Sector General Omnibus 3 - General Practice (51 page)

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Authors: James White

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“I have already destroyed the Cromsaggar,” Lioren ended miserably, “and I fear that I am bringing about an even greater philosophical destruction in the minds of the most advanced culture to be discovered since the Federation came into being.”
O’Mara placed its hands together and looked down at them for a moment before it spoke. There was a heavy emphasis on the first word as it said, “We do indeed have a problem, Lioren. The simple answer would be to lose the patient, allow Hellishomar to terminate here, for the greater good of its people, naturally. But that is a solution which we would find ethically unsound, a relic of our presapient past. Our rejection of it would have the agreement of the entire hospital staff, the Monitor Corps, the Federation, and the Groalterri Parents. We must therefore do the best that we possibly can do for the patient, in the hope that the Parents also knew what they were doing when they sent it to us. Agreed?”
Without waiting for a reply, the Chief Psychologist went on. “The suggestion that you should be the only contact with the patient is a valid one. Hellishomar will be isolated from all other visual and verbal contact during surgery, and I shall certainly not contact it. At least, not directly.
“You have been doing very well,” O’Mara continued. “But you lack my professional experience or, as Cha Thrat insists on describing it, my knowledge of the subtler spells. You do not know everything, Lioren, even though you often act as if you do. For example, there are several well-tried methods of reestablishing communication and friendly relations with an other-species patient who has broken off contact for emotional reasons—”
O’Mara stopped and, with its eyes still directed toward Lioren, one
hand moved to the desk communicator. “Braithwaite, reschedule today’s appointments for this evening or tomorrow. Be diplomatic; Edanelt, Cresk-Sar, and Nestrommli are Seniors, after all. For the next three hours I am not here.
“And now, Lioren,” it went on, “you will listen and I shall talk …”
“
T
he modifications to the ward structure necessary for the performance of this operation will be completed within the hour,�� Diagnostician Conway said, loudly enough to be heard above the din of shouting voices and the metallic clangor of massive equipment being moved into position and given its final operational checks, “and the surgical team is already standing by. But any cranial investigation involving a newly discovered intelligent species, especially of a macro life-form like yourself, must of necessity be exploratory and with a high element of risk. For anatomical and clinical reasons, the sheer body mass combined with our present ignorance regarding the metabolism involved makes any estimate of the quantity of medication required sheer guesswork, so that the procedure will have to be carried out without benefit of anesthetic.
“Such a procedure is completely contrary to normal practice,” Conway went on, in a voice which was less than steady, “so that it is the psychological rather than the clinical preparations which Chief Psychologist O’Mara and I must satisfy ourselves are complete.”
Hellishomar did not speak. It was probable, thought Lioren, that the Groalterri knew nothing of the tiresome Earth-human habit of asking questions in the form of statements.
Conway looked quickly at the large openings that had been cut in
the deck, walls, and ceiling all around them, and at the heavily braced structural supports for the tractor- and pressor-beam installations projecting from them before going on. “It is imperative that you do not move during the procedure, and you have told us several times that you will remain still. But, with respect, that is too much to expect from a fully-conscious patient when the degree of pain being inflicted is unknown, and there is a risk of our instruments stimulating the locomotor network and causing involuntary body movements. Total restraint and immobility will therefore be imposed by use of wide-focus tractor and pressor beams even though we may not, as you have assured us, require them.”
Hellishomar remained silent for a moment; then it said, “Surgery under anesthesia is not practiced by Groalterri Cutters, so I would not consider your procedure abnormal or the discomfort associated with the entry wound of major importance. As well, you will remember that Seldal, Lioren, and yourself have assured me that, in the majority of life-forms of your clinical experience, deep cranial surgery can be undertaken without discomfort since the protection afforded by the thickness of the cranium obviates the necessity for pain sensors within the brain itself.”
“That is true,” Conway said. “But the Groalterri life-form is like no other in the hospital’s experience, so it is not a certainty.
“Another and more important reason for the absence of anesthesia,” the Diagnostician continued before Hellishomar could reply, “is that we will be forced to call on you from time to time for a report on the subjective effects of our surgery while the operation is in progress. The high intensity of scanner radiation required to penetrate and chart the cranial contents, although harmless in itself, would almost certainly affect the local nerve networks and cause—”
“All this has been explained to me,” Hellishomar said suddenly, “by Lioren.”
“And it is being explained again by me,” Conway said, “because I am performing the operation and must be absolutely sure that the patient is fully aware of the risks. Are you?”
“I am,” Hellishomar said.
“Very well,” Conway said. “Is there anything else you would like to know about the procedure? Or anything that you would like to do or say, up to and including changing your mind and canceling the operation entirely? This can still be done without any loss of self-respect. In fact I, personally, would consider it to be an intelligent decision.”
“I have two requests,” Hellishomar said promptly. “Shortly I will be experiencing the first cranial surgery to be performed on a member of my species. As a Cutter as well as the patient I am deeply interested in the procedure and would appreciate a translated description of, and the reasons for, your actions while the operation is in progress. During the operation I might need to talk with the entity Lioren on another channel, but privately. If this conversation becomes necessary, no other entity in the hospital is to overhear our words. That is my second and more important requirement.”
Both the Diagnostician and the Chief Psychologist turned to look at Lioren. He had already warned them that Hellishomar would make such a request and that it would not accept a negative answer.
Reassuringly, Conway said, “My intention is to talk through the procedure and record it in sound and vision for staff-training purposes, so there is no reason why you should not overhear the original. We can also arrange for a second communications channel, but you will not be able to operate it yourself because your manipulatory appendages are too massive for the control mechanism. I suggest that both channels be controlled by Lioren, and any private words you have for Lioren be prefixed by its name so that all others can be switched out of the conversation. Would that be satisfactory?”
Hellishomar did not reply.
“We understand that privacy at such times is of great importance to you,” O’Mara said suddenly, staring at one of the patient’s enormous, closed eyes. “As Chief Psychologist of this establishment I possess the authority of a Parent. I can assure you; Hellishomar, that your second communication channel will be private and secure.”
The Chief Psychologist’s curiosity regarding the words that had and
would pass between Hellishomar and Lioren was personal, professional, and intense. But if there was disappointment in O’Mara’s voice, it was lost in translation.
“Then I would like you to proceed with minimum delay,” Hellishomar said, “lest I take Diagnostician Conway’s good advice and change my mind.”
“Doctor Prilicla?” Conway said quietly.
“Friend Hellishomar’s emotional radiation fully supports its decision to proceed,” the empath said, joining the conversation for the first time. “The feeling of impatience is natural in the circumstances, and the expression of self-doubt may be considered as an oblique verbal pleasantry rather than indecision. The patient is ready.”
A great wave of relief, so intense that he could see Prilicla shaking with it as well, burst over Lioren’s mind. But the empath’s trembling was slow and regular, like the movements of a stately dance, and indicated the presence of emotional radiation that was pleasant rather than painful. Even with O’Mara advising him at every stage, it had taken five days and nearly as many nights of argument, closely reasoned at times but at others purely emotional, to obtain Hellishomar’s agreement to the operation. It was only now that he knew they had succeeded.
“Very well,” Conway said. “If the team is ready we will go in. Doctor Seldal, I’d be obliged if you would open.”
The instruments required for the macroprocedure, the drills and cutters and suction tubes so massive that some of them had to be individually manned, hung in position all around them. The preparations, Lioren had thought, more closely resembled those for a mining operation than a surgical procedure. But the Diagnostician’s words were another example of an oblique verbal pleasantry, because the operating team was ready and waiting, and Seldal had already been thoroughly briefed on its part at every stage of the operation.
Politeness was a lubricant, Lioren thought, that reduced friction but wasted time.
Even though Hellishomar was a member of a macrospecies with a head that was large in proportion to its enormous body, the sheer size
of the operative field came as a shock to Lioren. The area of the flap of tegument that was excised and drawn back to reveal the underlying bone structure was larger than any of the decorative rugs scattered around his living quarters.
“Doctor Seldal is controlling the subdermal bleeding by clamping off the incised capilliaries,” Conway was saying, “which in this patient more closely resemble major blood vessels, while I drill vertically through the cranium to the upper surface of the meningeal layer. The drill is tipped with a vision sensor linked to the main monitor, which will show us when it reaches the surface of the membrane … We’re there.
“The drill has been withdrawn and replaced by a high-speed saw of identical length,” the Diagnostician continued a few minutes later. “This is being used to extend the original bore-hole laterally until a circular opening has been made in the cranium of sufficient diameter so that, when the resulting plug of osseous material is removed, the surgeons will be able to enter the wound and work freely. That’s it. The plug is being removed now and will be kept under moderate refrigeration pending its replacement. How is the patient?”
“Friend Hellishomar’s emotional radiation,” Prilicla said quickly, “suggests feelings of mild discomfort, or more severe discomfort that is under firm control. Feelings of uncertainty and anxiety normal to the situation are also present.”
“A reply from me,” Hellishomar said, opening the eye nearest to the display screen, “seems unnecessary.”
“For the moment, yes,” Conway said. “But later I will need the kind of help which only you will be able to give. Try not to worry, Hellishomar, you are doing fine. Seldal, climb aboard.”
Lioren wished suddenly that he could find something reassuring to say to the patient, because he, having convinced O’Mara and Conway and finally Hellishomar itself of the necessity for the operation, bore the responsibility for what was to happen here. But he could not excuse breaking into the operating team’s conversation without invitation, and the private communication channel was closed to him until or unless
Hellishomar spoke his name, so he remained silent and watchful.
Looking like a pink-flecked, shaven log of a large tree, the bony plug was lifted clear while Seldal, its three spindly legs strapped together so as to minimize bodily projections, was being lifted into Conway’s backpack so that only its long, flexible neck, head, and beak were uncovered. A similar pack containing the instruments and inflatable equipment that both surgeons would use was strapped tightly to Conway’s chest and abdomen. The Diagnostician’s legs were not strapped together, but the sharp contours of its feet were encased in thick padding, and a white, frictionless overgarment was drawn over the limbs and fastened at the shoulders so that only the arms and head were uncovered. A transparent helmet that was free of external projections and large enough to accommodate the necessary lighting and communications equipment was added. Seldal, whose upper body was naturally streamlined, kept its head and beak pressed firmly against the back of Conway’s helmet. The Nallajim wore only eye protection and an attachment for the thin air line running into the corner of its mouth.
“Zero gravity in the operative field,” Conway said. “Ready, Seldal? We will now enter the wound.”
A tractor beam seized their weightless bodies in its immaterial grasp, deftly upended them, and lowered them heads first into the narrow opening. The thick cable loom comprising their air supply, suction and specimen extraction hoses, and the emergency rescue line unreeled like a multicolored tail behind them. Conway’s helmet lighting showed the smooth, gray walls of the organic well they had created moving past them, and an enlarged and enhanced image was reproduced on the external display.
“We are at the base of the entry well,” Conway said, “level with the internal surface of the cranium, and have encountered what is probably the equivalent of the protective meningeal sheath. The membrane responds to firm hand pressure, in a way which suggests the presence of underlying fluid, and what appears to be the outer surface of the brain itself lies just beyond. A precise estimate of the distance is difficult because either the membrane or the fluid, or perhaps both, are not completely
transparent. A small test incision is being made through the membrane. That’s strange.”
A moment later the Diagnostician went on, “The incision has been extended and opened, but there is still no apparent loss of fluid. Oh, so that’s it …”
Conway’s voice sounded pleased and excited as it went on to explain that, unlike in other species of its experience, the cere-brospinal fluid, which helped protect the brain structure from shocks by acting as a lubricant between the inner cranium and brain, was not in the Groalterri species a fluid. It was instead a transparent, semisolid lubricant with the consistency of a thin jelly. When a small piece of the jelly was cut away for closer examination and then replaced, it immediately rejoined the main body without any trace of the earlier incision. This was fortunate since it enabled them to go through the meninges without having to worry about controlling fluid losses, and they could move laterally with minimal resistance and loss of time between the brain surface and the meningeal layer to the first objective, a deep fissure between two convolutions in the area suspected of housing the Groalterri telepathic faculty.
“Before we proceed,” Conway said, “is the patient aware of any unusual physical sensations or psychological effects?”
“No,” Hellishomar said.
For a few moments the main screen gave glimpses of Conway’s hands and Seldal’s beak, brightly lit by the helmet lamp, as they pushed themselves carefully through the clear jelly between the smooth inner meninges and the massively wrinkled outer surface of the cortex and into the narrow crevice.
“As closely as we can estimate,” Conway went on, “this fissure extends about twenty yards on each side of our entry point and the average depth is three yards. On the upper brain surface the division between adjoining convolutions is clearly evident, but with depth the walls begin to press together. The pressure is not sufficient to be life-threatening, and the effort required to push the surfaces apart is minimal and does not reduce our mobility, but it would seriously hamper any surgical
procedure that may become necessary and quickly cause disabling levels of fatigue. Soon we will have to deploy the rings.”

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