Examination of Madeline

Sæternadâ, the 28th of Ostaramonað in the year 267

William strode into the clinic room and stopped just inside the threshold, his breath catching at the transformation. The air was sterile and dry, almost astringent; it clung to the back of his throat and made his skin feel tight. The space itself was stark: white walls, white ceiling, a single medical bed positioned beneath harsh overhead lights that somehow managed to feel both clinical and oddly comforting.

His gaze went immediately to the woman on the bed.

‘Wow,’ he thought, relief flooding through him. ‘She’s looking better.’

Madeline lay swathed in white garments, multiple blankets piled around her slight frame. Her skin, which had been a ghastly grey when they’d found her, now showed a faint flush of colour, still pale, but no longer deathly. The contrast was striking. Hopeful.

Black rectangular monitors flanked the bed, humming softly with the steady buzz of technology. On the top screen, vibrant patterns danced and shifted, interspersed with scrolling lines of text. The other displays showcased vital signs in glowing green and amber: heart rate, blood pressure, oxygen saturation, all monitored in real time.

William stepped closer, his footsteps muted on the smooth floor. The rhythmic beep of the heart monitor punctuated the silence, steady, if faster than it should be.

“Prime Magister,” CMO Sinclare said, looking up from the console. Relief flickered across his features. “It’s good to see you.”

“CMO Sinclare, likewise.” William approached the bedside, his brow furrowing as he studied Madeline’s face. Her breathing was shallow but regular. “You’ve had the opportunity to examine the patient. What have you discovered?”

Sinclare allowed a slight smile, though his eyes remained serious. “Well, sir, the key thing is we’ve completed a blood infusion.” He gestured to the IV line running into Madeline’s arm. “Using a small sample of her blood, we determined that she is AB-negative and sourced blood matching that type. However, we had to ensure it was plasma-rich blood.”

He pressed a series of buttons on the control panel. The monitors adjusted their displays, numbers shifting and recalibrating. “She’s suffering from hypovolaemic plasma depletion, severe fluid loss in the bloodstream.”

William leaned in, scanning the readouts himself. The blood pressure figure caught his eye: 142/95. Still elevated. His jaw tightened.

“We’ve reduced her blood pressure to stage one hypertension,” Sinclare continued, “and her heart rate at rest to 132 beats per minute. A significant improvement from the dangerously high 179 we recorded when we began treating her.”

William’s heart gave an uncomfortable lurch. ‘That seems far too high,’ he thought, his gaze dropping to Madeline’s chest, watching the rapid rise and fall. He reached out, his fingers hovering just above her wrist, then gently resting there. Her pulse fluttered beneath his fingertips, quick, thready, desperate.

“So she is in a stable condition?” he asked, though he already suspected the answer.

“I won’t express it as such,” Sinclare replied, his tone measured. He crossed his arms, his expression grave. “We’ve made positive steps, but her vitals at present are in flux. We’re slowly introducing medicine to steady them, but it’s a delicate balance.”

He shifted his gaze to the next monitor, then back to William. “The problem we have is the lack of medical records. Her society doesn’t have a medical establishment; no one collects medical records, not even the cunning men and women. As we proceed, we’re completing allergy intolerance tests in stages because of her poor condition.”

William let out a heavy sigh, the implications settling like a stone in his stomach. ‘My, this society is primitive,’ he thought, a new sense of urgency washing over him. ‘No medical professionals. She could be in here for weeks. Months.’

He straightened, meeting Sinclare’s eyes. “CMO, do you anticipate that she’ll remain unstable for a long time, or do you think we can stabilise her soon, even if she remains in serious condition?”

“She’s currently in critical condition,” Sinclare stated. He gestured to the monitors, where amber warnings blinked intermittently. “Our immediate goal is to stabilise her by the end of today. However, we must also consider underlying factors.”

He tapped a control, bringing up a detailed readout. “As part of our routine assessment, we’ve administered calcium channel blockers, iron, B12, folic acid supplements, and erythropoiesis-stimulating agents due to the acute anaemia. Her body isn’t currently producing enough red blood cells, so the ESAs will help increase production and haemoglobin levels.”

William nodded slowly, absorbing the information. He glanced at Madeline’s face again, so still, so fragile.

“Though,” Sinclare added, his voice dropping slightly, “we’re monitoring her closely for signs of blood clots due to the medication we’ve administered.”

He gestured toward the bottom monitor, where a series of graphs highlighted her multifaceted health issues. “As you can see here, beyond the anaemia, she’s suffering from tachycardia and hypertension, which we’ve already discussed, as well as hypovitaminosis D and long-term malnutrition. I can confirm she’s suffered from those latter two conditions long-term, likely years.”

The gravity of the situation pressed heavily on William. He stepped closer to the monitor, studying the graphs himself. The vitamin D levels were abysmal. The nutritional markers painted a picture of chronic deprivation.

‘How long has she been struggling?’ he wondered, a knot forming in his chest. ‘How long has she been suffering in silence?’

“We’ve identified several bruises on her back and arms,” Sinclare continued, moving to Madeline’s side. He gently lifted the edge of the blanket, revealing dark purple contusions along her shoulder and upper arm. “Which, in my medical opinion, were sustained during her attack.”

William’s hands curled into fists at his sides.
Sinclare shifted his focus to her neck, his fingers hovering just above the skin. “As you can see now on her neck, she has a rash-like pattern. This extends to the back of the neck, as well as the shoulders.” He carefully adjusted the collar of her gown. “And this now goes to the chest and breasts.”

William leaned in, his eyes narrowing as he studied the marks more closely. The rash was distinctive, small reddish spots, raised slightly, clustered in irregular patterns across her pale skin. It looked almost like... puncture marks. Dozens of them.

His jaw tightened. ‘Not a rash,’ he thought grimly. ‘Feeding marks.’

“What is causing the rash?” he asked, keeping his voice carefully neutral despite the cold anger building in his chest. “Is it a symptom of any of her conditions?”

“Our precursory examination shows several puncture wounds,” Sinclare replied, his tone becoming more clinical. He pressed a button on the side of the monitor. A keypad slid out from beneath the console with a soft mechanical hiss. He began to type, his fingers moving with practised urgency.

The screen flickered, then resolved into an image that made William’s stomach turn.

A bizarre, worm-like shape filled the display, elongated, segmented, with a bulbous end that tapered into something disturbingly organic. The magnification revealed tiny serrations along what appeared to be a feeding apparatus. It looked alien. Wrong. Like something that should never have existed in nature.

William felt his breath catch. He’d seen parasitic organisms before, but nothing quite like this. The structure was too deliberate, too... engineered.

“We’ve discovered three of these objects buried in her skin,” Sinclare said quietly, “and we believe they’re part of a much larger organism or structure.”

William stepped closer to the screen, his breath shallow. The image rotated, showing two cross-sectional views. One end bore circular pinchers, tiny, serrated, designed to latch on. The opposite end bulged out before flattening, as though it had been torn from something larger.

‘That’s... concerning,’ he thought, his pulse quickening. A cold unease coiled in his chest. ‘What kind of creature leaves pieces of itself behind?’

“A large structure?” he asked, his voice carefully controlled.

“Yes,” Sinclare confirmed, his tone grave. “The front end is the pincher end, whereas the bottom end appears to have broken off a much more substantial structure. Our scans indicate a notable absence of internal organs, suggesting that this creature could not have survived on its own.”

William’s eyebrows shot up. His mind raced through possibilities, parasites, symbiotes, bioweapons. “So we’re looking at evidence pointing to only a small segment of a larger organism. Could we potentially reverse-engineer the creature or perform a comprehensive genetic analysis?”

“I must clarify, sir,” Sinclare replied firmly, straightening. “I’m a chief medical officer. I cannot possibly discuss the possibility of reverse-engineering a sample into a larger organism. That would be the biomedical scientists’ remit.” He paused, then added, “Though our laboratory technicians and scientists are working on genetic analysis.”

William nodded, accepting the distinction. He turned back to the screen, his jaw tight.

Sinclare typed again, and the image shifted. “Additionally, we’ve also noted in our examination that there are signs of sexual activity.”

William’s head snapped around. His eyes locked on Sinclare’s.

“Though,” Sinclare continued carefully, “no indication that it wasn’t consensual. Unfortunately, the male sample is severely degraded, making it difficult to identify him. Though we have no DNA database for this society to compare it against, so we can’t match the sample to a specific individual.”

William closed his eyes briefly. A faint unease coiled in his chest, tightening into something darker. Whoever had come to her bed had done so while she lay weakened, grieving, barely able to move. The thought stirred something deeper, something that made his hands tremble slightly before he forced them still.

He opened his eyes, his voice low. “So there is no chance to determine who had sexual intercourse with her? Do we know roughly when?”

“Exactly,” Sinclare acknowledged. “But from the degradation levels, we estimate this occurred roughly five days ago, give or take some time. The lack of resistance observed and, given the details provided by her children, suggests that she knew the person she had sexual intercourse with.”

“That would make sense,” William replied, his voice thoughtful but strained. He stepped back from the bed, needing distance. “They’d said that after the attack, she had begun moving independently again, lifting small items, stretching to reach things whilst still seated.” He frowned, his brow furrowing deeply. “Nevertheless, it seems peculiar that she’d be intimate with someone whilst still recovering from her injuries and grieving the loss of her husband.”

“I assume so, but without knowing her state of mind at that time, I’d be unable to comment,” Sinclare replied, his voice tinged with uncertainty. He glanced at the pile of case files on a nearby console, as though searching for answers there.

William’s mind was already racing. ‘Best if I look through our records,’ he thought, his gaze distant. ‘Find cases matching these new details. See whether a generalised profile could be generated to help identify potential suspects. Maybe there are clues we’re missing.’

He drew in a deep breath, then let it out slowly, the weight of responsibility settling over him like a mantle. His shoulders sagged slightly, just for a moment, before he straightened again.

The monitors beeped steadily. Madeline’s chest rose and fell. The clinical lights hummed overhead.

William’s gaze drifted back to Madeline’s still form. Her chest rose and fell with mechanical regularity, the ventilator doing the work her body couldn’t manage. The monitors beeped their steady rhythm, each sound a reminder of how close she’d come to death.

“Have you found any similar cases in the medical archives?” William asked, though he suspected he already knew the answer.

“None in our database,” Sinclare confirmed. “This is entirely unprecedented. Whatever attacked her, it’s unlike anything we’ve encountered before.”

William turned back to Madeline one final time. In the harsh white light of the medical bay, she looked impossibly fragile, a young woman who’d been in the wrong place at the wrong time, caught in something far larger and more sinister than a simple attack.

‘She’s a victim,’ he thought, ‘but she’s also evidence. Whatever did this to her is still out there. And if it’s attacked once, it will attack again.’

And William stood there, piecing together a puzzle that grew darker with every revelation.

“Thank you for the update,” William said, nodding appreciatively at Sinclare. “Have you finalised your medical assessment report?”

“Uhm, yes, it should be available to you,” Sinclare responded, his brow furrowing slightly as he checked a few documents in front of him.

“Excellent. I appreciate it,” William said, offering a small smile. “I wonder if going back to where she was attacked may provide more insight.”

“It is possible,” replied Sinclare. “It may be that you find more relics of the attacker.”

William nodded. “Well, there’s my next stop. Take care, CMO Sinclare.”

William moved towards the door, his footsteps measured and deliberate on the polished floor. At the threshold, he paused and glanced back over his shoulder. The medical bay stretched behind him, all gleaming surfaces and softly beeping machines. Madeline lay at its centre, a small figure dwarfed by the technology keeping her alive.

The door slid open with a soft hiss.

“The graveyard,” William said quietly, more to himself than to Sinclare. “That’s where this started. That’s where I’ll find answers.”

He stepped through, and the door whispered shut behind him, sealing Madeline back into her sterile sanctuary. The corridor beyond was dimmer, cooler, and William welcomed the change. His mind was already racing ahead, cataloguing what he knew, what he suspected, and what he needed to discover.

The creature had left pieces of itself behind. That was careless, or perhaps intentional. Either way, it was a mistake William intended to exploit.

His footsteps echoed down the corridor, each one carrying him closer to the next phase of the investigation. The graveyard waited, with its ancient stones and buried secrets. And somewhere in that darkness, answers lurked.

William’s jaw set with determination. Whatever had attacked Madeline, whatever had left those parasitic constructs in her flesh, it had made one critical error.

It had left evidence behind.

And William was very good at following evidence to its source.