by James White
“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 morning—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 active life. 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. She 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 limbs form 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’s words 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-Seventy-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 patient 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 look directly 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 branch 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 mechanical 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 horrid 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 membrane 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 anything should 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 irresponsible 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.
Impatiently the Earth-human said, “Are you capable of performing this operation?”
“Yes,” she said.
Had it asked her if she wanted to perform the operation, Cha Thrat thought sadly as she moved toward the cradle, the answer would have been different. Then, with the incredibly sharp FROB Number Three cutter in her hand, she tried again.
“What,” she asked quickly, “is my precise responsibility in this case?”
The Earth-human took a deep breath and let it out slowly, then said, “You are responsible for the surgical removal of the patient’s left forelimb.”
“Is it possible to save this limb?” she asked hesitantly. “Can the circulation be improved, perhaps by surgical enlargement of the blood vessels, or by—”
“No,” said Conway firmly. “Please begin.”
She made the initial incisions and proceeded exactly as the others had done, without further hesitation or need of prompting by the Diagnostician. Knowing what was to happen, she suppressed her fear and steadfastly refused to worry about or feel the pain until the moment it would engulf her. She was utterly determined now to show this strange, highly advanced but seemingly nonresponsible medic how a truly dedicated warrior-surgeon of Sommaradva was expected to behave.
As she was inserting the last few staples into the flap covering the stump, the Diagnostician said warmly, “That was fast, precise, and quite exemplary work, Cha Thrat. I am particularly impressed by—What are you doing?”
She thought that her intentions were obvious as soon as she lifted the Number Three cutter. Sommaradvan DCNFs did not possess forelimbs as such but, she thought proudly, the removal of a left-side medial limb would satisfy the professional requirements of the situation. One quick, neat slice was enough, then she looked at it lying in the container among the Hudlar limbs and gripped the stump tightly to control the bleeding.
Her last conscious memory of the episode was of Diagnostician Conway shouting above the general uproar into the communicator.
“FROB lecture theater on the double,” it was saying urgently. “One DCNF, a traumatic amputation, self-inflicted. Ready the OR on Level Forty-three, dammit, and assemble a microsurgery team!”
CHAPTER 8
She could not be sure about the time required for her post-op recuperation, only that there had been lengthy periods of unconsciousness and a great many visits from Chief Psychologist O’Mara and Diagnosticians Thornnastor and Conway. The DBLF nurse assigned to her made caustic comments about the special attention she was receiving from the hospital’s hierarchy, the quantity of food she was moving for a supposedly sick patient, and about a newly arrived Nidian trainee whose furry little head had been turned by Cresk-Sar of all people. But when she tried to discuss her own case it was obvious from the Kelgian nurse’s agitated fur that that was a forbidden subject.
It did not matter because, by accident or design, the medication she was receiving had the effect of making her feel as if her mind was some kind of dirigible airship, moving at her direction but detached and floating free of all mundane problems. It was, she realized, a very comfortable but suggestible state.
During one of its later visits, O’Mara had suggested that, regardless of her reasons for acting as she had, she had discharged her particularly strict professional obligations, so that no further action was required on her part. The limb had been completely severed and removed from the torso. The fact that Conway and Thornnastor had together performed some very fancy microsurgery to reattach it, with no loss of function or feeling, was a piece of good fortune that she should accept gratefully and without guilt.
It had taken a long time to convince the wizard that she had already arrived at the same conclusion, and that she was grateful, not only for her good fortune, but to Diagnosticians Conway and Thornnastor for giving her back the limb. The only part of the incident that continued to puzzle her, sh
e had told O’Mara, was the adverse reaction of everyone to the noble and praiseworthy thing she had done.
O’Mara had seemed to relax then, and it had proceeded with a long, devious spell that involved subjects which Cha Thrat had considered too personal and sensitive to be discussed with a fellow Sommaradvan, much less a stranger. Perhaps it was the medication that reduced her feelings of shock and outrage, and made the suggestions of the wizard seem worthy of consideration rather than outright rejection.
One of its suggestions had been that, when viewed nonsubjectively, the action she had taken had been neither noble nor praiseworthy, but a little bit silly. By the end of that visit she almost agreed with it, and suddenly she was allowed visitors.
Tarsedth and the Hudlar trainee were the first callers. The Kelgian came bustling forward to ask how she was feeling and to examine her scars, while the FROB remained standing in silence just inside the entrance. Cha Thrat wondered if there was anything bothering it, forgetting for the moment that her medication frequently caused her to vocalize her thoughts.
“Nothing,” said Tarsedth. “Just ignore the big softie. When I arrived it was outside the door, don’t know for how long, afraid that the mere sight of another Hudlar would give you some kind of emotional relapse. In spite of all that muscle, Hudlars are sensitive souls. According to what O’Mara told Cresk-Sar, you are unlikely to do anything sudden or melodramatic. You are neither mentally unbalanced nor emotionally disturbed. Its exact words were that you were normally crazy but not certifiably mad, which is the condition of quite a few people who work in this place.”
It turned suddenly to regard the FROB, then went on. “Come closer! It is in bed, with a limb and most of its body immobilized, it has been blasted into low orbit with tranquilizers, and it isn’t likely to bite you!”