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starman-john-tracy · 3 years

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Radiation Poisoning | Chapter Ten

by @starman-john-tracy and @asteria-star

In which John Tracy gets exposed to uranium and nearly dies, The Hood is evil, and Star generally freaks out a lot.

Chapters: [One] [Two] [Three] [Four] [Five] [Six] [Seven] [Eight] [Nine] [Eleven]

Virgil shoves his fingers into his hair, burying his head in his hands.

“He must take after Mom, dammit.” He wants to swear a lot worse than that, but even as tired as he is, it feels inappropriate when John himself is dozing lightly just the other side of the room. “He’s got her blood type after all,” Virgil rambles on, “and the rest of us inherited Dad’s but I thought at least one of us would be a match for...” His fingers scrub hard through his locks, mussing his hair about, incredibly frustrated. “I can't believe how unlucky this is.” Virgil blows out a hard frustrated breath, “He’s gonna have to go to Melbourne, but the risk of infection out there is so much greater and….”

Virgil’s sore and tired and his spine feels like there’s still a massive needle in it, and there the oppressive, crushing guilt resting on his shoulders that he’s the most medically competent member of International Rescue and yet he still can’t help his own brother. Virgil’s fingers are shaking and he sounds just so genuinely distraught over the whole thing that no one would blame him if he wanted to cry.

“I feel like I’m sending him to his grave, Star.” Virgil manages, soft and strained, “I... I don’t know what to do...”

“Test mine,” Virgil looks up at her like she might have gone mad, and Star just shrugs as nonchalantly as possible in their situation, “See if I’m a match for John.”

Virgil just shakes his head, reluctant.

“I don’t know if that’s a good idea.” He tries to let her down gently, “I’m worried about how the test might disrupt your venous system, particularly as it winds all around your heart. After that little fainting spell of yours yesterday . Plus if your heart rate speeds up because you’re in pain and you still haven’t recovered from gravity...”

"But if I'm a match it could save John, right?" She points out, and it's hard to argue with that really.

"It could,” He says, though he shakes his head with it, “but without any genetic relationship the chances of you being a match are, like, one in three hundred, even if you are the same blood type and I don’t want to put you through the whole process for such a slim chance. It could be dangerous...“

"Virgil,” Star interrupts, “I know. This is me giving you my informed consent. Just do it."

Virgil watches her for a long, long moment. Then sighs.

“One in three hundred.” He reminds her, then makes his way wearily across the room to set up another test. He glances over a John on the way past, his expression skipping between scared and miserable. His brother needs someone’s healthy, matching marrow or he’s probably going to die. Star’s might be that match. It’s worth a shot. “Can you hop up here for me…? Same process, lay on your side and try and make yourself comfy with your knees as close to your chest as you can get them.”

“Well,” Star gives him a tight smile as she climbs up onto the bed and lies on her side. “This can’t be that much worse than being stabbed, right?”

Privately, Virgil thinks she has a very different pain scale to anyone else. Which explains a lot, really.

What she doesn’t mention is bullet wounds and torture, days in the forefront of a gang war, having a tongue so tightly sealed behind her lips grown men resorted to trying to cut answers out of her, and always coming out on top. She survived that, she could last a simple test. But… that was a lifetime ago, and she hadn’t exactly enjoyed it at the time. At least this time, the cause was worth it.

She pulls her knees up to her chest, and John’s sweatshirt is so big that she has to hike it up into a clump at the front for Virgil to have any chance of finding her bare back. Virgil, a frown on his face, reaches over to where her hands are tucked under her face and clips a monitor to her finger.

“It’ll be okay, Virgil,” she tells him, and looks away. The breath she draws between her teeth shudders, and the monitor spikes unhappily. “It’s all going to be fine.”

The only answer Virgil gives her is the rip of sterile packages opening, the snap of fresh gloves on his hands. In that moment, Star is both glad and disappointed that she can’t see his face. A cold hand rucked her shirt up the rest of the way and came to rest on her hip.

“You ready?”

Star just nods.

He numbs the area first, like he’d done with the others, but it still takes her breath away a little, and Star chokes back her gasp by putting the base of her thumb in her mouth and biting it. Virgil is murmuring his tried and true litany of comforting words, but Star can’t make out a single one, reducing his voice to a background hum. She holds completely and utterly still, breathing through the burn, not realising her eyes have squeezed until it’s over and Virgil is holding something over the point of entry. Virgil’s fingers press to her carotid artery, watching her pulse racing across the monitor like they might somehow tell him different stories.

When Star opens her eyes, breathing slightly uneven and sweat gathering under her eyes, she can see John looking at her from his bed, a frown tugging at his face.

“Alright?” Virgil is asking, he’s still facing her, so he doesn’t immediately notice that his other patient is awake. “You did really well. Gonna be alright while I go test this?” He’s reluctant to leave her while her heart is still tachycardic.

“What’s going on?” The soft voice from behind him nearly makes Virgil jump. It’s just as well he’s set all pointy objects and the little vial of precious marrow aside in a metal tray so that he can’t drop them. Virgil turns, finding John propping himself up on his elbows, weak and a bit shaky, but doing a lot better than he had been the last Virgil had seen those blue-green eyes of his open.

“Good Morning Sunshine.” Virgil grins at him, relieved, “Nice to see you up.”

John blinks slowly at him, processing the shape of Star curled on her side on the opposite bed. She shoots him a thumbs up to reassure him. Awkward skinny fingers make a fist with his own thumb poking up out the top, to return the gesture. It’s a little ridiculous.

“We’re just checking everyone’s bone marrow for matches for you,” Virgil seems to decide there’s no point in telling his brother anything but the bleak truth, though he leaves out just how many mismatches they’ve already had. “Star volunteered hers just now for testing, think you can keep an eye on her for fifteen minutes while I have a look at the sample? She’s got to keep herself still and, here,” He folds a heat pack into her hand, “Apply this to where the ache is the worst, ok?”

John nods agreeably, watching Virgil limp (why is he limping?) across the room as he shuffles himself slowly into a sitting position.

The astronaut has rapidly lost weight while he’s been bed bound and ill and his arms are rapidly beginning to resemble toothpicks covered with a thin layer of wasted muscle, making the movement a bit of a struggle, but not impossible. He looks much better sitting up. His hair needs a good wash though, and he could definitely use a clean set of clothes.

There’s a glass of water staring at him from the bedside table. He reaches out and grips the slippery glass with both hands, taking small, cautious sips to try and clear his dry throat. When he doesn’t immediately throw it back up, John counts that as a victory.

“You need to eat something,” Star tells him, and it's so stupidly familiar that it manages to bring shaky smiles to both their faces. Star wants to sit up, and Virgil is otherwise occupied with his back to her, but the trembling in her arms and John’s pointed look team up to keep her in place.

John’s eyes dart to the monitor Star is still attached to. He has enough experience with gravity to know when something isn’t entirely right.

“You didn’t have to do this.” He sounds ever so sad about that. Star brings up the smile again.

“I know, but you can’t exactly tell me you’re surprised.”

Something that might have been a laugh shakes John’s frail shoulders, his thin fingers gripping the bed weakly.

“Are you- how are you feeling?” Star tries to ask.

John looks ready to try lying to her in response, or he might shock them and be honest, but he doesn’t get very far into either option before something by Virgil clatters, and the darker Tracy starts muttering.

It doesn’t sound all bad.

“Star you’re- she’s a match!”

“What does that mean?” John, having slept through the morning, has missed out on a lot. He blinks up at Virgil celebrating, confused. “Her bone marrow is the same as mine, somehow?”

“Her stem cells are very similar to yours,” Virgil tries to make it clear, even as he’s collapsing deeply relieved into the chair by John’s bed. “She’s a match!” He barks out a slightly delirious, very relieved laugh. “Ah, sorry.” He notices John is still looking confused over his brother’s seemingly excessive joy. “So, stem cells are, like, special cells that get produced by bone marrow, that’s, uh the spongy tissue found in the centre of some bones, the stuff we took a sample from last night, if, um, you remember that.” From the flicker of a wince that comes across John’s face, it’s clear that he does, at least in part.

“Stem cells turn into three different types of blood cells when they’re in your bloodstream.” He goes on, wanting to make sure everything is very clear to his ill brother, “The red kind carry oxygen around the body, the white ones help fight infection and there are also these things called platelets, which help stop bleeding. All three of which in your body have been badly irradiated by the uranium exposure.” John nods, quiet and serious like he’s taking it all in. It’s perhaps a bit simple of an explanation for him, who already has a good knowledge of the types of blood cells, but it’s important to Virgil that he understands completely. There’s a squeak of the feet of Virgil’s chair as he scooches it in closer to his brother

“So, we need to do an allogeneic transplant of these stem cells, to replace your damaged ones with healthy ones, got that? To do this we need to get hold of some of these healthy cells, but they also have to carry a special genetic marker, something called a human leukocyte antigen, or HLA, that's identical or very similar to that of the person receiving the transplant, or else there’s a very high chance of the transplant failing. Usually these stem cells come from family members but, uh, I don’t quite know how to tell you this but…”

“None of you are a match.” The realization dawns on John, fearful, combined with the fact Virgil had just admitted all his brothers had had the horrible test. “So you had to look elsewhere and…?” His eyes flick over to Star, where she’s just starting to sit up on the bed, a heat pack clamped to her back. “Star… is?”

Star grins at John once she’s upright, all teeth. Her hair isn’t contained by the plait any more, giving her the slightly deranged look of having been dragged through a bush backwards. She’s breathing slightly heavier than she should be from sitting up, propping herself upright on her arms, but she doesn’t seem the least bit sorry about any of it.

“Yeah.” Virgil sounds so deeply relieved by this, it’s not hard to think he might cry. “Her tissue type happens to be a match for your tricky one, so, lucky for you, she can donate some of hers to you. Uh… If she chooses to, that is.” He looks up at her as well, his brown eyes liquid. “You do have a choice in this.” Virgil points out, though, if the alternative is John dying, they both it’s not really much of a choice at all.

“Ah!” He holds up a hand to prevent her from insisting that yes! Of course, she’ll do it! Star is halfway through what would have been a somewhat elated agreement in her mind when Virgil cuts her off, and she very patiently shuts her mouth and lets him finish. “I want you to understand the risks before you agree. You and John. It might be… I… you don’t have to go through this either John. If you don’t want to, if you think it’s too dangerous and your quality of life...” His voice is thick, a little shaky as he trails off. The idea his brother might not want to do the risky transplant, even if it could save his life, fills him with a kind of helplessness that he’s never had to face before. There’s always some way to rescue people, but John might think it’s too much to even try. Virgil’s fingers clasp tightly in his lap, trying to stop his hands from trembling.

“Star’s poor health-” Star snorts in disagreement, but shuts up when Virgil glares, “-your recent surgery, and the fact you live in space so much of the time.” Virgil sounds a little bitter about that, “They all complicate things.” He takes a breath. “I’ve got to give you options, John, before you decide, ok?”

“Option one,” He starts with what he thinks is the best, “We run regular tests on Star, until she’s healthy enough to donate some of her bone marrow’s stem cells to you. Sounds simple, really isn’t.” He shakes his head again. Someone really needs to get that man a coffee. “Option two, we can put you on the list at the Royal Melbourne and find you another donor, already in full health, but that could take weeks, and we risk exposing you to a great deal more germs than exist on our little Island. Either of the first two are going to be long, drawn out fights for your life.” He can’t lie to him, “It could be up to years of being unwell. Option three,” he takes a ragged breath here, steeling himself, “You can choose not to pursue treatment.”

“And what would that mean?” John asks tentatively.

“It means there’d likely be a marked decline in your health, over a period of months or, perhaps weeks, and…” Virgil shakes his head, “You could get better or…”

“Or I might die.” John finishes off for him, his voice light like that’s perfectly reasonable. “Thanks for letting me know Virgil, but I’m not just going to sit around and wait to get well or not.” Virgil looks absolutely miserable about the idea that John might not follow his advice. It feels selfish to worry them any more than he already is. It might be his body and his choice, but John Tracy’s not a man who gives it up so easily. “Even if it’s going to be a lot longer and harder, I think… I think I should take the treatment.”

Virgil looks like he might topple out of his chair from relief, and, with the way he sways, heady, he nearly does.

“I… you’re taking this very calmly.” Not that he should have expected much different from the most composed and patient of his brothers. “I’m really grateful you’ve got such a positive outlook on it.” Virgil’s got this fear that, once it’s all sunk in, John might break down later though. “You can change your mind at any point, none of us will judge you for it. You probably have a lot of questions.” John nods like his head is heavy, but he still seems alert enough that Virgil, selfishly, kind of wants to get all this over with.

“What does Star donating cells mean for her?” He asks, because of course he’s thinking of her over the massive, terrifying threat over his own head. Virgil shuffles around in his chair to face Star, the explanation is more for her benefit than John’s at least.

“John,” Star tries to scold, but submits at the look Virgil shoots her.

“Well,” He begins, “The whole thing is a long and complicated process. Harvesting stem cells will involve a slightly longer procedure than the one we did to collect a small sample. We would have to remove around a litre of bone marrow from your hip bone using a similar needle and syringe to the one we used before. The needle may have to be inserted into several parts of your hip to ensure we get enough bone marrow. We, Brains and I that is, would do this under a general anaesthetic, so you'll be asleep and won't feel any pain while it's carried out, but the area where the needle is inserted will probably be painful afterwards and you'll have marks on your skin where the needles were inserted on either side.” Virgil is careful and clinical at explaining but the sympathy is bright in his expression. Star doesn’t care for it. She might be able to save John, she doesn’t need Virgil’s sympathy. “To boost the number of stem cells in your blood, we’ll give you a medication that stimulates their production about four days before we schedule in the transplant. On the fifth day, a blood test will be carried out to check there are enough circulating stem cells, and if there are, we’ll do the extraction.”

“Sounds like fun,” Star says dryly, giving the two boys a clumsy shrug. “I’m in.” Virgil just nods, like, despite his worries, he hadn’t really expected any different.

“Before we can do a transplant for you, John, we’ll need to check a few things on your end as well. Transplants tend to be more successful in people who are in good general health, despite their underlying condition, but the radiation poisoning isn’t exactly being gentle on you. I need a blood test to check how well your liver and kidneys are working, another electrocardiogram for your heart, and a CT scan to check the condition of organs like the lungs and liver.”

“Then,” And this is going to be the real bombshell for him, “We’ll have to do a round of what’s called conditioning treatment. It’s a course of chemotherapy, in a high dose, to prepare your body for transplant.” He says it ever so quickly, as if to get it over with. “The chemo will destroy your existing irradiated bone marrow cells, to make room for the transplanted tissue, and it’ll stop your immune system working almost completely,” Which sounds ludicrous when the astronaut’s weak immune system is endangering him so to begin with, “which will reduce the risk of the transplant being rejected.”

John takes a long moment to process that, his fingers wandering up to the fine ginger strands on the top of his head. Star watches the trail of his hand, stomach bottoming out on his behalf.

“It might not fall out.” Virgil offers, optimistically, knowing that while his brother is hardly vain, losing all your hair is still a distressing experience. “Some patients undergoing chemo do keep all their hair.”

“But it’s not likely.”

Virgil shakes his head.

“It’s not likely.” He doesn’t want to go into the whole slew of side effects the chemo could have right now, he doesn’t think he’s got the strength to tell his brother how he’s going to feel tired and sick and weak all the time, even worse than he does now.

“And after the chemo?” John asks, looking like his energy levels are fading fast. It’s almost a shame Virgil’s going to have to ban him from caffeine for the foreseeable. “What then?”

“The transplant will be carried out a day or two after conditioning has finished.” Virgil reaches out to flick a distracting monitor off on his left, “The stem cells will be passed slowly into your body through a central line.” He gestures to the PICC implant in the crook of John’s elbow, protected by a tube-like section of sleeve that has been slipped over it at some point he’s been asleep, to keep everything safe and sterile. “The process will probably take a couple of hours. The transplant itself won't be at all painful and you'll be awake throughout.”

“And recovery, after that?” John tucks an elbow beneath him, trying to keep himself propped up for this important conversation, “What should I be expecting?”

“Maybe we should talk about that later.” Virgil’s keyed onto the fact his brother is rapidly drooping, like a plant that needs watering. “If you get a few more hours sleep for me I might even let you back up to your bedroom.” John’s going to be seeing far too much of these four walls soon enough, while he’s still got some strength in him to have his own independence, Virgil wants to give him it.

“I want to know, Virg.” John protests, even as his brother gets his hands under his back and helps him lie back down, ginger head sinking into the pillow. There’s a poorly disguised yawn from the spaceman that doesn’t help his case. “I need to know what might happen, what about the side effects?”

“Are you really going to remember it all if we have this conversation now?” Virgil hovers over him, concerned. It’s a bit of a redundant question though, and John Tracy just raises an eyebrow at him. Even like this his memory is impeccable. Sometimes, Virgil thinks, his brother is more computer than man. He wishes, ever so briefly, that he was fully computerised, protected from the fragility of the human body. “Ok, ok.” He concedes, “Once the transplant is finished, you'll have to stay down here, as germ-free as possible, for a week or so while we wait for the stem cells to settle into your bone marrow and start producing new blood cells.” Virgil is always careful to say we when talking about John’s treatment plan, and the astronaut can’t help but be grateful for it. It makes him feel just that little less alone in all this. Star can see that sick relief at his brother’s words and wishes she could hold his hand, not entirely sure she won't end up on her ass if she tries getting up.

“You’ve got to understand, bone marrow transplants are complex treatments that carry a significant risk of serious complications.” Virgil knots and unknots his fingers in a rapid, ever shifting pattern of anxiety. “You’re young and Star is a strong match, so that improves your chances. You’ll probably feel weak, and be frequently sick, and you won’t want to eat much.” That doesn’t sound too different to now, but John imagines if Virgil’s talking about it so grimly, it’s only going to get worse. “We’ll try and get you to drink lots of fluids, or, if you can’t keep them down, give you them through a tube running from your nose to your stomach, to prevent malnutrition. You’ll have to have regular blood and platelet transfusions, as you'll have a low number of these, and you’ll be at risk from infection for maybe even a couple of years after this.” John’s eyes flutter closed, that’s a lot.

“Side effects wise, with the transplant, we’re looking at a chance of something called graft versus host disease, or GvHD.” He really does want John to have all the facts, “This sometimes happens in allogeneic transplants, transplants from another person, when the transplanted cells start to attack the other cells in your body. We can give you immunosuppressants for that but…” Reduced immune system. John’s seeing a pattern here. “Other than that, the main danger is from having a further reduced number of blood cells. We’re talking anaemia, excessive bleeding or bruising, and yet more increased risk of infections.” He gives John the first, wry smile of the past thirty minutes, “We’re going to have to wrap you in bubble wrap at this rate Johnny.”

“Scott’s gonna be unbearable.” He groans, in sudden realization, “You guys are gonna get microscoped before you can get within five feet of me.”

Virgil laughs, short and startled, because that’s probably true.

“I’ll try and keep him at bay.” He promises, warmly, “But I do think it’s lucky you’re by far the most patient of us.”

“Mmm.” John doesn’t sound convinced, or perhaps he’s just well on his way back to sleep. “Remind me of that when he’s getting on my nerves.”

“Will do.” Virgil ever so gently tucks the covers back up over his sibling’s chest, his voice dropping much softer and lower as he senses him slipping away to sleep. “Night John.”

“Mmm… S’night Virg…”

#Thunderbirds #Thunderbirds Are Go #Thunderbirds 2015 #John Tracy #Radiation Poisoning RP

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