Bloodstar: Star Corpsman: Book One

by Ian Douglas

  His Mk. 10 armor had taken the brunt of the impact, bleeding off both heat and kinetic energy. The overload had managed to burn through, however. I could see charred tissue and burnt ribs behind a hole in his plastron the size of my fist. Not good, not good at all. My God, I could see his heart beating in there, a rapid, quivering pulse beneath sheets of translucent red tissue.

  I thought at first he was unconscious, but as I sprawled out flat next to him, his left arm reached over, his glove closing tight on my wrist. “Take it easy, Gunny,” I told him. “I’ve got you!”

  There was no verbal reply, not by audio, not through my in-head. I didn’t know if that was because his transmitter was dead, or because he couldn’t say anything. He was shaking, though, trying to writhe against my touch when I laid my hand on his chest, and his breath was coming in short, hard, paroxysms, like hiccoughs.

  Damn. He was in agony.

  Corpsmen aren’t generally called upon to handle open-chest surgery, but I didn’t have much in the way of options. St. Croix’s chest was wide open already.

  His armor had already fired nano into his system to counter the pain, but right now his brain was getting so many major pain messages from so many sources that the nananodyne blocks were being overloaded or bypassed.

  A plasma burst howled past, detonating against tarmac a few meters away. There wasn’t a lot I could do about that right at the moment; St. Croix was in a very bad way, so bad I couldn’t take the time to move him, not without stabilizing him first.

  I linked into his suit diagnostics. His BP was low—80 over 30—and his heart rate fast and weak. Pain readings off the scale. Those spasmodic hiccoughs suggested a problem with his phrenic nerves—the nerves supplying his diaphragm. His thoracic mesothelium and endothoracic fascia, the thin sheets of tissue shrouding the cavernous space containing his lungs and heart, had been burned through in places. I guessed that droplets of molten armor had spalled off the inside of his suit and were lodged, now, somewhere deeper in his thoracic cavity.

  It was only a guess—the hole was rapidly filling with blood and I couldn’t see—but I was pretty sure that most of the pain must be coming from his parietal pleura. The lungs, you see, are surrounded by two membranous sheaths collectively called the pleura. The inner layer is the pulmonary pleura, the outer the parietal pleura. That inner layer doesn’t have much in the way of nerve endings, but the parietal pleura is innervated by both the intercostal and the phrenic nerves. I double-checked my stores of data on the central nervous system—the intercostal nerves arise from the thoracic spinal nerves, which emerge through the vertebrae all the way from T1 through T11, while the two phrenic nerves come in from higher up, from C4, though in humans they’re also fed from the 5th and 3rd cervical nerves, at C3 and C5. Got it.

  Another burst of high-energy plasma shrieked through the air above me. I ignored it.

  I sent a massive dose of nano into St. Croix’s carotid, programming it to shut down sensory input all the way from C3 down to T11. I had to be especially careful to target only sensory nerves. His diaphragm was entirely run by motor impulses from his phrenic nerves, and if I shut those down he would stop breathing.

  I followed through with a second jolt of nananodynes targeting the cingulate cortex of his brain, to shut down his major pain receptors. After a few more seconds, he shouldn’t have been feeling anything at all, but anodyne blocking is not as precise a science as we would like to believe. I redirected a portion of the intracranial nanobots to his hippocampus and prefrontal cortex with orders to shut down his NMDA receptors. St. Croix’s struggles grew weaker . . . weaker . . . then dropped away as he slipped into deep anesthesia.

  I hated doing that. A battlefield, in the middle of a firefight, is not the best place to take a patient into anesthesia, but I had no choice at the moment. Pain management was critical, but by dealing with that by knocking St. Croix out, I had new and urgent problems to deal with.

  For one thing, he stopped breathing.

  For another, his left lung was collapsing.

  I’d tried to be careful with the phrenic nerves, hoping to keep his diaphragm working, but when the hiccoughing stopped, so did his breathing. The lung collapse was pneumothorax—what happens when the pleura are pierced and air gets into the pleural cavity. This was especially serious with the Marine’s chest open to the Bloodworld’s atmosphere; with a surface pressure more than one and a half times greater than Earth’s, the local air was forcing its way into St. Croix’s lungs through his chest wound, forcing his left lung into a smaller and smaller volume.

  The injury is sometimes called a “sucking chest wound,” and it’s serious. In the old days, battlefield medicine took a brutally pragmatic approach: Navy Corpsmen would slap the cellophane wrapper from a pack of cigarettes over the wound, and the suction would hold it in place, preventing further air from getting inside. I had to look up “cigarettes” when I first downloaded that bit of history; it’s astonishing what people used to do to themselves.

  On second thought, I suppose it was no worse than o-looping.

  I didn’t happen to have a cigarette wrapper handy, and it wouldn’t have been big enough to seal the hole in St. Croix’s chest in any case. I pulled a cylinder of hemostatin foam from my M-7 and squirted it directly into St. Croix’s chest. The stuff hit the blood and congealed, sealing over the wound.

  “Corpsman!” someone yelled. “Corpsman front!”

  “Wait one!” I yelled back. Damn it, I couldn’t leave St. Croix now.

  “I’ve got it, e-Car!” That was Dubois. Bless him.

  St. Croix was bleeding, but not too badly, not as much as you might think with his chest torn open. The major blood vessels emerging from his heart—the aorta, the pulmonary veins and arteries, the venae cavae—none of them had been nicked, thank God. All of the blood appeared to be seeping from ruptured vessels in the layers of skin and muscle over his burned-open sternum and ribs, and the hemostatin sealed them off at once. It would also provide an airtight seal over his chest.

  Through my link, I ordered his suit to up the pressure on his air feed, and also to dial up the O2 mix to 50 percent. That would help force the Bloodworld air out of his pleural cavity and into the surrounding thoracic cavity, would stop the lung from collapsing further, and if I got lucky, might even partially re-inflate it. The richer gas mix would help his respirocytes do their thing even though he wasn’t actively breathing, and help boost the efficiency of his lungs if I could get him breathing again.

  For that, I needed to take some of the nanobots on analgesic duty and redirect them to St. Croix’s medulla—his brain stem, the portion at the very base of the brain leading to the spinal cord—which was what controlled his breathing, heart rate, and blood pressure, among other things. There was a column of neurons tucked away inside the medulla called the dorsal respiratory group, or DRG, and they were the primary center in the brain for initiating respiration. The nanobots entering his brain stem began infiltrating the DRG, feeding them a trickle charge that mimicked the neurochemical impulses from his apneustic center, the part of his brain that told him to breathe. At first, nothing happened . . . and then St. Croix’s chest jerked up off the ground, and he drew a tremulous breath.

  Next I had to get him out of there. We were out on a relatively flat and open part of the spaceport field, nakedly exposed. Enemy plasma gun and laser fire continued to snap around us, kicking up bursts of flame and spinning fragments as they struck the tarmac. A larger explosion—an incoming rocket, I think—detonated five meters off to my left and showered me with rock.

  Ten meters behind me, a crater gaped in the field, three meters wide. Several Marines were already crouched inside, taking shelter from the storm of high-energy bolts sleeting overhead. I grabbed a handhold on St. Croix’s backpack, directly beneath his helmet, and started crawling in that direction. I couldn’t stand up. The incoming fire was too heavy, and once I started moving, I seemed to be attracting a lot more of the stuff. An explosion
went off three meters to my right, slamming me to the side, spraying my armor with chunks of tarmac. St. Croix plus his armor massed about 110 kilos, but on Bloodworld they weighed closer to 200, damned close to a quarter of a ton. The ground was rough and hard, and the friction from trying to drag him over the tarmac wasn’t helping.

  I was in the same situation I’d been in with Joy at a spot just a hundred meters or so from here, needing a quantum spin-floater of some sort. “Logistics!” I called.

  “We hear you,” a voice came back. “Whatcha need, Doc?”

  The logistics staff consisted of three Marines in the Company HQ platoon tasked with getting combat expendables and other supplies to the Marines and Corpsmen who needed them—fresh battery packs and recharges, ammunition for the slug throwers and plasma guns, and spin-floater stretchers for casualties. “I need a stretcher out here! Stat!”

  I started broadcasting a homing signal. The logistics people were somewhere back there, on the other side of a tumbledown spaceport structure. They generally debarked inside an armored supply vehicle, which gave them some maneuverability, but usually they stayed hunkered down in a firefight, doing their best to stay inconspicuous under a layer of nanoflage.

  The stretcher arrived about ninety seconds later, skimming in a few centimeters above the ground on its spin-repulsors, guided by an onboard robot and propelled by a miniature jet engine strapped to its underside. I caught it as it drifted up, keyed the control that dropped it to the ground, and proceeded to get it underneath St. Croix.

  That’s not as easy as it sounds, especially in a surface gravity of 1.85 Gs. I had to tell St. Croix’s armor to go stiff, then lever the Marine like a flat, heavy log over onto his left side, nudge the stretcher into place, then let him, rigid armor and all, roll back onto the floater’s surface. I keyed the controls again, and the stretcher levitated; frictionless, the stretcher could be guided with one hand. I could give him a shove and get him started moving in the right direction.

  But not easily when I was lying down flat. I rose to my knees to give him a shove.

  That’s when I got hit.

  Chapter Twenty-Three

  Something struck me in the back of my left leg, struck me hard and knocked me down. It didn’t hurt, but the shock jarred me, smashing me forward, and an instant later I was sprawled facedown on the tarmac, with red warning icons flashing across my in-head.

  I rolled over and looked at myself. The walker framework and the armor encasing my lower left leg was a tangle of half-melted ceramic, plastic, and titanium, and appeared to be attached above my knee by a ragged twist of metal as thick as my finger. There was a lot of blood, and it was still spurting, bright arterial orange-red, all over the pavement; as I lay there, staring at the damage, something went snick inside my leg, a few centimeters up from my thigh, and the lower leg and what was left of my knee dropped off. My armor, sensing both the loss of blood and the inflow of higher-pressure air from outside, had decided to guillotine me, amputating my leg.

  So far, all I felt was a dull, heavy, throbbing sensation in my leg . . . and I needed to take care of St. Croix. When I’d fallen, his stretcher had skittered away, and was drifting free now, ten meters away.

  I started crawling.

  Okay, okay, so I wasn’t thinking real straight just then. The iris valve that had cut off my leg wasn’t pressed as tightly against the stump as it could have been, and blood was still pouring into my armor. I tried to tighten the tourniquet by telling my armor over my in-head to constrict, but I was having trouble bringing up the right menu.

  It felt as though the damned planet was dragging at me, pinning me to the broken tarmac. I raised my head, trying to spot the drifting stretcher.

  There . . .

  It might as well have been on the other side of the planet, so far as I was concerned. The in-head menu connecting me to the stretcher’s engine was still open, at least. Somehow, I managed to use it to engage the engine, and set the stretcher moving toward the crater I’d spotted a moment before. “Logistics!” I called. “Take control of the stretcher! I’m hit!”

  “Copy that, Doc. How bad is it?”

  “Sucking chest wound,” I told them. “His chest’s open. I’ve packed it and—”

  “Not him, Doc. You!”

  About then was when the pain hit, searing, shrieking, excruciating.

  Gasping, I rolled over onto my back. I used my in-head to access my suit controls and trigger an injection of nanobots, half earmarked for pain control, half to travel to my leg and start sealing off blood vessels.

  “Not . . . good.”

  My big problem at the moment was the common femoral artery, or CFA. One branches off from each of the iliac arteries in the abdomen, one entering each leg at the groin, moving down to divide above the knee into the deep and the superficial femoral arteries. They were big and they carried a lot of blood, at high pressure. I could easily exsanguinate—bleed to death—in just another few minutes if I didn’t get the damned bleeding under control. I was feeling dizzy and nauseated, my blood pressure was dropping past 90 over 40, and my vision was starting to blur. God, had I lost that much blood already?

  The injury was similar to Bennie Andrews’ wound.

  I’d patched him up in a couple of minutes, no sweat.

  I was having trouble doing the same to myself.

  The pain began to fade somewhat. At least, the screaming agony in my leg was losing some of its edge as the nananodynes began shutting down nociceptors in my leg—the neural receptors responsible for transmitting pain. I could have done a better job at pain management if I’d begun diverting nano to my brain, but I didn’t trust myself to do it right. I was feeling very fuzzy.

  I used my N-prog to follow and to control the repair efforts in the stump of my leg. A cloud of nano was moving down the left femoral artery, the individual bots linking physically one to another in order to form a tightly woven net spanning the lumen—the interior diameter—of the artery. The problem was that the pressure of the blood flow there was so great, carried along in massive spurts, that there was a danger that any patch was going to tear free before it could slow the bleeding.

  The guillotine blade, though, was pressed up hard against the severed end of my leg, applying pressure, and the wall of the armor around my thigh had automatically constricted, tightening to form a tourniquet. That’s what had saved Andrews’ life a few minutes ago. His wound, however, had been cauterized to begin with, so he hadn’t bled out as much as I had when the guillotine blade irised shut. I had already lost a lot of blood by the time my suit amputated my leg, and quite a bit more had seeped into the armor enclosing my thigh afterward.

  So my attempts to staunch Andrews’ bleeding had been pretty straightforward and quickly successful; I was still bleeding despite the tourniquet, proof that no two first-aid procedures ever work out quite the same way. No two people are precisely the same anatomically or in the way that they respond to drugs or programmed nano.

  I fumbled with my N-prog. I needed to increase the amount of nano trying to close off my left femoral artery.

  I couldn’t see the screen. . . .

  “Take it easy, e-Car. I’ve got you.”

  It was Dubois.

  I tried to follow what he was doing on my in-head, but I was having trouble focusing on the windows open in my mind. Numbers and words jittered and flickered there, at the very edge of my comprehension, but I couldn’t make them snap onto focus.

  Blood. I’d lost too much. My brain wasn’t getting enough of the stuff.

  I mumbled something incoherent at him, felt him jacking into my armor.

  They say that Hospital Corpsmen make the very worst medical patients in the cosmos, although I suppose the same thing could be said about doctors, nurses, or civilian emergency trauma techs. I was trying to tell Doob that I needed BVEs, that I was still bleeding, that my BP was dangerously low—all stuff that he already knew.

  “Nothing wrong with you, my friend,” I heard h
im say. His voice sounded like it was coming from very far off. “You’ve just been at my hooch supply again, is all.”

  The pain was starting to return. Possibly Doob had redeployed some of the nananodyne ’bots to other duties, like stabilizing my BP or helping to tie off my femoral artery. Or maybe the pain signals were finding other ways past the blocks and into my brain. Funny. I could still feel my left leg, which was hurting like hell all the way down to my toes.

  “I’m sending you off to sleepy land,” Doob told me. The words were faint, far-off and coming at me out of a vast, roaring cloud of static.

  And Paula was there, looking up at me in the well deck of our sailboat. I could feel the bite of the cold wind off the glacier, feel the pitch and roll of the boat. Her eyes were going glassy. Damn, I was losing her! Losing her!

  Paula’s face faded, replaced by . . . what the hell? I was looking down on someone in Mk. 10 Marine armor, lying flat on the ground. Another armored figure lay next to the first, jacked in through a couple of slender cables connecting helmet to helmet. The first figure’s left leg was gone from just above the knee.

  With a heart-stopping jolt, I realized that I was looking down at me.

  You know, my family had always been pretty serious about the Gardnerian stuff. Reincarnation, the migration of the soul from body to body, hell, the existence of the soul . . . something, some noncorporeal part of us that is more than and distinct from the mere chemical and biological machinery that we call us.

  So I’d heard all about NDEs—near death experiences—growing up. My medical training had mentioned the phenomenon, but relegated it to the realm of the psychochemical and the hallucinatory. Blood loss, neural shut-down, anoxia, and other stimuli—or perhaps the failure of neural stimuli—could create hallucinations that were remarkably similar across thousands of case histories. There was the sensation of leaving the body, of looking down on your own body from a vantage point somewhere overhead, of feeling peaceful and happy. There was the iconic tunnel of light, the experience of moving toward the light, of joining loved ones long dead somewhere up there, of meeting beings or a Being that the mind interpreted as the departed or as angels or gods or a divine and immortal part of the Self.