by Anthology
"Yes. But something has gone wrong, we don't know what."
"I see." It was all Dal could do to keep from shouting at the huge creature. The Moruans had no duplication of organs, such as Earthmen and certain other races had. A tumor of the lung would mean death ... but the technique of grafting a culture-grown lung segment to a portion of natural lung required enormous surgical skill, and the finest microscopic instruments that could be made in order to suture together the tiny capillary walls and air tubules. And if one lung were destroyed, a Moruan had no other to take its place. "Do you have any micro-surgical instruments at all?"
"Oh, yes," the Moruan rumbled proudly. "We made them ourselves, just for this case."
"You mean you've never attempted this procedure before?"
"This was the first time. We don't know where we went wrong."
"You went wrong when you thought about trying it," Dal muttered. "What anaesthesia?"
"Oxygen and alcohol vapor."
This was no surprise. With many species, alcohol vapor was more effective and less toxic than other anaesthetic gases. "And you have a heart-lung machine?"
"The finest available, on lease from Hospital Earth."
All the way through the city Dal continued the questioning, and by the time they reached the hospital he had an idea of the task that was facing him. He knew now that it was going to be bad; he didn't realize just how bad until he walked into the operating room.
The patient was barely alive. Recognizing too late that they were in water too deep for them, the Moruan surgeons had gone into panic, and neglected the very fundamentals of physiological support for the creature on the table. Dal had to climb up on a platform just to see the operating field; the faithful wheeze of the heart-lung machine that was sustaining the creature continued in Dal's ears as he examined the work already done, first with the naked eye, then scanning the operative field with the crude microscopic eyepiece.
"How long has he been anaesthetized?" he asked the shaggy operating surgeon.
"Over eighteen hours already."
"And how much blood has he received?"
"A dozen liters."
"Any more on hand?"
"Perhaps six more."
"Well, you'd better get it into him. He's in shock right now."
The surgeon scurried away while Dal took another look at the micro field. The situation was bad; the anaesthesia had already gone on too long, and the blood chemistry record showed progressive failure.
He stepped down from the platform, trying to clear his head and decide the right thing to do.
He had done micro-surgery before, plenty of it, and he knew the techniques necessary to complete the job, but the thought of attempting it chilled him. At best, he was on unfamiliar ground, with a dozen factors that could go wrong. By now the patient was a dreadful risk for any surgeon. If he were to step in now, and the patient died, how would he explain not calling for help?
He stepped out to the scrub room where Tiger was waiting. "Where's Jack?" he said.
"Went back to the ship for the rest of the surgical pack."
Dal shook his head. "I don't know what to do. I think we should get him to a hospital ship."
"Is it more than you can handle?" Tiger said.
"I could probably do it all right--but I could lose him, too."
A frown creased Tiger's face. "Dal, it would take six hours for a hospital ship to get here."
"I know that. But on the other hand...." Dal spread his hands. He felt Fuzzy crouching in a tight frightened lump in his pocket. He thought again of the delicate, painstaking microscopic work that remained to be done to bring the new section of lung into position to function, and he shook his head. "Look, these creatures hibernate," he said. "If we could get him cooled down enough, we could lighten the anaesthesia and maintain him as is, indefinitely."
"This is up to you," Tiger said. "I don't know anything about surgery. If you think we should just hold tight, that's what we'll do."
"All right. I think we'd better. Have them notify Jack to signal for a hospital ship. We'll just try to stick it out."
Tiger left to pass the word, and Dal went back into the operating room. Suddenly he felt as if a great weight had been lifted from his shoulders. There would be Three-star Surgeons on a Hospital Ship to handle this; it seemed an enormous relief to have the task out of his hands. Yet something was wriggling uncomfortably in the back of his mind, a quiet little voice saying this isn't right, you should be doing this yourself right now instead of wasting precious time....
He thrust the thought away angrily and ordered the Moruan physicians to bring in ice packs to cool the patient's huge hulk down to hibernation temperatures. "We're going to send for help," Dal told the Moruan surgeon who had met them at the ship. "This man needs specialized care, and we'd be taking too much chance to try to do it this way."
"You mean you're sending for a hospital ship?"
"That's right," Dal said.
This news seemed to upset the Moruans enormously. They began growling among themselves, moving back from the operating table.
"Then you can't save him?" the operating surgeon said.
"I think he can be saved, certainly!"
"But we thought you could just step in--"
"I could, but that would be taking chances that we don't need to take. We can maintain him until the hospital ship arrives."
The Moruans continued to growl ominously, but Dal brushed past them, checking the vital signs of the patient as his body temperature slowly dropped. Tiger had taken over the anaesthesia, keeping the patient under as light a dosage of medication as was possible.
"What's eating them?" he asked Dal quietly.
"They don't want a hospital ship here very much," Dal said. "Afraid they'll look like fools all over the Confederation if the word gets out. But that's their worry. Ours is to keep this bruiser alive until the ship gets here."
They settled back to wait.
It was an agonizing time for Dal. Even Fuzzy didn't seem to be much comfort. The patient was clearly not doing well, even with the low body temperatures Dal had induced. His blood pressure was sagging, and at one time Tiger sat up sharply, staring at his anaesthesia dials and frowning in alarm as the nervous-system reactions flagged. The Moruan physicians hovered about, increasingly uneasy as they saw the doctors from Hospital Earth waiting and doing nothing. One of them, unable to control himself any longer, tore off his sterile gown and stalked angrily out of the operating suite.
A dozen times Dal was on the verge of stepping in. It was beginning to look now like a race with time, and precious minutes were passing by. He cursed himself inwardly for not taking the bit in his teeth at the beginning and going ahead the best he could; it had been a mistake in judgment to wait. Now, as minutes passed into hours it looked more and more like a mistake that was going to cost the life of a patient.
Then there was a murmur of excitement outside the operating room, and word came in that another ship had been sighted making landing maneuvers. Dal clenched his fists, praying that the patient would last until the hospital ship crew arrived.
But the ship that was landing was not a hospital ship. Someone turned on a TV scanner and picked up the image of a small ship hardly larger than a patrol ship, with just two passengers stepping down the ladder to the ground. Then the camera went close-up. Dal saw the faces of the two men, and his heart sank.
One was a Four-star Surgeon, resplendent in flowing red cape and glistening silver insignia. Dal did not recognize the man, but the four stars meant that he was a top-ranking physician in the Red Service of Surgery.
The other passenger, gathering his black cloak and hood around him as he faced the blistering wind on the landing field, was Black Doctor Hugo Tanner.
* * * * *
Moments after the Four-star Surgeon arrived at the hospital, he was fully and unmistakably in command of the situation. He gave Dal an icy stare, then turned to the Moruan operating surgeon, whom he seemed
to know very well. After a short barrage of questions and answers, he scrubbed and gowned, and stalked past Dal to the crude Moruan micro-surgical control table.
It took him exactly fifteen seconds to scan the entire operating field through the viewer, discussing the anatomy as the Moruan surgeon watched on a connecting screen. Then, without hesitation, he began manipulating the micro-instruments. Once or twice he murmured something to Tiger at the anaesthesia controls, and occasionally he nodded reassurance to the Moruan surgeon. He did not even invite Dal to observe.
Ten minutes later he rose from the control table and threw the switch to stop the heart-lung machine. The patient took a gasping breath on his own, then another and another. The Four-star Surgeon stripped off his gown and gloves with a flourish. "It will be all right," he said to the Moruan physician. "An excellent job, Doctor, excellent!" he said. "Your technique was flawless, except for the tiny matter you have just observed."
It was not until they were outside the operating room and beyond earshot of the Moruan doctors that the Four-star surgeon turned furiously to Dal. "Didn't you even bother to examine the operating field, Doctor? Where did you study surgery? Couldn't you tell that the fools had practically finished the job themselves? All that was needed was a simple great-vessel graft, which an untrained idiot could have done blindfolded. And for this you call me clear from Hospital Earth!"
The surgeon threw down his mask in disgust and stalked away, leaving Dal and Tiger staring at each other in dismay.
CHAPTER 6
TIGER MAKES A PROMISE
"I think," Black Doctor Hugo Tanner said ominously, "that an explanation is in order. I would now like to hear it. And believe me, gentlemen, it had better be a very sensible explanation, too."
The pathologist was sitting in the control room of the Lancet, his glasses slightly askew on his florid face. He had climbed through the entrance lock ten minutes before, shaking snow off his cloak and wheezing like a boiler about to explode; now he faced the patrol ship's crew like a small but ominous black thundercloud. Across the room, Jack Alvarez was staring through the viewscreen at the blizzard howling across the landing field below, a small satisfied smile on his face, while Tiger sulked with his hands jammed into his trousers. Dal sat by himself feeling very much alone, with Fuzzy peering discreetly out of his jacket pocket.
He knew the Black Doctor was speaking to him, but he didn't try to reply. He had known from the moment the surgeon came out of the operating room that he was in trouble. It was just a matter of time before he would have to answer for his decision here, and it was even something of a relief that the moment came sooner rather than later.
And the more Dal considered his position, the more indefensible it appeared. Time after time he had thought of Dr. Arnquist's words about judgment and skill. Without one the other was of little value to a doctor, and whatever his skill as a surgeon might have been in the Moruan operating room, he now realized that his judgment had been poor. He had allowed himself to panic at a critical moment, and had failed to see how far the surgery had really progressed. By deciding to wait for help to arrive instead of taking over at once, he had placed the patient in even greater jeopardy than before. In looking back, Dal could see clearly that it would have been far better judgment to proceed on his own.
But that was how it looked now, not then, and there was an old saying that the "retrospectoscope" was the only infallible instrument in all medicine.
In any event, the thing was done, and couldn't be changed, and Dal knew that he could only stand on what he had done, right or wrong.
"Well, I'm waiting," Black Doctor Tanner said, scowling at Dal through his thick-rimmed glasses. "I want to know who was responsible for this fiasco, and why it occurred in the first place."
Dal spread his hands hopelessly. "What do you want me to say?" he asked. "I took a careful history of the situation as soon as we arrived here, and then I examined the patient in the operating room. I thought the surgery might be over my head, and couldn't see attempting it if a hospital ship could be reached in time. I thought the patient could be maintained safely long enough for us to call for help."
"I see," the Black Doctor said. "You've done micro-surgery before?"
"Yes, sir."
"And organ transplant work?"
"Yes, sir."
The Black Doctor opened a folder and peered at it over his glasses. "As a matter of fact, you spent two solid years in micro-surgical training in Hospital Philadelphia, with all sorts of glowing reports from your preceptors about what a flair you had for the work."
Dal shook his head. "I--I did some work in the field, yes, but not on critical cases under field conditions."
"You mean that this case required some different kind of technique than the cases you've worked on before?"
"No, not really, but--"
"But you just couldn't quite shoulder the responsibility the job involved when you got into a pinch without any help around," the Black Doctor growled.
"I just thought it would be safer to wait," Dal said helplessly.
"A good conservative approach," Dr. Tanner sneered. "Of course, you realized that prolonged anaesthesia in itself could threaten that patient's life?"
"Yes, sir."
"And you saw the patient's condition steadily deteriorating while you waited, did you not?"
"It was too late to change my mind then," Dal said desperately. "We'd sent for you. We knew that it would be only a matter of hours before you arrived."
"Indeed," the Black Doctor said. "Unfortunately, it takes only seconds for a patient to cross the line between life and death, not hours. And I suppose you would have stood there quietly and allowed him to expire if we had not arrived at the time we did?"
Dal shook his head miserably. There was nothing he could answer to that, and he realized it. What could he say? That the situation seemed quite different now than it had under pressure in the Moruan operating room? That he would have been blamed just as much if he had gone ahead, and then lost the case? His fingers stole down to Fuzzy's soft warm body for comfort, and he felt the little creature cling closer to his side.
The Black Doctor looked up at the others. "Well? What do the rest of you have to say?"
Jack Alvarez shrugged his shoulders. "I'm not a surgeon," he said, "but even I could see that something should be done without delay."
"And what does the Green Doctor think?"
Tiger shrugged. "We misjudged the situation, that's all. It came out fortunately for the patient, why make all this fuss about it?"
"Because there are other things at stake than just medical considerations," the Black Doctor shot back. "This planet has a grade I contract with Hospital Earth. We guarantee them full medical coverage of all situations and promise them immediate response to any call for medical help that they may send us. It is the most favorable kind of contract we have; when Morua VIII calls for help they expect their call to be answered by expert medical attention, not by inept bungling."
The Black Doctor leafed through the folder in his hands. "We have built our reputation in the Galactic Confederation on this kind of contract, and our admission to full membership in the Confederation will ultimately depend upon how we fulfill our promises. Poor medical judgment cannot be condoned under any circumstances--but above all, we cannot afford to jeopardize a contract."
Dal stared at him. "I--I had no intention of jeopardizing a contract," he faltered.
"Perhaps not," the Black Doctor said. "But you were the doctor on the spot, and you were so obviously incompetent to handle the situation that even these clumsy Moruan surgeons could see it. Their faith in the doctors from Hospital Earth has been severely shaken. They are even talking of letting their contract lapse at the end of this term."
Tiger Martin jumped to his feet. "Doctor Tanner, even Four-star Surgeons lose patients sometimes. These people should be glad that the doctor they call has sense enough to call for help if he needs it."
"But no help was neede
d," the Black Doctor said angrily. "Any half-decent surgeon would have handled the case. If the Moruans see a patrol ship bring in one incompetent doctor, what are they going to expect the next time they have need for help? How can they feel sure that their medical needs are well taken care of?" He shook his head grimly. "This is the sort of responsibility that doctors on the patrol ships are expected to assume. If you call for help where there is need for help, no one will ever complain; but when you turn and run the moment things get tough, you are not fit for patrol ship service."
The Black Doctor turned to Dal Timgar. "You had ample warning," he said. "It was clearly understood that your assignment on this ship depended upon the fulfillment of the duties of Red Doctor here, and now at the first real test you turn and run instead of doing your job. All right. You had your opportunity. You can't complain that we haven't given you a chance. According to the conduct code of the General Practice Patrol, section XIV, paragraph 2, any physician in the patrol on probationary status who is found delinquent in executing his duties may be relieved of his assignment at the order of any Black Doctor, or any other physician of four-star rank." Doctor Tanner closed the folder with a snap of finality. "It seems to me that the case is clear. Dal Timgar, on the authority of the Code, I am now relieving you of duty--"
"Just a minute," Tiger Martin burst out.
The Black Doctor looked up at him. "Well?"
"This is ridiculous," Tiger said. "Why are you picking on him? Or do you mean that you're relieving all three of us?"
"Of course I'm not relieving all three of you," the Black Doctor snapped. "You and Dr. Alvarez will remain on duty and conduct the ship's program without a Red Doctor until a man is sent to replace this bungler. That also is provided for in the code."
"But I understood that we were operating as a diagnostic and therapeutic team," Tiger protested. "And I seem to remember something in the code about fixing responsibility before a man can be relieved."
"There's no question where the responsibility lies," the Black Doctor said, his face darkening. "This was a surgical problem, and Dal Timgar made the decisions. I don't see anything to argue."