Sector General Omnibus 3 - General Practice

by James White

  Altogether it promised to be a long, busy day and an even longer evening, during which he would view the recording of Seldal’s operation and discuss the Nallajim’s procedure at length. Having been told of Lioren’s abiding interest in other-species surgery, the two nurses would be expecting many questions from him. In the circumstances it would be natural for the conversation to wander from the operation to the personality, habits, and behavior of the surgeon performing it. Everyone liked to gossip about their superiors, and the quantity of highly personal information available usually increased in direct proportion to the rank of the individual concerned. If he was careful, this information could be abstracted in such a way that neither his informants nor his case subject would be aware of what was happening.

  As the beginning of a covert investigation, Lioren thought with a little shiver of self-congratulation, it was faultless.

  CHAPTER 9

  “With Nallajims,” Tarsedth said while they were reviewing the Seldal operation late that evening, “I can never make up my mind whether I’m watching surgery or other-species cannibalism.”

  “In their early, precurrency days,” the Hudlar said, the modulation of its speaking membrane suggesting that its words were not to be taken seriously, “that was the only way a Nallajim doctor could obtain its fee from a patient.”

  “I am filled with admiration,” Lioren said, “that a life-form with three legs, two not-quite atrophied wings, and no hands at all could become a surgeon in the first place. Or, for that matter, perform any of the other delicate manipulatory functions which led to the evolution of intelligence and a technology-based culture. They began with so many serious physiological disadvantages that—”

  “They do it by poking their noses into the most unlikely places,” Tarsedth said, its fur rumpling with impatience. “Do you want to watch the operation or talk about the surgeon?”

  Both, Lioren thought, but he did not speak the word aloud.

  The LSVO physiological classification to which Seldal belonged was a warm-blooded, oxygen-breathing species which had evolved on Nallaji, a large world whose high rotational velocity, dense atmosphere, and low gravity in the intensely fertile equatorial regions had combined to provide an environment suited to the proliferation of avian life-forms. It had been an environment which enabled airborne predators to evolve which were large both in variety and size, but so heavily armed and armored that they had gradually rendered themselves extinct. Over the millennia while this incredibly violent process was working itself out, the relatively tiny LSVOs had been forced out of the skies and their high, vulnerable nests and had taken to the shelter of the trees, deep gullies, and caves.

  Very quickly they had to adapt to sharing the ground with the small animals and insects which had formerly been their prey.

  Gradually the Nallajim had lost the ability for sustained flight, and as a species they had progressed too far along the evolutionary path for their wings to become arms, or even for their wingtips to subdivide into the digits suitable for the fabrication of tools or weapons. But it was the savage, mindless, and continuing threat from insects large and small who infested, and by their sheer numbers dominated, the land as the giant avians interdicted the air that brought about the minor changes in bone structure and musculature of the beak that caused the Nallajim to develop intelligence.

  Handless but no longer helpless, they had been forced to use their heads.

  On Nallaji, the winged insects that swarmed and stung their prey to death were outnumbered by those that burrowed and laid eggs deep within the sleeping bodies of their victims. The only way these burrowing insects could be removed was by pecking them out with the long, thin, flexible Nallajim beak.

  From being a simple family and tribal debugging device, the LSVO beak progressed to a stage where it was capable of fabricating quite complex insect-proof dwellings, tools, insect-killing weapons, cities, and ultimately starships.

  “Seldal is fast,” Lioren said admiringly, after one particularly delicate piece of deep surgery, “and it gives remarkably few instructions to its OR staff.”

  “Use your eyes,” Tarsedth said. “It doesn’t have to talk to them because the staff are engaged in supporting the patient more than the surgeon. Look at the way its beak jabs all over that instrument rack. By the time it gave directions to a nurse and the correct instrument was stuck onto its beak, Seldal could have obtained the instrument unaided, completed the incision, and been ready for the next stage.

  “With this surgeon,” the Kelgian went on, “it is the choice and disposition of the racked instruments that is important. There is no juggling with clamps and cutters, no verbal distractions, no tantrums because an OR nurse is slow or misunderstands. I think I’d like to work with this birdbrained Senior Physician.”

  The conversation, Lioren thought, was moving away from Seldal’s operation to the subject of Seldal itself, which was exactly what he had been hoping would happen. But before he could take advantage of the situation, the Hudlar, who was plainly another enthusiast where Nallajim surgery was concerned, tried to be helpful while displaying its own expertise.

  “Its procedure is very fast and may seem to be confusing to you, Lioren,” it said, “especially since you have told us that you have no prior surgical experience with Melfan ELNTs. As you can see, the patient’s six limbs and all of the body are exoskeletal. The vital organs are housed within that thick, osseous carapace and are so well protected that traumatic injury rarely occurs although these organs are, unfortunately, subject to a number of dysfunctions which require surgical intervention …”

  “You,” Tarsedth broke in, its fur spiking with irritation, “are beginning to sound like Cresk-Sar.”

  “I’m sorry,” the Hudlar said. “I only meant to explain what Seldal was doing, not bring back unpleasant memories of our tutor.”

  “Do not trouble yourself,” Lioren said. The Hudlar FROBs were acknowledged to be the physically strongest life-forms of the Galactic Federation and with the least-pervious body tegument, but emotionally their skins were extremely thin. He added, “Please continue, so long as you don’t ask questions afterward.”

  The Hudlar’s membrane vibrated with an untranslatable sound. “I won’t. But I was trying to explain why speed is so important during Melfan surgery. The major internal organs float in a shock-absorbent fluid and are only tethered loosely to the interior walls of the carapace and underside. When the fluid is removed temporarily prior to surgery, the organs are no longer supported and they sink onto each other with consequent compression and deformation effects which include restriction of the blood supply. Irreversible changes take place which could result in termination of the patient if the situation is allowed to continue for more than a few minutes.”

  With an intensity that shocked his sensorium like a traumatic injury, Lioren found himself wishing suddenly for the impossible, for a recent past that had taken a different turning and would have allowed him to share this trainee’s enthusiasm for other-species surgery rather than a demeaning and probably unproductive interest in the surgeon’s mind. The thought that the pain, no matter how severe or often it came, would always be less than he deserved brought little comfort.

  “Normally an ELNT surgical procedure requires a large operative field and many assistants,” the Hudlar went on, “whose principal purpose is to support these no-longer-floating organs on specially shaped pans while the surgeon-in-charge performs the operation proper. This procedure has the disadvantages of requiring an unnecessarily large opening in the carapace to allow entry of the supporting instruments, and the healing of such a wound is slow and sometimes leads to unsightly scarring and discoloration where the section of carapace was temporarily removed. This can lead to severe emotional trauma in the patient because the carapace, the richness and graduations of its color and individuality in pattern, plays an important part in the courtship process. With a single Nallajim operating, however, the greater speed of this procedure combined with the
smaller entry wound reduces both the size and the possibility of a disfigurement occurring postoperatively.”

  “A good thing, too,” Tarsedth said, its fur rippling in vehement sympathy. Kelgian DBLFs had the same feelings about their mobile, silvery fur as the Melfan ELNTs about their beautifully marked carapaces. “But would you look at the way it is pecking at the operative field, sometimes with its naked beak, like a bloody astigmatic vulture!”

  Seldal’s instrument rack was suspended vertically just beyond the operative field, within easy reach of the surgeon’s beak. Each recess contained specialized instruments with hollow, conical grips that enabled the Nallajim’s upper, lower, or entire beak to enter and grasp, use, replace, or discard them with bewildering rapidity. Occasionally Seldal went in with nothing but the two, long, cylindrical lenses that extended from its tiny eyes almost to the tip of its beak—which had been strapped in position for the duration of the operation—to correct its avian tendency for long-sightedness. Its three claws were wrapped tightly around the perch attached to the operating frame, and the stubby wings fluttered constantly to give it additional stability when it jabbed with its beak.

  “In early times,” the Hudlar said, “both the eggs and the egg-laying insects which had to be removed from the patients were edible, and it was considered proper for the surgeon to ingest them. Melfan tissue would not be harmful to a Nallajim, and you will remember from basic training that any ELNT pathogens it contained would not affect or infect an entity who had evolved on a different world. But in a multispecies hospital like Sector General eating parts of a patient, however small, can be emotionally disturbing to onlookers, so you will note that all such material is discarded.

  “The operation,” the Hudlar went on, “is to remove—”

  “It surprises me,” Lioren broke in, again trying to guide the conversation back to the surgeon rather than its work, “that a same-species surgeon, Senior Physician Edanelt, for example, was not assigned to the case instead of a life-form who requires a Melfan Educator tape to—”

  “That,” Tarsedth said, “would be like expecting Diagnostician Conway to forgo all other-species surgery until it had first treated the Earth-human DBDGs in the hospital. Don’t be stupid, Lioren. Operating on an other-species patient is far more interesting and exciting than one of your own kind, and the more physiological differences there are the greater the professional challenge. But you know all this already. On Cromsag you treated—”

  “There is no need to remind me of the results,” Lioren said sharply, irritated in spite of knowing that the other could not help being irritating. “I was about to say that Seldal, who has a beak and no arms, is showing no signs of mental confusion while its mind is partially under the control of a being accustomed to using six limbs all of which are capable of various degrees of manipulation. The psychological and emotional pressure, not to mention the input from its mind-partner’s involuntary muscle system, must be considerable.”

  “Yes,” the Hudlar said. “Obviously it has good control of both minds. But I wonder how I, another six-limbed being, would feel if I had to take a Nallajim tape. I don’t have a beak equivalent or even a mouth.”

  “Don’t waste time worrying about it,” Tarsedth said. “Educator tapes are only offered to those studious, highly intelligent, and emotionally stable types who are being considered for promotion to Senior Physician or higher. The way Cresk-Sar criticizes our work, can you imagine one of us ever being offered an Educator tape?”

  Lioren did not speak. Much stranger things had happened in Sector General—the staff records showed that Thornnastor’s principal assistant, the DBDG Earth-human Pathologist Murchison, had joined the hospital as a trainee nurse—but it was a strict rule of the department that the subject of a long-term promotion should not be discussed with trainees who were being considered for it nor, except in the most general terms, any of the problems associated with the Educator-tape system.

  The major problem from which all the others stemmed was that, while Sector General was equipped to treat every known form of intelligent life, no single entity could hold in its mind even a fraction of the physiological data necessary for this purpose. Surgical dexterity was a product of aptitude, training, and experience, but the complete information covering the physiology of a given patient could only be transferred artificially by Educator tape, which was the brain record of some great medical authority belonging to the same species as that of the patient to be treated.

  If a Melfan doctor was assigned to a Kelgian patient, it was given a DBLF tape until the treatment was complete, after which the mind recording was erased. The exceptions to this rule were the Senior Physicians of proven emotional stability such as Seldal, and the Diagnosticians.

  The Diagnosticians were those rare beings whose minds were stable enough to retain permanently six, seven, and in one case up to ten physiology tapes simultaneously. To these data-crammed minds were given the initiation and direction of original research in xenological medicine in addition to the practice and teaching of their considerable art.

  The tapes, however, imparted not only the physiological data required for treatment, but the entire memory and personality of the donor entity as well. In effect a Diagnostician, and to a lesser extent a Senior Physician, subjected itself voluntarily to an extreme form of multiple schizophrenia. The donor entities apparently sharing the host doctor’s mind could be aggressive, unpleasant individuals—geniuses were rarely nice people—with all sorts of pet peeves and phobias. Normally these would not become apparent during the course of an operation or treatment because both host and donor minds were concentrating on the purely medical aspects of the work. The worst effects were felt when the possessor of the tape was sleeping.

  Alien nightmares, Lioren knew from a few of his own tape experiences, were really nightmarish. And alien sexual fantasies were enough to make the host mind wish, if it was capable of wishing coherently for anything at the time, that it was dead. He could not even imagine the physical and emotional effect of the sensorium of an enormous, intelligent crustacean on the mind of a ridiculously fragile but equally intelligent bird.

  He continued to watch the frenetically active Seldal while recalling the saying often repeated among the hospital staff that anyone who was sane enough to practice as a Diagnostician was mad, a remark reputed to have originated with O’Mara itself.

  “Seldal’s ELNT procedure fascinates me,” Lioren said, firmly returning to the subject of his investigation. “It shows no hesitation whatever, no pauses for thought or reconsideration, none of the too-careful movements one sees with Educator-tape work. Is it like this with other life-forms?”

  “With respect, Lioren,” the Hudlar said, “at the speed it works would you notice an awkward pause if you saw one? We have watched it perform an Earth-human gastrectomy and, among others, do something to a DBLF that Tarsedth had better explain to you since the Kelgian reproductive mechanism is proving difficult for me to understand—”

  “You should talk!” Tarsedth broke in. “Every time a Hudlar mother produces offspring it changes to male mode. That’s—that’s indecent!”

  “Presumably these patients required only short-duration Educator taping,” the Hudlar went on, “but Seldal accommodated itself to them without apparent difficulty. For the past six weeks it has been engaged principally on Tralthan surgery and says that it finds the work most interesting, stimulating, and comfortable, next to working on another Nallajim—”

  “Another female Nallajim, it means,” Tarsedth said, ruffling its fur in disapproval, or perhaps envy. “Do you know that in the three years that Seldal has been here it has been nested by nearly every female LSVO on the staff? What they see to ruffle their tail feathers in such a scrawny, self-effacing nonentity is beyond my understanding.”

  “Is my translator faulty,” Lioren asked, trying to hide his excitement at acquiring this new and potentially useful datum, “or am I to understand that Seldal actually discussed its Educat
or-tape problems with a couple of trainees?”

  “The discussion was perfunctory,” the Hudlar said before Tarsedth could reply, “and was concerned with personal preferences rather than problems. Seldal is very approachable, for a Senior, and usually invites post-op questions from anyone who has been watching from the observation gallery. There wasn’t time this morning or you could have asked questions yourself.

  “In any case,” it went on, turning itself ponderously to regard Tarsedth, “my interest in Seldal’s love life, which seems to have become less gaudy in recent weeks, is at best academic. But even among my own species it is not uncommon for female-mode persons to be attracted to males who have personalities which are as shy and timid as that of Seldal. Such people are frequently more sensitive, unhurried, and interesting as lovers.”

  It returned its attention to Lioren and continued. “To modify a saying of one of our classmates, which seems to apply to activities associated with same-species reproduction, a faint heart sometimes wins the fair lady.”

  “It’s talking about Hadley,” Tarsedth explained, “an Earth-human trainee. It was supposed to have gone into the maintenance tunnels with …”

  He had not heard that particular item of gossip before, probably because no official notice had been taken of the incident or the grapevine had been already overloaded with even more scandalous material that day. The story of Hadley’s misdemeanor was followed by others, many of which had found their way to his department in the form of much less interesting psych-file updates which were, regrettably, free of Tarsedth’s creative exaggeration. He was forced to use every verbal strategem he could devise to bring the conversation back to the Nallajim Senior and keep it there.