Sector General Omnibus 3 - General Practice (52 page)

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Authors: James White

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Hellishomar had not spoken directly to Lioren, even on the open channel, so that he had no way of knowing what was going through the patient’s mind. But Prilicla’s gauzy wings were beating slowly, and the stability of its hovering flight made it plain that there was no source of unpleasant emotional radiation in the area.
“Ease your mind, friend Lioren,” the empath said quietly. “At this time your anxiety is greater than friend Hellishomar’s.”
Greatly reassured, Lioren returned his attention on the main screen.
“This is the lobe where the highest concentration of trace metals occurs,” Conway said. “It has been chosen because similar traces have been associated with the telepathic function of the few other species known to possess the faculty, and although the operating mechanism remains unclear, the higher concentration of metal indicates the presence of an organic transmitter-receiver. It is the possible impairment of the patient’s higher brain functions, including the telepathic faculty, that we are trying to investigate and correct.
“Regrettably our charting of this area is imprecise,” it continued. “This is because the volume and density of the cranial contents would make it necessary to use very high power levels on our deep scanners, which would cause interference with neural activity.
“For this reason the portable, low-powered scanner will be used briefly and only in an emergency.
“The patient’s earlier cooperation in making voluntary muscle movements at our direction and submitting to external touch, pressure, and temperature stimuli has enabled us, by observing the local increases in neural activity, to identify those areas and eliminate them from the investigation. This information was obtained by sensor only, a detection system which produces no troublesome radiation, but which lacks the precision of the scanner.”
Lioren could not believe that there was anyone in the hospital, either presently on the staff or future trainees, who did not know the difference
between a scanner and a sensor, and assumed that the explanation was for the patient’s benefit.
“It was expected,” Conway went on, “that the brain of a macro life-form would be more open and coarse-structured to correspond with its large body mass. As we can now see, the blood supply network is on the expected large scale, but the neural structure appears to be as highly condensed and finely structured as that of a being of smaller mass. I cannot … it is completely beyond my ability to estimate the level of mentation possible to a brain of this size and complexity.”
Lioren stared at the enlarged image of Conway’s hands as they stretched slowly forward, pushed palms outward to each side, and then moved back out of sight, as if the Diagnostician was swimming endlessly through a fleshy ocean. For a moment he tried to put himself in Hellishomar’s place, but the thought of a white, slippery, two-headed insect crawling about in his brain was so repulsive that he had to control a sudden feeling of nausea.
Conway’s voice became uneven and its respiration more audible as it went on. “While we cannot be completely certain of what is or is not normal in this situation, it seems that the investigation so far has uncovered no evidence of structural abnormality or dysfunction. Our progress is being gradually impeded by increasing pressure from the fissure walls. At first this was ascribed to increasing fatigue in my arm muscles, but Seldal, who has no arms to tire, notes a similar increase in pressure against the outer surface of its carrying pouch. It is not thought to be a psychosomatic effect caused by claustrophobia.
“Mobility and the field of view are seriously reduced,” it added. “We are deploying the rings.”
Lioren watched as Conway struggled to pull the first ring over their heads and, with the help of Seldal’s incredibly flexible neck and beak, position it at waist level before breaking the compressed-air seal and inflating it around them. Two more rings were inflated at knee and shoulder level and joined into a hollow, rigid cylinder by longitudinal spacers. When the initial triple-ring deployment was complete, they
added another ring and spacers to extend the structure forward. By deflating and withdrawing the rearmost ring and attaching it in front, and varying the lengths of the spacers, they were able to move the hollow cylinder and travel within it in any required direction. The open structure provided all-around visibility and ready access to perform surgery.
They were no longer swimmers in a near-solid ocean, Lioren thought, but miners boring through a tunnel that they carried with them.
“We are encountering increasing resistance and pressure from one wall of the fissure,” Conway said. “The tissues on that side appear to be both stretched and compressed. You can see there, and over there, where the blood supply has been interrupted. Some of the vessels are distended where the blood has pooled and others deflated and all but empty. This does not appear to be a naturally occurring condition, and the absence of necrosis in the area suggests that the circulation is seriously impeded but so far not completely blocked. The structural adaptation that has taken place also suggests that the condition has been present for a long time.
“Scanning is needed to find its cause and source,” Conway went on. “I will use the hand scanner briefly, at minimum penetration, now. How does the patient feel?”
“Fascinated,” Hellishomar said.
The Earth-human barked softly. “No emotional or cerebral effects are reported by the patient. I will try again with a little more penetration.”
For a few seconds Conway’s scanner image appeared on the main screen, then dissolved. The recording was projected onto an adjacent screen and frozen for study.
“The scanner shows the presence of another membrane at a depth of approximately seven inches,” the Diagnostician continued. “It is no more than half an inch thick, and has a dense, fibrous structure and a degree of convex curvature which, if continued uniformly, would enclose a spherical body of approximately ten feet in diameter. The underlying tissue structure is still unclear but shows a marked difference
to that encountered so far. It may be that this is the site of the lobe responsible for the telepathic faculty. But there are other possibilities which can only be eliminated by surgical investigation and tissue analysis. Doctor Seldal will make the incision and obtain tissue samples while I control the bleeding.”
The main screen was filled with a picture of Conway’s hands, looking enormous and distorted because of the proximity of the helmet’s vision pickup, as they fitted a cutter to the Nallajim Senior’s beak. Then an index finger moved forward to outline the position and extent of the required incision.
There was a sudden blur of motion as the back of Seldal’s head and neck briefly obscured the operative field.
“You can see that the initial incision has not uncovered the membrane,” Conway went on, “but the underlying pressure has forced apart the edges of the wound to a degree that, if we don’t relieve the situation by extending the incision at once, there is a serious risk of it tearing open at each end. Seldal, would you go a little deeper and extend … Oh,
damn
!”
It was as Conway had foreseen. The incision had torn apart at each end and weightless globules of blood were drifting out of it and totally obscuring the operative field. Seldal had discarded the cutter because its beak came into view gripping the suction unit, which it moved expertly along and inside the wound so that Conway could find and seal off the bleeders. Within a very few minutes the wound, now with torn, uneven edges and fully three times its original length, was clear and gaping open to reveal at its base a long, narrow ellipse of utter blackness.
“We have uncovered a strong, flexible, and light-absorbent membrane,” the Diagnostician resumed, “and two tissue samples have been taken. One is being sent out to you through the suction unit for more detailed study, but my analyzer reading indicates an organic material that is totally foreign to the surrounding tissues. Its cell structure is more characteristic of a vegetable than an—What the blazes is happening? We can feel the patient moving. It
must
remain absolutely still! We are not supposed to be in an area where accidental stimulation of
the motor muscles is possible. Hellishomar, what is wrong?”
The Diagnostician’s words were lost in the bedlam of the outer ward, where the tractor and pressor units were emitting audible and visible signals of overload as their operators struggled to keep Hellishomar’s heaving body motionless. The Groalterri’s enormous head was jerking from side to side against its immaterial restraints, and the ends of the incision were tearing and bleeding again. Prilicla’s body was being shaken by an emotional gale, and everyone seemed to be shouting questions, instruction, or warnings at each other.
But it was Hellishomar who succeeded in making itself heard above the din, suddenly and with one word.
“Lioren!”
“
I
am here,” Lioren said, switching quickly to the secure channel, but the sounds that the patient was making did not translate.
“Hellishomar, please stop moving,” Lioren said urgently. “You could seriously injure, perhaps kill yourself. And others. What is troubling you? Please tell me. Is there pain?”
“No,” Hellishomar said.
Telling the patient that it might kill itself would be a waste of time, Lioren thought, because the Groalterri’s presence in the hospital was due to it trying to do just that. But the reminder that it was endangering others must have penetrated the frenzy in its mind, because the violence of its struggles was gradually diminishing.
“Please,” Lioren asked again. “What is troubling you?”
The reply came slowly at first, as if each and every word had to break through a great, individual wall of fear, shame and self-loathing; then suddenly the words rushed out in a near-incoherent flood that swept away all such barriers. As he listened to Hellishomar pouring out everything that was in its mind, Lioren’s confusion changed slowly to anger and then to sadness. This was utterly ridiculous, he told himself. Had he been an Earth-human he might have been barking with laughter by now at this display of ignorance from a member of a species that was the most highly intelligent of any race known to the Federation.
But if Lioren had learned anything since joining O’Mara’s department it was that emotional distress was the most subjective of all phenomena, and the most difficult to relieve.
But this was an entity trained in the Groalterri concepts of healing. It was a young and perhaps mentally retarded Cutter whose experience was restricted to peripheral surgery performed on aged members of its own race, and it was viewing an intercranial procedure, on itself, for the first time. In those circumstances ignorance was excusable, he told himself, provided it remained a temporary condition.
“Listen,” Lioren said quickly into the first, brief pause in the tirade. “Please listen carefully to what I am saying, ease your mind, and above all, be still. The blackness inside your head is
not
the physical manifestation of your guilt, nor did it grow because of evil thoughts or any sin committed by you. It is likely that it is a bad and a dangerous thing, but it is not your spirit or soul or any part of—”
“It is,” Hellishomar broke in. “It is the place where I am. The thinking, feeling, and grievously sinning me who tried to destroy myself lives in that place, and it has a blackness that is beyond hope.”
“No,” Lioren said firmly. “Every intelligent entity I know of believes that its personality, its soul lives in the brain, usually a short distance behind the visual receptors. They believe this because, even when there has been gross trauma and physical dismemberment, it remains intact. Sometimes there is physical damage or disease that causes the personality to change. But this change does not come about because of an act of will, so the entity concerned cannot be held responsible for subsequent behavior.”
Hellishomar remained silent and its body movements had reduced to the point where the overload lights were no longer showing on the tractor-beam installations.
Lioren went on quickly. “It is possible that the inability of your brain to mature to the stage where direct mind-to-mind contact can be achieved with the Parents is due to a genetic defect. But it is also possible that the crimes you blame yourself for committing were the result of a disease or injury to the brain, and the reason for these wrongful
thoughts and actions may now have been found. You must know that the black mass that Conway and Seldal have uncovered is not your personality, because you have told me yourself that the soul is immaterial, that when the Parents die and their bodies decay and return their substance to the world, their souls leave Groalterri to begin their neverending exploration of the universe—”
“While my own soul,” Hellishomar said, beginning to struggle against the restraints again, “sinks like a stone into the mud of the ocean floor, to fester in darkness forever.”
Lioren felt that he would lose what little control he had gained over the situation if he did not speak quickly, and move the argument from metaphysics to medicine. Focusing one of his eyes on the side screen where the results of Conway’s analysis were being displayed, he went on. “It may well rot at the bottom of your ocean if that is where you want it placed, but more likely it will end in a waste-disposal furnace at Sector General. I do not know what it is exactly, but it is not your soul or, for that matter, any other part of you. It is completely foreign material, a vegetable form of life, an invader of some kind. I ask you to be calm and to think, to think as a Groalterri Cutter and healer, and to remember if there was anything in your past experience that resembles this black growth. Please think carefully.”
For several moments Hellishomar was silent and absolutely still. The ward was quiet again and he could hear the voice of Conway saying that it was about to resume the operation.
“Please wait, Doctors,” Lioren said, switching briefly to the public channel. “I may have important clinical data for you.” On the main screen one of the Diagnostician’s hands waved acknowledgment, and he returned to the private channel.
“Hellishomar,” Lioren said again, “please try to recall anything resembling this black growth, whether the memory is from recent experience, the less certain recollections of infancy, or even the hearsay experiences of others. Can you remember having contact with such a growth, or having suffered an injury, not necessarily to the cranium, which would have allowed it to enter the bloodstream?”
“No,” Hellishomar said.
Lioren thought for a moment. “If you do not remember, is it possible that you contracted the disease as a very small infant, before you were capable of forming memories? Can you recall any later reference to something like this happening to you by an older Small charged with your care? This person may not have considered it important at the time, or mentioned it until you were grown and—”
“No, Lioren,” Hellishomar broke in. “You are trying to make me believe that this foul thing in my brain is not the result of wrong thinking, and what you are doing is a great kindness. But I have already told you, it is only the very aged Parents who are afflicted with diseases, the Small never. We are strong and healthy and immune. The invisible attackers you have told me about are ignored, and those large enough to be visible are treated as a nuisance and simply brushed away.”
Lioren had been hoping that he would discover something useful to Conway and Seldal by questioning the patient, but he was making no progress at all. He was about to signal them to proceed when another thought occurred to him.
“These pests that you brush away,” he said. “Please tell me all that you can remember about them.”
Hellishomar’s replies sounded polite but very impatient, as if it had guessed that the other’s only intention was to keep its mind on other things and the answers were unimportant. But gradually its answers became very important indeed and Lioren’s questions more precise. Slowly his earlier feeling of hopelessness was changing to one of excitement and mounting anxiety.
“From all that you have told me,” Lioren said urgently, “I am convinced that the pest you call a skinsticker is the original cause of your trouble, but I do not want to waste time giving my reasons to you and then again to the operating team. A final question. Will you give me permission to speak of this to the others? Not all that has passed between us, and nothing about your thoughts and fears, only the details of the description and behavior of the skinstickers.”
Subjectively it seemed that a very long time elapsed without any
response from Hellishomar. Lioren could hear Conway, Seldal, and the support staff in the ward talking together, their words muffled by his earpads but their impatience plain. He tried again.
“Hellishomar,” Lioren said, “if my theory is correct, your life may be at risk, and the cerebral damage will certainly render you incapable of future coherent thought. Please, your answer is needed quickly.”
“The Cutters inside my skull are also at risk,” Hellishomar said. “Tell them.”
Without taking time to reply Lioren switched to the public channel and began to speak.
Although he could not be absolutely certain because of the small amount of information that the patient had been able to give him, Lioren said that he felt sure the original cause of the black intercranial growth was due to infestation by a species of parasitic vegetable vermin known to the Groalterri as a skinsticker, which was considered to be a periodic nuisance rather than a threat to life. Nothing was known about the life cycle or reproduction mechanism of the skinsticker because they could be easily removed, brushed away with the manipulatory tentacles or by rubbing the affected area of tegument against a tree, and a life-form with the enormous physical mass and limited dexterity of the Groalterri had neither the desire nor the ability to investigate the habits of a near-microscopic form of plant life.
Skinstickers were black, spherical, and covered with a vegetable adhesive which enabled them to attach themselves to the host’s body and extend their single feeder root while they were still too small to be seen. They required only an organic food source and the presence of light and air to grow very quickly to the size when they became a nuisance and were removed. They could be destroyed by crushing between hard surfaces or by burning, and after removal the root, which had a high liquid content, withered quickly and fell out of the wound it had made.
Lioren went on, “My theory is that this case was the result of infestation by a single skinsticker which gained entry via a small abrasion which the patient no longer remembers or through the puncture wound left by the root of an earlier and unsuccessful skinsticker, and was carried
through the circulatory system until it lodged in the cranium. Once there it had a virtually limitless food supply but not, apart from the tiny amount of oxygen it was able to absorb from the local blood supply, the light and air its metabolism required for optimum growth. The growth rate was inhibited but it has had a great many years, a young Groalterri’s very long lifetime, in which to grow to its present size.”
Except for the slow and near-silent beating of Prilicla’s wings, the ward might have been a still picture as Lioren finished speaking. It was Conway who reacted first.
“An ingenious theory, Lioren,” the Diagnostician said, “and while obtaining this information and discussing it between you, you have succeeded in pacifying our patient. That was well done. But whether or not your theory is correct, and I believe that it is, our procedure must continue as originally planned.”
Imperceptibly Conway’s manner changed from one of person-to-person conversation to that of lecturer-student instruction as it went on. “This foreign tissue, tentatively identified as a massively overgrown Groalter skinsticker, will be excised in very small pieces whose size will be dictated by the maximum orifice setting of our suction unit. Many hours of patient, careful work will be required to accomplish this, particularly in the later stages if there are adhesions to healthy brain tissue, and rest periods or relays of surgeons may be necessary. However, since the patient has shown no impairment or deterioration in mentation since its arrival here, and the growth has been present for a very long time, its removal may be considered necessary but non-urgent. We will be able to take all the time we need to insure that—”
“No,” Lioren said harshly.
“No?” Conway sounded too surprised to be angry, but Lioren knew that the anger would not be long in coming. “Why not, dammit?”
“With respect,” Lioren said, “the screen shows that your original incision is widening and extending in length. Let me remind you that the skinsticker grows rapidly in the presence of light and air and, after a great many years in the airless dark, light and air are again present.”
For a few moments Conway directed angry and self-abusive words
at itself, then suddenly the main screen turned black as it switched off its helmet lighting and said, “This will slow the rate of growth a little. I need time to think …”
“You need more surgical assistance,” Thornnastor said. “I will—”
“No!” Seldal broke in. “Another set of enormous, awkward feet in here is what we don’t need! There isn’t enough space as it is to—”
“My feet aren’t that big—” Conway began.
“Not yours,” said Seldal. “I’m sorry, for a moment I was thinking of—”
“Doctors!” Thornnastor said, speaking suddenly with the voice and authority of the hospital’s senior Diagnostician. “This is not the time for arguments about the relative sizes of your ambulatory appendages. Please desist. I was about to say that the Nidian Senior, Lesk-Murog, is available and anxious to assist. Its surgical experience is as large as its feet are small. Conway, what are your instructions?”
The main screen brightened again as Conway switched on its helmet light. “We need a much wider suction unit, a flexible pipe of six inches’ diameter or as large as Lesk-Murog can handle, linked to one of the air circulation pumps, so that large pieces of the growth can be excised and withdrawn quickly. We cannot work without light, but we should be able to reduce the air that has leaked from the edges of our breathing masks by withdrawing it with the operative debris and replacing it with an inert gas pumped through the existing suction line. The inert should inhibit the skinsticker’s rate of growth as effectively as a complete absence of air, but that is a hope rather than an expectation.”

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