In her dream Nicole was ten years old again and playing in the woods behind her home in the Paris suburb of Chilly-Mazarin. She had a sudden feeling that her mother was dying. The little girl panicked. She ran toward the house to tell her father. A small snarling cat blocked her path. Nicole stopped, She heard a scream. She left the path and went through the trees. The branches scraped her skin. The cat followed her. Nicole heard another scream. When she awakened a frightened Janos Tabori was standing over her. “It’s General Borzov,” Janos said. “He’s in excruciating pain.”
Nicole jumped swiftly out of bed, threw her robe around her, grabbed her portable medical kit, and followed Janos into the corridor, “It looks like an appendicitis,” he mentioned as they hurried into the lobby, “But I’m not certain.”
Irina Turgenyev was kneeling beside the commander and holding his hand. The general himself was stretched out on a couch. His face was white and there was sweat on his brow. “Ah, Dr. des Jardins has arrived.” He managed a smile. Borzov then tried to sit up, winced from the pain, and let himself lie back down. “Nicole,” he said quietly, “I am in agony. I’ve never felt anything like this in my life, not even when I was wounded in the army.”
“How long ago did it start?” she asked. Nicole had pulled out her scanner and biometry monitor to check all his vital statistics. Meanwhile Francesca and her video camera had moved over right behind Nicole’s shoulder to film the doctor performing the diagnosis. Nicole impatiently motioned for her to back away.
“Maybe two or three minutes ago,” General Borzov said with effort. “I was sitting here in a chair watching the movie, laughing heartily as I recall, when there was an intense, sharp pain, here on my lower right side. It felt as if something were burning me from the inside.”
Nicole programmed the scanner to search through the last three minutes of detailed data recorded by the Hakamatsu probes inside Borzov. She located the onset of the pain, easily identifiable in terms of both heart rate and endocrine secretions. She next requested a full dump over the time period of interest from all channels. “Janos,” she then said to her colleague, “go over to the supply room and bring me the portable diagnostician.” She handed Tabori the code card for the door.
“You have a slight fever, suggesting your body is fighting some infection,” Nicole told General Borzov. “All the internal data confirms that you are feeling severe pain.” Cosmonaut Tabori returned with a small electronic array shaped like a box. Nicole extracted a small data cube from the scanner and inserted it into the diagnostician. In about thirty seconds the little monitor blinked and the words 94% likely appendicitis appeared. Nicole pressed a key and the screen displayed the other possible diagnoses, including hernia, internal muscle tear, and drug reaction. None were, according to the diagnostician, more than 2 percent probable.
I have two choices at this juncture, Nicole was thinking rapidly as General Borzov winced again from the pain. I can send all the data down to Earth for a complete diagnostic, per the procedure… She glanced at her watch and quickly computed twice the round-trip light time plus the minimum duration of a physician’s conference after the electronic diagnosis was completely which time it might be too late.
“What does it say, Doctor?” the general was asking. His eyes were entreating her to end the pain as quickly as possible.
“Most likely diagnosis is appendicitis,” Nicole answered.
“Dammit,” General Borzov responded. He looked around at all the others. Everyone was there except Wilson and Takagishi, both of whom had skipped the movie. “But I won’t make the project wait. We’ll go ahead with the first and second sorties while I’m recuperating.” Another sharp pain jolted him and his face contorted,
“Whoa,” said Nicole. “It’s not certain yet. We need a little more data first.” She repeated the earlier data dump, now using the extra two minutes of information that had been recorded since she arrived in the lobby. This time the diagnosis read 92% likely appendicitis. Nicole was about to routinely check the alternative diagnoses when she felt the commander’s strong hand on her arm.
“If we do this quickly, before too much poison builds up in my system, then this is a straightforward operation for the robot surgeon, isn’t it?”
Nicole nodded.
“And if we spend the time to obtain a diagnostic concurrence from the Earth — ouch — then my body may be in deeper trauma?”
He is reading my mind, Nicole thought at first. Then she realized that the general was only displaying his thorough knowledge of the Newton procedures.
“Is the patient trying to give the doctor a suggestion?” Nicole asked, smiling despite Borzov’s obvious pain.
“I wouldn’t be that presumptuous,” the commander answered with just a trace of a twinkle in his eye.
Nicole glanced back at the monitor. It was still blinking 92% likely appendicitis. “Do you have anything to add?” she said to Janos Tabori.
“Only that I have seen an appendicitis before,” the little Hungarian answered, “once, when I was a student, in Budapest. The symptoms were exactly like this.”
“All right,” Nicole said. “Go prepare RoSur for the operation. Admiral Heilmann, will you and cosmonaut Yamanaka help General Borzov to the infirmary please?” She turned around to Francesca. “I recognize that this is big news. I will allow you in the operating room on three conditions. You will scrub like all the surgical staff. You will stand quietly over against the wall with your camera, And you will absolutely obey any order that I give you.”
“Good enough,” Francesca nodded. “Thank you.”
Irina Turgenyev and General O’Toole were still waiting in the lobby after Borzov left with Heilmann and Yamanaka. “I’m certain that I speak for both of us,” the American said in his usual sincere manner. “Can we help in any way?”
“Janos will assist me while RoSur performs the operation. But I could use one more pair of hands, as an emergency backup.”
“I would like to do that,” O’Toole said. “I have some hospital experience from my charity work.”
“Fine,” replied Nicole. “Now come with me to clean up.”
RoSur, the portable robot surgeon that had been brought along on the Newton mission for just this kind of situation, was not in the same class, in terms of medical sophistication, as the fully autonomous operating rooms at the advanced hospitals on Earth. But RoSur was a technological marvel in its own right. It could be packed in a small suitcase and weighed only four kilograms. Its power requirements were low. And there were more than a hundred configurations in which it could be used.
Janos Tabori unpacked RoSur. The electronic surgeon didn’t look like much in its stowed configuration. All of its spindly joints and appendages were neatly arranged for easy storage. After Janos rechecked his RoSur User’s Guide, he picked up the central control box of the robot surgeon and affixed it, as suggested, to the side of the infirmary bed where General Borzov was already lying. His pain had only subsided a little. The impatient commander was urging everyone to hurry.
Janos entered the code word identifying the operation. RoSur automatically deployed all its limbs, including its extraordinary scalpel!hand with four fingers, in the configuration needed to remove an appendix. Nicole then entered the room, her hands in gloves and her body covered with the white gown of the surgeon.
“Have you finished the software check?” she said.
Janos nodded his head.
“I’ll complete all the preoperation tests while you scrub,” she said to him. She motioned for Francesca and General O’Toole, both of whom were standing right outside the door, to enter the small room. “Any better?” she said to Borzov.
“Not much,” he grumbled.
“That was a light sedative I administered. RoSur will give you the full anesthetic as the first step in the operation.” Nicole had done all her memory refreshing in her room while she was dressing. She knew this operation inside out; it had been one of the surgical procedures they had performed during the test simulations. She entered Borzov’s personal data file into RoSur, hooked up the electronic lines that would bring patient monitor information to RoSur during the appendectomy, and verified that all the software had passed self-test. As her last check, Nicole carefully tuned the pair of tiny stereo cameras that worked in concert with the surgical hand.
Janos came back into the room. Nicole pressed a button on the robot surgeon’s control box and two hard copies of the operations sequence were quickly printed. Nicole took one and handed the other to Janos. “Is everyone ready?” she asked, her eyes on General Borzov. The commanding officer of the Newton moved his head up and down. Nicole activated RoSur.
One of the robot surgeon’s four hands gunned an anesthetic into the patient and in one minute Borzov was unconscious. As Francesca’s camera recorded every move of this historic operation (she was whispering occasional comments into her ultrasensitive microphone), the scalpel hand of RoSur., aided by its twin eyes, made the incisions necessary to isolate the suspect organ. No human surgeon had ever been so swift or deft. Armed with a battery of sensors checking hundreds of parameters every microsecond, RoSur had folded back all the requisite tissue and laid the appendix bare within two minutes. Programmed into the automatic sequence was a thirty-second inspection time before the robot surgeon would continue with the removal of the organ.
Nicole bent over the patient to check the exposed appendix. It was neither swollen nor inflamed. “Look at this, quick, Janos!” she said, her eye on the digital clock counting down the inspection period. “It looks perfectly healthy.” Janos leaned over from the opposite side of the operating table. My God, Nicole thought, we’re going to remove… The digital clock read 00:08. “Stop it,” she shouted. “Stop the operation.” Nicole and Janos both reached for the robot surgeon control box at the same time.
At that instant the entire Newton spacecraft lurched sideways. Nicole was thrown backward, against the wall. Janos fell forward, smacking his head against the operating table. His outstretched fingers landed on the control box and then slowly released as he slumped to the floor. General O’Toole and Franceses were both thrown against the far wall. A beep, beep from one of the inserted Hakamatsu probes indicated that someone in the room was in serious trouble physically. Nicole checked briefly to see that O’Toole and Sabatini were all right and then struggled against the continuing torque to regain her position next to the operating table. With great effort she pulled herself across the room on the floor, using the anchored legs of the table. When she was beside the table she steadied herself, still holding on to the legs, and stood up.
Blood spattered Nicole as her head crossed the plane of the operating table. She stared with disbelief at Borzov’s body. The entire incision was full of blood and RoSur’s scalpel!hand was buried inside, apparently still cutting away. It was Borzov’s probe set that was going beep, beep, despite the fact that Nicole had inserted, by command, significantly wider emergency values just before the operation.
A wave of fear and nausea swept through Nicole as she realized that the robot had not aborted its surgical activities. Holding on tight against the powerful force trying to push her against the wall again, she somehow managed to reach over to the control box and switch off the power. The scalpel withdrew from the pool of blood and restowed itself against a stanchion, Nicole then tried to stop the massive hemorrhaging.
Thirty seconds later the unexplained force vanished as suddenly as it had appeared. General O’Toole clambered to his feet and came over beside the now desperate Nicole. The scalpel had done too much damage. The commander was bleeding to death before her eyes. “Oh, no. Oh, God!” O’Toole said as he surveyed the wreckage of his friend’s body. The insistent beep, beep continued. Now the life system alarms around the table sounded as well. Francesca recovered in time to record the final ten seconds of Valeriy Borzov’s life.
It was a very long night for the entire Newton crew. In the two hours immediately after the operation, Rama went through a sequence of three more maneuvers, each, like the first one, lasting one or two minutes. The Earth eventually confirmed that the combined maneuvers had changed the attitude, spin rate, and trajectory of the alien spaceship. Nobody could ascertain the exact purpose of the set of maneuvers; they were just “orientation changes,” according to the Earth scientists, that had altered the inclination and line of apsides of the Rama orbit. However, the energy of the trajectory had not been changed significantly — Rama was still on a hyperbolic escape path with respect to the Sun.
Everyone onboard the Newton and on Earth was stunned by the sudden death of General Borzov. He was eulogized by the press of all nations and his many accomplishments were lauded by his peers and associates. His death was reported as an accident, attributed to the untimely motion of the Rama spacecraft that had taken place during the middle of a routine appendectomy. But within eight hours after his death, knowledgeable people everywhere were asking tough questions. Why had the Rama spacecraft moved at exactly that time? Why had RoSur’s fault protection system failed to stop the operation? Why were the human medical officers presiding over the procedure not able to switch off the power before it was too late?
Nicole des Jardins was asking herself the same questions. She had already completed the documents required when a death occurs in space and had sealed Borzov’s body in the vacuum coffin at the back of the military ship’s huge supply depot. She had quickly prepared and filed her report on the incident; O’Toole, Sabatini, and Tabori had all done the same. There was only one significant omission in the reports. Janos failed to mention that he had reached for the control box during the Raman maneuver. At the time Nicole did not think his omission was important.
The required teleconferences with ISA officials were extremely painful. Nicole was the person who bore the brunt of all the inane and repetitious questioning. She had to reach deep inside herself for extra reserves to keep from losing her temper several times. Nicole had expected that Francesca might hint at incompetence on the part of the Newton medical staff in her teleconference, but the Italian journalist was evenhanded and fair in her reportage.
After a short interview with Francesca, in which Nicole discussed how horrified she had been at the moment she had first seen Borzov’s incision filled with blood, the life science officer retired to her room, ostensibly to rest and!or sleep. But Nicole did not allow herself the luxury of resting. Over and over she reviewed the critical seconds of the operation. Could she have done anything to change the outcome? What could possibly explain RoSur’s failure to stop itself automatically?
In Nicole’s mind there was little or no probability that RoSur’s fault protection algorithms had a design flaw; they wouldn’t have passed all the rigorous prelaunch testing if they contained errors. So somewhere there must have been a human error, either negligence (had she and Janos, in their haste, forgotten to initialize some key fault protection parameter?) or an accident during those chaotic seconds following the unexpected torque. Her fruitless searching for an explanation and her almost total fatigue made her extremely depressed when she finally fell asleep. To her, one part of the equation was very clear. A man had died and she had been responsible.