she needs to take her blood pressure more seriously now that her medication regimen has changed post-surgery. She hasn't stopped eating like a goblin and that actually matters now that her medication is doing much less to alter that.
Looking a little embarrassed, she takes that one on with a, "... Meal plan?" and a sheepish look at Rikka.
"Meal plan." Rikka confirms, meeting Akane's sheepish look. The news isn't... too surprising. Well, it is, but in a way that comes as a great relief. She was worried, but she can let some of that go, now. She does, though, offer her an encouraging smile. "Don't worry. I'll help, too."
"Thanks," Akane says, with a relieved look on her face. She scoots in a bit, mumbling, "I guess we can start with getting the low-sodium versions of all the cooking stuff..."
There's a longer wait for Rikka's results.
Akane spends it trying to shove down her anxiety. There being nothing substantial wrong with her makes her more certain there has to be something catastrophically wrong with Rikka; her brain wouldn't just seize on nothing-in-particular and get anxious about it, right?
Rikka finds herself anxious, too. She didn't think they'd be in and out, but it's taking a while... Rikka looks toward Akane. She can practically feel her anxiety from here... Or, more than practically, perhaps. It melts in with her own, a little.
Before, she would've taken it as a cue to put her guard up, but - they talked about this. Rikka reaches for her hand, taking it and squeezing gently.
The hand catches Akane off guard; her eyes widen for a moment, and then she seems to relax into it a bit. "... we'll figure it out," she affirms. "Thanks for taking the time to do it."
Rikka nods, and offers her a small, slightly awkward smile.
"Thanks... for asking me to." She replies.
After some back and forth between the staff, Hinoki Sai was the one chosen to discuss Rikka's results with the girls. She's been with Rikka for most issues secondary to her time on the Garuda, even if she eventually took on a supporting rather than primary role in her care.
"Chief Takarada," she says; as much as it's 'Rikka' in casual situations, health issues put Hinoki a bit more in that formal space. Looking from Rikka to Akane thoughtfully, she makes a few mental notes before proceeding. "You're a fairly lucky patient; because of your treatment over a long period we have a lot of records of your brain in particular to compare to."
"Now, before we get started, explaining this is going to involve some words that sound kind of scary. When most people hear them come up, they immediately assume the worst." She holds up a hand and continues, "I want to express that while the type of injury you have sounds frightening, you're sub-symptomatic for a reason."
"Doctor Sai." Rikka greets, offering her a respectful nod. The professional approach is expected - and appreciated, honestly. Not that she expected anything differently from her, but it's good to know she's taking this seriously, and not treating her any differently because of their familiarity.
She listens as Hinoki gives her warning. That it'll sound scary, that she'd usually assume the worst... but that she's sub-symptomatic. That's a relief, but she'd be lying if she wasn't feeling the nerves just a bit from that already. She looks toward Akane briefly, then back toward Hinoki, and nods.
"Okay." She says, drawing in a breath.
The lead-in does a lot to prevent Akane from spiraling; knowing that what's about to come in is scary makes it, paradoxically, less scary. The clarity there makes it manageable.
Emphasis on "manageable," mind you. Still, even the physicalizing is less than usual; rather than that agitated foot-tapping or fist-clenching, she just scoots briefly back and then forward a bit.
"... Let's get into it," she says, closing her eyes and trying to center herself.
"You have... a, small, amount of acute, recent brain damage. You also have what looks like it could be residual damage from two years ago that hasn't healed quite as fast as I would have liked to report. I'm going to say, again -- this isn't catastrophic." Hinoki's expression turns toward a relaxed, almost teasing smile. "If I didn't know what was happening, I'd probably just start by asking if you tried joining NT Tech's boxing team, got your bell rung, and didn't tell any of us." Rikka lets out the breath she'd been holding. Acute, recent brain damage... and residual damage from two years ago. Hinoki's right - that does sound scary. But she says it isn't catastrophic, so she tries not to let her fears run away with themselves.
"No, nothing like that." Rikka says with a smirk that suggests she's trying her best to keep herself positive.
Akane nods slowly. The first impulse is to catastrophize -- but Hinoki's bedside manner has made it clear that this isn't something they should panic about imminently.
"... now I'm really glad I asked to do this," Akane murmurs to herself.
Those responses seem fairly reasonable to Hinoki -- but she can tell that keeping an upbeat mood is taking a little effort.
She can help with that.
"With that out of the way, I have a lot of good news. First, the areas where lesions associated with HADES-E use start are the same ones affected by Algernon, which means," and here she cracks a small smile in spite of the heavy topic, "you have an expert on your case." The confidence is hard-won -- a far cry from the girl who'd beat herself up whenever a conversation wasn't going her way.
"And, again -- we're intervening early before this sort of thing becomes complex. Two, the same treatments we've developed for Algernon should substantially reverse the damage. We're in a better position than we were two years ago, both in terms of identifying this type of damage and in terms of treating it." ... yeah, there's no two ways about it: Dr. Sai is really happy to deliver this one. Seeing the culmination of multiple areas of her work over the last two years in an immediate, actionable way... it does feel good.
The fact that Hinoki can smile about this means that Rikka can manage a small, but more genuine smile herself. And that anxiety she was feeling tapers off, just a little, as she continues.
"That's... good to hear." Rikka says. It's a relief. She remembers what it's like - and it's even better to know that things are better now.
Akane, conversely, has always lived in a world where Algernon is a much more active threat; as such, hearing it invoked, even laterally, makes her fears spike for a moment...
... but then she remembers that they have Algernon incidence down to near-zero now. 'This problem is similar in scope to a relatively unremarkable one common in healthy people' and 'this problem is in a category where our interventions are great' gets her to calm down a lot. She keeps listening.
"Most studies indicate that the heightened risks of dementia and brain cancer associated with damage to these areas reduce to normal levels seen in the general population with this type of treatment, and I'd say every case we have records for is... much worse than yours is presently." Before either of the girls can run away with that, Hinoki appends, "That's -- not an invitation to be cavalier about this, but it is a reason to be glad you got the scan, because it identified an issue that responds well to treatment."
Hearing 'dementia' and 'brain cancer' does give Rikka a bit of a start - but only a bit, because she quickly reminds herself why they're doing this - and the reassurance that her case is, comparatively, better off.
"So it's not too late..." Rikka breathes out. Hinoki appends a statement. A reason to be glad... Rikka looks toward Akane, squeezing her hand with gratitude clear on her face.
Because they spoke about it... because Akane was worried enough to bring it up. If she hadn't, where would she have ended up...? It's better not to think about it.
Those issues don't hit Akane the same way they do Rikka; she's always been the sort of person who obsesses over any sort of nonzero risk, and over time that's given way to a more healthy understanding of the numbers. Knowing that there is never zero risk of anything used to paralyze her; now it's almost reassuring.
"Oh, not too late at all, no! By our standards, this is an incredibly early intervention," Hinoki agrees with Rikka. "Assuming this sort of once-or-twice-a-year frequency of injury, this is still something that we wouldn't normally consider screening for for a few decades, and identifying the scale, location, scope, and cause this early means we can renormalize your risks."
She takes a moment, again looking at both of the girls before continuing. Her gut tells her she needs to start moving toward action instead of just placating doubt. "The first line of treatment here would probably be a short course of multidrug therapy. Like I said, your injuries are comparatively small. As far as I know, you also got a lot of rest afterward as well, so I don't think we need to treat this like an advanced Algernon case and perform extended intervention."
She looks down at Rikka's chart consideringly. "If you want to pursue treatment, I would probably start with a two-week course based on your current presentation and prognosis. There are a few side effects -- muscle weakness, a small risk of muscle rupture under sufficient strain, occasional light nausea, and mild risk of diarrhea a few hours after a dose." She adds, "Akane mentioned you had trash duty this month before your vacation; I'd recommend trading that back if you do choose treatment! Now, again, that isn't obligatory. If someone else came to me with your presentation, I might say another week of light duty would be enough and not to concern yourself until age 50! But..."
With the data before her, Rikka is a lot more relaxed. It's something she can take in and consider, not a big unknown. So for now, she focuses on the practicals.
"Yeah, we didn't do a whole lot for the next couple of days... On our trip we did a lot of walking around and went out swimming with friends once, but nothing too strenuous." Rikka explains with a shake of her head. She doesn't know how much of that, if anything, will be significant, but it's better to have it on the table than not when they're discussing her health.
She goes quiet, though, to consider the treatment. She does grimace a little at the side-effects... but she nods.
Akane doesn't interject yet, but the 'but' makes her squirm into Rikka a bit. Something about this is making her skin crawl, but she can't identify it yet.
In response, Rikka looks toward her. She studies her for a moment, as if expecting her to bring something up... but when she doesn't, she looks back toward Hinoki as she resumes her statement.
"That'd definitely constitute sufficient rest for our purposes," Hinoki agrees. "It was never going to be a perfect rest under the circumstances, but that's... well, as good as it's going to get."
Here, though, her expression turns serious. "If you're going to continue using Red Umbrella -- I think you should consider the treatment as a serious option. The course of medication gets significantly longer with more unaddressed damage, which means more time dealing with medication side effects."
(It's here that Hinoki has to shift to brass tacks, a bit -- not just as a doctor but as a member of 3G, who knows the risks of the job and knows that most people who go on Mobile Corps operations... continue going on mobile corps operations.)
She weighs whether to say what she has to say next... but it's better to put every option on the table than not. Rikka has good judgment -- it's why she's Chief. "... If it were just that, I'd send you on your way, but there's also been... some research indicating this type of treatment is effective prophylactically -- that is, among populations that face short-term, predictable spikes in Algernon incidence. The first few trials were in rescue workers, correctional officers in 'science crime optimized' carceral facilities, and certain types of space mining operations. If you'd like, I can send those articles along." Rikka is in both pre-medical and engineering course tracks; Hinoki thinks that at this point she can probably derive meaningful data from the literature, especially with the researcher conducting it in her organization.
"I don't think your situation is predictable enough or short-term enough for that type of intervention, but it does color how we consider future treatments if this happens again." She pushes up her glasses. "I think it's worth considering skipping the MRI next time you activate the system? Since we have a fairly long record of your brain, we can take one more look at it after this and, if the treatment is working for you, treat the issue the same way next time."
The skin-crawling feeling rapidly accelerates. Akane goes from vaguely unsettled to genuinely afraid, but her reflex is to stuff all that down. The only signs are the way her smile gets just a bit more plastic -- the steady rise and fall of her chest accelerating -- and of course the whine-roar in her heart.
Rikka nods. Continuing to use Red Umbrella, to use the Mu Gundam... it's not a question. It's what she has. She could return to the Kakuseijin V2 alongside Akane, but the machine is beginning to show its age. She can't be certain it's enough, and shuffling around the resources to build something different... Now isn't a great time for it. Hinoki has Rikka pretty well figured out.
"I'd like to read them, thank you." Rikka replies with a nod. Her expression goes thoughtful for a moment. Treating for it ahead of time... She doesn't voice her thoughts on it yet, instead nodding as Hinoki continues.
But before Rikka can address it, before she can decide on things one way another... she sees the look on Akane's face. The way her expression freezes, turns fake, the way her breathing accelerates. And perhaps just as much as what's on the surface, she hears it. She's always been receptive to the sound of Akane's heart. She'd guarded herself for so long, but now...
It's a small feeling. Formless, and perhaps a little indistinct, but Rikka makes her presence known. In her heart, and outside it, as well, as Rikka takes Akane's hand and squeezes gently, running a thumb over her palm.
"Do you want to talk it over?" Rikka asks.
Someone knocks on the door of Akane's heart. It's a bit startling; she's used to associating that feeling with a crisis, and when it comes, there's a split second where she shrinks away. That gets Hinoki to notice just how much Akane's mien shifts, though, and while she doesn't say anything yet, she scoots back.
... She can't keep shrinking away from that feeling of genuine connection, though. One step closer, rather than one step further away.
"... Yeah," Akane says. "Let's -- we need to step out for a second," she says to Hinoki. "Sorry."
Hinoki nods, and shifts position to make it easier for Akane and Rikka to leave the office. "I'll be here," she says.
Akane takes a deep breath once they're out. Her head tilts forward a bit, and she shuts her eyes. It takes her a few seconds to put everything together.
"... I -- sorry, I thought if we stayed in there I'd just start shouting at Hinoki-san," Akane says, shaking her head. "And... I know this isn't, like -- it's not, a thing where... I don't think she wants to do this. But Leina said -- the more you use that kinda option the easier it gets." She opens and closes her hand repeatedly, making and then releasing a fist to try to shake things out of her brain.
Shaking her head, she says, "Just solving it with drugs feels like what would've happened... if Dr. Murasame snuck off with us." Her eyes track down. "I don't... want this to get easy. I'm not going to tell you never to take that kind of risk, just... I'm scared that you'd find it easy to get used to."
Her lips curl up in a small smile at a few memories -- once scary, now fond. "... the world's better with you in it, so I want you in it as long as possible. Okay?"
"It's alright." Rikka replies, shaking her head as Akane apologises. She listens, though, she wants to hear her thoughts, wants her to put her fears out in the open.
The more she uses it, the easier it gets...
Rikka wants to say that she'll be fine, that she'll only use it responsibly, but... how many people have said that same thing before her? She wants to say it's different - but is it? No... Akane has a point. Rikka stares at the floor for a moment quietly.
"...You're right." Rikka says with a nod. "It shouldn't be easy... But I can feel how it would be. I can feel how it'd become easy."
Akane offers her a small smile, and Rikka smiles back, those words stirring her heart.
"...Yeah. I want that for me, too." Rikka replies with a nod. She wants to be in this world as long as possible, with her and everyone else she's come to know and love. With that in mind...
"I think... We should still go forward with the treatment, at least until I'm recovered. It'd be better to address it. ...Even if it means reshuffling the chore chart again so soon." Rikka's smile turns just a bit apologetic, then, before she continues. "After that... We'll approach things as they come. I can't promise I'll never use the system again, but... you're right. I think it's better not to treat it as an inevitability, something to get used to."
"What do you think?" Rikka asks. She thinks it over for a moment longer and adds, "...I think we should start looking for a better alternative to the system, too. I don't need to be a weapon... I just need to be Rikka Takarada."
Akane nods to Rikka, agreeing, "Yeah. I'm not gonna object to you getting treated for stuff that's already happened! Just the... getting okay with doing it ahead of time. That kinda risk needs..."
She pauses. "Huh. I guess it makes sense that you wouldn't have thought about it that hard... the approval system's something they only really drill into you about why it's important in Mobile Corps," Akane reflects, quietly. That Rikka has the blind spot makes sense -- but that just means it's a good thing Akane spoke up, she'd suppose.
"That's a really good idea too... we should go down to Engineering a little later," she agrees.
Leaning in, she gives Rikka a peck on the cheek. "Let's head back in."
"Let's." Rikka replies with a smile. She opens the door, heading back inside and settling back into her seat.
When the two come back in, Hinoki greets them warmly. "I hope everything's okay," she offers, gently. "How are you feeling about next steps?"
Akane nods to Rikka, taking a half-step back and letting her say her piece rather than sitting down immediately.
"It is now. Sorry to keep you waiting, Doctor Sai." Rikka apologises, offering her a fresh smile.
"I'd like to undergo the initial treatment plan. I think we should start with that and see where I'm at, and proceed from there." Rikka says with a nod. "I've also decided against the proactive treatment. We're going to instead look into phasing out the HADES-E. It's tied into too many systems to just tear it out entirely… but that doesn't mean we can't replace it with something better, that induces less strain."
...She pauses for a moment.
"...I would still be interested in seeing those articles, though." She adds - that much just out of scientific curiosity.
Hinoki nods. "I think that's a reasonable step. It's not the first time 3G's started out with a system that damaged the pilot and started seeking less painful alternatives, though a lot of that is before my time here," she affirms. "That's a good start."
She looks to Akane, then. "As for you, there's a fair amount you can do to help, but most of it is as her partner and not as a member of 3G. I'd actually like to recommend that, with class starting, you both take another week to recover."
"I know there's some outreach work on the table for the two of you, and that's fine, but I'd like you to leave Break The World-related coordination to Munakata-san and Tamura-san, and data analysis to Taki-san." Hinoki's done this dance with bigger workaholics than either of these two before; she knows if she doesn't underline that the work will get done without them they'll push back. "This part I'm concerned about not as a member of your care team but as a member of 3G. I don't have the authority to force the matter on my own, but if you don't take the time voluntarily, I'll ask the other Chiefs to discuss it among themselves."
Akane looks to Rikka, letting her decide... though she's inclined toward taking the week.
Rikka frowns just a little at the thought of taking another week off of work... but it soon turns itself back around into another small smile.
"No, that won't be necessary... You'd know best, I think. I guess looking after my health is part of my job, too." Rikka replies with a nod. "We can proceed with the lighter workload."
As much as she wants to help... sometimes, part of that is knowing when to leave the heavy lifting to others - and they have a lot of good, reliable people to count on. They're all in this together, after all.
"All right. Thank you for taking this seriously. I'll have the prescriptions sent to your usual pharmacy," Hinoki agrees. "Unless you have any more questions, that's all I have for you. Have a nice evening."
Akane gives Hinoki a still-slightly tense, "... Thanks," and then turns to Rikka, cheeks puffing out slightly. "Let's get something to eat," she says, a little pouty.