“Psych ordered it,” someone replied. “Dr. Kelstrom.”
“No! That couldn’t have happened. A computer error, maybe.”
“See for yourself. Kelstrom’s signature. You’re from his office, aren’t you? You’ll recognize it.”
Evidently Carla did recognize it. Jesse heard no more from her as they turned up the lights and plunged a large needle into his hip.
~ 3 ~
Carla Francesco hurried down the corridor from the stairwell, her face flushed as she strode into the office of the one man in the Hospital she fully trusted. “There’s been some sort of snafu,” she declared with anger. “Since when have you been signing orders without reading them?”
He was calm, composed, as always—yet strangely distant. “I do read them.”
“Not this morning, apparently, unless somebody’s learned to forge your seal. They have Jesse Sanders in the demonstration room; they’re about to do a full workup with student techs.”
“I know that. In this case, I’m allowing it.”
She couldn’t believe what she was hearing. Upon finding Jesse’s bed empty, she’d run a computer trace; the result had been so surprising—so unlike Kelstrom—that it hadn’t occurred to her it could be anything but an error. “There’s nothing wrong with the man, no possible reason to subject him to that,” she protested. “It would be hell for him even if he were used to such things.”
“Anybody who works for Fleet is used to medical workups, I imagine.” He turned to his computer, not looking at her.
“Not like ours. Offworld they’re not like ours, not unless there are symptoms serious enough to warrant the stress. You told me that.” Furious, confused because he was holding back in a way not at all characteristic of him, Carla paused. Her heart was pounding, and not just from rushing upstairs.
“Carla. They wanted a subject on whom there were no recent records; the computer tagged Sanders. The official view’s that we’re doing him a favor. He’s getting tests that would cost twice his annual pay on worlds like Earth where preventative care’s not free.”
His voice was level; none of the irony she’d have expected came through. “That’s not your view,” she insisted, baffled. “We spend half our time knocking ourselves out to protect patients assigned to you from that sort of thinking.”
Still not meeting her gaze, Kelstrom agreed, “I don’t order physical workups often enough to suit my colleagues. Well, for once I saw a chance to display orthodoxy. My position here will be strengthened by it.”
Incredulous, Carla could only stare. He had never been so cold before. He’d shown no lack of feeling even yesterday—when she’d shown him the results of Jesse’s initial psych tests, he’d shared her outrage at the injustice already done. “We’ll get the man out of here,” he’d assured her. “Action’s clearly called for, from what I can see at first glance. He’s not a true substance abuser, and certainly not paranoid. There’ll be no problem with a quick discharge.”
And then, about to close the file, he had taken a closer look at its biographical section. “Carla,” he’d said in a low voice, tinged with excitement. “This man is a starship captain.”
She had known what lay beneath his reaction. The responsibilities he bore obscured boyish enthusiasms, at least within Hospital walls—but like herself and most of her friends, he was stirred by the mere thought of starships. Not that offworld travel would ever be possible for any of them, but space was a symbol. It meant freedom from the problems they faced on Undine.
Their eyes met, and as usual, their emotions; voicing them wasn’t necessary. “I’ll call up his chart at home tonight, and review it carefully,” he’d said, clearing the screen. “Meanwhile, he does have a drinking problem—not one that warrants intervention, but a problem nonetheless. Find out what’s back of it.”
“Frustration, don’t you think? If his case had gone to anyone but you, I’d have tweaked the test results.” By most staff doctors, Jesse’s underlying discontent would have been labeled “illness” and antidepressants would have been ordered in high enough doses to distort his natural response to what was happening to him. “How can I learn anything more specific?”
“Try asking him. He’ll reveal more than he says in words, to you. I don’t want to talk to him myself—he won’t trust me in this setting.”
“He’d be a fool if he did,” she’d agreed. Now she wondered if her own trust had been misplaced. Yet it couldn’t have been. The grounds for it had been unquestionable. How could anyone, let alone this man, change so totally?
“I believe what Jesse told me this morning,” Carla said, “as I reported in the first place. He was open with me, and our minds—touched.” The moment was vivid in her memory: an ordinary-looking man, light brown hair, skin pale from a life spent aboard starships . . . and yet his grey-blue eyes had met hers in a way that was not ordinary. “I think he’s more of a workaholic than an alcoholic,” she added. “He drinks to fill the hours away from his job. That’s not the kind of problem we should mess with here. How can you use him like a lab animal, let him be tortured, his body exposed and probed without regard for his human dignity—”
She broke off, aware with dismay of her sensations. She had seen Jesse’s nakedness in the examining room, and unlike the others present, had been embarrassed by it. She was a psych technician, not a medical nurse. Her attitude toward bodies was not clinical. In view of her longstanding hatred of Hospital policy, she had taken pride in that. Now, unaccountably, she felt vulnerable and a little afraid. Remembering, she saw not just a helpless patient, but a man. She had never reacted to a man’s body before, except one, her former husband’s; though he was dead, such feelings had been reserved for him. . . .
“Carla.” The man across the desk stretched out his hand, then quickly withdrew it. It was as if on the verge of reassurance, he drew back from the bond of friendship that they normally shared. “Is it possible that you’re feeling what I think you are—and for an offworlder?” he asked softly.
“And why shouldn’t I? Is an offworlder less than we are? Is that why you’re violating all your own rules?”
“My rules have always permitted ruthlessness. People I work with do suffer at times, as you know.”
“Not without their consent. That’s how your rules differ from the Hospital’s, isn’t it? Jesse Sanders has not consented to anything, let alone to a three-day invasive workup that serves no purpose except to train tech personnel and produce a standard file on him! Or to aversion therapy. Are you going to allow that, too?”
Kelstrom nodded. “Yes, I think so. It will be expected by the staff. There’s an experimental protocol they’ve been wanting try, but most patients aren’t in shape for it. I see no reason to deprive them of this one.”
“Experimental?” Appalled, Carla felt her knees weaken. She was up-to-date on the research discussed in the department, though much of it was repugnant to her. The idea she’d heard advanced with regard to aversion therapy was so repellent that she’d assumed not even the Administration took it seriously.
“I’m sorry,” Kelstrom told her, not showing any genuine regret. “My goal here is to help as many patients as possible. That means sparing the weak ones, not the strong. Sanders can handle himself—or if he can’t, I want to know. I think under these circumstances it’s justifiable to ignore his not having consented.”
Bitterly, Carla burst out, “I never thought I’d see you compromise your ideals on an end-justifies-the-means basis. And I won’t stand by and let it happen, either! If you’re expecting me to go along with you, you’ll be surprised.”
“I doubt it,” the psychiatrist declared. “I was surprised a moment ago, I’ll admit. I’ve watched you a long time, wondering when you’d let your sexual awareness resurface. Perhaps you wouldn’t have dropped your guard if this man were one of us. In a way it’s too bad it happened. Personal feelings may make the case tough for you; I want you to go on visiting him, keep me informed of his reactions. Bu
t I don’t think you can surprise me further, Carla.”
We’ll see about that, she thought grimly. There were ways around Hospital orders. She’d find opportunity to intervene, as she had many times in the past. But without her supervisor on her side, the risk was going to be a great deal bigger.
~ 4 ~
Jesse lay flat, not daring to move, wondering if there was any portion of his anatomy not sore from internal probing. Local anesthetic had, of course, been used for the most traumatic flesh punctures. With that added to repeated blood samplings, he’d felt more needles than he could count. The feeling of sensitive inner parts, however, had not been dulled. His stomach hurt. His throat hurt, though the apparatus thrust into his windpipe had long since been withdrawn. His ass and a good portion of his gut hurt—what he’d once thought a mere vulgar expression had been carried out all too literally.
Wearily he forced his eyes open, sensing someone’s approach. To his relief, it was Carla who stood beside him. “Keep your spirits up,” she said gently, straightening the sheet with which he’d at last, mercifully, been covered. “This phase lasts just one more day.”
“What will they do to me tomorrow?” he asked, feeling that there was little left they could do. In addition to getting a variety of scans, they had directly examined every nook and cranny of his body’s interior; not only all orifices, but arteries had been explored. They had inserted miles of tubing. They had injected dyes, taken tissue samples. They had probed the very marrow of his bones.
Now, for the night anyway, he had been granted respite, perhaps only because the supervising doctors were tired. There seemed to be an endless succession of technicians and interns. Last night he had been left alone, but hardly at peace; he’d undergone violent purging in preparation for this morning’s intestinal studies. Tonight the only procedure in progress appeared to be IV feeding, necessitated by the past two days’ required fast and the fact that his stomach was too badly abused from inner inspection to hold liquid nourishment. Tomorrow . . .
“What will they do tomorrow?” he repeated, for Carla’s face was averted; she seemed reluctant to reply.
“You don’t want to know.”
“Yes, I do. Nothing’s worse than trying to guess.” This woman would be honest, he felt. She would not resort to stock, patronizing phrases. Perhaps she might even offer reasons.
She pressed his hand with cool, smooth fingers. “Biopsies of internal organs to start with, I think. The ones they couldn’t reach with endoscopy. Liver, kidney and so forth.”
“You’re kidding. Needles in my liver? But there’s nothing to look for, no symptoms that would suggest—”
“They don’t wait for symptoms. There might be something wrong, you see, that could be found long before symptoms showed up.”
“But there isn’t. I’m healthy! At least I assume so—they haven’t by any chance discovered a problem, have they?” Dismaying as that thought was, it was almost better than the idea of so much invasive work having being done by mistake.
“No!” Carla exclaimed. “Don’t start thinking that way, Jesse! There is nothing wrong with your body. The problem is with the system we’ve got here. It can’t tolerate an incomplete file.”
“You mean all this is done to every patient who’s admitted for some minor complaint?” She wasn’t a psychologist after all, he realized, for she didn’t speak as a member of the system’s hierarchy.
“To every citizen of this colony,” Carla replied. “Not all at once like this, of course. And not so many invasive tests for young people. Besides telemetry of data from our homes, we have scheduled checks and rechecks according to age.”
“Oh, my God, Carla. That’s carrying annual physicals too far.”
She said slowly, “Not really—it’s the logical extension of the concept.” She paused, almost as if waiting for a retort.
“Well, it’s a tradeoff between stress and benefit,” Jesse said, trying to be tactful. “Not to mention economics. The chances of finding anything serious enough to warrant such tests on a routine basis must be pretty small.”
“That’s not the point. The theory is that preventing illness is worth any cost, either in discomfort or in resources.”
“I’m not sure I feel up to arguing with you, but there’s a flaw in that logic. If you subject people to this much regular stress, and make them worry enough about their health to put up with it, they’re going to get problems that might never have developed otherwise.”
“Exactly,” Carla said, her eyes lighting. “That’s one reason statistics support the testing. It does turn up potential problems. Sometimes it actually creates problems, because none of these things are wholly risk-free.”
Jesse grimaced. “Instruments poked into bladders, you mean? Catheters shoved up arteries into hearts? I tried to tell myself they couldn’t really slip, but—”
“They can and do, especially in the hands of student medics. It’s not dangerous, you understand. We’re skilled here in repairing damage.” She sounded bitter.
“You mean I needn’t be afraid they’ll kill me.”
Carla turned white. “No,” she declared with strange intensity. “That’s the one thing they will never do.”
He frowned. Something was wrong in this place, something more than the hospital’s gung-ho policies and its obvious violations of patients’ rights and privacy. “You seem to share my skepticism,” he said to Carla. “Yet you said ‘we’ as if you get checked like everyone else.”
“We aren’t given a choice.”
“God! Is that what’s meant by the health laws someone mentioned?”
“That’s part of it.”
“I guess maybe I don’t want to know the other part,” Jesse admitted, wishing only to be light-years away.
“Believe me, you don’t. You’ve got enough to face right now.”
He saw she was really troubled. “Don’t worry, I can stand another day of this, Carla,” he said with such cheerfulness as he could muster. “Internal organ biopsies can’t hurt more than the spinal tap and the bone marrow sampling.”
“That’s not what I’m thinking about. I wish—I wish I could get you out of here before they start the treatment phase.”
“What? Oh, you mean the aversion therapy. I can stand that too,” he declared grimly. “They can’t keep me nauseous all the time, after all; I’m supposed to associate it with drinking.” Presumably, he thought sardonically, I will forget all about associating it with having my guts turned inside out for the inspection of assembled interns. “So it won’t be bad compared to this—just brief episodes.”
“Do you know anything about the theory behind aversion therapy, Jesse?” Carla asked, seeming reluctant. She drew a chair to his bedside, sat close to him; he was aware of the sweet, fresh scent of her hair.
“Well, it’s a standard conditioning technique, I guess. Behavior modification. They make you drink and then punish you, so you’ll connect suffering with the act of drinking.”
“No. The induced nausea isn’t punishment; it works on the principle that makes animals reject poisonous foods. We have a built-in genetic mechanism for avoiding things that make us sick when we ingest them. Ordinary aversive conditioning, using shocks, isn’t nearly as effective.”
“But it doesn’t always work, at least not permanently.”
“Because we have minds that override associations. Humans know, underneath, that alcohol doesn’t produce nausea. A person has to be awfully suggestible to be fooled subconsciously, even for a little while.”
“That’s some comfort,” Jesse remarked, trying to make light of it. “I don’t think I’m the suggestible sort.”
“Definitely not. Your psych tests show you’re not. And the Meds know that, of course. Aversion therapy’s standard procedure, but they’re aware that it has a worse record here than on worlds where submission to it’s voluntary. That’s a problem they’ve been trying to get around.”
“Well, they might try eliminating the
force.”
“The Meds? Never; that’s contrary to their goal of curing everyone.”
“Much as I’d like to prove them wrong, Carla, I want to get out of here—and stay out. So I’ll pretend to be ‘cured.’”
“Never getting drunk again would be wise, certainly. But are you ready to give up social drinking, too?”
“Well, temporarily—in public, anyway. But I’m not an addict, after all. I can drink small amounts with meals.”
“I’m sure you can. But the authorities here won’t recognize that. Being drunk just once is interpreted as susceptibility to addiction; they don’t rely on DNA data, which has proven unreliable for predicting behavior.”
“Then why isn’t liquor banned entirely?” This had been puzzling him; it seemed the kind of world where prohibitions would flourish.
“There’s no need for a ban. Alcohol really isn’t a problem here. Anyone drunk enough to cause trouble is treated, and that’s the end of it—except there’s a small amount of recidivism. Medical science hopes to eliminate that.” Carla paused, then added painfully, “You’ve been chosen as the guinea pig, Jesse.”
That figured. He was stranded, friendless, and strong enough to withstand unlimited therapy—no wonder they were verifying his health. “Tell me what they’ll try,” he urged, steeling himself.
“You’ll be given drugs that cause real sickness when combined with alcohol. Not just nausea—heart symptoms, difficulty breathing, and so forth.”
“But that’s an ancient technique! They were doing that on Earth as far back as the twentieth century. It doesn’t work on anyone who won’t keep taking the stuff.”
“You won’t have to take it. They’ll implant an internal device for timed release, just as they do to treat chronic diseases—a much more sophisticated one, of course, than the cheap near-surface implants used on most worlds.”
Stewards of the Flame Page 2