Author's Note

So I wasn't going to publish a chapter today and this was going to be part of a longer Chapter 85... buuut, Mondays suck ass, and this is a good enough stand-alone piece that I figured why not?

The rest of 85 (now 86) should be ready next week. I've barely even started on what will be 87, so no promises regarding 11/13.

As always, thanks for reading / rating / commenting. Enjoy!

Chapter 85: Tools for Penetration & Fluid Exchange

Friday, July 24th, 909 AB (11 days later)
Baltimare Hospital, just before noon

“It’s a collar,” Dr. Care flatly observes. “A thick, fleshy collar.”

“And a backpack!” Cure excitedly nods, patting the attached rectangular device. “Sort of. And you’re right, it is a collar, but this is less the ‘Slap it on for a good time’ collar and more the ‘My patient’s vitals are crashing’ collar. See, a few weeks back I went out to the ocean at Mason’s Cove -”

“Right, I saw the pictures in the paper.” She chuckles lightly and adds, “The ones comparing your escort to a duck were funny.”

“Heh… yeah, I hope she’s not gettin harassed too much for that. Anywho, one of the things I was lookin for in the ocean are the plankton that convert carbon dioxide into oxygen. This baby,” he pats the backpack, “is a fully enclosed cardiopulmonary system complete with its own internal rebreather. All you do is take this lil fella,” he starts, unclasping the collar and wrapping it around his own neck, “slap it on the patient, then hit the activate button. Got yer stethoscope, doc?”

“Always,” she answers with a nod.

“Cool. Come take a listen,” he says in invitation, patting his chest.

Though a little leery of what the colt has in mind, the doctor doesn’t hesitate to stand and walk around the table, donning her stethoscope as she does.

Cure had told her he was working on a couple new inventions to help out when he is not available, or for other regions that don’t happen to have a walking magical hospital in colt form on hoof. The first, his collar, is a half-hoof thick green strap that he has wrapped around his neck. It looks long enough to fit around even a large earth pony’s neck, but on the small colt the excess simply dangles off the one side all the way down to the booster he’s sitting on.

Two thick tubes attach to the dangling end of the collar and lead back to the pack which is also colored green with the universal medic symbol - the white cross - displayed on two sides. On the top of the unit is a smooth, dark panel that looks like glass. A red-yellow-green scale is displayed, as is a status window reading “Attached - Standby” on it. A large button sits on either side of the panel; a green button with an odd circle and line symbol and a red button opposite it with a white X.

Dr. Care presses the end of the stethoscope to the colt’s chest finding, unsurprisingly, a strong, slow, steady heartbeat. Just as she’s about to question what exactly he’s showing her, that beat suddenly ceases. Panic briefly sets in as she goes wide eyed and looks at the colt in alarm. Holding up a hoof to forestall her worry, he points back at the backpack.

The unit, previously sitting inert, is humming quietly with activity. The readout now shows “Attached - Active” and the red to green scale shows a black box with “99% - 5:26:14” on it, counting down. Curiosity prompts the mare to move the stethoscope to the pack and, as she’d somewhat expected, she hears a steady heartbeat along with the sounds of moving fluid.

“Huh. Little warning next time?” she suggests with a weak scowl.

Smiling sheepishly, Cure bobs his head. “Sorry doc. I was gonna say something but ya stuck yer stethoscope on me before I could and I know how loud it is when somepony talks with that on ‘em.”

“Fair… so what is this, some kind of blood oxygenator?”

“That and more! It’s still a prototype so I need to work out a few things. Like how to ‘feed’ it. It does use solar energy like all my other plants and it has some internal fat stores, but I’ll probably have to make some kind of dock to recharge it since it doesn’t have intake ports for food and water. It’ll last about three hours for most ponies, maybe more like one or two on a large earth pony and, obviously, a fair amount more on a foal.

“It’s also subsidizing any lack of nutrients a typical pony needs and cloning their blood if it detects their blood pressure is way too low, so it does way more than just oxygenate the blood, but those other features will deplete its stores faster. It’s somethin I figured your EMTs can take in the field and slap around somepony to keep ‘em alive long enough to get ‘em back to the hospital where you can fix them proper-like.

“The collar,” he pokes at the unit around his neck, “isn’t just sittin on here. It’s bonded to my skin and linked into my carotids and jugulars. When the shutdown process is initiated it’ll use a small bit of the origin cells to patch the holes before detaching. Ya gotta hold the red X button for five seconds for it to do that. Just hittin the power button again will put it back into standby mode, and tapping it twice will set it to an ‘auto’ mode that will kick on when it detects the patient’s vitals falling.

“The only downside is that they will leave a patch of bare skin,” he explains, removing the collar to show that his coat was removed on his throat. “That’s kinda by necessity, obviously. Griffon feathers, especially the stems, would get in the way otherwise. I have my doubts this’ll penetrate a dragon’s scales, but with so few of them in Equestria,” he finishes with a shrug.

“Right, a bit unnecessary. Overall it seems like a good idea. I am concerned that it’s a little large for our pegasus EMTs to carry.”

“Lift it,” he suggests, motioning with his snout. “It weighs a lot less than you’d think and will even sit on clouds.”

At his prompting, Dr. Care ignites her horn and lifts the unit, finding it just as the colt had described. “Huh. Good thinkin, colt. How many have you made and when do you think you’ll have the… dock, you said?”

“Yep! I’ve only made two of these units so far. I should have a dock of some kind ready by Monday. I’ll probably set that up to run the usual sterilization process that y’all do for medical equipment when the units are plugged in, that way you can hit it with a quick Cleaning and you’ll know you’re not hookin anypony up to somethin that’ll make ‘em sick.”

“Not bad at all. I’ll have to see how we can go about testing and certifying them, but if they work like I’m sure they do, this’ll save at least a few lives every year.”

“Maybe a few more for the Baltimare area. As long as you can get one of these on a pony within about five minutes of ‘death’ then I should be able to revive ‘em. I mean, as long as their brain is okay, then why not?”

“Sweet Celestia, colt… that’s insane!”

Cure gives a helpless shrug. “You were there for the near-miscarriage. You saw what I can do.”

“True… true. Do you have a written up brief on these ready?”

Cure digs into his bag again, pulling out a few sheets of paper. “You bet. Here ya go, doc. I’ll hafta update it once I get the dock set up, but that should just be a couple extra pages and I don’t expect it’ll be that complicated.”

“Fantastic! Now… you said you had a second invention?”

“Yep! That’s in OR three but it’s a heck of a lot more complex than this little guy.”

“Great!” She motions to the door as she calls, “Let’s go check it out. Gotta admit, I’m pretty excited!”

“Should I just leave this here?” he asks, waving at his creation on the table.

“Yep. I’ll have Facilities come pick it up.” She pushes the door open and motions for him to lead the way. “After you, your highness.”

Cure rolls his eyes as he hops down off his booster and trots past the doctor. The three guards from Meadow form up behind them as they make their way through the halls.

“So, colt, got any plans tonight?”

“You bet, doc! Once I get done with my business appointments I’m meetin up with a couple of my fillyfriends for a evenin on the town.”

“Ahh, right… that’s tonight, isn’t it? I think I’ve seen a dozen articles in the papers since you made those reservations. Club Oceano, right?”

“Yup! Gonna get me some clam chowder and a big ‘ol salmon steak.” He punctuates the sentence with an exaggerated lick and smack of his chops. “You ever have seafood, doc?”

“I have,” she confirms. “I had shrimp scampi at a wedding once. Liked it so much I even tried cooking it at home. It stunk up the house something fierce.” The doctor gives Cure a small pout as they round a corner. “I’m officially banned from cooking seafood ever again.”

“Ah… yeah, that’s one of those ‘air the house out’ kinda meals. Lotsa seafood is that way, unfortunately. Shame too ‘cause it’s so friggin good. Ya oughta try bacon sometime, doc. When I was in Canterlot this last time I went to this griffon restaurant,” he pauses at the mare’s quirked brow.

“I figure that would have been in the news. Everything you did outside the castle was, after all.”

“I was in disguise as a hippogriff. I think they all knew something was up with me, but nogriff said anything. Anyhow, bacon is where it’s at. I have a plant-based alternative. If you’re interested, I could bring a half kilo on Monday for ya. Not only does it taste awesome but it makes the whole house smell like sweet, delicious bacon when you cook it. That goes for you all as well,” he adds, looking over his guards.

All three look a little unsure at the offer, either because they’re not sold on the whole meat thing or because they’re reluctant to accept a gift from their charge.

“Plant based, sir?”

“You bet, sarge! No pigs required. One hundred percent ethically sourced. As big ‘a fan as I am of the real deal I’m pretty sure I’ve got it beat. And that’s no small boast, either. Being able to literally design the meat to specification has its advantages. Each strip has a thin wrap of fatty goodness around the outside edge, so if you prefer the crispier, meatier part you can cut that off pretty easily. One of my mom’s didn’t care for the chewy fat.

“I think I’m getting close to coming up with a fully ‘plant’ alternative that’ll be a lot healthier, but getting the flavor right without simply adding in the real product is tricky. I guess it’s not a big deal since most ponies have never tried the real thing, but still.”

“You seem unusually fond of meat, sir.”

“Alicorns are omnivores, sarge, just like bat ponies. We get a little of each tribe, it seems. Every tribe can handle a bit of meat without gettin an upset belly, though. Unicorns and earth ponies can only have a few ounces at a time, but pegasi should be fine unless they really go bonkers. You wouldn’t wanna eat that much bacon at once anyhow. Too much salt. Interested?”

“I think I’ll pass.”

Despite Sgt. Blackhoof and the unicorn both declining, the pegasus speaks up. “I wouldn’t mind trying it, sir.”

“Sweet. You in, doc?”

“Sure, why not?”

“Cool.” The group pauses just before the OR doors. “Now, doc, before we head in I am gonna give you a little heads up here, alright?”

“Ohhh…kay?”

“The creation I set up in here is… out there. Most ponies would probably freak out just seeing it, and I totally get that. To be fair, I think most ponies would probably freak out if they had a candid glimpse of what goes on in a real surgery anyhow.”

The doctor nods in agreement. Most surgeries are, by their nature, a rather brutal affair. His escort takes up their station outside as Dr. Care follows the colt into the OR and freezes at what she sees. The object arranged over the operating table is unlike anything she has ever seen, and she can’t help but feel like it’s going to reach out and grab her at any second.

The plant, because that must be what this is given the source, is almost like a scaffolding arched over the surgical bed, not unlike an archway trellis in a fancy garden. Dozens of vines or tendrils line the inside of the structure, many of them tipped in a living approximation of a common surgical implement. Several more have either no discernable instrument attached or have spigot-like openings that Dr. Care can’t fathom the use of.

The unit continues underneath as well with a semi-flat base extending nearly to the closest end of the bed. A dozen larger, thicker vines are coiled underneath the unit, hopefully to manipulate the patient’s position, not capture unwitting prey. A quick exam shows no visible mouths or teeth, much to the doctor’s relief.

Cure gives the mare a knowing look, saying, “Yeah, that’s why I warned ya. May I introduce you to the Variable Instrument Neurolink-Enhanced Surgical Suite.”

“VINESS?” she deadpans.

Cure studiously avoids her look and stoically insists, “Coincidence, I assure you.”

“Uh huh. So… how’s this work?”

“I’m happy to demonstrate!” the colt chirps, trotting up to the left side of the device. He grabs a thick cord of some sort with a square patch on the end of it and, after pausing to uncover the area, presses it into his withers. Dr. Care inhales sharply when the entire contraption comes alive, revealing far more tendrils than the few dozen that were initially visible.

“So when you press this puppy,” he waves at his withers, “into yer withers it sends a couple hundred nanothread connections down into your spinal column and hooks right into your central nervous system. You would think that would be very overwhelming, and you would normally be right.

“This isn’t my first time developing a neural interface, though, so instead of your brain having to do all the heavy lifting of coordinating all these guys,” dozens of tendrils wave in unison to the doctor, making it a real struggle not to dive back out the doors, “most of that is offloaded onto a series of ganglia and supported by, essentially, a fake cerebellum that would put what we have in our noggins to shame.”

“This thing has a brain?!” she shouts in alarm.

“No!” he instantly denies. “It has organs that do the same thing that parts of our brains do. There are no actual brains in here at all.” The colt goes still and makes a face as Dr. Care quietly snickers. “In the plant, I mean.” She laughs harder. “Quiet, you!”

“Alright, alright. So… you’re hooked into this thing and, I’m guessing, all those,” she waves a hoof at the array of tendrils before her, “make it so you can… do what, exactly?”

“Lots of things. First, the obvious common tools are all here. Scalpel, forceps, clamps, suction, etcetera, etcetera,” he explains, waving instrument after instrument for the mare to see. “I’ve also got some specialized tools for foalbirth here,” he adds as an absolutely gargantuan stalk raises up from underneath the base of the bed, easily as big around as her neck.

Dr. Care eyes the limb with no small amount of concern. “Uhh… I’m a little scared to ask how that works, exactly.”

Obviously incredibly proud of his invention, the colt positively beams as he explains, “See, if this were a birthing table you’d have the patient get into position just like normal, then this little fella,” the stalk waves to her with a surprising amount of dexterity, “attaches right to the vaginal opening. On a bed like this I guess you could just use these puppies,” the larger vines under the bed reach up on either side like a kraken entombing a ship, “to position the dam as needed or just help her be comfortable.”

Dr. Care has an inordinately difficult time imagining those making anypony feel comfortable in the slightest, and is more than a little relieved when they retract back under the bed.

“In addition to the standard tools, it can secrete a variety of chemicals to reduce pain, increase dermal elasticity, and encourage dilation! It can even be used internally to create a temporary amniotic sac,” he explains as fleshy bands extend from the outside rim of the end of the tendril and assemble themselves into an oblong sheath, wrapping an imaginary foal in a cocoon. “It can encase the foal or foals, connect to their umbilical cords to supply them with everything just like the placenta, and extract them while protecting them on the way out!” he finishes, bouncing excitedly as the cocoon retracts.

“It’s… uh… a tad large for that particular opening, Cure.”

“That right there is quitter talk, doc,” he instantly responds, waving a scolding hoof. The mare shoots him an annoyed look when he suddenly starts cracking up. “Sorry! I couldn’t help it! It’s fully adjustable!” She watches in shock as the unit thins, much of the mass seemingly shifting under the green exterior, until it’s small enough that even a pegasus or bat could survive it.

“It sounds like it could be useful in the right circumstances,” Dr. Care finally admits. “I’m not so sure many dams would exactly be eager to give that a whirl.”

“Eh, to each their own.” It would be a hit in some cultures, he silently considers. “I figured I would include it just in case. It has a version of something built in that can also be used from the main canopy. These here are what I’m calling the microsurgical tools.”

The doctor’s unease diminishes as the birthing stalk retracts and another tendril extends down from the device. The new limb is as thick as her foreleg with no obvious instruments attached at all.

“It doesn’t look very micro, Cure,” she flatly observes.

“Look closer,” he beckons, waving the appendage in her direction. The way the green snake-like tentacle is motioning to the doctor only serves to increase her wariness, but she dutifully steps closer to take a better look. Extremely fine filaments extend out the end of the arm reminding the mare of a dandelion’s seed bulb, just far longer and mobile.

“Hairs?”

“Sort of. Hair thick microsurgical tools like the neck connector, sort of. This limb can extend them out nearly a meter, so as long as you can get them inside somepony in the general vicinity of the actual surgical site then you oughta be able to do whatever you need.

“So for a tonsillectomy, just cram this fella,” the vine makes an unfortunately awkward thrusting motion, “right in their mouth, then you can use the cutting instruments on here,” he waves it back and forth, eliciting a cringe from the doctor, “to snip them puppies right outta there. There’s origin cell extruders in there, too, so you cut out the crap you don’t need, you patch over the wound, voilà! Quick, pain free, minimally-invasive surgery with vastly reduced recovery time.

“VINESS has a full array of life support capabilities just like my pack I showed you and it can synthesize blood as needed. It will take some getting used to, especially the different visual settings -”

“Wait! This thing has eyes too?”

“Yep! Eyes and bioluminescent emitters. Infrared, visible, ultraviolet, the works. They come in sizes as big as a pony’s,” he explains as an eye stalk swivels and opens up, staring directly at her unblinkingly, “or as small as the ones on the end of the multitool. I can make them smaller, but they’re not very good at that point; you would have to point several at a single object just to make it out.”

The colt pauses, tapping at his chin in thought as he regards the unit. “Maybe I could enhance and adjust the internal visual cortex to resolve multiple images into a coherent whole. I’ll have to experiment with that,” he finishes, slowly nodding to himself. He shakes himself free from the thought and continues, “You do need to be careful with the emitters. Ultraviolet in particular is not so awesome for the peepers.”

The eyestalk swivels away from the doctor and looks over the rest of the unit in some approximation of consideration before he adds, “Then again if yer gonna blind somepony there’s not a much better time to do it than when you already have the thing ta fix it on hoof.”

“I’m not so sure that ultraviolet light is very useful in a surgical setting, Cure.”

“I’m not a surgeon, so I figured I’d put everything but the kitchen sink in there and let y’all figure out what ya don’t need. I’ve been working on this fella since I got back from Canterlot. I’d made an offhoof comment about growing scalpels on a tree, then thought, ‘Why not just make a plant just for the surgery by itself?’

“So,” he says, suddenly detaching himself from the unit and holding the connection vine in offering, “wanna try it out?”

Dr. Care gives the hookup an unsure look. On one hoof, the machine has potential to revolutionize the entire field of surgery. On the other, she’s plugging an untested device into her spine; one made by a foal, no less. On the third hoof, he did just demonstrate that it works fine, and on the last hoof… if the thing does fry her brain he’ll probably be able to bring her back good as new.

“Ya know what? Sure. Hook me up.”

The colt nearly lights up in joy as the mare removes her coat and lays on her barrel beside him. “Alright doc, it’ll be a little disorienting at first, but just give it a minute and it’ll all be pretty instinctual.” With little ceremony, the colt brushes her mane aside and sets the pad on her withers.

Disorienting. That’s a word that doesn’t exactly have a scale associated with it, but at the very least she has a pretty good idea of where the upper end of it is now. Fortunately the sensation of the world spiraling and turning inside out a couple times passes before she falls over, even laid on her barrel as she is.

“Fffuck!” she barely manages to slur out.

“Language, doc! Yer killin my innocence over here!”

“Sure, innocence. How’s the second set treatin ya, colt?”

“Floppy and uncomfortable. That’s why I usually leave it at home.”

“Hah! You know I’ve been asked about that a million times, right?”

“I’m not surprised. You okay yet?”

“Yeah… yeah, I think I’m good now. Wow, this is nuts!”

Cure watches on as the plant slowly comes to life. Tendrils unwind from the canopy, various appendages flex and weave, and a variety of light spectrums turn on and off. He reabsorbes his flight suit over his left foreleg and hops up on the bed, holding it under the unit as he calls out, “Move that microsurgical tool over here and take a look.”

“Okay… that’s this one, right?” Several tendrils move, then still and retract until the correct one finally starts descending.

“You got it. Just press it right against my thigh here and you should be able to tell what to use to remove my coat, cut an incision, and insert a viewing stalk. I don’t need anesthesia, but practice how you perform, so use it all anyhow. It won’t work on me, but I can turn off my pain receptors.”

“You sure, colt? I don’t normally cut on ponies that are walking me through the process.”

“I’m sure. Go ahead. You literally can’t hurt me with my own creation, doc.” Cure has to stifle a laugh when, instead of her prone body shrugging, the various tendrils bob in a roughly equivalent motion instead.

“Alright, let me go ahead and… huh. Neat.” The mare pauses when the stalk makes contact with his skin and the microtools penetrate the dermis, affixing themselves to his medial palmar artery. Cure knows a variety of measurements are presenting themselves to the doctor; blood pressure, oxygen levels, heart rate, and temperature are all displayed in her mind’s eye. “Thought of everything, didn’t ya?”

“I tried to think of how I would be able to see without my cheating talent feeding me info. How are the eyestalks workin? Enough lights?”

“Yep. It’s like the best microscope I’ve ever heard of.”

“Technically, it is a microscope.” He cocks his head in thought, idly musing, “Maybe I should make some microscopes while I’m at it. I bet Director Storm’s researchers would be pretty excited about that.”

“Just give ‘em a couple of these things and I bet you won’t see them come outta their labs for a month or two.”

“Probably. Something you may not have considered; if you attach the life support system to yourself after you plug in you could even perform your own surgeries. Not something I’d normally advise, but if you think about it, if the plant is supplying everything to keep you conscious and fully functional, then once you apply the nerve block there’s no reason you couldn’t do whatever you needed. It’s almost a one-pony comprehensive surgical suite.”

“Huh. You’re right; I hadn’t considered that at all. I doubt that would ever be an approved procedure. That sounds like a situation where something's already gone horribly wrong.”

“Yeah, I suppose,” he acknowledges. He watches as the mare plays with the different tools, prodding around inside of his leg. After several minutes of her thoughtful humming and making quiet exclamations of surprise he finally speaks up. “So, doc, what do ya think? Is it a keeper?”

“I think if you put a couple of these in every hospital in the nation you’ll see a massive increase in surgical success rates, eventually. Another one for each university with a medical program, too.

“They’ll probably take years to get approved, assuming everything works as well as you said. The more complex something is, generally, the more testing has to be done. The life support system alone will require extensive testing to be approved. It’ll also take a while to train everypony on them, myself included, but… I don’t know what to say, Cure. Losing a patient on the table, or even after, is the hardest part of this job. This may have almost as big an impact as the Origin Cell Trees.”

“Awesome. So… are there any tools you can think of that I may have missed?”