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Cultural Support Team
U.S. Army TRADOC Science Fiction Writing Contest
"Your soldiers call you Ellen. Is there a story there?" asked Captain Carter Carroway, U.S. Army Medical Corp.
Captain Dianne Ripley leaned back in her Aeron office chair. The chair, pilfered from some Flag Officer's staff, had no business at the prefab outpost. The Doc was older than her. If he was career military, he would be a Major or Lieutenant Colonel. She concluded he was a reservist doing his time or a war tourist, looking for adventure. She leaned forward and her scatterlight camo shifted in slow waves. Her arms rested on the plastic table that served as her desk. "It's my last name."
"I still don't get it," said Carter.
"Have you seen the movie Alien? Aliens? And not the remakes, which sucked, but the originals. Ellen Ripley."
"No, I've never seen either," said Carter.
"Too bad," said Ripley. She leaned back and smiled and shuffled papers from one side of the battle-scarred desk to another. "I'm glad you’re here. We've been trying to get you out here for about 6 months."
"Well, I'm here, and mission aside, I need to give you a field physical. You've been avoiding."
"I'm good. I don't have time."
"I've been directed and I don't have to take your word. Listen, no stirrups or anything. Why don't you just humor the Army's only combat gynecologist? I'm just going to interrogate your medical recorder, take a drop of blood, look in your eyes and we'll talk a bit. You can tell me about tomorrow's mission."
Against her nature, she acquiesced. "What do you need?"
"Put your finger here." He held out a medical analyzer. "You will feel a little prick and it's over."
"You just described my sex life."
"Don't be embarrassed Doc. I'm just messing with you."
She pressed her index finger on the analyzer. The machine beeped.
"You can remove your finger." The analyzer whirred and he consulted it, squinting his eyes, processing the datastream.
"You're doing good. Liver function is nominal, Sugar normal. Oxygenation is good. No toxins. Nanotech load and amenerol levels are fine. Is the ameneral still working for you? Its effectiveness diminishes over time."
"Not a drop in about a year. I don't have time to bleed."
"You don't have…"
"It's from another movie. Never mind."
"Yeah, so it's working, but you've been on it for a long time. The jury is still out on long term effects. You can order tampons through the supply system and give your body a bit of a break. Women menstruate for a reason."
"Have you ever used a tampon built by the lowest bidder?"
"I understand they are useful for plugging bullet holes. There is the possibility the amenerol could compromise your fertility when you do decide to have children."
"That’s not going to be a problem for me," said Ripley.
"At least you would have the option of changing your mind."
"I don't plan on having any kids, but if I were to, I have eggs on file in the Army repository. Standard hedge against teratogenic weapons."
"You don't see much of that around here," said Carter.
"The first law of weapons is that they proliferate."
"Right then. What is your preferred method of birth control?"
"Abstinence," said Ripley.
"Really, out here?"
"The Army's policy permits…."
"I'm familiar with policy. Let me interrupt you before you get on my bad side. There is not much to work with on this outpost. Abstinence is the safest policy for all concerned. And I am just flat out not interested."
"Side effect of the amenerol."
"Thank God for that. It's obvious that you have never experienced a CST (I) outpost."
"I know about CST teams. Eye?"
"No, "I" for independent. We are on the ass end of nowhere. This valley is like a retirement home for the survivors of the terror wars. We have Al-Qaeda, Taliban, ISIS, Wahhabi Jihadists, Tayyibba and even a few Al-Shabaab. This valley crawls. They snipe at us. We snipe back, but mostly we leave each other alone. I keep an eye on them and provide essential services such as yourself. They don't allow themselves to feel threatened because we are women. There is not a lot of activity, but there is activity. They tolerate us because I tread lightly and don't screw with them."
"Winning over their hearts and minds?"
"No tits and ass. Petty Officer First Class Tiegs, is our Independent Duty Navy Corpsman, she is also a surgical nurse at a women's hospital in her real life. She has done good work with pediatric and gynecological care. She has connections back home so we get expired supplies without having to beg the U.S. taxpayer. She has saved a few lives. If it wasn't for her, the locals probably would have overrun this outpost a long time ago."
"I think I get it."
"I don't think you do, but that’s not your fault. We have problems beyond Tiegs' skill level so we need you, the Army's only combat gynecologist. We have coordinated with three villages and have gotten permission from husbands, elders, and mullahs for you to treat three obstetric fistulas and a case of breast cancer.
"We've pre-staged everything you need and you have one day to work. I can't stretch the Army's or the local's patience."
"You have a mobile surgery?"
"It's standard equipment for a CST(I) team."
"I could have done this remotely."
"It is an older model. The AI is corrupt and there is no negotiating with it. The telepresence software is obsolete. It won't connect to MedNet, so it can only use its organic expert routines."
"No improvisation," said Carter.
"Exactly. The Army considers it expended, so we will deploy it on-site and abandon it in place."
"What for?" asked Carter.
"That's how I sold this operation. We are leaving it to collect genetic intelligence. The locals won't trust it at first, but it will be the only medical facility for 200 clicks. They'll use it."
"It beats dying of sepsis or gangrene," said Carter. "I need some post-surgical time with the patients."
"You are not getting it. They don't want us here and they certainly don't want us touching their women, but, like most men, they are willing to make concessions where pussy is concerned. I'm not worried about the ones that have given us permission. I am worried about the other ones. The ones that would rather see their women and children die than accept charity from us. How long will it take? I want to minimize our exposure."
"Fistulas are usually an easy repair, but they can get complicated and then there is the possibility of infection in a field environment."
Gun shots rang out and he flinched.
"Just a gun check." She jerked a warped desk drawer open, took out a box, and opened it up on the desk. A dozen glass cylinders filled with silver nanochines rested in foam inserts. The medical nano-scale machines, reacting to light, swirled like a quicksilver.
"You know what these are. Use them as you see fit."
"Silver bullets. Where did you get those?"
"Don’t worry about it."
"I can't give nanotech to enemy combatants."
"Of course you can't, because you don't have any." She slid them across the desk. "They're not combatants. They are civilians."
"I don't have the equipment to program them.
"Programmer is in the surgery. Have you repaired fistulas before?"
They are pretty rare in the developed world, but I've been a few places, Venezuela, Yemen, so yeah, I've seen them before and fistula repair is on the continuing education list for certification, so I've done complicated surgeries in the virtual a few times. Don't worry captain, I can do this."
"Good. It's life changing for these women, Doc. Remember that. I also need you to remember that the only thing simple about this operation are the operations. It took me six months to get you out here through the chain of command and another six months of working with villages to get permission for you to lay hands on their sick wives so they don't leak piss and shit everywhere," said Ripley.
"Sounds like it’s a bit personal for you."
"It is. I'm not going home until these women are fixed."
"Is that why you keep extending?" asked Carter.
"That’s it. If I can excise just a tiny bit of misery from this world I will consider myself a success. You've seen women with fistulas, but you've never seen a woman living with a fistula. I can't go home until this is done."
He consulted his machine and pursed his lips.
"We will get you home then. Your blood pressure is up. Stress hormones peaking," said Carter.
"No shit, casual conversation pisses me off," said Ripley
"I'll be quick then. Lean forward. Let me look in your eyes."
She leaned forward and he shined a flashlight into her eyes.
"Not unusual. "Silver flecks in your iris. Nothing to worry about. Side effect of your performance enhancing drugs."
"I monitor myself. I'm on profile."
"I can see that, but like the amenerol, you've been on them for a long time. You won't have to worry about osteoporosis. Your bone density is 90th percentile. I bet you have physical strength and endurance to match."
"It's useful out here."
"You didn't need it to complete Ranger training."
"You are not allowed to use Pee-Eees for Ranger training lest they camouflage mental weakness with physical strength. I'm not as young as I used to be and women fall off the curve a lot faster," said Ripley.
"Twenty-seven is not exactly over the hill."
"For a female Ranger it is," said Ripley.
"You're not competing with anyone out here. You can ease off a bit. As your Doctor, I recommend it."
"You're not my Doctor, and there is no second place in the field. When the Army said, Independent Operations, they meant it. We are thirty minutes away from drone support and that’s if they deliver them ballistically. We can all be dead in thirty minutes, if the locals tried hard enough, but they cut me some slack because I am a woman. They don't take me seriously and I leverage their misogyny."
"How did you get the men to agree to treating their wives?"
"I promised them they could get back to fucking."
"You really don't. "Doc, It's going to be a long day for you. I recommend you turn in early. We will be moving out before the sun rises. I'll send a wakeup. Two prefabs down is the guest quarters. If you hear an alarm, take cover in the nearest fighting hole. Tomorrow, if you need any stims, I have you covered."
Carter stood and Ripley woke her laptop.
"Doc, thanks for coming"
"Cold," said Carter. He stamped his feet on the spray foam floor of the prefab.
"Hell, yea it is," said Connor. "It will warm up later in the day."
Captain Ripley walked in and her team made to stand.
"Seats. Good morning, listen up," said Ripley. They sat back down in a hodgepodge of chairs stolen from better funded commands. "Myself, Doc, and Vazquez will take the lead Bulldog." The Bulldogs were the Army's light tactical vehicles, a bit larger than the old Humvees and capable of autonomous patrols. "Vazquez, Connor, and Tiegs will ride the second. Comms between the Bulldogs will be line-of-site datalink. UHF backup. Threat is estimated to be low. But we will keep ourselves buttoned up. Vazquez keep your Sparrows up and about."
"When we reach the village, I will liaison with the elders. Tiegs and the Doc will set up the surgery. Vazquez, Connor, and Shaw will provide security. Position the Bulldogs for a rapid retreat. The Bulldog's guns will be set to auto track, manual engage. Let me be clear, manual engage, unless we get into a fight, then switch to auto-auto. With that in mind, opcheck your personal transponders. Recognition software should discriminate, but the guns don't have an apology setting, so don't bet your life on it. Shaw make sure to update the database to include the Doc's profile we don't want to shoot the only reason we have to go outside the perimeter today," said Ripley.
"Is she serious?" asked Carter.
"As a heart attack," said Shaw.
When she wasn't carrying a rifle, Shaw administered the outpost's machine systems and fabricator-printer.
"Doc, how long before you can bring in your first patient?" asked Ripley.
"About thirty minutes after setup."
"How long before you are finished?"
"With the anticipated caseload, it is going to take all day."
"I want to get back before sunset."
"It's surgery, I can't make any promises."
"Do your best," said Ripley. "Bring up the overhead."
Satellite imagery appeared and drilled down to the village.
Ripley pointed. "We will set up the surgery here. The adjacent structure is for triage and recovery. It ain't optimal, but it is the best I can do. We've spray coated the walls, floor, and ceiling to keep it clean. After the small talk and ass kissing with the elders is done, we will epoxy AC, skywater, and fuel cell units inside. I just hope the elders let the women recover before one of them moves in.
"Next," said Ripley.
A picture of a woman appeared. She looked worn and tired. One of her front teeth was missing.
"This is Fatimah. She is an English speaker, American, if you can believe that. She was lured by ISIS about two decades ago and stayed. She has been through about four husbands. They keep getting killed. She is very bright and we have given her as much medical training as we can. She will be your post-surgical care nurse. Treat her like a local," said Ripley.
"Nurse?" asked Carter.
"Yes, we gave her some basic first aid training and paid her husband to let her be a nurse. I promised him the second half of the payment if he actually follows through."
"Hey Doc, what the hell is a fistula?" asked Vasquez.
"It’s a basically a hole."
"What? Shit, No big deal. I like me some holes, ain't it right, Tiegs," said Connor.
"Bite me," said Tiegs.
"A fistula is hole between hollow organs such as the vagina, intestines, or urinary tract," said Carter. "Probably brought about by hard labor."
"I should be full of holes then," said Vasquez.
"Alright, knock it off," said Ripley. "Taking care of these women is a big deal. You know what happens to them out here. We will help, but this operation isn’t worth any of our lives. Stay situationally aware. Vazquez, opcheck Mac and Cheese, and put a couple rounds through their guns. Bulldog turrets too. Shaw, print out armor and a sidearm for the Doc."
"You want me to get him some bullets?" asked Connor.
"That would be nice," said Ripley. "Ok, get to it."
The team split up going about their assigned tasks. Ripley and Carter stayed behind.
"Coffee?" asked Ripley.
"Yeah, black," said Carter.
"That’s the only way we have it around here." She made two from coffee maker resting on the plywood table and handed him one.
"After this, you get to go home right?" asked Carter.
"Yeah, I go home."
They drove slowly along the mountain road. The sun rose casting slanting rays across the dry landscape. Ripley drove the lead Bulldog. Vasquez sat next to her, monitoring the imagery beamed from the Sparrows. Carter sat in the back. The stink of his freshly printed armor filled the cabin.
"Can we crank on the AC," said Carter.
"No, that would mean taking off the armored doors," said Ripley. The women laughed. "Open your vent."
"I've got signature," said Vazquez. "Doesn't look like they have any intent. They are opening our position." The biomimetic surveillance UAVs, the Sparrows, looked and flew like birds. The machines soared above the terrain in advance of the convoy using multi-spectral sensors to detect threats and relay imagery back to the Bulldogs. The Bulldogs in turn beamed the sensor data up to a high- endurance Global Hawk UAV for even wider distribution. Right now, someone in Bahrain was filling in the blanks for this particular valley. "Probably goat herders and look outs."
"How the hell do they live up here?" asked Carter. The vegetation was sparse.
"With an immense amount of difficulty. These people live hard," said Ripley.
"And die hard," added Tiegs over the Bulldog datalink. Her voice sounded like she was sitting in the same vehicle.
"Yeah, they do. Graveyard of empires. Brits tried it. Russians…and now us…twice" said Ripley. "Like, we didn't figure it out the first time."
"Excuse me ma'am, I'm going to have to ask you to exit the vehicle." said Tiegs. "It looks like you have had a bit too much to think."
"More than my fair share," said Ripley. "Two clicks out, Vazquez you got anything?"
"Negative, normal activity.
Carter leaned forward to look over Vazquez's shoulder to see her monitor display of the village.
"Doesn’t look like much," said Carter.
"It isn't. Goats and guns outnumber the people," said Ripley. "Vasquez, bring your Sparrows down and give'em a couple of passes."
The view zoomed as the Sparrows dove down and crossed the village, a few heads turned skyward. One, a grizzled old man with a long beard, waved.
"Okay, Vasquez, we got permission, put'em in a security orbit."
"They know we are here?"
"How can you tell?"
"Oh yeah, makes sense," said Carter.
"Doc, don't underestimate these people. It looks like a shitty little mud and stone village but they ain't stupid. These people have been collecting guns foreigners have been dropping for over a century. They have everything from Enfield's to XM micro-munitions," said Ripley.
The image swirled. The Sparrows flew in a wide orbit around the village. The data fused into a slow spinning panoramic.
"This is the solar mirror and battery building. It powers a well, the mosque, and the elder's home. See that thing hanging from the line? Do you know what that is?" asked Vasquez.
"No," said Carter.
"It’s a Chinese Stingbat drone being inductively charged," said Vasquez.
"How would they get that?"
"Some Chinese dropped it while they were running away," said Vasquez. "If that gear ever leaves its wire my Sparrows would tear that piece of crap up. Get inside its turn and claw out its circuits. Stingbats are shit."
They drove past a man and his son walking slowly down the road. Each had an AK-47 slung over their shoulders. The son's gun looked ancient, like it was acquired during the Soviet invasion. Servos whined as the Bulldog's turret auto-tracked the two. Recognition software outlined the AKs in red.
"You are going to be busy with the surgery, but just to be sure," said Ripley. "Stay away from the mosque. Do not engage with anyone other than your patients. Your bedside manner is not welcome."
The Bulldog crested a ridge and the village came into view. The morning back light and distance made it look picturesque.
"Stay alert," said Ripley.
Carter triaged the women. All of them would need surgery.
He used a flashlight to augment the dusty sunlight filtering through the translucent plastic fixed over the windows. The frightened women smiled nervously and lay back on cots. Their eyes glazed over from the 10 milligrams of pre-op valium. Tiegs held one woman's hand as she spoke and the local woman, Fatimah, translated. The breast cancer surgery would be the most complicated surgery as it involved substantial reconstruction. His handheld indicated that it hadn't metastasized beyond the breast tissue but the surgery's more powerful MRI would confirm. He would take her first and last. The first time he would reduce a knot of tumors with surgery, analyze it so it could be targeted by the programmable nanotech, and then take samples of healthy tissue. He needed at least four hours to grow a sufficient quantity for re-implantation.
"Tiegs, are we ready?"
"Yes sir. The valium is hitting them hard. We should move the first two now. Fatimah will administer to the other two when you are ready. Family will receive the patients and bring them back here.
"Okay, let's get to it." He bent over to help the breast cancer patient get to her feet, and she recoiled.
"Let us do it, Doc. Nothing personal," said Tiegs.
Fatimah and Tiegs flanked the patent and walked her slowly. Before they left the white, spray-coated room, the woman covered her face.
He followed, passing Ripley and Shaw carrying in the equipment to install the fuel cell, AC, and skywater units.
"Are you good, Doc?" asked Ripley.
After meeting with the men, Ripley posted herself with the women. Her helmet was off and her tangled blond hair cascaded down her back. Blond hair was a bit of an anomaly so it always drew attention. Back home, her hair was her vanity. With the women, she was fine. If she needed to go back to speak to any of the men, she would gather her hair up and tuck it under her helmet. The drawback of not wearing a helmet, besides a fatal headshot, was that without it, she didn't have her heads-up display to monitor the Leopards and Sparrows.
"Vasquez, how are Mac and Cheese?"
"New faces, so we are collecting intel. No obvious threat."
Mac and Cheese, the outpost names for two of the four General Atomics Anti-personnel robots assigned to their unit, were patterned after big cats. The machines were powerful and agile with polymorphic plastic muscles laminated over a carbon fiber skeleton. A distributed nervous system made them virtually immune to small arms. The machines had a war reserve mode that did not require a human in the kill chain. With a flick of the switch, the Army could withdraw from the Geneva Convention protocols against autonomous killing machines. The men in this valley did not fear other men, but the Leopards were another story. She had learned that it was best to keep them outside of the villages when she entered.
She walked to the Bulldogs. She could see Vasquez through the thick bullet-resistant windshield monitoring the feeds. Connor leaned on one Bulldog and Shaw the other. Their M-4s were held muzzle down at the ready. They had never had trouble in this village before. The turrets had parked themselves in a ready position.
"Good?" asked Ripley.
"Good," replied Shaw.
"Have you guys eaten?"
"Yes ma'am, the local women brought us some chow."
"Great, make sure you take your anti-diarrheal."
Female family members gathered in front of the surgery, covered from head to toe. Children kicked a half deflated soccer ball to each other. Men sat removed and watched warily. Fatimah and Tiegs stretchered out the first fistula patient and the women shrieked until Fatimah spoke to reassure them. Ripley pulled up next to Tiegs.
"Is it going well?" asked Ripley.
"Yes, the breast cancer patient is bit more complicated. We need to keep her in for reconstruction. But, fine. You have a lot of new faces out here. Everything Okay?" asked Tiegs.
"They are having a wedding," said Ripley.
"Is it going to be a problem?" asked Tiegs.
"No, it shouldn't be. How is our Doc doing?"
"He knows his job.
A boy ran to Ripley and tugged on her sleeve.
"Come, come," said the boy. Ripley followed crossing the village and being led through a gathering throng into a home. Women wailed and men gestured angrily.
A young girl lay bleeding on a mattress. An elder of the village, Aamir, spoke rapid-fire, agitated Pashto that boggled the translator. The bleeding child explained what the translator could not. Ripley opened her medkit and put a compression bandage on the wound. She gathered the child up, bullied herself through the crowd and ran.
Doc was exiting the surgery. "Doc!" he met her at the door.
"What happened?" asked Carter.
"Stab wound in the upper thigh. I think it nicked the femoral. I got a compression bandage on it."
Blood soaked her hands and the front of her uniform
"Where's Tiegs?" asked Ripley.
"Busy with Post-op. Let's go. You're with me."
Ripley followed Carter through the airlock into the sterile interior of the surgery.
"Put her down on the table."
Ripley lay the child out and Carter cut away her robes and bandage. The girl's eyes were glassy with shock. Blood pulsed weakly out of the wound.
"Oh, got the femoral. Keep pressure here while I get a line in." He positioned her hand just above the wound on the girl's inner thigh. He fastened a mask over her face. Oxygen hissed.
He took two attempts to set up an Intravenous line. "OK, got it." He attached a bag of clear synthetic blood. "Captain, trade spots. Squeeze the bag gently, just a bit of positive pressure. When it's empty attach another."
The girl moaned. He injected the wound site with a local anesthetic.
"Are you going to use the machine?" asked Ripley.
"In a second. I am still a bit faster than the machine." He opened the wound further with a scalpel, irrigated and suctioned. Her blood had a pinkish cast as it mingled with the clear synthetic. He clamped the artery. "Okay, we got some time here. I am going to set up the table to monitor vitals and let the expert do the rest."
He set up the bed to monitor vitals. A display lit up and the muted medical beeps of the girl's life filled the surgery. Line traces scrolled on a monitor.
"Watch your head," said Carter. A silver armed machine descended from an alcove in the ceiling and lowered itself over the injury. Theoretically, a wounded soldier could crawl in here lay down and the machine would fix them up. The machine set itself into motion. Delicate arms stitched and glued the artery back together.
"What happened?" asked Carter.
"So, this is the bride. She stabbed herself."
"She can't be older than 13."
"Her name is Dari and she is twelve," said Ripley.
"Twelve? No, we can't let that happen. Who do we have to a talk to?"
"Talk is done. That is why she is getting married."
The machine retracted into the ceiling and Carter inspected its work.
"You know what can happen to her," said Carter. "We can tell them she needs to go back with us for her leg. A man can…She could die."
"Remember who you are talking to. I know exactly what can happen. She knows too. Women here are disposable commodities to be exchanged and offerings to end disputes."
"I came here to help. I can't let this happen."
"You are not letting anything happen. This is not your problem."
Dari's eyes fluttered open and her face scrunched up to cry.
"Shhhh, It's okay sweetheart," lied Ripley. "You'll be fine." She looked up at Carter. "Can she be moved?"
"Yes, but we should keep her."
"She is not a puppy. These are her people." Ripley picked the girl up.
"Stay here, Doctor. I don't need a fight because you can't control your emotions."
Ripley exited the surgery. It was nearly dark. The women had retreated, clustered around the post-op room. A semicircle of men waited in front of the surgery. She counted three guns. The Bulldog turrets trained, smoothly adjusting to prioritized targets.
"We good, Vasquez?"
"We're ready if it comes to that."
Ripley walked towards the girl's father. The groom, a wire-thin, bearded man in his thirties, stood next to him. The father spoke and the broken translation filtered through her earpiece.
"Ripley! You can't," yelled Carter.
"Shit," said Ripley to herself. She heard the spring tension of the steps as the Doctor stepped off the mobile surgery. She turned to face him. "Doc, I told you to stay inside." said Ripley.
"Ripley, maybe we could just….I don't know."
"Vasquez?" asked Ripley over Tacnet. Her heads-up showed the leopards in flanking position. The Sparrows tightened their orbits.
Carter walked towards her with his hand on his freshly printed sidearm
"Ready," said Vasquez. She had passed control of her machines to Connor and intercepted the doctor.
The Afghan men pulled the weapons tight, preparing to raise their muzzles.
"Vasquez, educate the Doctor."
"Vasquez, this is wrong," said Carter.
"On so many levels." She hit him in the pit of his stomach. Carter crumpled, air woofing from his lungs. He gasped for breath on hands and knees. Not that she needed it, but the armor she wore was fitted with the same polymorphic plastic muscles that drove the Leopards.
The local men laughed.
Ripley handed the frightened girl over and the wedding party retreated. Two men, one with an AK, the other with a sand-colored M-4, stood watch. She took two steps back and turned away. The spot between her shoulder blades itched. The sun was nearly gone. Dark mountains hemmed them in. The single light affixed to the mosque provided most of the illumination.
"Vasquez, round everyone up. I'll help the Doctor adjust to the real world."
Vasquez spoke into her radio to recall everyone.
"Carter," said Ripley. "You okay?"
Carter took deep gasping breaths.
"What a waste," said Carter. "How do you manage?"
She extended her hand and he reached up to take it. She pulled him to his feet.
"Are you going home now?" asked Carter.
"I think I will," said Ripley. "I've seen enough."
"Me too," said Carter.
Scratchy music blared as the wedding began.