Sector General Omnibus 3 - General Practice

by James White

  Two days later she was told to present herself at FROB Geriatric in time for morning duty and to make herself known to the DBLF nurse in charge. Cresk-Sar said that it would not need to introduce her on this occasion because Charge Nurse Segroth, and probably every other being on the hospital staff, would have heard all about her by now. That may have been the reason why, on her meticulously punctual arrival, she was given no opportunity to speak.

  “This is a surgical ward,” Segroth said briskly, indicating the banks of monitors occupying three walls of the Nurses’ Station. “There are seventy Hudlar patients and a nursing staff of thirty-two counting yourself. All the nurses are warm-blooded oxygen-breathers of various species, so you will not need environmental protection other than a gravity compensator and nasal filters. The FROBs are divided into pre- and post-op patients, segregated by a light- and soundproof partition. Until you learn your way around you will not concern yourself, or go anywhere near, a post-op patient.”

  Before Cha Thrat had time to say that she understood, the Kelgian ran on. “We have an FROB trainee and classmate here who will, I’m sure, be happy to answer any questions you are afraid to ask me.”

  Silvery fur puckered into irregular waves along its flanks in a way, she had learned from observing Tarsedth, that indicated anger and impatience. It continued. “From what I’ve heard of you, Nurse, you are the type who will already have studied the available Hudlar material and will be eager to make a contribution. Don’t even try. This is a special project of Diagnostician Conway, we are breaking new surgical ground here, so your knowledge is already out of date. Except for those times when you are required by O’Mara for AUGL-One Sixteen, you will do nothing but watch, listen, and occasionally perform a few simple duties at the direction of the more experienced nurses or myself.

  “I would not want to be embarrassed,” she ended, “by you producing a miracle cure on your first day.”

  It was easy to pick out her FROB classmate from among the other nurses on duty—they were either Kelgian DBLFs or Melfan ELNTs—and even easier to tell it apart from all the FROB patients. She could scarcely believe that there was such a horrifying difference between a mature and an aged Hudlar.

  Her classmate’s speaking membrane vibrated quietly on her close approach. It said, “I see you’ve survived your first encounter with Segroth. Don’t worry about the Charge Nurse; a Kelgian with authority is even less charming than one without. If you do exactly as it tells you, everything will be fine. I’m glad to see a friendly, familiar face in the ward.”

  It was an odd thing to say, Cha Thrat thought, because Hudlars did not possess faces as such. But this one was trying hard to reassure her and she was grateful for that. It had not, however, called her by name, and whether the omission was deliberate or due to an oversight she did not know. Perhaps the Hudlars and Chalders had something in common besides great strength. Until she was sure that their names could be used without giving offense, they could call each other “Nurse” or “Hey, you!”

  “I’m spraying and sponging-off at the moment,” the Hudlar trainee said. “Would you like to strap on a spare nutrient tank and follow me around? You can meet some of our patients.”

  Without waiting for her reply, it went on. “This one you won’t be able to talk to because its speaking membrane has been muffled so that the sounds it makes will not distress the other patients and staff. It is in considerable discomfort that does not respond very well to the painkilling medication, and, in any case, it is incapable of coherent speech.”

  It was immediately obvious that this was not a well Hudlar. Its six great tentacles, which normally supported the heavy trunk in an upright position for the whole of its waking and sleeping life, hung motionless over the sides of its support cradle like rotted tree trunks. The hard patches of callus—the knuckles on which it walked while its digits were curled inward to protect them against contact with the ground—were discolored, dry, and cracking. The digits themselves, usually so steady and precise in their movements, were twitching in continual spasm.

  Large areas of its back and flanks were caked with partially absorbed nutrient paint, which would have to be washed off before the next meal could be sprayed on. As she watched, a milky perspiration was forming on its underside and dripping into the suction pan under its cradle.

  “What’s wrong with it?” Cha Thrat asked. “Can it, is it being cured?”

  “Old age,” the nurse said harshly. In a more controlled and clinical tone it went on. “We Hudlars are an energy-hungry species with a greatly elevated metabolic rate. With advancing age it is the food absorption and waste elimination mechanisms, both of which are normally under voluntary control, that are first to suffer progressive degeneration. Would you respray this area as soon as I’ve washed off the dried food, please?”

  “Of course,” Cha Thrat said.

  “This in turn causes a severe impairment in the circulation to the limbs,” the Hudlar went on, “leading to increasing deterioration in the associated nerve and muscle systems. The eventual result is general paralysis, necrosis of the limb extremities, and termination.”

  It used the sponge briskly and moved clear to enable Cha Thrat to apply fresh nutrient, but when it resumed speaking its voice had lost some of its former clinical calm.

  “The most serious problem for the Hudlar geriatric patient,” it said, “is that the brain, which requires a relatively small proportion of the available energy, remains organically unimpaired by the degenerative process until a few moments after its double heart has ceased to function. Therein lies the real tragedy. Rare indeed is the Hudlar mind that can remain stable inside a body which is disintegrating painfully all around it. You can understand why this ward, which has been recently extended for the Conway Project, is the closest that the hospital comes to providing treatment for psychologically disturbed patients.

  “At least,” it added, forcing a lighter tone as they moved to the next patient, “that was so until you started analyzing your AUGL-One Sixteen.”

  “Please don’t remind me of that,” Cha Thrat said.

  There was another thick, cylindrical muffler encasing the next patient’s speaking membrane, but either the sounds the Hudlar was making were too loud for it or the equipment was faulty. Much of what it was saying, which was clearly the product of advanced dementia and great pain, was picked up by her translator.

  “I have questions,” Cha Thrat said suddenly. “By implication they may be offensive to you, and perhaps critical of Hudlar philosophical values and professional ethics. On Sommaradva the situation within the medical profession may be different. I do not wish to risk insulting you.”

  “Ask,” the other nurse said. “I shall accept your apology, if required, in advance.”

  “Earlier I asked if these patients could be cured,” she said carefully, “and you have not yet replied. Are they incurable? And if so, why were they not advised to self-terminate before their condition reached this stage?”

  For several minutes the Hudlar continued to sponge stale nutrient from the second patient’s back without speaking, then it said, “You surprise but do not offend me, Nurse. I cannot myself criticize Sommaradvan medical practice because, until we joined the Federation a few generations ago, curative medicine and surgery were unknown on my world. But do I understand correctly that you urge your incurable patients to self-terminate?”

  “Not exactly,” Cha Thrat replied. “If a servile-healer or warrior-surgeon or a wizard will not take personal responsibility for curing a patient, the patient will not be cured. It is given all the facts of the situation, simply, accurately, and without the kindly but misguided lying and false encouragement that seem to be so prevalent among the nursing staff here. There is no attempt to exert influence in either direction; the decision is left entirely to the patient.”

  While she was speaking the other had stopped working. It said, “Nurse, you must never discuss a patient’s case with it in this fashion, regardless of your f
eelings about our medical white lies. You would be in very serious trouble if you did.”

  “I won’t,” Cha Thrat said. “At least not until, or unless, the hospital once again gives me the position and responsibilities of a surgeon.”

  “Not even then,” the Hudlar said worriedly.

  “I don’t understand,” she said. “If I accept total responsibility for a patient’s cure—”

  “So you were a surgeon back home,” the other nurse broke in, obviously wanting to avoid an argument. “I, too, am hoping to take home a surgical qualification.”

  Cha Thrat did not want an argument, either. She said, “How many years will that take?”

  “Two, if I’m lucky,” the Hudlar replied. “I don’t intend going for the full other-species surgical qualification, just basic nursing and the FROB surgical course, taken concurrently. I joined the new Conway Project, so I’ll be needed at home as soon as I can possibly make it.

  “And to answer your earlier question,” it added. “Believe it or not, Nurse, the condition of the majority of these patients will be alleviated if not cured. They will be able to lead long and useful lives that will be pain-free, mentally and, within limits, physically active.”

  “I’m impressed,” Cha Thrat said, trying to keep the incredulity she felt from showing in her voice. “What is the Conway Project?”

  “Rather than listen to my incomplete and inaccurate description,” the Hudlar replied, “it would be better for you to learn about the project from Conway itself. It is the hospital’s Diagnostician-in-Charge of Surgery, and it will be lecturing and demonstrating its new FROB major operative techniques here this afternoon.

  “I shall be required to observe the operation,” it went on. “But we will need surgeons so badly and in such large numbers that you would only have to express an interest in the project, not actually join it, to be invited to attend. It would be reassuring to have someone beside me who is almost as ignorant as I am.”

  “Other-species surgery,” Cha Thrat said, “is my principal interest. But I’ve only just arrived in the ward. Would the Charge Nurse release me from duty so soon?”

  “Of course,” the FROB said as they were moving to the next patient. “Just so long as you do nothing to antagonize it.”

  “I won’t,” she said, then added, “at least, not deliberately.”

  There was no muffler around the third patient’s speaking membrane, and a few minutes before their arrival it had been having an animated conversation about its grandchildren with a patient across the ward. Cha Thrat spoke the ritual greeting used by the healers on Sommaradva and, it seemed, by every medic in the hospital.

  “How are you feeling today?”

  “Well, thank you, Nurse,” the patient replied, as she knew it would.

  Plainly the being was anything but well. Although it was mentally alert and the degenerative process had not yet advanced to the stage where the pain-killing medication had no effect, the mere sight of the surface condition of the body and tentacles made her itch. But, like so many of the other patients she had treated, this one would not dream of suggesting that her ability was somehow lacking by saying that it was not well.

  “When you’ve absorbed some more food,” she said while her partner was busy with its sponge, “you will feel even better.”

  Fractionally better, she added silently.

  “I haven’t seen you before, Nurse,” the patient went on. “You’re new, aren’t you? I think you have a most interesting and visually pleasing shape.”

  “The last time that was said to me,” Cha Thrat said as she turned on the spray, “it was by an overardent young Sommaradvan of the opposite sex.”

  Untranslatable sounds came from the patient’s speaking membrane and the great, disease-wasted body began twitching in its cradle. Then it said, “Your sexual integrity is quite safe with me, Nurse. Regrettably, I am too old and infirm for it to be otherwise.”

  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 talk about 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 of the demonstration distresses you, leave at once and as unobtrusively 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’m starving!”

  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 in height, with head fur 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.