Sector General Omnibus 3 - General Practice (49 page)
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Authors: James White
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Asking help from others, which would of necessity reveal the lack of knowledge and ability within himself, was not the Tarlan way. But he had been receiving help from many entities in the hospital, often without
asking for it, and he did not expect that repeating the shameful process would cause any severe emotional trauma.
asking for it, and he did not expect that repeating the shameful process would cause any severe emotional trauma.
As he was leaving Khone’s ward a few minutes later, Lioren wondered if his own habits of thought were beginning to change.
Very slightly, of course.
S
enior Physician Seldal was present because Hellishomar had been its responsibility from the beginning and it had more clinical experience with the patient than any of the others, although that situation was expected to change very soon. The Tralthan Diagnostician-in-Charge of Pathology, Thornnastor, and the equally eminent Earth-human Conway, who had been recently appointed Diagnostician-in-Charge of Surgery, were there to discover why Chief Psychologist O’Mara, who was the only entity with sufficient authority to call such a high-level meeting at short notice, had thought it necessary to bring them together to discuss a patient who was supposedly well on the way to a full recovery.
enior Physician Seldal was present because Hellishomar had been its responsibility from the beginning and it had more clinical experience with the patient than any of the others, although that situation was expected to change very soon. The Tralthan Diagnostician-in-Charge of Pathology, Thornnastor, and the equally eminent Earth-human Conway, who had been recently appointed Diagnostician-in-Charge of Surgery, were there to discover why Chief Psychologist O’Mara, who was the only entity with sufficient authority to call such a high-level meeting at short notice, had thought it necessary to bring them together to discuss a patient who was supposedly well on the way to a full recovery.
It reminded Lioren of his recent court-martial, and even though the arguments would be clinical rather than legal, he thought that when it came the cross-examination would be much less polite. Seldal spoke first.
Indicating the big clinical viewscreen, it said, “As you can see, the Groalterri patient presented with a very large number, close on three hundred, punctured wounds that were equally divided over the dorsal and lateral areas and in the anterior region between the tentacles, where the tegument is thin and affords minimum natural protection. The punctures were apparently caused by a fast-flying and burrowing insect species which laid eggs and introduced infection to the wound sites. The
Nallajim operational procedure was judged to be best suited to the treatment of the condition, and I was assigned. Because of the patient’s unusually large body mass, progress has been slow, but the prognosis is good except for an unfortunate lack of—”
Nallajim operational procedure was judged to be best suited to the treatment of the condition, and I was assigned. Because of the patient’s unusually large body mass, progress has been slow, but the prognosis is good except for an unfortunate lack of—”
“Doctor Seldal,” Thornnastor broke in, its voice sounding like an impatient, modulated foghorn. “Surely you asked the patient how its wounds were sustained?”
“The patient did not give this information,” Seldal said, the rapid, background twittering of its natural voice reflecting its irritation at the interruption. “I had been about to say that it rarely spoke to me, and never about itself or its condition.”
“The distribution of the punctures,” Diagnostician Conway said, speaking for the first time, “is too localized to suggest a random attack by an insect swarm. To my mind, the angles of penetration and the concentration on one clearly defined area indicates a common point of origin, as in an explosion, although I suppose it is possible that Hellishomar disturbed a hive and the insects attacked the parts of its body that were closest to them. From what little we know of the Groalterri species, they have refused to speak to everyone, so the reticence of the patient may be irritating but not unusual. In the past we have all treated our share of uncooperative patients.”
“Hellishomar was cooperative during treatment,” Seldal said, “and when it spoke it did so with politeness and respect, but without saying anything about itself. I suspected that the clinical picture might have psychological implications, and I asked Surgeon-Captain Lioren to speak to the patient in the hope that—”
“Surely this is a matter for the Chief Psychologist,” Thornnastor said impatiently. “What are a couple of busy Diagnosticians doing here?”
“I,” O’Mara said in a quiet voice, “was not consulted.”
Thornnastor’s four eyes and Conway’s two stared at O’Mara for a moment; then all six were directed at Lioren. It was probably fortunate that he could not read Tralthan or Earth-human expressions.
“In the hope,” Seldal went on, “that Lioren would have a similar
degree of success in making a reticent patient talk as it had achieved with another of my patients, the former-Diagnostician Mannen. At the time I was not sure whether the matter was important enough to ask for the help of the Chief Psychologist. Now Lioren believes that it is, and, after consultation with the Surgeon-Captain, I am in total agreement.”
degree of success in making a reticent patient talk as it had achieved with another of my patients, the former-Diagnostician Mannen. At the time I was not sure whether the matter was important enough to ask for the help of the Chief Psychologist. Now Lioren believes that it is, and, after consultation with the Surgeon-Captain, I am in total agreement.”
Seldal settled back into its perch, and Lioren placed two of his medial limbs on the table and tried to order his thoughts.
Thornnastor’s six elephantine feet thumped restively against the floor in a manner which could have indicated impatience or curiosity. Conway made an untranslatable sound and said, “Surgeon-Captain, for the nonmedical improvement you have brought about in Doctor Mannen, who was my tutor and is my friend, I am most grateful. But how can we help you with what appears to be a psychiatric problem?”
“Before I begin,” Lioren said, “I would prefer that you do not use my former title. You know that I am forbidden and have forsworn the practice of medicine, and the reason for it. However, I cannot change the way my mind works, and my past training leads me to the conclusion that Hellishomar’s problem is not entirely psychiatric. But first I must discuss briefly the patient’s evolutionary and philosophical background.”
Thornnastor’s feet remained at rest and there were no other interruptions while Lioren described the strangely divided cultures of the telepathic Parents and the more technologically oriented Small, and how strongly the latter were affected by the teachings of the former and by the uncertainties of approaching maturity. He told them how O’Mara had explained that the division was due to an uncompleted stage of their evolution, that the Small were subintelligent by Groalterri standards until they reached maturity, although the concern of the Parents for their Small was very strong. The intelligent macrospecies inhabiting Groalter were so physically massive and extremely long-lived that their numbers had to be strictly controlled if their planet and their race was not to become extinct. Orbital observations had shown that the total Groalterri population of both Parents and Small numbered less than
three thousand, so that the birthing of a Small was an extremely rare event and the parental regard for the newborn proportionately large.
three thousand, so that the birthing of a Small was an extremely rare event and the parental regard for the newborn proportionately large.
Lioren was careful to speak in the most general terms, and he was particularly careful to give only information that Hellishomar had given him permission to pass on, or material that he had been able to deduce for himself.
“Doubtless you will discover for yourselves that the information I am about to give you regarding the patient is incomplete,” Lioren went on. “This is a deliberate omission on my part, and I have told the Chief Psychologist O’Mara why he and yourselves must be kept in partial ignorance—”
“You told O’Mara that,” Conway broke in, showing its teeth, “and you are still alive?”
“Because Hellishomar is the first and only source of data on the Groalterri culture,” Lioren continued, deciding that it was not a serious question. “This information is of great value to the Federation and the hospital, but I have been told that a small proportion of it is not for general distribution. Were I to break confidence with the patient there is a risk, virtually a certainty, that the source of this valuable knowledge would dry up. My observations of the patient’s behavior and clinical condition, however, are as complete and accurate as I can make them.”
Lioren paused briefly so as to select words that would combine maximum information with complete confidentiality. “Patient Hellishomar came here at the unconscious direction, or suggestion or whatever means was used on the captain of the orbiting vessel, of the Parents because they hoped that it could be treated. They themselves are physically and temperamentally incapable of inflicting pain or injury on another intelligent life-form, and the treatment was not available on Groalter because the surgical procedures of the Small, while precise enough, are too crude for the fine work of removing large numbers of deeply embedded insects. Senior Physician Seldal has been performing this work as only it can, but with the minimum of verbal contact with the patient. I had nothing but verbal contact with Hellishomar and had many opportunities to observe its behavior while we were speaking.
These observations led me to the conclusion, a conclusion with which Seldal and O’Mara now agree, that the infected insect punctures were not the only reason for Hellishomar being sent here.”
These observations led me to the conclusion, a conclusion with which Seldal and O’Mara now agree, that the infected insect punctures were not the only reason for Hellishomar being sent here.”
They were all watching him and so still were they that the whole office with its living contents might have been a holograph.
“From our conversations together,” Lioren went on, “it has become obvious that Hellishomar has grown much too old and large to live and practice as a Cutter among the Small, and that by now it should be undergoing the psychological as well as the physical changes that precede full maturity. But the Parents have not touched minds with it, as is customary at this time, or if they have tried to do so it has not been aware of it because the patient is telepathically deaf, and the possibility exists that Hellishomar is mentally retarded.”
There was a short silence that was broken by Thornnastor. “Judging by the evidence you have given us so far, Surgeon-Captain, I would say it is a strong probability.”
“Please do not use my former title,” Lioren said.
The Earth-human, Conway, made a dismissive gesture with one hand. “You still retain the manner of a Surgeon-Captain if not the rank, so the mistake is excusable. But if you are convinced that Hellishomar is mentally defective, that is not the concern of Pathology or Surgery, so what are Thornnastor and myself doing here?”
“I am not fully convinced,” Lioren replied, “that the condition is due to a congenital defect. Rather, I favor the theory that there might be a structural abnormality which has temporarily affected the proper development of the patient’s telepathic faculty without, however, impairing the other brain functions. This theory is based on behavioral observations by myself as well as those reported by Seldal, and on conversations with the patient which I will not repeat in detail.”
O’Mara made an untranslatable sound but did not speak. Lioren ignored the interruption and went on. “Hellishomar is a Cutter, the Groalterri equivalent of a surgeon, and, although the gross differences in its body mass and ours mean that its work seems crude by our standards, it has displayed to me and to the ward’s vision recorders a
high degree of muscular coordination and precision of control. There was no evidence of the uncoordinated movements or the mental confusion normally expected of a damaged or otherwise abnormal brain. Even though it is only an immature member of a species whose adult minds are immeasurably more advanced than our own, in conversation it displays a mind that is flexible, lucid in its thinking, and well able to debate the finer points of philosophy, theology, and ethics that have arisen between us. This is not, I submit, the physical behavior or the quality of thinking expected of a congenitally defective brain. I believe that the deficiency lies only with the telepathic faculty and that there is a high probability that the abnormality causing it is localized and may be operable.”
high degree of muscular coordination and precision of control. There was no evidence of the uncoordinated movements or the mental confusion normally expected of a damaged or otherwise abnormal brain. Even though it is only an immature member of a species whose adult minds are immeasurably more advanced than our own, in conversation it displays a mind that is flexible, lucid in its thinking, and well able to debate the finer points of philosophy, theology, and ethics that have arisen between us. This is not, I submit, the physical behavior or the quality of thinking expected of a congenitally defective brain. I believe that the deficiency lies only with the telepathic faculty and that there is a high probability that the abnormality causing it is localized and may be operable.”
The Chief Psychologist’s office became a still picture once again. “Go on,” Conway said.
“For the first time,” Lioren resumed, “the Groalterri have contacted the Federation so that we at Sector General might cure one of their ailing Small. Perhaps they are hoping that Hellishomar’s cure will be complete. We should do our best not to disappoint them.”
“We should do our best,” Conway said, “not to kill the patient. Do you realize what you are asking?”
Thornnastor answered the question before Lioren could reply. “It will require the investigation of a living and conscious brain about which we know nothing, because there are no Small cadavers available for prior investigation. We will be looking for structural abnormalities when we do not even know what is normal. Microbiopsies and sensor implants will not give data of the precision required for a cerebral procedure. Our deep scanners cannot be used because the level of radiation needed to penetrate a cranial structure of that size would almost certainly interfere with the locomotor muscle networks, and we cannot risk a patient of Hellishomar’s mass making involuntary muscle movements during an op. To a greater or lesser degree, depending on the findings of the nonsurgical investigation, we will be trusting to luck and instinct. Has the patient been informed of the risks?”
“Not yet,” Lioren replied. “As the result of a recent conversation
with the patient there was an emotional upset of some kind. Hellishomar broke off verbal contact and physically evicted me from the ward, but I am hoping to resume communication soon. I will inform it of the situation and try to obtain its permission and cooperation during the operation.”
with the patient there was an emotional upset of some kind. Hellishomar broke off verbal contact and physically evicted me from the ward, but I am hoping to resume communication soon. I will inform it of the situation and try to obtain its permission and cooperation during the operation.”
“Thankfully,” Conway said, showing its teeth again, “that is your problem.” It turned toward O’Mara. “Chief Psychologist, in matters pertaining to Patient Hellishomar and until further notice I want Trainee Lioren placed under my authority. I shall take overall surgical responsibility for this one, and move it to the top of my operating schedule. Thornnastor, Seldal, and Lioren will assist. And now, if there is nothing further to detain us—”
“With respect, Diagnostician Conway,” Lioren said urgently, “I am forbidden to practice—”
“So you have said,” Conway broke in as it rose to its feet. “You will not be required to cut, simply to observe and advise and give nonsurgical support to the patient. You are the only one among us who may have sufficient knowledge of the patient’s mind and thought processes—and it is Hellishomar’s mind that we will be tinkering with—to keep it from ending up a worse mental cripple than you say it already is.
“You
will
assist.”
will
assist.”
Lioren was still trying to think of a reply when the office had emptied except for O’Mara and himself. The Chief Psychologist had risen to its feet, which was a clear nonverbal signal that Lioren should also leave. He remained where he was.
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