Star Healer

CHAPTER 15

Hossantir made a sound which did not translate, and its manipulators holding the long-handled instruments moved with incredible slowness as they felt about in the totally obscured operative field. Its assistant, also moving with a lack of urgency which could only have been subjective to Conway’s racing mind, introduced a clamp but could not find the vessel which was hemorrhaging. Trained as he was to react quickly and positively to such emergencies, Conway did not move slowly.

He could not move at all.

His hands, his stupid five-fingered, Earth-human, and utterly alien hands, trembled uncontrollably while his multiple mind tried desperately to decide what to do with them.

He knew that this kind of thing could happen to medics who were carrying too many tapes, but that it should not happen too often if the Doctor concerned hoped to make it as a Diagnostician. Frantically, he tried to impose order on the warring factions within his mind by calling up the memory of O’Mara, who was totally unsympathetic where disorderly thinkers were concerned-in particular, the memory of the Chief Psychologist telling him what the Educator tapes were and, more importantly, what they were not.

No matter how he felt subjectively, his mind was not being taken over by the alien personalities who were apparently sharing it-his Earth-human mind had simply been given a large quantity of extraterrestrial knowledge on which it could draw. But it was very difficult to convince himself of that when the other-species material in his mind belonged to medical people with their own individual ideas on how he should react to this emergency.

The ideas were very good, particularly those of the Melfan and Tralthan components. But they required the use of ELNT pincers or FGLI primary manipulators, not Earth-human fingers, and he was being urged to do too many things at once with the wrong organic equipment.

Hossantir’s Melfan assistant whose ID, like everything else in the immediate area, was obscured by the bloody spray, said urgently, “I can’t see. My visor is—”

One of the nurses quickly cleaned the helmet in front of the eyes, not wasting time on the rest of the transparent bubble. But the fine red spray was re-covering it as Conway watched. And that was not the only problem, because, deep inside the operative field, the light sources on the instruments were likewise obscured.

The Tralthan Senior had been closest so that only the front of its bubble helmet had been affected. One of its eyes curled back to regard Conway through the still transparent rear section.

“We require assistance, Conway. Can you suggest a …” Hossantir began; then it noticed the trembling hands and added, “Are you indisposed?”

Conway clenched his fists slowly — everything seemed to be happening in the slowest of slow motion-and said, “It is temporary.”

Silently he added, I hope.

But the alien personalities who were not really there were still clamoring for attention. He tried to ignore all but one of them at a time, thinking vaguely of the principle of divide and rule, but that did not work either. All of them were offering medical or surgical advice, all of it had potential value in the present situation, and all of it called for an immediate response. The only available material which did not force itself forward was the Gogleskan data accidentally provided by Khone, and that was of little value anyway. But for some reason his mind kept returning to it, holding on to that frightened but strong-willed alien personality as if it were some kind of psychological life-raft.

Khone’s presence was not at all like the sharp, intense, and artificially enhanced impressions produced by the Educator tapes. He found himself concentrating on the little being’s mental imprint, even though the strange and visually terrifying creatures around the operating frame threatened to throw it into a panic reaction. But the Gogleskan data also included material on Conway’s work at the hospital, transferred to its mind during the mishap on Goglesk, and this to a certain extent had prepared Khone for just this kind of experience. It was also a member of a race of individualists whose mental processes were adept at avoiding contact with, or of negating the influence of, other beings around them.

More than any other entity in Conway’s experience, Khone knew how to ignore people.

All at once his hands were no longer shaking and the alien babel within his mind had quieted to an insistent murmur which he could choose to ignore. He tapped the Melfan assisting Hossantir sharply on its carapace.

“Please withdraw and leave your instruments in position,” he said. To the Tralthan Senior he added, “The bleeding is obscuring everything in the operative field, including the magnifiers and light sources of the instruments and, if we approach closely, our visors. We must …

“Suction isn’t working, Conway,” Hossantir broke in, “and won’t until the flow has been checked at source. But we can’t see the source!”

… Use the scanners,” Conway continued quietly, enclosing the tiny, hollow-coned handles of the Melfan clamp with his Earthhuman fingers, “in conjunction with my hands and your eyes.

Since normal vision was useless because of his helmet’s close proximity to the spray from the wound, Conway’s idea was that Hossantir use two scanners angled so as to bear on the operative field from two viewpoints as far apart as possible. This would give an accurate stereoscopic picture of what was happening which the Senior could describe for him and guide the movements of his clamp. He would be operating blind, but only long enough to find and seal off the bleeder, after which the operation would proceed in the normal way. It would be a very uncomfortable few minutes for Hossantir, two of whose four eyes would be extended laterally to the limits of its flattened, ovoid helmet. It would also have to withdraw temporarily from the operation, Conway told it apologetically, so that its scanners and helmet would not be affected by the spray.

“This could give me a permanent squint,” Hossantir said, “but no matter.”

None of his alter egos saw anything funny in the idea of a great, elephantine Tralthan with a squint in two of its widely extensible eyes. Fortunately, a smothered Earth-human laugh was not translatable.

His hands and the instruments felt heavy and awkward, and not just because he was using Melfan clamps. The gravity nullification field surrounding him did not, of necessity, extend to the patient, so that everything at the operating site weighed four times heavier than normal. But the Tralthan used its scanners to guide him verbally to the blood vessel which had to be origin of the massive hemorrhaging, and considering the elevated blood pressure of the Hudlar life-form, he expected to feel resistance as he clamped it off.

There was none, and the bleeding continued with undiminished force.

One of his alter egos had encountered something like this situation during a transplant on an entirely different life-form, a diminutive Nidian whose blood pressure had been only a fraction of that of this Hudlar. On that occasion the blood flow had also been a fine spray rather than the pulsing stream characteristic of arterial bleeding, and the trouble had been due to a mechanical failure rather than to faulty surgical technique.

Conway was not sure if that was the problem here, but a part of his multiple mind felt sure, and he decided to trust that part.

“Stop the artificial heart,” he said firmly. “Cut off the blood supply to the area.

“We can easily make good the blood loss,” Hossantir objected, “but cutting off circulation for more than a few minutes could kill the patient.”

“Do it now,” Conway said.

Within a few seconds the bright red spray had subsided and died. A nurse cleaned Conway’s visor while Hossantir used suction to clear the operative field. They did not need the scanners to see what had happened.

“Technician, quickly,” Conway said.

Before he had finished speaking there was a furry little Nidian, looking like a gift-wrapped teddy bear in its transparent OR suit, hovering beside his elbow.

“The nonreturn valve of the connector is jammed in the closed position,” the Nidian said in its staccato, barking speech. “This was caused, I would say, by the valve setting being altered accidentally when it was struck by one of the surgical instruments. The flow from the artificial heart has been blocked and was forcing its way out via the recess of the valve setting control, hence the fine, highpressure spray. The valve itself isn’t damaged, and if you will raise the organ so that I will have space to reset the valve …”

“I’d rather not move the heart,” Conway said. “We are very short of time.”

“I am not a doctor,” the Nidian said crossly. “This repair should properly be performed on a workbench, or at least in an area with room for my admittedly small elbows. Working in close contact with living tissue is … is repugnant to me. However, my tools are sterile in readiness for such emergencies.”

“Do you feel nauseous?” Conway asked worriedly. He had visions of the little being choking inside its helmet.

“No,” the Nidian said, “just irritated.”

Conway withdrew his Melfan instruments to give the technician more room to work. A nurse had clipped a tray of Earth-human DBDG instruments to the frame beside him, and by the time he had selected the ones he would need the Nidian had freed the jammed valve. Conway was thanking the little being for the speed of the repair when Hossantir broke in.

“I’m restarting the artificial heart,” it said.

“No, wait,” Conway said sharply. He was looking at the monitor and getting a feeling-a very vague feeling that was not strong enough even to be called a hunch-that any delay at all would be dangerous. “I don’t like the vital signs. There is nothing there which should not be there, considering that the flow from the artificial heart was interrupted, initially by the jammed connector valve and later when the system was shut down during the repair. I realize that if the artificial heart is not restarted within the next few minutes, irreversible changes leading to termination will take place in the brain. Even so, I have the feeling that we should not restart but go instead for an immediate resection of the replacement orgao …

He knew that Hossantir would want to object and take the safer course, that of restarting the artificial heart and waiting until they were sure that the patient’s circulation had returned to optimum, and then proceed as originally planned. Normally Conway would not have argued against this, because he, too, preferred not to take unnecessary risks. But there was something niggling at the back of his mind, or one of his minds, something about the effect of longterm trauma on certain gravid, heavy-gravity life-forms, and the feeling was so persistent that he had to act on it. And while he had been speaking, Conway had unclipped his instruments to show Hossantir, nonverbally so that the Senior’s feelings would not be hurt too much, that he was not about to argue the point.

“… Will you work on the connection to the absorption organ, please,” he ended, “and keep an eye on the monitor.”

Sharing the operative field with the Tralthan, Conway worked quickly and carefully in the restricted space, clamping off the artery beyond the artificial heart connection, detaching it, and reconnecting it to the arterial stub projecting from the replacement organ. Unlike the first, shocking seconds of the earlier hemorrhaging, time seemed to have speeded up. His hands and instruments were well outside the field of the nullifiers, being acted on by four Earth-Gs, so they felt incredibly slow and awkward. Several times his instruments clinked loudly against those of Hossantir. He could sympathize with the surgeon, whoever it had been, who had accidentally knocked that connector valve off its setting. He had to concentrate hard to keep his instruments from leading a life of their own.

He did not watch Hossantir’s work, because the Tralthan knew its stuff and there was no time for surgical sightseeing.

He inserted retaining sutures to hold the artery in position on each end of the connector, which was designed both to hold the ends firmly in position when circulation was restored and to keep the sections of original and replacement tissue apart so as to reduce postoperative rejection problems. There were times when, immunologically speaking, he wondered why a highly evolved and complex organism should be its own worst enemy. Next he began the linkup of the vessel which supplied nutrient from the absorption organ to one of the major heart muscles.

Hossantir had completed its connection and had turned its attention to the minor vessel which supplied one half of the womb when the Hudlar was in female mode-the second, undamaged heart had been performing double duty since the start of the operation. They were short of time, but as yet not dangerously so, when the Tralthan indicated the Monitor with a free appendage.

“Ectopics,” Hossantir said. “One in five, no, one in four. Pressure is reducing. The indications are that the heart will go into fibrillation and arrest very quickly. The defibrillator is ready.”

Conway took a quick look at the visual display where the irregular, ectopic heartbeat broke into the normal rhythm once in every four beats. From experience he knew how soon it could degenerate into a rapid, uncontrollable flutter and, with the subsequent loss of the pumping function, failure. The defibrillator would almost certainly shock it into action again, but that device could not be used while the operation on the replacement heart was in progress. He resumed his work with desperate, careful speed.

So deep was his concentration that all of his minds were becoming involved again, contributing their expertise and at the same time their irritation that it was a set of Earth-human hands which were doing the work and not the assorted manipulators, pincers, and digits of his alter egos. He looked up finally to find that Hossantir and he had finished their connections at the same time. But a few seconds later the other heart went into fibrillation, then arrest. Their time was really short now.

They eased the clamps on the main artery and secondary vessels and watched the flaccid replacement organ swell slowly as it was filled with Forty-three’s blood, checking with their scanners for the formation of air embolisms. There were none, so Conway placed the four tiny electrodes in position preparatory to restarting the replacement heart. Unlike the defibrillator charge needed for the other heart, which would have to penetrate more than ten inches of hard, Hudlar tegument and underlying tissue, these electrodes would be acting directly on the surface muscles of the replacement organ and would be carrying a relatively mild charge.

The defibrillator brought negative results. Both hearts fluttered unsteadily for a few moments and then subsided.

“Again,” Conway said.

“The embryo has arrested,” Hossantir said suddenly.

“I was expecting that,” Conway said, not wanting to sound omniscient, but neither did he have the time for explanations.

Now he knew why he had wanted to complete the replacement connections so fast after the emergency with the valve. It had been not a hunch but a memory from the past when he had been a very junior intern, and the memory was one of his own.

ft had happened during his first lecture on the FROB life-form, which had been given by the Diagnostician-in-Charge of Pathology, Thornnastor. Conway had made a remark to the effect that the species was fortunate in having a standby heart if one should fail. Conway had meant it as a joke, but Thornnastor had jumped on him, figuratively speaking, with all six of its feet for making such a remark without first studying the Hudlar physiology in detail. It had gone on to describe the disadvantages of possessing two hearts, especially when the possessor was a gravid female-mode Hudlar nearing parturition, and the nerve network which controlled the involuntary muscle system was maintaining a delicate balance between the impulses to four hearts, two parental and two embryonic. At that particular stage the failure of one heart could quickly lead to the arrest of the other three.

“And again,” Conway said worriedly. The incident had not been worth remembering then, because major surgery on FROBs was considered to be impossible in those days. He was wondering if survival for this particular Hudlar was impossible now when both of its hearts twitched, hesitated, then settled into a strong, steady beat.

“The fetal hearts are picking up,” Hossantir said. A few seconds later it added, “Pulse-rate optimal.”

On the sensor screen the cerebral traces were showing normal for a deeply unconscious Hudlar, indicating that there had been no brain damage as a result of the few minutes cessation of circulation, and Conway began to relax. But oddly, now that the emergency was over the other occupants of his mind were becoming uncomfortably obtrusive. It was as if they, too, were relieved and were reacting with too much enthusiasm to the situation. He shook his head irritably, telling himself once again that they were only recordings, simply stored masses of information and experience which were available to his, Conway’s, mind to use or ignore as he saw fit. But then the uncomfortable thought came to him that his own mind was simply a collection of knowledge, impressions, and experience collected over his lifetime, and what made his mind data so much more important and significant than that of the others?

He tried to ignore that suddenly frightening thought by reminding himself that he was still alive and capable of receiving new impressions and continuously modifying his total experience as a result of them, while the taped material had been frozen at the time it had been donated. In any case, the donors were long since deceased or far removed from Sector General. But Conway’s mind felt as though it was beginning to doubt its own authority, and he was suddenly afraid for his sanity.

O’Mara would be furious if he knew Conway was indulging in this kind of thinking. So far as the Chief Psychologist was concerned, a Doctor was responsible for his work and for the tools, both physical and psychological, which enabled him to do that work. If the Doctor could not perform satisfactorily, then the person concerned should seek a less demanding job.

There were few jobs more demanding than that of a Diagnostician.

His hands were beginning to feel wrong again, and the fat, pink, and strangely awkward fingers were trembling. Conway stowed away his DBDG instruments and turn — ed to Hossantir’s Melfan assistant, whose ID was still smeared with blood and only partly readable, and said, “Would you like to resume, Doctor?”

“Thank you, sir,” the ELNT said. Obviously it had been worrying in case Conway, as a result of his intervention, had thought the Melfan incapable of doing the work. Right now, he thought grimly, the opposite is true.

“It is not expected,” Hossantir said gravely, “that you should do everything yourself, Conway.”

Plainly the Tralthan knew that something was wrong with him- Hossantir’s eyes missed nothing, even when all four of them seemed to be looking in other directions. Conway watched for a few minutes until the team had closed up, then he left Forty-three to check on the progress of the other two patients. Psychologically he felt unwell.

The organ of absorption had been successfully transplanted into Ten, and Edanelt and his team were busy with the microsurgery required on the replacement limbs. The patient was out of danger, however, because the new organ had been tested with an application of nutrient paint and the sensors showed that it was performing satisfactorily. While he was complimenting the team on its work, Conway stared at the heavy staples which held the edges of the wound together-so closely sutured were they that the wound looked like an enormous zip-fastener. But nothing less would serve to hold an FROB’s hard, thick, and incredibly tough hide together, and the material of the staples was molecularly unstable so that they could be rendered flexible for withdrawal when the healing process was complete.

But an almost invisible scar, the Hudlar component of Conway’s mind insisted, would be the least of this patient’s problems.

All at once Conway wanted to run away from all this major surgery and its attendant postoperative problems, instead of having to make yet another examination of a third Hudlar patient.

Yarrence had concentrated its efforts on the cranial injury, leaving FROB-Three’s abdominal wound to the medics freed by the demise of FROB-Eighteen, while the remaining members of both teams were deployed on the limb amputation and replacement work. It was obvious after the first few minutes that they were engaged in performing a very complex but smooth-running operation.

From the talk around the frame he gathered that it was also an operation without precedent. To Conway it had seemed to be an obvious solution to FROB-Three’s problem, replacing the missing forelimbs with two from the rear. While not as precise as the originals they would be much more satisfactory in every way than the prosthetics, and there would be no rejection problems. He had read in the old medical texts of Earth-human arm amputees learning to draw, write, and even eat with their feet, and the Hudlar feet were much more adaptable than those of an Earth-human DBDG. But the admiration that simple solution had aroused among the team was making Conway feel embarrassed, because, given the present circumstances, anyone could have thought of it.

It was the circumstances which were without precedent-the Menelden disaster with its aftermath of massively injured Hudlars requiring transplant surgery together with the ready availability of spare parts. The possibility of one of the transplant cases being able to return to its home planet with the bonus of a pair of forelimbs which were almost as good as the originals was an idea which would have occurred to any moral coward like himself, who dreaded those postop conversations with patients whose transplants were from normal donors rather than from themselves.

Conway made a mental note to separate FROB-Three from Ten and Forty-three before they returned to consciousness and could begin talking together. The atmosphere between Three and its two less fortunate colleagues would be strained to say the least, and their convalescence would be difficult enough without two of the three being eaten up with envy.

Consideration of the FROB’s problems had brought his Hudlar component into prominence again, and it was difficult not to sympathize and suffer at the thought of his patient’s postoperative lifestyle. He tried to bring forward the material on the Tralthan, Melfan, and Kelgian components who, as other-species medics, should have been more clinical regarding the situation. But they, too, were overly sympathetic and their responses painful. In desperation he called up the material of Khone, the Gogleskan, who retained its sanity and intelligence by isolating itself from all close contacts with its fellows.

The Gogleskan material was not at all like that of an ordinary Educator tape. It had more texture, more immediacy, as if another person were truly sharing his mind, however reluctantly. With this degree of understanding between them, he wondered how it would feel to meet and talk to Khone again.

It was unlikely to happen in the hospital, Conway was sure, because the experience of staying in Sector General would probably drive Khone insane, and O’Mara would never allow it anyway. One of the Chief Psychologist’s strictest rules was that tape donors and carriers must never be allowed to meet because of the psychological trauma, incalculable in its intensity, which would result if two entities of widely different species, but possessing identical personalities, tried to communicate.

In the light of what had happened to Conway on Goglesk, O’Mara might have to modify that rule.

And now even the problems of the Gogleskans were clamoring for Conway’s attention, as were the Tralthan, Kelgian, Melfan, and Illensan occupants of his mind. Conway moved back to a position where he could watch the activity around all three operating frames without the team-members being able to see his distress. But the alien babel in his mind was so bad that he could scarcely speak, and it was only with a great effort that he could comment on some aspect of the work or give a word of praise to one of the medics. All at once he wanted out, and to escape from his too-demanding selves.

With a tremendous effort he guided his alien fingers to the transmit key for his general communication and said carefully, “You people are too good and there is nothing here for me to do. If a problem should arise, call me on the Red Three frequency. There is a matter which I must attend to at once on the methane level.”

As he was leaving, Hossantir bent an eye-stalk in his direction and said gravely, “Stay cool, Conway.”