Abyss Deep (13 page)

Kirchner wasn't there. That surprised me. I'd figured he would be there to put the boot in, as it were. “HM2 Carlyle, reporting for mast, as ordered, ma'am.”

“Stand at ease, Carlyle.” She gave me a sharp look up and down. “You seem to be making a habit of coming to captain's mast.”

“That certainly was not my intent, ma'am.”

“I suppose not. Dr. Kirchner says you disobeyed explicit orders in the handling of a patient last night. What do you have to say about that?”

Well, what
could
I say? Dr. Kirchner was an officer and a doctor and I was a mere petty officer second class . . . the equivalent of a sergeant in the Marines or Army. If it came down to his word against mine in an argument over medical procedure or diagnosis, guess who was going to win?

And if I criticized Kirchner in any way, or tried to point out that he'd been acting strangely since he'd come aboard, or called him an asshole or even just said something snarky about how I didn't know what his problem was, it was certain to rebound back against me. I would be the one with the attitude problem . . . or the one who thought he knew it all.

“I don't know what to say, Captain,” I replied. “I
did
disobey an order, but I was worried about missing a spinal fracture. I was trained to . . . well, if a guy falls on his head, you
always
check for spinal injury along with the obvious head trauma.”

“And Dr. Kirchner didn't do this?”

I grimaced. “You can use the CC rack to get X-­rays of the patient, ma'am. But there's a chance of missing something. You have a much better chance of seeing it on the soft-­tissue scan.”

“So you were second-­guessing the doctor.”

I could see which way this was going. “Yes, ma'am. No excuse, ma'am.”

“Why?”

“Ma'am . . . when a patient has a serious head injury—­
especially
if he falls on his head, or is in a serious accident—­you always assume there's a C-­spine injury as well, until you can rule it out. Always.”

“But as I understand it, Dr. Kirchner
was
making that assumption. He didn't want you risking that additional patient transfer onto the scan table, and then from there to the critical-­care rack, which did have the diagnostic equipment required to determine if Pollard had a spinal injury.”

There are very rarely clear-­cut situations in emergency medicine.

“That's . . . that's correct, ma'am.”

What, I wondered, was Summerlee going to do to me? I was already confined to quarters—­which essentially meant the ship. She might extend the extra duty, which was pretty much a joke to begin with since I didn't have much else to do. Or she might write me up with a recommendation for further disciplinary action when we got back to Earth. Or . . .

Her office door chimed. “What is it? I'm busy!”

The door opened and Chief Garner came in. “Captain? I've got something you ought to see.”

“About this case?”

“Yes, ma'am. May I?”

She nodded, and Garner looked at the captain's viewall, which switched on with his thoughtclick. Pollard's three-­D STS image came up on the bulkhead, eerily translucent, rotating in space.

“Those images were deleted!” I said. “I watched Kirchner do it!”

“
Doctor
Kirchner,” Summerlee said, stressing the title.

“Yes, ma'am.”

“The doctor deleted the images from the table,” Garner said, “but there's
always
a record with the AI that runs the medical-­imaging systems.”

True. But it was also true that to get at those records, you needed special authorization. Kirchner—­sorry,
Dr.
Kirchner—­could have given it, though that hardly seemed likely. Captain Summerlee could have ordered it, but she obviously was as surprised by Garner's arrival as I was. Fleet Command or a medical review board could have given the necessary authorization . . . but they were light years away, now, and even if there was such a thing as faster-­than-­light radio, we were wrapped up inside our Alcubierre warp bubble, in effect barricaded inside our own private universe.

Garner was steering the viewpoint on the image in toward the side of Pollard's neck, which grew so huge against the viewall that all we could see were his cervical vertebrae, neatly interlocked and protecting the all-­important spinal cord within. The image continued to expand until we were looking at a pair of vertebrae, one atop the other, now stretching across three meters of space and still expanding slowly.

“There,” Garner said. “You see it, ma'am?”

“I'm not sure what I'm looking at.”

“C6, the sixth cervical vertebra down from the spine.” He touched the back of his neck, right above his shoulders. “Just about here.” A hair-­thin line appeared in the bone, highlighted by the imaging program. “That is a hairline compression fracture, ma'am. And if you'll notice, the entire vertebra is very slightly out of line with the one above, with C5. See how it's pushed forward a bit? The medical term is
spondylolisthesis
, the forward slippage of one vertebra over another.”

The bone faded away, revealing a slender trunk of tissue hidden inside, with branches extending out and down.

“No damage to the spinal cord, thank God,” Garner said. “But the slippage was putting some pressure on the nerves just about here. See the swelling?
Any
movement at all and that fracture could have split and shifted.”

“And that would have killed him?”

“That, or it would have left him paralyzed from the neck down.
That
we could have fixed, once we got him back to a big hospital Earthside. But, yeah, it could also have killed him, at least temporarily. Pollard had a CAPTR program on file—­all of the Marines do—­so we could have downloaded his backup once we repaired his body, but, well—­”

“But it's not the same. I know.”

Summerlee didn't say it, but I could feel her thinking the unpleasant word.
Zombie
.

The bone faded back into view on the screen, the minute fracture again visible. “So, would this have shown up on X-­rays?”

“It did not, ma'am. I couldn't see it, at any rate.”

“What about the . . . what did you call it? The slippage?”

“Spondylolisthesis, ma'am. That depends on the exact angle of the X-­ray shot. I missed it when I saw the X-­rays last night. If you know exactly what to look for, you can maybe see that the one vertebra is very slightly out of line, but it's not obvious.”

“I see. So you are challenging Dr. Kirchner's handling of the case?”

“Challenging? No, ma'am. Not really. Medicine is not an exact science, whatever they say. It's an
art
, and success in medicine depends on luck and skill and training and
really
good instincts. Private Pollard was very, very lucky, ma'am. And Carlyle here had some excellent instincts going for him.”

“Has Dr. Kirchner seen these images?”

“No, ma'am. I just pulled them down from the sick bay AI.”

“Uh-­huh.” I wondered if she was going to call Garner on his unauthorized tapping of sealed medical records. “And how's the patient?”

“Doing well, ma'am. His condition is stable and improving. The swelling inside his skull is down, now that we have it drained, and the intracranial bleeding has stopped. His head and neck are immobilized, of course, but we've applied a very slight traction to his head, which let the surrounding soft tissue push the misalignment back into place. Now we have nanobots beginning to reconnect the bone. We're applying low-­intensity pulsed ultrasound to accelerate bone growth. The prognosis for a full recovery is excellent.”

“In how long?”

“Two, maybe three weeks.”

“I see.” Summerlee looked at me. “So, Carlyle, it seems that you have . . . good instincts.”

I said nothing. It seemed the safest course of action.

“However,” she went on, “those instincts have left us with a rather serious problem.”

“Yes, ma'am,” Garner said. He didn't look happy.

“I cannot relieve Doctor Kirchner of his responsibilities as expedition medical officer, nor can I challenge his fitness as a physician. That would require a medical board back on Earth. And if Petty Officer Carlyle goes back to working in sick bay, it will raise . . . issues.”

She was dead right there. I'd just been wondering how the hell I was going to fit back into shipboard routine after this little . . . misunderstanding.

“We all make mistakes, ma'am,” Garner said.

“Indeed. But when doctors make mistakes, ­people die. I can't sideline him. I can't even write him up for a reprimand, because I don't have the medical training to sit in judgment on his decisions.”

“If I could make a suggestion, ma'am?”

“By all means, Chief. I would love to hear it.”

“Nurses and Corpsmen are used to . . . let's call it
managing
doctors.”

“How do you mean?”

“Look, doctors are busy, okay? In a hospital, they sweep into a patient's room, half the time in conversation with an expert AI so they're not really there. They look at the test results, prescribe a round of treatment, and they're gone, usually muttering to themselves. It's the nursing staff that's with the patient all the time, including the patient-­care AI that's supervising everything.”

“So?”

Garner's expression said he didn't really want to go into the details. “Don't get me wrong. There are good doctors out there,
really
good ones. But there always are a few bad apples, and nursing staffs know how to take up the slack and look after the patients' best interests.”

“That's horrifying.”

Garner shrugged. “It's the way things are. The medical community—­other doctors, mostly—­tend to close ranks and protect the bad ones. Sometimes it's tough to tell which ones are genuinely
bad
, and which ones are just having a bad day.”

“Is Dr. Kirchner . . . a bad doctor?”

“Ma'am . . . I don't know. I don't even want to guess. It's not my place to say.”

“Take a shot at it.”

“Ma'am, he
must
know his stuff. He taught medicine at SMMC, and that's not a billet for mediocrity. But since he's come aboard, he's been abrupt, short-­tempered, rude, and making snap decisions that . . . aren't always the best. He doesn't
listen
—­”

“None of which makes him incompetent. He sounds like he's a little shy on ­people skills.”

“Yes, ma'am.”

I'd been wondering if they'd forgotten I was in the room, but now the captain looked at me.

“What do you think, Carlyle?”

“I don't think Dr. Kirchner is incompetent, ma'am. He's been acting like . . . I don't know. Like he has personal problems, maybe? Stress at home . . . or maybe he didn't want to come on this expedition.”

“Mm. Point. How do you feel about going back to work with him?”

Damn, what was I supposed to say to that? “I'm not exactly looking forward to it, ma'am . . . but I'll do what I'm told to do.”

“What do you have to say about the idea of protecting patients from the man?”

“Well . . . Chief Garner is right. That sort of thing does happen. Not very often, thank God, but sometimes a doctor gets assigned to a duty station, and you wonder how he ever got through medical school. The nursing staff has to follow his orders . . . but they know when the physician in charge makes a bad call. And . . . well, I don't expect that there'll be mass casualties on the
Haldane
, ma'am. The crew and the Marine complement on board are all healthy. All we're likely to have are minor complaints and the odd case of accidental trauma, like Pollard.”

“You're saying Dr. Kirchner can't do that much damage.”

“I guess so, ma'am.”

“And when we get to Abyssworld?”

That stopped me. As senior medical officer, Dr. Kirchner would be responsible for everyone on
Haldane
operating in a highly dangerous, extremely unforgiving environment . . .
and
he would be the biochemistry expert backing up our civilian specialists, Drs. Montgomery and Ortega.

“You know, Captain,” Garner put in, “that if the cuttlewhales turn out to be intelligent . . . Dr. Kirchner might be lacking ­people skills, but the cuttlewhales aren't
­people
.”

It was a lame attempt at humor, and no one laughed.

“Okay,” Summerlee said, arriving at a decision. “I'll have a private word with Dr. Kirchner about his . . . attitude. Carlyle . . . I'm dropping all charges against you.”

The relief I felt was palpable, a warm flush from the head down. “Thank you, ma'am.”

“I'm assigning you to First Section, where you'll serve as resident Corpsman. Understand?” The MSEP was divided into two sections, First and Second, with twenty-­four Marines in each.

“Yes, ma'am.” She was essentially pulling me out of sick bay and sticking me in with the Marines full-­time. I wouldn't have a lot to do, but it would keep me out of Kirchner's sight.

“Chief? That means the other Corpsmen will be standing a watch-­in-­three. Is that okay?”

One of us always had to be in the sick bay, in case there was an emergency, like last night. Garner didn't stand watches, which meant the remaining four of us split up two night watches—­1600 to 2400, and 2400 to 0800. That meant that we got a full night's sleep every other night. Taking a watch-­in-­three meant that the other Corpsmen would have to cover for me, basically working two nights, and getting off the third.