"Beck to sleeping quarters, STAT." The urgency in Martinez's voice, more than his words, had Chris grabbing his emergency bag before the intercom had clicked off. Even as he mentally checked off who was where on the Hermes, in his gut he knew that the call was about Mark.
It had been two months since they'd rescued Mark from the surface of Mars, and Mark wasn't gaining back weight as quickly as expected. He'd steadfastly refused Chris's requests for tests to find out why.
Lewis and Vogel were coming towards him from the transit tunnel, but they moved aside so that he could go up the ladder first climbing the rungs two at a time.
Chris could hear Mark's protests, before he could see him. Martinez was kneeling on the floor next to Mark's bunk. Chris moved over to where he could see them–Mark's face was pasty white, his hair matted against his forehead with sweat.
"I told you, it was nothing. Breakfast just didn't agree with me." Chris ignored Mark's protests as he joined Martinez on the floor. He took a hold of Mark's wrist, checking his pulse, thready and fast.
"What happened?" he asked Martinez, not bothering to ask Mark because he knew he wouldn't get a straight answer.
"I came in to change, and he was in the head vomiting up some nasty stuff." Martinez pointing toward the head with his chin. "Wouldn't have made it back to his bunk without me helping him."
"Christ, Martinez, drama queen much? I'm fine." Mark tried to tug his arm free, but Chris held onto him.
"What kind of nasty? Blood?"
"No, dark green slime. Didn't look like any vomit I've ever seen."
Chris's own stomach did a flip. He'd learned as an intern that nothing good was ever diagnosed when the words green and vomit were used together. "Okay, we're going to need get you to sick bay."
"No, don't need it. I'm just queasy. Let me sleep it off and I'll be fine." Mark was looking down at the floor. That he wasn't staring Chris down, challenging him, was enough to tell Chris that Mark knew there was a problem.
Chris reached over and lifted Mark's chin, feeling the soft bristle of Mark's morning stubble against his fingers, along with the clamminess of illness. His pupils were dilated, and the dark circles under his eyes were stark against the paleness of his face. "Don't make me order you. I'm not letting you off the hook until I've given you a full physical."
From the corner of his eye, Chris could see Lewis edging closer, ready to force the issue. Chris reached with his other hand to squeeze Mark's, not caring what the others might notice or think. "Mark…"
"Fine." Mark looked away. "You don't have to be so obvious, I know you've been waiting to get your hands on my body for weeks now, haven't you, Dr. Nosy Beck?"
"Right, I've just been waiting for you to get sick enough to let me," Chris said dryly, as he slid his hand under Mark's elbow to help him up. Mark wobbled on his feet, and managed to become even paler. "Easy does it. We're going to take this slowly." From the way Mark was hunched over, his hand pressed into his stomach, it was obvious he was in pain. Chris furtively hoped that it was just severe cramping from Mark's upset digestive track, but Chris's own gut was telling him it was something not so easily fixed.
"What do you need from us?" Lewis asked. Her arms were crossed around her waist, and Beck made a mental note to keep an eye on her. All of the extra months of command in space were not what she had signed on for, and he'd already noticed that her sleep log showed she was only sleeping a few hours a night. The ongoing issues of the Hermes showing signs of wear, and now Mark being seriously ill, were just going to add to her stress levels.
"Let me get him settled. I'll let you know what's up after I've given him a thorough examination. Providing Mr. Fussy here lets me treat him," Chris said with a grimace. Mark wasn't the best of patients on a good day.
"What the hell, Chris. You are bleeding me dry. Enough's enough," Mark grumbled as Chris fit another empty vial onto the venipuncture needle.
"Two hundred and fifty mils, you great wimp, and this is the last one." Chris pulled off the tube as soon as it was filled. Setting it aside, he slid out the needle, pressing the gauze pad firmly in place before taping it off, "How's your nausea?"
"This is really a lot of non-"
"Is that what we are calling it these days?" Mark asked, his eyebrow raised. "Back in my day-"
"You are only five years older than me."
"You know I didn't have to submit to all these tests the whole time I was on Mars, and I managed to do okay."
And you were days away from dying of malnutrition. "Would you rather we had left you there? How's the nausea?"
"Fine. I just threw up. It's nothing to get worried over."
Chris ignored the obvious lie. Mark wasn't going to tell him the truth until there weren't any other alternatives. "Okay. I want you to lie down on the table. Just going to check a few things." Chris adjusted the back of the examination table so that Mark didn't have to be completely vertical.
"Knew you just wanted me in your bed," Mark said as he eased onto the table and swung legs up. His color was already improving, maybe there was no reason to be so worried, Chris thought as he positioned the prongs of his stethoscope in his ears.
"Hush." Chris pulled up Mark's shirt, flinching back his hand at the sight of Mark's ribs cage jutting out against his concave stomach. Mark had lost weight since the last time Chris examined him. Frowning, Chris pulled off the stethoscope. "How long have you been throwing up?"
"My system is just getting used to food again." Mark looked at Chris, and then flicked his head towards the hatch. "I'm fine."
"Hmmmph." Chris put the stethoscope back on, and listened for bowel sounds; there were none below the midsection of Mark's abdomen. Chewing the inside of his cheek, Chris mechanically went through the motions of palpating his abdomen. Mark tried to hide the pain, but Chris noticed the the intake of breath and squint of his eyes. "Hurts here?" Chris pressed Mark's upper abdomen again, a little more carefully. Mark nodded, biting his lip.
"I'm going to ask you again, and this time I need the truth. When did you start vomiting?" Chris stared down Mark, daring him to lie again.
"Two, three days ago. It's just space flu or something."
"No, it's not the stupid space flu. Which doesn't exist, for the thousandth time. It's an obstructed bowel," Chris snapped as he walked over to the communication station. "Johanssen."
"What do you need, Beck?" she responded immediately, no doubt the others were gathered in the bridge waiting for his report.
"Notify Houston that I'll be transmitting medical records. I need their medical team on it without delay. Starting with Mark's ultrasound scans. Blood labs will be next. I'll type up my own findings as soon as I'm done with my exam. I'll need an off-public channel with Houston/Med once they've seen everything."
"Roger that, I'll contact Houston and put the medical team on alert. You can start transmitting files to them whenever you're ready. Off-channel com can be set as soon as everyone's in place." There was a beep as Johanssen disconnected.
"You called me Mark."
Chris turned. "What?"
"With Johanssen, you called me Mark. And with Lewis." Mark quirked his eyebrow. "You never slip like that."
"Mark, Christ...don't…" Chris turned away, fighting to keep his anger in check. Walking over to the centrifuge, he loaded the vials. Jabbing at the buttons with unnecessary force, he started running the tests. It wasn't as if he didn't have the right to be angry. At himself and at Mark.
Chris had known something was off with Mark, but hadn't wanted to push it with him. Mark's months of isolation were like nothing any human had ever experienced. Chris had spent the weeks leading up to the time of the rescue worrying about what effect being the only human being-for millions of miles-would have on Mark—and the impact it would have on the two of them.
Being in a secret relationship was never what Chris wanted, but neither of them had wanted to give up Mars, or each other. Throughout the months of training, and on the journey to Mars, they had somehow managed to find time to get away from the others without raising suspicions. It had kept him going, those stolen moments.
Since Mark came back onboard though, those moments never seemed to happen. Mark was always focused on repairing the parts of the Hermes that were failing due to the extended trip. That he couldn't find any time for Chris, made Chris begin to wonder if Mark's feelings had changed. Nothing like having a year and a half of being the only person on a planet to give you time to reflect on what, and who, you wanted.
Now, Chris saw that it was obvious Mark had been avoiding him to hide his condition. Chris was furious at himself and Mark. He'd been so relieved to have Mark back, and then worried about why Mark was brushing him off, that he'd forgotten to be a proper doctor.
That Mark had let his condition get progressively worse, until it was life-threatening made Chris want to throttle him—and he knew Mark was still not being honest. He'd admitted to vomiting for two or three days, which likely meant it had been at least four, if not more.
Four days with a bowel obstruction. Christ. Mark's life was in his hands. Chris swallowed back a bitter laugh, he wasn't going to let Mark die now that he finally had him back. Straightening his shoulders, he turned to walk back to Mark.
"I'm sorry, Chris. I didn't want to make a fuss and worry you." Mark reached out for Chris's hand, pulling him towards the bed. He gave Chris the same appealing smile that he'd used in training, sweet-talking him to take a chance, to risk everything, because whatever chemistry was happening between them was worth the risk. It still worked.
"I know…" Chris gave his hand a squeeze. "But I can't help wondering if I wasn't the doctor on the trip, if you wouldn't have hidden your condition. If our...relationship endangered your life-"
"Stop. Don't, it isn't your fault. I should've told you, but a few bouts of vomiting isn't anything to worry about…I'll be fine. I don't know why you are getting Houston involved on this."
"You aren't fine," Chris said. "You have an obstruction in your intestines. That's why you're throwing up, nothing's getting through. When's the last time you had a bowel movement?"
"And they say romance is dead." Mark tried to shift on the bed, only to wince with pain.
"Cut it out. When?" Chris clenched his jaw. Mark was making jokes while his internal organs were dying.
"I've had diarrhea the last few days." Mark said, dropping Chris's hand. "It's no big deal, happened all the time on Mars, and off-and-on since I got back onboard."
"That explains why you aren't gaining weight back." Chris went to get the ultrasound trolley. "I'm going to check to see if I can find the block. Ultrasound isn't great for that, but it is all we have available. Then, Houston and I will decide the best way to treat you."
He wheeled it next to Mark's bed and powered it up. "Pull up your shirt," he said, as he reached for the bottle of gel.
Mark hissed as the cold liquid hit his skin. "Is that lube? Have you been holding out on me?"
"Hush." Chris used the transducer to spread the gel, before pressing it firmly against Mark's abdomen. He swept from left to right, working his way towards where he suspected the blockage was located. Chewing on his lip, he stopped and used the keyboard to snap screenshots. Even with the graininess of the ultrasound screen, he could see Mark's bowel was dilated and thickened.
Gritting his teeth, Chris moved on to find the blockage, ignoring the way Mark sucked in his breath as Chris pressed the transducer firmly against the sore spot. It was there, the black void he didn't want to see. He snapped a shot of it before trying to get a better angle. It was difficult to tell with just an ultrasound, but it didn't look like a partial. He methodically started gathering the measurements. Muttering to himself, he sent the first lot to Houston before moving on to the next section. There were two more areas that appeared to have fistulae, but didn't seem to be blocking the intestines.
"What?" Chris looked away from the screen for the first time to look at Mark. "What's wrong?"
"Dr. Beck, you're not showing your usual stellar bedside manner."
Needing time to think, Chris wiped off the transducer and set it back on the hook, before tossing the wipe towards the waste bin and missing. "Sorry."
"So, it's what you thought?"
"Yeah. We have to wait for Houston to confirm, but it looks like a complete obstruction—called an ileus—nothing can get past it, and that is why you've been vomiting. With what I have onboard it is difficult to make an absolute diagnoses. The thickening in your intestines, the block, and the fistulaes, make me suspect it could be Crohn's disease. The blood test results might help narrow down potential causes...there are markers we can look for that...well. It doesn't matter, the obstruction is the biggest obstacle right now. Once it is cleared, we can worry about the cause." Chris shook his head. "I'm sorry, Mark. I should've caught the signs before it got this bad."
"It isn't your fucking fault." Mark said. He tried to sit up, but immediately doubled over, as he went pale, gripping his abdomen. Chris cursed, and helped him lower himself back down on the bed.
"You aren't going anywhere. I need to put in a nasogastric tube and start an IV," Chris said firmly. "The gastric tube will drain your stomach to remove secretions that aren't getting through because of the blockage. It will ease the pressure on your intestines, and hopefully reduce the discomfort you're feeling right now. The bad part is that it is inserted through your nose. You'll still be able to talk, although it may feel a little funny."
"I do not like the sound of that." Mark shook his head. "Trust me, a couple of days of soup and I'll be fine."
"Not this time, Mark." Chris put his hand on Mark's shoulder. "An obstruction is not anything we can take a chance on fixing itself. I'll try to clear it medically. Give you meds to relax your intestines. The gastric tube and IV feeding will buy us time while those work."
"Chris, this is a lot of fuss for-"
Johanssen's voice came over the intercom. "Beck? Houston is starting to review what you've sent them so far. The medical team will be on channel five in sixty minutes. Current communication delay time is twelve minutes."
"Roger that, Johanssen. Send Vogel to sick bay to assist, if he's free," Chris responded. "Beck out."
"Chris…it's going to be okay," Mark said.
Trust Mark to be the one reassuring the doctor, instead of the other way around. "I didn't spend all that time on Mars fighting to live, just to die on the Hermes."
"You aren't going to die. There's no fucking way I'm going to let you." Chris bent down and kissed Mark hard, bruising his lips against Mark's teeth. Mark kissed him back, gripping Chris's head and pulling him closer. He cupped Mark's cheek, as their lips parted, and Chris was able to forget everything but the pleasure of feeling Mark against him. They hadn't kissed since the first day, in the few moments that they'd had to themselves when Mark was first back on board.
There was a rumble outside of Vogel coming, and Chris reluctantly pulled away. By the time the sick bay hatch opened, Chris was on the other side of the room opening supply drawers, pulling out the equipment he needed.
"How can I help?"
"I need you to assist me in inserting a gastric tube. Wash your hands, and then move that stand to the right side of the exam table, and put this over the top."
Chris handed him the package of blue sterile material. Putting in a gastric tube wasn't usually a sterile process, but he wasn't taking any chances of random germs complicating Mark's situation. Mentally he checked off all the things needed. Tubing. Drainage bag. Xylocaine gel. Numbing spray. Gloves. Syringe. Tape. Emesis basin. Behind him he could hear Mark making jokes and Vogel's chuckling responses.
Chris laid everything out on the table. Next he wheeled over the monitor and got out the leads.
"Is all this really necessary?"
"Yes," Chris said as he fit pads to the end of the leads. "Take off your shirt. Vogel, can you get one of the lab shirts?" Mark reluctantly pulled off his t-shirt for one of the lab ones that opened in the front. Chris picked up the safety razor and shaved bare spots on Mark's chest. He peeled off the sticker backings and attached the leads. A flick of a switch, and the monitor gave a long beep, and then displayed the readout from the feeds.
"Vogel, I need you to watch the monitor. Any changes as I'm putting in the tube, especially in respirations, let me know." All the crew members were trained in first aid and using the basic medical equipment.
Chris went to scrub his own hands. Coming back to the bed he looked at Mark.
Mark eyed the equipment laid out next to him and shuddered. "And this is the only way?"
Chris nodded. "Vogel, can you get a bottle of water?" After putting on his gloves, Chris opened the plastic bag of tubing and leaned over Mark, holding the tubing up to get the measurement, and slid the ring in place marking the correct length. When Vogel came back with the water, Chris explained everything on the table to him, so that Vogel could hand it to him when he asked for it.
"Okay, I'm going to spray your throat with numbing spray. Swallowing water as I put in the tube will make it go down easier, and help suppress your gag reflex."
Mark grinned at him, and Chris realized what he'd just said. "Right. I know, no gag reflex. Humor me, though, 'cause this isn't going to feel like...anything you usually swallow." Which made Mark laugh out loud, and even Vogel chuckled. Chris knew he was flushing bright red from the wink that Mark gave him.
"Back to kindergarten, both of you. Seriously. We need to get this in." He picked up the end of the tube and turned back to Mark. "Vogel, raise the head of the bed so he's upright." Mark grimaced as he sat up. "Ready?"
"Just do it."
Chris nodded. "Lift your head up. Vogel will give you sips of water and you just swallow, okay?" Chris forced himself to concentrate on what his hands were doing, and not the gagging sounds Mark was making, or the arch of his back as his body protested the intrusion. Mark had taken Vogel's hand, and was squeezing it so tightly his knuckles were white. "Almost done." Chris gave a sigh of relief when he reached the mark on the tube. "Okay. It's in. I just have to check to make sure it's in the right place. Are you okay? No pain?"
Mark nodded, relaxing his shoulders as he let go of Vogel's hand. Mark's eyes were tearing, but it was probably from the gagging.
Chris picked up the syringe and put on his stethoscope. A little blast of air down the tube, and he listened for the matching belch in Mark's stomach. "Okay, it's good. Let me get this taped off. You can talk now."
"Let's not do that again," Mark said hoarsely.
"Not if I can avoid it," Chris agreed. "I need to get the suction on the tube started, and then the IV put in, and then you can rest. Vogel, thanks for your help. I'll page you if I need you again."
"You wish me to tell Commander Lewis anything?"
"Just tell her I'll give her a full report as soon as all the results are in." Chris was stalling, but he didn't want to worry the rest of the crew until he had to. Lewis had enough on her plate, making things worse was not something he looked forward to doing.
As the hatch closed behind Vogel, Chris gave a sigh of relief when he turned back to Mark, who was tugging at the tube in his nose. "Stop that, the last thing you want is for me to have to put that back in."
Mark dropped his hand. "Are you angry?"
"Angry? About what?"
"Because I didn't tell you about the throwing up and stuff…" Mark grabbed Chris's hand. "I didn't want any fuss about me anymore. I just want to get home."
"I'm mad at myself. I should've noticed that-"
"Stop. Just stop. I didn't let you see any more than I wanted you to, but at least you can fix it now."
Chris tried not to wince at Mark's confidence in him. He reached up a hand and brushed the hair from Mark's eyes. "Can I just say an upside to you being sick, is you get to spend a lot of time in the sick bay with me and my rats?"
"With a tube down my nose." Mark said with a grimace. "Seriously. Why-"
"You need the tube. And everything else that I'm going to have to put you through. Trust me that I won't do anything to you that isn't medically necessary,"
"Define medically necessary."
An hour later, Chris had Mark settled and napping. That he'd fallen asleep so easily was just a another sign that Mark was more sick than he was letting on, Chris thought grimly. The blood test results were in, and there were clear indications of advanced malnutrition. Hematocrit and albumin levels were critically low, while Mark's white blood cell count was off the charts.
It took a laborious exchange of messages with Houston to decide that they would wait and see if the obstruction cleared on its own. In the meantime, Chris would start parenteral feedings to provide nutrition. It was a miracle that supplies for this kind of intravenous feedings had even been included in the supplies for the Hermes, one thing that had gone right, Chris thought.
Chris looked over at Mark's sleeping form on the bed, at the dark circles under his eyes and gray in his whiskers, that hadn't been there when they'd set off for Mars three years ago. He'd already used up his share of miracles, Chris prayed that there was one more left.
Closing the hatch door as quietly as he could, he went to find the others. They'd gathered in the rec room.
"Mark has a blockage of the intestines. Probably triggered by the lack of proper nutrition on Mars. It's too soon to say but this might not be a one time thing. There are conditions like Crohn's Disease that can cause these kind of obstructions. It could've been caused by the lack of proper nutrition while he was on Mars. No matter what the cause, he's in pretty serious shape, I suspect he's been hiding the symptoms ever since he got back on board."
"So you can treat it?"
"Yes, but the problem right now is that there is the blockage at the beginning of the small intestine. I'm starting him on steroids and antibiotics and see if it helps. We need to hope it will clear up on its own. If it doesn't…"
"If it doesn't, what?" Martinez jumped in, when Chris couldn't finish the sentence.
"If it doesn't, then I'll need to operate and remove that section of intestine," Chris said grimly.
"What?" Martinez shook his head. "You can't operate on the Hermes."
"Trust me, it is the absolute last resort." Chris hadn't done a resection since his residency. The thought of operating on the Hermes without any other trained medical personnel? It was almost unthinkable. "The Hermes is fully equipped for surgery, even though I never expected to have to do so, and I'm hoping it doesn't come to that."
"Whatever you need us to do, we will." Lewis said.
"Mostly, we will need to keep Mark from getting bored. It will be good for him to get up and move around when he is feeling up to it. We can all take turns when he does that, although he'll protest being watched over."
Mark was awake when Chris got back to the sick bay. A quick glance at the equipment attached to the bed told Chris that everything was as it should be. The tube was suctioning secretions from Mark's stomach, and hopefully easing his nausea and the pressure on the blockage. Chris sat on his stool next to the bed, and took hold of Mark's hand.
"I know you hate it when I ask you how you're feeling, so why don't we compromise? I won't ask, if you promise to tell me if you start feeling worse or have any new symptoms," he said quietly, as he stroked the back of Mark's hand with his thumb.
Mark hesitated and then sighed, breaking eye contact with Chris. "Deal. Did you tell the others?"
"Yep, they agreed with the diagnosis and treatment plan. I'm going to add an additional bag to your IV line. It will give you the nutrition you need while we wait for the blockage to clear. You can't eat anything, and you are significantly malnourished, so we need to get you nutrition. I can give you ice chips to chew by mouth, but nothing more."
"That can wait. This is nice." Mark said, closing his eyes and threading his fingers through Chris's. "I've missed this more than anything. Can't wait to get back to Earth…I haven't told you this, but I'm done when we're back. I'm not going back up here. Not even an orbit, or to the Moon."
"Thank God," Chris said, rolling his stool closer to the bed. He wanted to do nothing more than climb up on to the bed with Mark. "Three years in space is more than enough for me, too. Do you think you'll stay in the program to be a trainer? You have knowledge that no one else has..."
"Maybe, I don't know. Just want to get used to being on solid ground, breathe air that isn't filtered. Feel the rain on my face. Wake up next to you."
"You do? I mean…I wasn't sure. The last couple of months…"
"I've been avoiding you."
Chris nodded. "So it wasn't my imagination."
"No… I… It was hard, being back here. On Mars, I wanted to hope, to believe I was going to make it, but so many things could go wrong. I guess in my head, I'd already let you go." Mark covered his face with his arm, and Chris waited, afraid of what Mark would reveal next.
"Then I started feeling not-so-good, and I thought…I don't know."
"When did you start not feeling good?"
"Few days after I was back on board. Wanted to rip out my gut." Mark turned his head to look at Chris. "I was scared—"
"What the hell, Mark. Why didn't you tell me what was going on?"
"I thought it would go away...when it didn't and got worse. Well, I didn't want to worry you. You'd been through hell and—"
"I went through hell? You were the one—"
"Yeah, I was the one alone on Mars, but I was busy working the problem. My only focus was living long enough to find a way back. You had it worse—" Chris snorted. "No, listen. You had to go through everything: thinking I was dead, then finding out I wasn't, and then when the launch with all the supplies exploded... I know it must've been worse for you."
"I don't know, you had nothing to listen to but disco music..."
Mark laughed. "True." He turned to look at Chris. "And then, when it seemed like we were going to be too far apart, and the Hermes was going to just pass me by., but you came out and got me, and I was finally back with you, and after missing you so much, I wasn't letting anything mess us up, even my stupid body."
"I love you, you know. Never stopped. When you disappeared in the storm, I had to tell Lewis that you were gone and we left without you...I never want to go through that feeling again. It nearly destroyed me. And then to find out I was—"
"It all happened like it had to happen. You had to take off, never would have found me in time." Mark grimaced and shifted.
Chris started to stand and Mark stopped him. "No, it isn't that bad." He needed to remember that he was Mark's doctor, and not just his lover. Or his want-to-be-lover, or whatever they were right now.
"I need to get the parenteral bag hooked up so you can start getting some nutrition. Your body needs it, that alone is going to make you feel better. We can talk more once it is going."
"It can wait-"
"I'm not going anywhere. Just going to get the IV started, then we can talk some more."
By the time Chris had the extra bag hooked up though, Martinez arrived carrying a chess board. Mark gave Chris a rueful look as Martinez sat down on Chris's stool, and set the board down on the wheeled table that was still next to the bed.
Martinez waved a dismissive hand to Chris. "Go have some lunch. I have a feeling this is the day I'm finally going to beat Watney."
"I can bring back my lunch—"
"Oh sure, torture the guy who can't eat. Martinez will call for you if we need you," Mark said, and Chris had no choice but to do so.
Johanssen was the only one in the rec room when he got there, working on a 3-D crossword hologram projected from her tablet. He randomly grabbed a meal, stuck it in the microwave, and poured a coffee.
"What's a ten-letter book by Renault beginning with a C?" she asked, as she used her controller to rotate the projection.
"Uhm...Charioteer," Chris said as he sat down opposite her.
She tapped on the keyboard and gave a satisfied hum as the word slotted into place. "How's it going?"
"Okay so far. He's okay—"
"I didn't mean with Watney. I meant how you are doing? Holding up?" Johanssen reached across the table and laid her hand on his forearm. "It has to be hard…"
Chris took a deep breath and blew on his coffee to avoid looking at her. She was the only one who knew about Mark and him. She'd guessed it after he'd fallen apart following Mark's "death".
"I should've caught it a lot sooner. He was avoiding me because he knew he was sick."
"The man is stubborn. If he didn't want you to know—"
"I should have, though. I let my feelings interfere with my job as the doctor on this mission."
"Don't beat yourself up. You are going to get him through this."
The microwave dinged, and Chris was saved from responding. He pulled out the meal gingerly, as the steam burned his fingers. Prying off the cover, he dug a fork out of the drawer and used a towel to pick up the hot container, and put it on the table.
"Oh, chicken à la king. Good choice. Aren't that many of those left."
Chris pushed the creamy sauce around the bowl, it was hard to eat knowing that Mark wouldn't be able to for weeks. He cursed under his breath. Johanssen raised her eyebrow at him. "I just realized. We need to set aside food for Mark to eat. Once the block clears I'll have to figure out what he can eat and can't eat. He'll need to start with low fiber foods and probably will have to avoid dairy or gluten. Those could be what caused the obstruction." Chris ran his hand through his hair in frustration. "Or it could anything else in these packaged meals."
"He's going to have to eat something though," Johanssen said. She flicked a switch on her tablet and the crossword hologram disappeared. "How do you figure out what he can eat?"
"I guess the best thing to do would be to go through all the remaining meals and set aside anything that has ingredients to make into soups? No matter what he's going to need to be on a liquid diet once the block clears." Chris nodded, this was doable. He just needed to think instead of panic. "If we chop up the solids very finely and add hot water, it should work. We can separate out the dairy and gluten items and see how tolerates foods without those ingredients. Mark won't like it, but it can't be worse than eating potatoes for a year."
"Will do. I'll move them into a separate cupboard, and put a 'do not touch' sign on it."
"You bet. Anything else I can do?"
"Right now, it's just a waiting game."
"And if the block doesn't clear?"
"Let's hope it does." Chris wasn't mentally prepared to even contemplate the surgery.
When he got back to the sick bay, Mark and Martinez were still playing chess, but Mark's eyes were at half-mast and Martinez stood up as soon as Chris came in.
"We'll have to finish this game later. I need to redeem myself," Martinez said. "Okay if we keep the board here?"
"Sure, set it on the top bunk." Chris motioned towards the set of bunks on the far side of the room.
"Got it. Get some rest, Watney. I'm off to water your little plants." Martinez put the game on the bunk and disappeared through the hatch.
Chris checked the bags hanging from the IV stand and the vitals monitor. He tapped through and saw nothing alarming on the readings. Restlessly, he glanced at Mark, who was lying back with his eyes closed.
"You're regretting promising me not to ask how I'm doing, aren't you?" Mark asked without opening his eyes. "I'm fine. Stomach isn't so bad. Go play with your rats, or whatever you do in here. I'm just going to sleep."
"How about some ice chips? Or a sip of water?"
"Any chance you could add some scotch to those ice chip?"
"All out of scotch." Chris gave Mark the cup of ice with a spoon. "Just a few at a time."
Mark scooped up some ice chips and chewed on them. "When I was on Mars, I tried to figure out how to make potato moonshine. I thought if the crops did really well and there were enough to spare...was still trying to figure out what to use as yeast, when the airlock blew."
"I had some yeast in the medical supplies. Was for growing cultures, but might've worked," Chris said, as he went to feed his rats. Their growth rate was slower than on earth, but the extended length of the trip meant that the colony had grown more than anticipated.
"Damn. Missed opportunity..." Mark closed his eyes. He was asleep the next time Chris looked over at him. Chris took the cup of ice chips from Mark's hand, and ran his fingers softly along Mark's jaw. The rasp of whiskers against his fingertips stirred the feelings he had long tried to suppress. With a sigh of regret, he pulled the blankets up to cover Mark.
He spent the afternoon researching intestinal resections. It have been years since he'd assisted in a resection during medical school. Chris pulled up the set of Mark's MRIs that had been taken before they left Earth. It confirmed that his internal organs were all where they were supposed to be. Missing from the scans, of course, was where the antenna had punctured him. Scar tissue from that injury was in the same area, and could've contributed to his current condition, as was the fistulae he'd spotted on the ultrasound. It all meant that surgery on Mark would be a myriad of unknowns, that he'd have to figure out while Mark was under anaesthesia.
Chris tapped his fingers against the desk as he contemplated the options. Houston had already uploaded textbooks of data on the procedures for him. The big question, was whether or not to do it with the laparoscopic tools that his surgery was equipped with, but that he hadn't used in years. He could make bigger incision and do the resection visually, but the risk of infection was greater.
The hatch slid opened, and he turned to see who was coming in.
"Commander Lewis." Johanssen's voice echoed through the corridor, and Chris winced as Mark began to stir. From the corridor he could hear the women's brief conversation, as the hatch closed and reopened a moment later. By then, Mark was groggily wiping at his eyes, cursing as the IV line interfered with the movement.
"I'm sorry. I woke you up," Lewis said as she came through the hatch a moment later with Johanssen right behind her.
"'S'all right, I guess I fell asleep."
"Mid-sentence." Chris confirmed. He also had to bite his lip to keep from asking how Mark was feeling. From the smirk on Mark's face, Chris knew Mark knew it as well.
"How are you feeling, Watney?" Lewis was eyeing the tubes of fluids dripping in and out of Mark.
"Better. I thought Beck was just being his usual bossy self, but I guess there might be something to all of his fussing."
"That's the malnutrition and dehydration more than anything. As soon as you get a couple bags of fluids in you, I'll have to tie you down to keep you here," Chris said as he came over to check the monitor again, not missing Mark's arched eyebrow at the words 'tie down'.
"Anything we can do to help make your confinement a little easier?"
"Actually, I was thinking Commander Lewis, the one thing I thought was missing here in sick bay is music. Surely you can spare some of your fine disco music for the good doctor and I to enjoy."
"I would be happy to, but you neglected to bring my data stick back with you."
"Oh that's right. They did tell me every ounce counted."
Chris ignored Mark. "I already talked to Johanssen about setting aside food that we can modify for Mark once he can eat again."
"Already done." Johanssen nodded. "Mark, do you want to send a message to your folks? It could be on a private connection. Houston is keeping a lid on the situation but—"
"No, they don't need to know anything. I've worried them enough for a lifetime."
"Martinez is tending your plants, so there is nothing for you to do but get better. Dr. Beck, keep me posted. And Watney, don't make me have to order you to do everything he tells you to do."
"Don't worry, I'll obey Dr. Beck's every wish." From behind Lewis's back, Mark gave Chris a wink that immediately made Chris flush.
"I brought your tablet, if you wanted to read," Johanssen said, handing it to him.
After the women left, Chris turned to Mark. "Ready to hit the head?"
"Hell, yeah." Mark sat up, and Chris was pleased that he didn't show any signs of discomfort. Helping Mark wheel the IV stand across the floor, Chris hesitated. "Call out if you need help."
"Christ, Chris. I'm fine," Mark said as he shut the door.
By the time Mark was settled back in bed, and Chris had hung up a new bag of saline fluid, the hatch opened again. This time it was Vogel.
"It is like Grand Central Station here," Chris muttered to Mark.
"Lewis sent me so you can grab your supper, Beck. Evening, Watney. Had a question about the vents in the com hatch..."
They immediately fell into a conversation about the ventilation filter project that Mark had been working on the previous week, and Chris felt decidedly de trop as he headed to eat.
Lewis and Martinez were eating, and Chris joined them after heating up his own meal.
"Dr. Beck, any new concerns?" Lewis asked.
"No, too soon to tell really. If he shows any sign of fever or increased abdominal pain, it will be an indication that there is an immediate need for surgery, otherwise it's a waiting game. To be on the cautious side, it would be a good idea for everyone to review the procedures for assisting during a surgery. I've sent out the protocols in everyone's duty folders."
"I noticed. I'll be sure everyone is ready, if it comes to that. Anything else you need?"
"A lot of luck would be good. Prayers that Mark has another miracle left."
By the time he got back to the sick bay, Vogel and Mark were battling on a computer game on their tablets. The pink edge of Mark's tongue was sticking out just a little in the corner of his mouth, as he tried to destroy whatever needed destroying. At last he gave a fist pump of victory, as Vogel shook his head.
"I think you clearly had too much time on your hands on Mars. I haven't beat you since you got back."
"The sols were long, and nights even longer on Mars." Mark said, yawning, as Chris took the tablet from him and stored it in the bedside table. Vogel went off to get his dinner, and Chris logged Mark's vitals into the computer and uploaded for transfer to Houston. His oxygen levels were lower than Chris would like, but the main worry beyond the ileus was Mark's weight loss and malnutrition. When he looked up again, Mark was already asleep.
Chris dimmed the lights and pulled another blanket out of the warmer. He spread it over Mark, and put another on top to sandwich the warmth in.
Mark smiled in his sleep and turned on his side. What Chris wouldn't give to have Mark safely back home. How could he have been so foolish as to think that once Mark was back on board that everything would be okay? Mark shifted, shuddered in his sleep. Chris stroked his back until he was sleeping quietly again. With a sigh, Chris brushed the hair from Mark's forehead and gave him a light kiss. Lifting the safety rails on both sides of the bed, he went to his workstation and loaded the surgical simulation module.
Twelve hours later, it was clear that the blockage would have to be surgically removed. An hour-long consultation with the experts in Houston had helped take the decision out of Chris's hands, and time had run out—Mark was running a fever and the procedure had to be done now.
Chris had gone to the bridge to talk to Houston, not wanting Mark to hear the back-and-forth discussion on what to do. He was especially glad Mark wasn't there to hear when the team of gastroenterologists started giving Mark's odds of survival. "If you think you're helping, you're wrong," Chris had snapped at the doctor who'd casually calculated Mark's chances of pulling through as less than twenty percent. "His chances of living eighteen months on Mars and getting back aboard the Hermes were a million to one or more, so don't give me any more crap predictions. He's going to make it through this."
After ending the conference call, Chris summoned everyone except Martinez, who was with Mark. He'd been up half the night writing more detailed job assignments. On Earth, the simulations the crew had done had been theoretical for any type of surgery. Now they needed to know exactly what to expect with this kind of procedure. He was going to use the laparoscopic approach. If it went badly, he could open Mark's abdomen, but everyone agreed that the least invasive method would be better for Mark's chances of survival. Chris had to force himself not to show any uncertainty in the others' ability to do what was needed of them. Vogel would monitor Mark's vitals and administer anaesthesia, Lewis and Martinez would assist in surgery, Johannsen would relay everything that was happening to Houston.
"When do we start?" Lewis asked when he had finished describing what he hoped would happen, and had run through the worst-case scenarios, skipping the last one where Mark dies under Chris's knife.
"Two hours. Waiting any longer will only increase the risk of infection." Chris said. "I'll go tell Mark. In the meantime, read again. We'll run through everything in situ, answer any questions, and go from there. We'll have to set up the sterile field and the equipment, then scrub in and start."
Chris hoped he'd sounded more confident than he felt, as he headed through the Hermes to sick bay. If anyone had told him when he was in medical school, that he'd be operating in deep space with only non-medically trained assistants, he'd have told them they were crazy.
The chessboard was set up, and neither Martinez or Mark looked up as Chris entered. There were only seven pieces left on the board. He watched, as Martinez twice went to move one of his black pieces only to hesitate. Finally, he advanced his sole remaining knight. Mark gave a laugh and made his move. "Checkmate."
"You just got lucky. Set them up again-"
"Afraid not, I need to check on Mark, and Lewis has some information for you to review," Chris said, stepping forward.
"Spoilsport," Mark grumbled, but as he leaned back against his pillow, Chris noted he was paler than he'd been two hours before. Even more telling, he didn't object as Chris pulled out his stethoscope. Martinez tucked the chess board away, and with a tilt of his chin, looked towards the storage unit where the surgical equipment was kept. Chris nodded grimly. Martinez gave a low whistle, but to Chris's relief, didn't say anything as he left. Lewis would brief him on the bridge.
"What's up with him?" Mark said, with his eyes closed.
"Imagine he's plotting his revenge against you," Chris said as he listened in vain for any sign of bowel movements above Mark's lower intestines. Even the faintest rumble would give him cause to postpone the surgery. There was nothing. He stalled by checking the readout of the vitals monitor. Mark's temp was still hovering at just a couple degrees above normal, and his oxygen level was still off, but everything else was within normal ranges.
Chris looked at Mark. "What do you mean?"
"You're chewing on your lip. You only do that when you're mulling stuff over in your head."
Chris was going to deny it, but he could feel the swollen patch of the inside of his lip with his tongue. "You tap your fingers against your leg when you're nervous."
"Yeah, but I'm not doing that now. What's up?"
"The block isn't clearing. I'm going to have to a do a resection, remove the blockage in your intestines." Chris said it fast, knowing that Mark wasn't going to like it. Hell, he didn't like it.
Mark shook his head. "Surgery? No way—"
"We can't wait. You can't survive on the supply of parenteral feedings we have, and the area around the block is going to get inflamed and turn to poison in your gut. We need to do this before that happens. You're already starting to run a fever, if we wait until it turns septic then we'll have real trouble." Chris had to fight to keep from snapping at Mark. None of what had happened was Mark's fault.
"Chris..." Mark held out his hand and Chris took it, looking at their interlaced fingers he gave Mark's hand a squeeze.
"Do you really think if there was any other option that I would suggest surgery?" Chris asked at last. "I don't want to do this, but if we don't…"
"What are we talking?"
"Without being able to do a CT or MRI, I'm just guessing where the block is, but I'm hoping that I can do it laparoscopically. Three or four little incisions."
"And if that doesn't work?"
"A bigger incision so that I can locate the problem areas and do the repair."
"I assume you've told everyone?"
Chris nodded. "They're studying the procedure. They'll be here in about forty-five minutes and we'll do a dry run, talk everything through, then get started."
Mark stared at him. "Just like that? Jesus, Chris..."
"I know, but there's more danger in waiting. I…" Chris swallowed hard past the lump in his throat. "I shouldn't say this to you but I'm terrified. I'm going to have your life in my hands, and if I mess up—"
"Stop. You're not going to mess up. I trust you above anyone else."
"Well, I suppose between me and Martinez it's an easy choice?"
"Yeah. And Vogel has stubby hands. Don't want him operating on me."
"But he is handy when we need a bomb."
They laughed, and Chris felt a little bit of the tension ease. "I just wish you could get a break," Chris said, his thumb stroking Mark's. "The hard part was supposed to be over."
"It is over; I haven't had a potato in two months."
Chris smiled. "Well, hopefully when this is over you'll be able to eat again." He didn't mention how Mark's diet might need to be restricted for the rest of his life. One thing at a time.
"Chris, I believe in you." Mark gave his hand a squeeze. "If something does go wrong, it won't be your fault. It will be more of my bad luck."
Chris closed his eyes, unable to look at Mark anymore. If Mark knew how frightened Chris was, he'd never say those words. He couldn't tell Mark that he'd never done this surgery. He'd assisted in one. Theoretically, he knew how to do it, but he'd never actually led on a resection, and now he was going to be doing it with only semi-trained laymen as assistants.
"Fuck it, Chris." The mattress creaked as Mark pushed himself upright, pulling Chris to him with his shirt front and kissing him. Chris groaned as their lips met, tasting, biting at Mark's lips, He eased Mark back against the pillow. Chris cradled Mark's face in his hands as he kissed him. The gastric tube was in the way, but he needed this, they needed this. Desperate for more, he swung his legs up so that he was perilously perched on the narrow bed, pressing against Mark.
It had been days, weeks, and he was starving. The dry rasp of Mark's lips against his, the slide of tongue, and Chris moaned, needing more. He slid his hand behind Mark's head pulling him closer, and Mark tugged so that Chris was straddling him. As caught up as Chris was, he still knew he couldn't risk pressing against Mark's abdomen, and used his arms to keep from pressing down on him. Mark was kissing, sucking along Chris's jaw line—
"Sick bay, this is the com." The squawk of the com tore them apart, and Chris cursed under his breath. Johannsen voice was cool over the intercom. "Ready for us, doctor?"
"Give us another five minutes." Chris said with his eyes closed, his forehead pressed against Mark's as he fought to regain his composure.
"We'll be down in ten."
The intercom beeped off and Chris tried to get off the bed, but Mark's arms tightened around his wait. "You've got to let me go, Mark. I need to focus on—"
"Dammit, I know that, Mark, but I'm going to be operating on you in under an hour—"
"It's going to be all right."
"You don't know that." Chris said defensively, he couldn't believe that he'd let things gets so carried away. What kind of doctor makes out with a patient that he is about to cut open?
Mark ran his thumb over Chris's lip, and Chris hated himself for pressing a kiss against it. "I should've died eighteen months ago. I think it's a gift that the Hermes was able to come back for me, that I actually lived long enough to see you again. If it is just the gods, or whoever controls this universe, being kind and giving us these last few weeks, then that's okay, I'm ready to go, Chris." Mark was serious for once, and Chris shook his head refusing to accept his words.
"Bullshit." Chris swung off the bed and stood up. "We're both walking off this ship. And I'm not going to let you think anything else."
"Go get 'em, Doctor." Mark said with a grin.
Chris laughed. "You set me up for that, didn't you?"
Whatever Mark was going to respond back with was lost by the slide of the hatch, and the rest of the crew came in. "Okay. Here we go."
"How did I do?"
Chris turned around to see Mark looking at him. His color was good, and there was a clarity in his expression that made Chris's shoulders slump in relief.
"Hey. Welcome back. How are you feeling? Any pain?"
Mark narrowed his eyes at Chris. "I thought we had a deal that you wouldn't ask."
"Christ, I need to know." Chris said as, he came over to Mark. He resisted the urge to run his hand through Mark's tousled hair. "Don't move about too much. Seriously, what's your pain level? How do you feel"
"Feels weird. Bloated."
"The bloating is from the surgery, it'll pass. Literally. What about pain?"
"Hah. Dr. Beck made a funny. You should leave the joke-making to Martinez. Pain? It feels like I made the mistake of riding one of those bar broncos again."
Chris smiled at the memory of Mark's first, and only, experience riding an artificial bronco in a bar in Winter Park, Colorado, where they'd gone for a skiing weekend as just friends, co-workers. It had been that weekend that had sealed the deal, and made Chris realize that Mark Watney would never be just a crew-mate.
"No broncos in your near future. Seriously, I need to know if you have any sharp pain? Nausea?"
"No. Nothing I can't live with." Mark looked down at his abdomen that was still swollen, and there was a surgical drain and catheter tube leading out from beneath the blanket. "Don't suppose I'm going to allowed to stand up anytime soon?"
"No, not for twelve hours at least. It was a bit of work putting you together, and I don't want you to fall apart again." Chris gave an involuntary shudder at the hour he'd spent dealing with the scar tissue that had imbedded itself throughout Mark's abdomen. The antenna that had penetrated his suit had miraculously missed all major organs, but still had left a trail of scar tissue that had had to be dealt with before he could even start the resection. Six hours at the operating table. Chris was wiped out and needed to sleep.
"I need to let the crew know you're awake. They've been pretty anxious. I'll have someone come spell me for a bit."
Chris hesitated, and then decided to just tell Mark the other news. "Should probably tell you before they get here: everyone knows about us." Chris said as he slid his hand into Mark's.
Mark looked at him in confusion. "What do you mean? I thought Johanssen was the only who knew—did she tell?"
"No. Uhm, when you were first coming out of the anaesthesia a couple of hours ago they were still here, and you talked a lot. I couldn't gag you or put you back under, so we just had to listen to you babble on. And the things you said, damn. You made even Vogel blush."
Mark looked at Chris in horror, but he shrugged. "That's when Lewis told me that you and I were the worst kept secret ever. And everyone else laughed and agreed, so it turns out that they'd figured it out on the trip out, and after we left Mars, well, they figured the less said the better. Martinez said I was like the walking dead for weeks."
"Why didn't they say anything?"
"Vogel said that they figured it was best to just let sleeping dogs lie, and they weren't about to mention it before the surgery, because they were afraid it would be too much pressure on me."
"Well, then I guess it's easier we don't have to pretend any more." Mark stroked Chris's knuckles. "I've missed you."
The urge to fuss was overwhelming, Chris had to grip the brace bars, as he saw Mark struggling to get his safety straps tightened. Chris saw Martinez reaching to release his own straps, so he could help Mark, and shook his head at him. He knew Mark would snap at anyone who tried to help him.
In the five months since the surgery, Mark was doing better, but the food aboard that he could safely eat had been limited. He'd gained back a little weight, but not enough and the compression suit that had fit him like a glove three years ago now hung on him like it had been made for someone else. Chris knew the poor fit meant that the suit wouldn't be able to do its job and keep Mark's blood flowing to his extremities during re-entry, but there was nothing to be done.
Once they were back on earth he could get proper medical care, find the root of Mark's illness, but it wasn't just Mark's physical condition that was worrying. A year alone on Mars had left him...fragile. As much as Mark tried to bounce back and be who he was before, it was impossible.
Every pop and hiss he heard made Mark flinch and duck. A solid night's sleep for him was nearly impossible, and what was worse was Chris couldn't dose Mark with sleep medication, because then Mark would become trapped in his sleep as night terrors racked his body. Without the medication he woke up screaming, but at least Chris was there to comfort him.
The battle wasn't over, but they would face it together, Chris thought with relief as Mark finally got the strap snapped in and settled back. They were sitting facing each other, and through the glare of the helmet visor Chris could see Mark's eyes meet his, and he gave a smile.
They were going home.