“I am.”
“I am required to ask if you wish to press charges against the Sime who attacked you.”
Hogan met Digen’s eyes.
Digen said, “Joel, you are in a position to make all channels tighten up on their casual interactions with out-Territory Gens, to make sure such a thing never happens to anyone again. All you have to do is say that I’ve failed the trust you placed in me.”
For one long, pregnant moment, Digen looked into Hogan’s eyes and thought, A huge step backward into stagnation; another rift in the unity of mankind.
Hogan looked at the messenger and said, “Nobody attacked me.”
Reaching out a hand, he laid it over Digen’s tentacle sheaths. “It was I that failed the trust, Digen.”
Neither of them noticed the messenger shrug and withdraw. “Thanks,” said Digen roughly. “I don’t know what else to say.”
“Why not just say where we can get a good breakfast. Anyplace but the hospital cafeteria.”
After that, Digen and Hogan tried to go back to their old relationship, but from that moment on, their friendship became deeper and deeper. As the first snow flurries sifted down over the city, they were both under more and more stress: Hogan, as his battle to become a surgeon brought him longer and longer hours, and more and more of the critical or terminal patients became his responsibility; Digen, as the continued bad transfers and gradual loss of hope of getting Im’ran back took their toll.
The only bright spot for Digen was the rapid progress he made at learning surgery. He spent several weeks on the recovery wards, changing dressings, pulling drains, giving injections, replacing IV needles that infiltrated, and writing routine orders.
From time to time he was allowed to hold retractors on an appendectomy, and, just once, a gall bladder. But Thornton’s lectures ranged through every possible variation of Gen anatomy—and there were many variations, because Gens, like Simes, numbered dozen of submutations among them. Digen found to his relief that operating on a non-Donor out-Territory Gen was simple compared to what he’d been through with Ditana Amanso.
After a few weeks, Digen was following several dozen patients, making rounds with as many attending surgeons as he could, and scrubbing several times a day. The day passed in a delirium of fulfillment, for suddenly, after all the years of boredom and frustration, plodding through Gen schools merely to obtain the credentials—suddenly, all he had read and studied came to life under his hands. It was real now; he knew he could do it.
Gradually his duties began to center on the operating theater itself. Sometimes he scrubbed five or six times a day, and he often got cases that the other interns—ahead of him in the rotation—coveted jealously. Thornton was amusing himself, trying to find out just where Digen’s limit for absorbing new knowledge and skills might be.
And Thornton also kept close tabs on the mortality statistics, finding that the patients Digen spent a lot of time over tended to survive. He never said a word about it on the wards, but even the other patients noticed, and, despite their aversion to a Sime doctor, they began asking for Digen, claiming his time even when he was supposed to be elsewhere.
Life was not all deep fulfillment though. Once, Digen came back to the hospital after a long night at the Sime Center during which he had lost a changeover victim to brain hemorrhage. He found Hogan in their room, prone on the bed, in the deepest state of despondency he had yet seen in the Gen.
Easing off his retainers, Digen sat on the edge of the bed and placed one diagnostic hand on the back of the Gen’s neck. Hogan’s misery was paralyzing.
“You haven’t slept a wink all night,” said Digen. “You’ll never make it through the year—never mind another three years of surgical residency—like this.”
“It doesn’t matter,” Hogan said, then rolled over and sat up to face Digen. “Tell me, how do you do it? How do you survive it all? Where does the strength come from?”
Digen frowned, shaking his head in puzzlement. Hogan amplified, “I mean, well, look, you’re in worse shape than I am. What happened when you tried suturing the first time, remember? And after Ditana’s surgery. And all these things, they keep happening to you, yet you keep coming back for more. How? Why? Where does it come from—the—the courage to go up to a patient and say, ‘I’m a doctor. Let me help,’ when you know you’re on the edge of collapse—when a patient has just died on you—and you don’t know if it was your fault—and—and you might make another mistake—and—and you have to go and tell a bunch of kids their mother just died when maybe it was your fault—how, Digen, how?”
Digen said, “I shouldn’t have left you alone with Mrs. Korand last night. She died, didn’t she?”
“I had to tell her kids—after we bought them candy and jollied them into confidence in us. I can’t go down there again today, Digen. I can’t. What if it happens again?”
“It will happen again,” said Digen, with a kind of gentle brutality. “And again, and again. It’s what being a doctor is all about. You can’t fight death, Joel, there’s no way to win that battle. You can only enhance the enjoyment of life.”
“But when they die, and it’s your fault.…”
“It’s never your fault—when you follow the dictum ‘do no harm.’ “
“But how do you know?”
The vibrating torrent of pain and doubt bottled up in the Gen all night came flooding out onto Digen, and for once he was grateful that Hogan wasn’t a Donor.
“That’s the worst part,” said Digen, “not knowing if maybe you’d done this or that instead, maybe the patient would have lived.”
There was no way Digen could share with Hogan the intricate series of decisions that had led to the death by brain hemorrhage in changeover, but it had been substantially the same situation he and Hogan had faced the day before with Effy Korand. He and Hogan were only interns—rigorously supervised by residents and attendings. At the Sime Center, Digen made the decisions alone.
“How do you do it, though, Digen? How? Because I can’t anymore.”
“I cry a lot,” said Digen. “Desolately, disconsolately, even—if necessary—hysterically, like after Didi Rill.”
In a moment of shared silence they both thought of the lectures at medical school where they’d been exhorted to make every death count, to learn something from each one that would be of value to the living—and then they thought of the real world here at the hospital, in which people died and nobody could find anything to learn from their deaths.
Digen knew what was bothering Hogan. He’d gone through it in First Year camp. Every physician worthy of the title went through it during transition from school to the real world. Loss of self-confidence.
“Joel, if you think too much about the mistakes you might make and the terrible consequences you might face, you end up causing yourself to make those mistakes. It’s only human—when you’re gambling for more than you can afford to lose, the game isn’t fun anymore.”
“Who can afford to lose a life?”
Who indeed? “I have a friend,” said Digen. “Jesse Elkar. He’s a channel—we—went to school together. He asked me that same question once, when he was trying to qualify Second Order and kept failing because he was always brooding on the responsibilities the higher orders take on. But then he found—religion—a religious attitude, anyway—that life is not ours to create or take away, and that death is not the end of a soul’s existence. It helped him. He qualified First Order recently—that’s like, well, equivalent to finishing a residency, I suppose.”
“I’m not religious. Where I come from, the only religion is Church of the Purity—and you know what they teach—that Simes have no souls, and all that. I was raised in that, Digen, and I—No, none of it makes any sense to me.”
“I don’t consider myself very religious either,” said Digen. “But it seems to help more people to lower the stakes by giving the responsibility to a Higher Power.”
“I guess that’s it—the responsibility. I�
�m just not strong enough to take it. I’m just not cut out to be a doctor.”
Digen had worked with Hogan long enough that he could not accept that analysis. “No, Joel, I don’t think that’s it. You got to know Effy too well, became emotionally involved with her kids, and she became almost a mother figure to you. You could feel how her family would feel—without her. That preyed on your mind until you were afraid their loss would be your fault, and you just froze up inside at that. You couldn’t function—as a physician—because you were too closely, emotionally, involved—the stakes were too personal for you.”
“It’s never too personal for you. Take Skip, for example. You treat him like he was your own son. What will you do if he dies?”
“It’s not the same. I’m not on his case. I don’t make decisions about him.”
“But one day you may have to—like with little Didi Rill. Or what about Ditana Amanso? Thornton’s practically made her your patient. What if she’d died because of something you did or didn’t do?”
Digen knew there was a rumor around the hospital that he and Dita had some sort of romantic involvement going. In the celibate atmosphere of the interns, such rumors were inevitable.
“Joel, this discussion isn’t getting us anywhere. The way I handle my emotional problems has to be different from the way you handle yours. Or don’t you understand yet what a channel is?”
“But aren’t we all human? Isn’t that what you keep telling me?”
“Our problems are the same, the way we handle them is different. Look, what we’re talking about basically is the fear of getting hurt—emotionally or physically. As a Gen you have to arrive at a state where you know you will not be hurt. As a channel, I have to live with knowing I will be hurt and come to a state of mind where I offer no resistance. Every time I treat a patient—as a channel—I risk being affected by the patient’s disorder, even killed by it. It’s not unlike the Donor’s skill. The less resistance I offer the less risk I take. The only way I can reach that state of unresistance is via my utter confidence in my Donor therapists and assistants. That’s the secret of my strength, Joel, the whole secret.
“Just two hours ago I was—a basket case, from losing a little girl to a brain hemorrhage during breakout. I’m here now, reasonably calm and sane, only because my Donor has strength enough for both of us.”
“Then why don’t I have strength enough just for me?”
“I don’t know,” said Digen, but he was beginning to suspect. “Unless it’s just the basic difference between Sime and Gen. In-Territory, only the channels are physicians. I’ve always thought that was because we have keener, deeper perceptivity than a renSime, or a Gen. But now I see something else. Joel, you can’t do what I do, and there’s no reason for you to try. There’s no reason for you to become—emotionally involved with your patients. I do it because it’s part of the—nageric linkage that induces healing in the Gen. But you don’t work with nager, so there’s no reason to expose yourself to such—pain. The exposure itself prevents you from functioning as a physician—because when you care that deeply, when you understand your patient’s emotions so well that you can feel them yourself, the stakes are too high, the fear of being hurt keeps you from thinking clearly. The only solution for a Gen who’s a physician is to remove himself from that deep knowledge of the patient’s emotional life, from the knowledge of who they are and what their illness means to them. They have a name for it in this hospital. Clinical detachment.”
“Digen, do you know what you’re saying? You know what you’re telling me to do?”
Digen nodded. “You have to build your inner defenses so strong that you have no fear of being hurt. Otherwise, your judgment will always be in danger of being paralyzed by that fear, or by the pain of a loss. And one day somebody’s death may actually be your fault because of it.”
“Digen, I swore an oath—on my aunt’s deathbed I swore that the day I couldn’t care for my patients anymore, I’d quit medicine.”
“That was a little boy who swore that oath.”
“There are some things of childhood worth preserving.”
“Joel, don’t you see you have no choice?”
Staring bleakly at his hands, Hogan retorted, “What do you think I’ve been facing—all the damn night?”
Digen slumped. “I’m not much help, am I?”
“I can’t go down there anymore, Digen, I can’t make myself do it. I’m afraid to care, and I won’t not care.”
“I can’t let you quit—not now, just months away from the finish line. There’s nothing in all the universe you want more than surgery.”
“Yes there is,” said Hogan, with an oddly dull determination. “I just never knew it before I came here. And when I knew it—I couldn’t face it, couldn’t admit it to myself. That’s why I ran away—after the Amanso surgery. I walked and walked, trying to bury it. But it won’t stay buried, it just won’t.”
Digen was silent, choking on the Gen’s roiling emotions. Finally Hogan raised his eyes to Digen’s and said, “I want to be a Donor.”
Digen’s cold shock blocked out Hogan’s nager for one frozen moment. Then Digen gathered himself, recognizing—after months of studying Hogan—the Gen’s fear of rejection, of ridicule, of failure. And the earnestness in the man gave Digen a real scare. He doesn’t know. He hasn’t the faintest idea it’s impossible for him.
“Digen, don’t laugh at me.”
“I’m not laughing. I’m touched. Deeply, desperately touched. I had no idea I’d had such—an effect on you.”
“I think it’s the best thing that has ever happened to me—meeting you. Digen, I didn’t tell you—maybe I should have, but I couldn’t—but—after the Amanso surgery, while I was walking around out there, I found I—I could almost remember—just flashes—of what they say I saw. I remember my brother. His name was Dorian, but we called him Carrots because that was about all he’d eat as a baby. I remember him—killing my sister. I remember wanting to kill him, trying to, and I remember—what it felt like—when he—he—tried to kill me. It happened. It really happened—what they said—and I feel all different about everything now.”
Digen sat, trembling. What have I done? Oh, dear God, what have I done?
Digen felt an insane laughter rising within him, and buried his face in his hands. He rose, paced around the bed, and then sat on his own bed, stifling that laughter and the wrenching sob that followed it. He dared not seem to mock Joel now.
Digen shook his head and met Hogan’s eyes. “The work isn’t that different, Joel. The Donor is physician to the channel, applying knowledge to sustain life while maintaining a rigid, clinical detachment, yet at the same time using emotional resonance as a healing agent. But closeness between Donor and channel is even more dangerous than between doctor and patient, dangerous in ways I couldn’t begin to explain to you—and illegal, too. Not only that, but it’s a much greater temptation. And the responsibility—the decisions—it’s all the same. If you can’t hack it as a doctor, you can’t hack it as a Donor.” But what a Companion he would have made!
“It’s not that I’m trying to—avoid a struggle, Digen. It’s that I’ve finally found something worth struggling for.”
Digen could feel the truth of that. I have to tell him—there’s no way I can dissuade him. He took a deep breath, then another, steeling himself inwardly.
“Joel, our friendship has survived—a lot—and grown stronger all the time. That friendship means more to me than I can tell you—and not just here in the hospital; it’s important to me in my life as a whole. Now you’ve got me at a point where the stakes are too high, and I’m afraid of—losing your—esteem. And no Donor will be able to help.” At least nobody short of Im’ran…(Ilyana?).
Hogan shook his head, bewildered by Digen’s shift of mood.
“Joel, I swear to you—Unto Zeor, if you like—that I didn’t know you didn’t know, or I would have said something a long time ago. I’m sorry if I ever gave you the impr
ession I thought you could ever qualify—even Third Order.”
Hogan sat, furrows deepening across his brow, soaking up the implications of that. Confused, he shook his head. “But, why—why not? I learn fast, I’m willing to work hard, I’m not afraid—at least, I can get over it now….”
Oh no you can’t. You still just bury the fear.
“Digen, just think what it would mean to have a Donor who can assist you in surgery!”
If only!
“Why not, Digen? Why not?”
God damn the Church of the Purity and—and the Tecton too! The warped, twisted, broken lives! Damn them all to hell and back!
Digen reached out his hands and tentacles to Hogan beckoning him across the gap between the beds. “You want to do this. I know, I can feel it, and it is genuine. It’s true—being a Donor is more to you than being a surgeon. You’ve found yourself, Joel, the real you under all the scar tissue.”
As the Gen touched his hands, Digen shuddered with the intensity of it.
“I can do it, Digen, I know I can. I just want a chance to try.”
Digen shook his head and turned to sit cross-legged on the bed, facing Hogan. “You would have made—a great Donor. But you’ve been crippled, Joel—like me, permanently crippled. I’ve never seen your field vary even fractionally in response to any external selyn field—not even mine. You have no selyur nager—not a trace.”
“Handicaps can be overcome. I never said I thought it would be easy.”
“You don’t understand. It’s impossible, not just difficult. Look, if you took a newborn and bound up one of his legs and kept it that way all during his teens, would he be able to walk when you unbound it as an adult? Or put it another way. You were injured, paralyzed at a very critical age. Instead of growing, strengthening, maturing, that paralyzed capacity has atrophied, withered beyond reclaiming. Joel, you and I are both cripples, after a fashion. I sometimes think that everyone is, one way or another.”
A long, long while later, Hogan said, “I’ll never be a Donor.” He shifted a bit, and for the first time Digen noticed a fine silver chain around the Gen’s neck. Just peeking from the open V of his shirt was a little silver medallion. With a rush, Digen recognized it—Society of the Final Donation. Oh, Joel.
Unto Zeor, Forever Page 16