“That’s asking a lot.”
“No more than anybody expects of any in-Territory Gen, or child for that matter. Just ordinary good manners.”
Digen put the socks in a drawer, shoved them into two neat rows, and began shutting things. With two tentacles, he handed Hogan both glasses of juice. After a short pause, Hogan took them. Digen grinned. “See? The worst is over. You better rinse them out while I get the drawer. There’s some kind of commotion down the hall, and I think it’s a Grand Inspection.”
Hogan started to move toward the bathroom, but then Digen’s words penetrated. He looked quizzically at the Sime. “People who can see through walls make handy roommates,” said Hogan.
CHAPTER FIVE
TRANSFER DEPENDENCE
After that first day in Westfield, Digen’s first month passed in a blur of frantic activity. He and Joel Hogan were on duty in the emergency ward from late afternoon until midnight, and on call from midnight until dawn. At least, it was supposed to be that way—on paper. In practice, they rarely had a moment’s rest the entire night.
At first, the residents and even the attendings would turn out during peak work loads to keep Digen from doing any actual doctoring. He was allowed to run errands to the blood lab or search files for X-rays. He stocked supply cabinets. Once, they let him hold an instrument tray. He bore it all stoically, refusing to let Hogan make a fuss about them treating an intern, a graduate doctor of medicine, as if he were a first year medical student. Eventually they even began letting him take medical histories, if only from those patients who would consent to sit across a desk from him.
He did everything he was assigned to do with alacrity and his greatest precision. He took as much responsibility as he dared, always trying to make the doctors’ jobs easier by thinking ahead and being there first with what was required. He was never to be found idle while others were working, nor, in fact, was he idle when others were idle.
Each morning, after making rounds with the chief resident, occasionally even with the chief of internal medicine, Digen would go back to his room with Hogan, and as the Gen fell exhausted into bed, Digen would shower and head for the Sime Center, where he would spend most of the day on the administrative work of the changeover ward and in-Territory collectorium, himself performing only those special channel’s functions which were his peculiar talent.
After his wholly unsatisfactory transfer with Ben Seloyan, Digen clung to the certitude that he now had two consecutive transfers—and the intervening months—with Im’ran. Daily, the therapist would supervise Digen’s sleep insisting that he get no less than two hours sleep in twenty-four. Digen reveled in the luxury of two whole hours sleep every day. In budgeting for that, Mickland was virtually putting Digen on the critical list.
One day, Digen stood looking up the steps of the Gen hospital in the heavy heat of late afternoon. The air held the stillness of a gathering storm. Im’ran had stabilized Digen’s condition. For the moment, all Digen had to worry about was shifting gears from Hajene Farris, department head, to Dr. Farris, intern and errand boy.
When he got to the emergency ward, the place was seething. An out-Territory building under construction had collapsed during the busy afternoon. Hundreds of people had been hit by debris. Half of them had been brought to Westfield Memorial by police wagons. Dozens of gurneys lined the corridors of the EW, and all the treatment rooms were in use.
Nobody objected when Digen pitched in, filling out charts and admission cards, ordering X rays, blood cross-matches, and asking for consulting physicians. He couldn’t discharge anyone, but he could and did admit several emergency cases. He also found time to provide comfort. One little girl was hysterical, her nose gushing blood, and there was nobody to take care of her. Her mother had disappeared.
Digen was afraid the mother might lie buried in the rubble somewhere. But, equally likely, she’d been sent to another hospital. He found an ice pack for the girl’s nose and made some phone calls until he located the mother. He also spent time sitting with suddenly bereaved parents as they screamed out their grief and railed at their God for the death of their child. He could do nothing but sit and listen, but he did that well. He himself had lost his only two children to sudden death.
Gradually, the less severely injured were sent home, the seriously injured were admitted, and the dead were taken to the morgue located just off the EW corridor. Digen, limited in what he was permitted to do, tackled the worst of the cleanup jobs.
The nursing staff noticed his performance, and when the head nurse went off duty, she stopped by Digen and said, simply, “Thank you, Doctor.”
Months later, Digen looked back on that moment as the real beginning of his medical career. An intern can be made or broken by the nursing staff, and it wasn’t long before Digen began to feel the effects of their silent support.
Many of the nurses began to wear their sleeves rolled up to midforearm in the style Digen had adopted to keep his sleeves from snagging on the catches of the retainers. The hospital cafeteria began to serve trin tea, the favorite Sime drink, which became mysteriously popular. Arguments could be overheard in elevators and corridors between those who had become his staunch supporters and those who still adamantly refused to admit that he could do the job.
Grudgingly, the residents began to permit him to take more and more case histories. Those histories were scoured for every minor flaw of form, but, try as they might, the residents could not fault him. His tentative diagnoses, entered in his own hand at the bottom of the page, always proved correct.
One day, the chief of surgery, Dr. Reginald Thornton, stopped in to the staff room where Digen was whittling away at a stack of charts. With them piled all around him, he was surreptitiously working on the changeover ward monthly report rather than legitimate hospital charts. He smoothly dealt himself a new hospital chart and laid it on top of the Sime Center folder, saying, “Good evening, Dr. Thornton.”
Thornton picked up a chart, paging through it idly Digen recognized it as a tetanus death that had been misdiagnosed as shaking plague by one of the residents. Thornton’s eye stopped on the second page, bottom, where Digen’s preliminary and utterly correct diagnosis had been entered and then refuted by the resident. The lab report was stapled in over it.
Thornton said, “So you want to be a surgeon?”
“Yes, sir.”
“Think you’ll be as good a surgeon as you seem to be at internal medicine?”
“With a good teacher, yes, sir, I do.”
“Think your time is wasted in the EW?”
“No, sir. We get ten or twenty surgical emergencies a night. It’s very instructive.”
Thornton leaned on the edge of the chart folder, turning full to Digen. “This is ridiculous, you know. You are a First Order channel, already one of the finest diagnosticians in the world. All you have to do is look to tell one disorder from another.” He shook the chart at Digen. “When you do some phenomenal piece of work like this, people accuse you of cheating.”
Stung, Digen said, “I didn’t cheat! I can’t read fields very well wearing retainers. I went by the book. Truly…” He broke off, aware that there was no way to make a Gen sure he was indeed telling the truth.
Thornton shied back a little at Digen’s vehemence. But he stood his ground. “I believe you. Branoff believes you. But if you’re not cheating, how do you account for your obvious superiority to the other interns?”
There it is, thought Digen. The Gens are afraid Simes will take over medicine. What could he say to allay that fear?
“I’m not superior, Dr. Thornton. It’s just that I’m not—really—an intern.”
“What in the world do you mean by that?”
“Oh, yes, I’ve just graduated medical school, but—well, it seems to me that medical training out-Territory consists of a two part obstacle course. Medical school tests the ability to absorb knowledge. More and more is thrown at the class until only the fastest learners are left. Any doctor has to h
ave a vast store of knowledge and the ability to absorb new knowledge quickly. So that seems reasonable.
“Then, in the intern year, the stress shifts to character. The idea is to foster good medical judgment by exposing the intern to vast numbers of concrete examples of the things he’s learned about in school. But it’s done using a fourteen-hour workday, sometimes a straight thirty-six. It’s grueling, but the intern learns to know his own limits, to know how his judgment deteriorates at the limit, and how to compensate for the deterioration. He learns to know himself in relation to medicine in a way that can’t be accomplished without the crushing overwork. It’s perhaps the most important lesson he’ll learn in his whole lifetime.”
“That’s an excellent description,” said Thornton. “But how does that prove you’re not cheating?”
“What I have just described, Doctor, is a stretched out, diluted form of the channel’s basic training. We learn to absorb and apply information to problem solving. Then, under field conditions, we learn judgment. But, most important, we learn to compensate for the deterioration of our judgment at our fatigue limits. The work that these interns are just encountering for the first time is work I’ve been doing professionally for fourteen years. It’s hardly surprising that I’m a little more experienced. I wouldn’t have that edge in surgery.”
Thornton looked at him thoughtfully, and Digen thought he had surely blown it this time. His retainer resting across the hospital chart that covered the Sime Center folder, Digen returned Thornton’s gaze, wishing he could read the man’s field more clearly. He moved, easing the pressure of the retainer against his injured left outer lateral.
Thornton said, “I admire your guts, Dr. Farris, but I’m not entirely sure I admire your objectives.” He raised one eyebrow. “Or your manners.”
Digen lowered his eyes and said, very quietly, “I’m sorry, Dr. Thornton, I didn’t mean to be rude.”
Thornton shook his head, grinning. “By God, I don’t know how you can take the humiliation!”
He left, still shaking his head and laughing. Digen watched him go, unsure of what humiliation the man was talking about. But, as he relaxed, he realized that the backs of his knees were wet with perspiration, and his hand, where it lay over the center folder, was shaking. If he’d caught me with this! Digen resolved never to bring center work into the hospital again.
During the latter half of his first month at Westfield Memorial, only one incident proved of lasting significance in Digen’s life.
One afternoon he came on duty to find the EW flooded with train wreck victims, and he waded in to help sort out the chaos. He and Joel Hogan passed each other often, but hardly spoke until they both were stopped by a woman with a small family gathered around her. They were farm people, soiled and disheveled as so many who rush into the EW with a critical patient.
“My boy is dying,” said the mother to Digen. “Help him, Doctor. Nobody else will.”
She led them to one of the stretchers lined up two deep by the walls. The frail young boy there was as still as death. But the IV bottles strung about him dripped steadily. Digen noticed the smell, ripe and pungent. Manure.
The shoes bulging under the red blanket lay at odd angles.
“He fell off the barn roof into the manure pile,” said the mother anxiously. “It took us all evening to get him out. Now they won’t even look at him!”
Digen peered over Hogan’s shoulder at the boy’s chart. “He’s been worked up, Mrs.—Cudney. He’s in shock. That’s why he’s being kept down here, where the nurses can keep an eye on him. He’ll be moved as soon as the more critical train wreck patients have been sent upstairs. Don’t worry, it’s a good night to break a leg. All our surgeons have been called in for the wreck, and they’ll probably have—Skip here upstairs within an hour or two, reduce those fractures, and have everything under control by morning. Don’t worry.”
“But, Doctor, shouldn’t something be done? Shouldn’t he be cleaned up?”
Digen looked around at the rapidly quieting EW. There were no more red blankets in evidence. His eyes met Hogan’s. A slight nod passed between them. The two of them spent the rest of the night over Skip Cudney.
Near morning, Thornton came into the room where they were working, accompanied by the chief resident in orthopedics. Thornton looked over what they had done, glanced through the chart, and said to Digen, “Scrub in on this one, Dr. Farris.”
They took the boy up to surgery then and Digen watched while they did an open reduction, scraping the ends of the bones where bits of manure were lodged, and then scraping them again and yet again until Thornton was satisfied that they had done the best they could.
As they were stripping off their scrub suits, Thornton eyed Digen’s retainers. “Well, at least you didn’t turn green and dash from the room the way the student nurses do.” Contemplating the surgeon’s retreating back, Digen decided Thornton reminded him awfully much of his own father.
However pleased he was with himself, though, Digen knew it hadn’t been a real test. Skip was just a child; his nager had no power.
Digen saw the boy the next evening, and the day after that. Occasionally he’d run into Hogan around the boy’s room in the intensive care unit. It hadn’t taken long for infection to set in, and though the boy was still cheerful, Digen had begun to worry.
They expected the boy would lose both legs from the infection. Digen was more pessimistic. He didn’t know any antibiotics, even in-Territory, that could combat all the microbes multiplying in the boy’s body—and bone marrow. He said as much to Hogan, one day outside the room, which reeked with such a stench that only the boy’s mother still visited him.
Hogan, hands thrust in pockets, contemplated the white tips of his shoes. “And what would you do, Hajene Farris?”
He wasn’t mocking Digen. They had many long discussions on the different approaches of healing used here and in the Sime Center. “There isn’t anything I could do. But if by some miracle of timing, Skip should go through changeover, now that the wounds are cleaned of all foreign matter, well, this particular set of microbes couldn’t survive in the Sime metabolism. Changeover is the only chance I can see for him.”
“Hm,” said Hogan. “There are those who would consider that a fate worse than death.”
“Oh, it’s not that bad.”
They looked at each other, laughed silently, and went for coffee. The next day, Digen found Hogan lingering around Skip’s door. He hung back, seeing that the mother was inside, sitting by the bed, crying silently but wretchedly.
After a time, Hogan went in and spoke softly to the woman, who wiped her eyes and made a brave face. “Mrs. Cudney, we really do think we’re going to be able to save both of Skip’s legs. He’s responding very well to the medications.”
It was a false hope. Skip had responded well to every new drug, but then the infection would break out with some new microbe dominating. It was only a matter of time and they would have to take his legs. But Hogan was convinced that it was better to give hope than utter resignation.
Or is that his rationalization? Digen wondered. Is it that he can’t face death? Or is it just Skip’s death he can’t face?
She raised a tear stained face to Hogan and said, so low Digen almost didn’t hear, “He said he’s going into changeover. He said it would make him well. He wanted to make me feel better! I’d rather he were dead!”
Oh, joy, thought Digen. He overheard me talking to Joel.
Digen went in then and tried to comfort the woman, to explain what he’d said and why. He promised to keep an eye on Skip. He’d been doing that anyhow. The boy was just about the right age for changeover, and something indefinable had alerted Digen.
Over the next few days, the mother came less and less often, spent less time with Skip. And one day Digen walked into the room and found another doctor confronting Hogan, who was standing with his fists clenched, restraining himself mightily. Hogan’s nager was ripe with the odd anxiety pattern that alwa
ys appeared in the Gen when he was confronted with changeover. But there was no sign of changeover in the boy.
Digen knew the other doctor’s name was Dr. Lankh and that he worked in the research wing, wherever that was. But Digen had no idea what Lankh did there.
Lankh said, “Dr. Farris. May I ask what you’re doing here?”
“Just looking in, Doctor.”
“Your assignment is in the emergency ward, Doctor. You’re not supposed to be on this ward except when bringing up a patient.”
“I know the rules, Dr. Lankh. But Skip doesn’t have an attending doctor, and since Dr. Thornton let me scrub on the case, I’ve been expected to follow it.”
Digen surmised that Lankh had been reprimanding Hogan for the same thing.
Lankh said, “I am his attending now. You will no longer be permitted to write orders on the Cudney case. I don’t want to see you in this room again.”
Digen opened his mouth to protest. He was irritable, impatient with rising Need, as the time of his first transfer with Im’ran was approaching. Hogan, who had begun to grasp how Digen’s temperament varied with need, stepped forward. “Come on, Dr. Farris. We have work to do.”
Out in the hall, Hogan whispered harshly, “That’s Dr. Lankh, you idiot!”
Safe in the elevator, Digen vented his feelings by barking, “And who the blazing shen is Dr. Lankh?”
“You don’t know?”
Digen shook his head.
Hogan peered around the elevator as if expecting to find an eavesdropper. “Since we’ve been here, the hospital has turned over nineteen changeover victims to the Sime Center.
“Well, I know that! The center’s statisticians have been going crazy trying to figure out why the sudden drop in the city’s average.”
“I know where the other fifteen went.”
Digen stopped, suspicion dawning. “Where?”
Unto Zeor, Forever Page 6