by James White
A Sommaradvan memory came back to her, of seriously wounded and immobilized warrior-patients of her own species trying to flirt with her during surgical rounds, and she did not know whether to laugh or cry.
“Thank you,” she said. “But I may need further reassurance in this matter when you become convalescent …”
It was the same with the other patients. The Hudlar nurse said very little while the patients and Cha Thrat did all the talking. She was new to the ward, a member of a species from a world about which they knew nothing, and a subject, therefore, of the most intense but polite curiosity. They did not want to discuss themselves or their distressing physical conditions, they wanted to talkabout Cha Thrat and Sommaradva, and she was pleased to satisfy their curiosity — at least about the more pleasant aspects of her life there.
The constant talking helped her to forget her growing fatigue and the fact that, in spite of the gravity compensators reducing the weight of the heavy nutrient tank to zero, the harness straps were making a painful and possibly permanent impression on her upper thorax. Then suddenly there were only three patients left to sponge and feed, and Segroth had materialized behind them.
“If you work as well as you talk, Cha Thrat,” the Charge Nurse said, “I shall have no complaints.” To the Hudlar, it added, “How is it doing, Nurse?”
“It assists me very well, Charge Nurse,” the FROB trainee replied, “and without complaint. It is pleasant and at ease with the patients.”
“Good, good,” Segroth said, its fur rippling in approval. “But Cha Thrat belongs to another one of those species that require food at least three times a day if a pleasant disposition is to be maintained, and the midday meal is overdue. Would you like to finish the rest of the patients by yourself, Nurse?”
“Of course,” the Hudlar said as Segroth was turning away.
“Charge Nurse,” Cha Thrat said quickly. “I realize that I’ve only just arrived, but could I have permission to attend the—”
“The Conway lecture,” Segroth finished for her. “Naturally, you’ll find any excuse to escape the hard work of the ward. But perhaps I do you an injustice. Judging by the conversations I have overheard on the sound sensors, you have displayed good control of your feelings while talking with the patients and, considering your surgical background, the practical aspects of the lecture should not worry you. However, if any part ofthe demonstration distresses you, leave at once and asunobtrusively as possible.
“Permission would normally be refused a newly joined trainee like yourself,” it ended, “but if you can make it to the dining hall and back inside the hour, you may attend.”
“Thank you,” Cha Thrat said to the Kelgian’s already departing back. Quickly she began loosening the nutrient tank harness.
“Before you go, Nurse,” the Hudlar trainee said, “would you mind using some of that stuff on me? I’mstarving!”
Cha Thrat was among the first to arrive and stood— Hudlars did not use chairs, so the FROB lecture theater did not provide them — as close as possible to the operating cradle while she watched the place fill up. There was a scattering of Melfan ELNTs, Kelgian DBLFs, and Tralthan FGLIs among those present, but the majority were Hudlars in various stages of training. She was hemmed in by FROBs, so much so that she did not think that she would be able to leave even if she should want to, and she assumed — she still could not tell them apart — that the one standing closest to her was her partner of the morning.
From the conversations going on around her it was obvious that Diagnostician Conway was regarded as a very important being indeed, a medical near-deity in whose mind resided, by means of a powerful spell and the instrumentation of O’Mara, the knowledge, memories, and instincts of many other-species personalities. Having seen the hapless condition of the FROB ward’s pre-op patients, she was looking forward with growing anticipation to seeing it perform.
In appearance Conway was not at all impressive. It was an Earth-human DBDG, slightly above average inheight, with head fiir that was a darker gray than the wizard O’Mara’s.
It spoke with the quiet certainty of a great ruler, and began the lecture without preamble.
“For any of you who may not be completely informed regarding the Hudlar Project, and who may be concerned with the ethical position, let me assure you that the patient on which we will be operating today, its fellows in the FROB ward, and all the other geriatric and pre-geriatric cases waiting in great distress on the home world, are all candidates for elective surgery.
“The number of cases is so great — a significant proportion of the planetary population, in fact — that we cannot possibly treat them in Sector General …”
As the Earth-human Diagnostician talked on, Cha Thrat became increasingly disheartened by the sheer magnitude of the problem. A planet that contained, at any given time, many millions of beings in the same horrifying condition as the patients she had been recently attending was an idea that her mind did not want to face. But it became clear that Conway had faced it and was working toward an eventual solution — by training large numbers of the medically untutored Hudlars, assisted by other-species volunteers, to help themselves.
Initially, Sector General would provide basic tuition in FROB physiology, pre- and postoperative nursing care, and training in just one simple surgical procedure. The successful candidates, unless they displayed such an unusually high aptitude that they were offered positions on the staff, would return home to establish their own training organizations. Within three generations there would be enough own-species specialist surgeons to make this dreadful and hitherto unavoidable scourge of the Hudlars a thing of the past.
The sheer scale and what appeared to be the utter,criminal irresponsibility of the project shocked and sickened Cha Thrat. Conway was not training surgeons, it was turning out vast numbers of conscienceless, organic machines! She had been surprised when the Hudlar trainee had mentioned the time required for qualification, and it was possible that the hospital’s tutors would be able to provide the necessary practical training during that short period. But what about the long-term indoctrination, the courses of mental and physical exercises that would prepare the candidates for the acceptance of responsibility and pain, and the long, presurgery novitiate? As the Diagnostician talked on, there was no mention of these things.
“This is incredible!” Cha Thrat said suddenly. Softly the Hudlar beside her said, “Yes, indeed. But be quiet, Nurse, and listen.”
“The degree and extent of the suffering among aging FROBs is impossible to imagine or describe,” the Earth-human was saying. “If the majority of the other races in the Federation were faced with the same problem, there would be one simple, if completely unsatisfactory, answer for the individuals concerned. But the Hudlars, unfortunately or otherwise, are philosophically incapable of self-termination.
“Would you bring in Patient FROB-Eleven Thirty-two, please.”
A mobile operating frame driven by a Kelgian nurse glided to a stop in front of the Diagnostician. It held the patient — one of the Hudlars she had sprayed that mom-ing — already prepared for surgery.
“The condition of Eleven Thirty-two,” the Earth-human went on, “is too far advanced for surgical intervention to reverse the degenerative processes completely. However, today’s procedure will ensure that the remainder of the patient’s life will be virtually pain-free, which, in turn, means that it will be mentally alert, and, it will be able to lead a useful if not very activelife. With Hudlars who elect for surgery before the onset of the condition, and there are few members in the age groups concerned who do not so elect, the results are immeasurably better.
“Before we begin,” it continued, unclipping the deep scanner, “I would like to discuss the physiological reasons behind the distressing clinical picture we see before us …”
What miracle of irresponsible and illegal surgery, Cha Thrat wondered sickly, could make Eleven Thirty-two well again?But her curiosity was outweighed by a growing fear. Sh
e did not know whether or not she could bear to hear the answers that this terrible Earth-person would give, and still retain her sanity.
“In common with the majority of the life-forms known to us,” the Diagnostician continued, “the primary cause of the degenerative process known as aging is caused by increasing loss of efficiency in the major organs and an associated circulatory failure.
“With the FROB life-form,” it went on, “the irreversible loss of function and the abnormal degree of calcification and fissuring in the extremities is aggravated by the demand for nutrient, which is no longer available.
“From your FROB physiology lectures,” it continued, “you know that a healthy adult of the species possesses an extremely high metabolic rate that requires a virtually continuous supply of nutrient, which is metabolized, via the absorption mechanism, to supply major organs such as the two hearts, the absorption organs themselves, the womb when the entity is in gravid female mode, and, of course, the limbs. These six immensely strong limbsform the most energy-hungry system of the body, and demand close to eighty percent of the total nutrient metabolized.
“If this excessive demand is removed from the energy equation,” the Diagnostician said slowly and emphatically, “the nutrient supply to less-demanding systems is automatically increased to optimum.”
There was no longer any doubt in Cha Thrat’s mind regarding the surgical intentions of the Earth-human, but still she was trying to convince herself that the situation was not quite as bad as it seemed. With quiet urgency she asked, “Do this life-form’s limbs regenerate?”
“That is a stupid question,” the Hudlar beside her said. “No, if such were the case, the limb musculature and circulation would not have degenerated to their present state in the first place. Please be quiet, Nurse, and listen.”
“I meant the Earth-human’s limbs,” Cha Thrat said insistently, “not the patient’s.”
“No,” the Hudlar impatiently said. When she tried to ask other questions, it ignored her.
Conway was saying, “The major problem encountered while performing deep surgery on any life-form evolved for heavy gravity and high atmospheric pressure conditions is, of course, internal organ displacement and decompression damage. But with this type of operation there is no real problem. The bleeding is controlled with clamps, and the procedure is simple enough for any of you advanced trainees to perform it under supervision.
“In fact,” the Diagnostician added, showing its teeth suddenly, “I shall not even lay a cutter on this patient. The responsibility for the operation will be collectively yours.”
A quiet, polite uproar greeted the Earth-human’swords and the trainees surged closer to the barrier, imprisoning Cha Thrat within a barricade of metal-hard Hudlar bodies and tentacles. So many conversations were going on at once that several times her translator was overloaded, but from what she did hear it seemed that they were all in favor of this utterly shameful act of professional cowardice, and stupidly eager rather than afraid to take surgical responsibility.
She had never in her wildest and most fearful imaginings expected anything like this, nor thought to prepare herself for such a vicious and demoralizing attack on her ethical code. Suddenly she wanted away from this nightmare with its group of demented and immoral Hudlars. But they were all too busy flapping their speaking membranes at each other to hear her.
“Quiet, please,” Diagnostician Conway said, and there was silence. “I don’t believe in springing surprises, pleasant or otherwise, but sooner or later you Hudlars will be performing multiple amputations like this on your home world hour after hour, day after day, and I feel that you should get used to the idea sooner rather than later.”
It paused to look at a white card it was holding in one hand, then said, “Trainee FROB-Severity-three, you will begin.”
Cha Thrat had an almost overwhelming urge to shout and scream that she wanted out and far away from this hellish demonstration. But Conway, a Diagnostician and one of the hospital’s high rulers, had commanded silence, and the discipline of a lifetime could not be broken — even though she was far from Sommaradva. She pushed silently against the wall of Hudlar bodies enclosing her on three sides, but her attempts to pass through were ignored if they were even noticed. Everyone’s eyes were focused exclusively on the operating cradle and pa-tient FROB-Eleven Thirty-two and, in spite of her attempts to look elsewhere, hers were turned in the same direction.
It was obvious from the start that Seventy-three’s problem was psychological rather than surgical, and caused by the close proximity of one of the hospital’s foremost Diagnosticians watching every move it made. But Conway was being both tactful and reassuring during its spoken commentary on the operation. Whenever the trainee seemed hesitant, it managed to include the necessary advice and directions without making the recipient feel stupid and even more unsettled.
There was something of the wizard in this Diagnostician, Cha Thrat thought, but that in no way excused its unprofessional behavior.
’The Number Three cutter is used for the initial incision and for removing the underlying layers of muscle,” Conway was saying, “but some of us prefer the finer Number Five for the venous and arterial work, since the smoother edges of the incisions make suturing much easier as well as aiding subsequent healing.
“The nerve bundles,” it went on, “are given extra length and covered with inert metal caps, and are positioned just beneath the surface of the stump. This facilitates the nerve impulse augmentors that will later control the prosthetics …”
“What,” Cha Thrat wondered aloud, “are prosthetics?”
“Artificial limbs,” the Hudlar beside her said. “Watch and listen; you can ask questions afterward.”
There was plenty to see but less to hear because Trainee FROB-Seventy-three was working much faster and no longer seemed to be in need of the Diagnostician’s covert directions. Not only could Cha Thrat lookdirectly at the operative field, but the internal scanner picture was also being projected onto a large screen above and behind the patient, so that she could watch the careful, precise movements of the instruments within the limb.
Then suddenly there was no limb — it had fallen stiffly, like the diseased brnch of a tree, into a container on the floor — and she had her first view of a stump. Desperately she fought the urge to be physically sick.
“The large flap of tegument is folded over the stub limb,” Conway was saying, “and is attached by staples that dissolve when the healing process is complete. Because of the elevated internal pressure of this life-form and the extreme resistance of the tegument to puncturing by needle, normal suturing is useless and it is advisable, in fact, to err on the generous side where the staples are concerned.”
There had been unsavory rumors of cases like this on Sommaradva, traumatic amputation of limbs during a major industrial or transportation accident, after which the casualty had survived, or insisted on surviving. The wounds had been discreetly tidied up, usually by young, nonresponsible and as yet unqualified warrior-surgeons or even, if nobody else was available, by an amenable servile-healer. But even when the warriors concerned had sustained the wounds as a result of an act of bravery, the matter was hushed up and forgotten as quickly as possible.
The casualties went into voluntary exile. They would never dream of revealing their disabilities or deformities to the public gaze, nor would they have been allowed to do so. On Sommaradva they had too much respect for their bodies. And for people to parade around with me-chanical devices replacing their limbs was abhorrent and unthinkable.
“Thank you, Seventy-three, that was well done,” the Earth-human said, glancing once again at its white card. “Trainee Sixty-one, would you like to show us what you can do?”
Abhorrent and repulsive though it was, Cha Thrat could not take her eyes from the operating cradle while the new FROB demonstrated its surgical prowess. The depth and positioning of every incision and instrument was burned into her memory as if she were watching some h
orrid but fascinating perversion. Sixty-one was followed by two other advanced trainees, and patient FROB-Eleven Thirty-two was left with only two of its six limbs remaining in place.
“There is still a fair degree of mobility in one of the forelimbs,” Conway said, “and, considering the advanced age and reduced mental adaptability, I feel that it should be left intact for psychological as well as physiological reasons. It may well be that the increased blood and available nutrient supply due to the absence of the other limbs will partially improve the muscle condition and circulation in this one. As you can see, the other forelimb has degenerated virtually to the point of necrosis and must be removed.
“Trainee Cha Thrat,” it added, “will perform the amputation.”
Suddenly they Were all looking at her, and for a moment Cha Thrat had the ridiculous feeling that she was in the center of a three-dimensional picture, frozen in this nightmare for all eternity. But the real nightmare lay a few minutes in the future, when she would be forced into a major professional decision.
Her partner from the ward vibrated its speaking mem-brane quietly. “This is a great professional compliment, Nurse.”
Before she could reply, the Diagnostician was speaking again, to everyone.
It said, “Cha Thrat is a native of a newly discovered world, Sommaradva, where it was a qualified surgeon. It has prior experience of other-species surgery on an Earth-human DBDG, a life-form that it had encountered for the first time only a few hours earlier. In spite of this, the work was skillfully done, Senior Physician Edanelt tells me, and undoubtedly saved the entity’s limb and probably its life. And now it can further increase its other-species surgical experience with a much less difficult procedure on an FROB.”
Encouragingly it ended, “Come forward, Cha Thrat. Don’t be afraid. If anythingshould go wrong, I will be here to help.”
There was a great, cold fear inside her mixed with the helpless anger of having to face the ultimate challenge without adequate spiritual preparation. But the Diagnostician’s concluding words, suggesting that her natural fear might somehow keep her from doing the work, filled her with righteous anger. It was a hospital ruler and, no matter how misguided and irresponsibile its orders to her had seemed, they would be obeyed — that was the law. And no Sommaradvan of the warrior class would show fear before anyone, and that included a group of other-species strangers. But still she hesitated.