Sector General Omnibus 3 - General Practice

by James White

  Both the Diagnostician and the Chief Psychologist turned to look at Lioren. He had already warned them that Hellishomar would make such a request and that it would not accept a negative answer.

  Reassuringly, Conway said, “My intention is to talk through the procedure and record it in sound and vision for staff-training purposes, so there is no reason why you should not overhear the original. We can also arrange for a second communications channel, but you will not be able to operate it yourself because your manipulatory appendages are too massive for the control mechanism. I suggest that both channels be controlled by Lioren, and any private words you have for Lioren be prefixed by its name so that all others can be switched out of the conversation. Would that be satisfactory?”

  Hellishomar did not reply.

  “We understand that privacy at such times is of great importance to you,” O’Mara said suddenly, staring at one of the patient’s enormous, closed eyes. “As Chief Psychologist of this establishment I possess the authority of a Parent. I can assure you; Hellishomar, that your second communication channel will be private and secure.”

  The Chief Psychologist’s curiosity regarding the words that had and would pass between Hellishomar and Lioren was personal, professional, and intense. But if there was disappointment in O’Mara’s voice, it was lost in translation.

  “Then I would like you to proceed with minimum delay,” Hellishomar said, “lest I take Diagnostician Conway’s good advice and change my mind.”

  “Doctor Prilicla?” Conway said quietly.

  “Friend Hellishomar’s emotional radiation fully supports its decision to proceed,” the empath said, joining the conversation for the first time. “The feeling of impatience is natural in the circumstances, and the expression of self-doubt may be considered as an oblique verbal pleasantry rather than indecision. The patient is ready.”

  A great wave of relief, so intense that he could see Prilicla shaking with it as well, burst over Lioren’s mind. But the empath’s trembling was slow and regular, like the movements of a stately dance, and indicated the presence of emotional radiation that was pleasant rather than painful. Even with O’Mara advising him at every stage, it had taken five days and nearly as many nights of argument, closely reasoned at times but at others purely emotional, to obtain Hellishomar’s agreement to the operation. It was only now that he knew they had succeeded.

  “Very well,” Conway said. “If the team is ready we will go in. Doctor Seldal, I’d be obliged if you would open.”

  The instruments required for the macroprocedure, the drills and cutters and suction tubes so massive that some of them had to be individually manned, hung in position all around them. The preparations, Lioren had thought, more closely resembled those for a mining operation than a surgical procedure. But the Diagnostician’s words were another example of an oblique verbal pleasantry, because the operating team was ready and waiting, and Seldal had already been thoroughly briefed on its part at every stage of the operation.

  Politeness was a lubricant, Lioren thought, that reduced friction but wasted time.

  Even though Hellishomar was a member of a macrospecies with a head that was large in proportion to its enormous body, the sheer size of the operative field came as a shock to Lioren. The area of the flap of tegument that was excised and drawn back to reveal the underlying bone structure was larger than any of the decorative rugs scattered around his living quarters.

  “Doctor Seldal is controlling the subdermal bleeding by clamping off the incised capilliaries,” Conway was saying, “which in this patient more closely resemble major blood vessels, while I drill vertically through the cranium to the upper surface of the meningeal layer. The drill is tipped with a vision sensor linked to the main monitor, which will show us when it reaches the surface of the membrane … We’re there.

  “The drill has been withdrawn and replaced by a high-speed saw of identical length,” the Diagnostician continued a few minutes later. “This is being used to extend the original bore-hole laterally until a circular opening has been made in the cranium of sufficient diameter so that, when the resulting plug of osseous material is removed, the surgeons will be able to enter the wound and work freely. That’s it. The plug is being removed now and will be kept under moderate refrigeration pending its replacement. How is the patient?”

  “Friend Hellishomar’s emotional radiation,” Prilicla said quickly, “suggests feelings of mild discomfort, or more severe discomfort that is under firm control. Feelings of uncertainty and anxiety normal to the situation are also present.”

  “A reply from me,” Hellishomar said, opening the eye nearest to the display screen, “seems unnecessary.”

  “For the moment, yes,” Conway said. “But later I will need the kind of help which only you will be able to give. Try not to worry, Hellishomar, you are doing fine. Seldal, climb aboard.”

  Lioren wished suddenly that he could find something reassuring to say to the patient, because he, having convinced O’Mara and Conway and finally Hellishomar itself of the necessity for the operation, bore the responsibility for what was to happen here. But he could not excuse breaking into the operating team’s conversation without invitation, and the private communication channel was closed to him until or unless Hellishomar spoke his name, so he remained silent and watchful.

  Looking like a pink-flecked, shaven log of a large tree, the bony plug was lifted clear while Seldal, its three spindly legs strapped together so as to minimize bodily projections, was being lifted into Conway’s backpack so that only its long, flexible neck, head, and beak were uncovered. A similar pack containing the instruments and inflatable equipment that both surgeons would use was strapped tightly to Conway’s chest and abdomen. The Diagnostician’s legs were not strapped together, but the sharp contours of its feet were encased in thick padding, and a white, frictionless overgarment was drawn over the limbs and fastened at the shoulders so that only the arms and head were uncovered. A transparent helmet that was free of external projections and large enough to accommodate the necessary lighting and communications equipment was added. Seldal, whose upper body was naturally streamlined, kept its head and beak pressed firmly against the back of Conway’s helmet. The Nallajim wore only eye protection and an attachment for the thin air line running into the corner of its mouth.

  “Zero gravity in the operative field,” Conway said. “Ready, Seldal? We will now enter the wound.”

  A tractor beam seized their weightless bodies in its immaterial grasp, deftly upended them, and lowered them heads first into the narrow opening. The thick cable loom comprising their air supply, suction and specimen extraction hoses, and the emergency rescue line unreeled like a multicolored tail behind them. Conway’s helmet lighting showed the smooth, gray walls of the organic well they had created moving past them, and an enlarged and enhanced image was reproduced on the external display.

  “We are at the base of the entry well,” Conway said, “level with the internal surface of the cranium, and have encountered what is probably the equivalent of the protective meningeal sheath. The membrane responds to firm hand pressure, in a way which suggests the presence of underlying fluid, and what appears to be the outer surface of the brain itself lies just beyond. A precise estimate of the distance is difficult because either the membrane or the fluid, or perhaps both, are not completely transparent. A small test incision is being made through the membrane. That’s strange.”

  A moment later the Diagnostician went on, “The incision has been extended and opened, but there is still no apparent loss of fluid. Oh, so that’s it …”

  Conway’s voice sounded pleased and excited as it went on to explain that, unlike in other species of its experience, the cere-brospinal fluid, which helped protect the brain structure from shocks by acting as a lubricant between the inner cranium and brain, was not in the Groalterri species a fluid. It was instead a transparent, semisolid lubricant with the consistency of a thin jelly. When a small piece of the jelly was cut away
for closer examination and then replaced, it immediately rejoined the main body without any trace of the earlier incision. This was fortunate since it enabled them to go through the meninges without having to worry about controlling fluid losses, and they could move laterally with minimal resistance and loss of time between the brain surface and the meningeal layer to the first objective, a deep fissure between two convolutions in the area suspected of housing the Groalterri telepathic faculty.

  “Before we proceed,” Conway said, “is the patient aware of any unusual physical sensations or psychological effects?”

  “No,” Hellishomar said.

  For a few moments the main screen gave glimpses of Conway’s hands and Seldal’s beak, brightly lit by the helmet lamp, as they pushed themselves carefully through the clear jelly between the smooth inner meninges and the massively wrinkled outer surface of the cortex and into the narrow crevice.

  “As closely as we can estimate,” Conway went on, “this fissure extends about twenty yards on each side of our entry point and the average depth is three yards. On the upper brain surface the division between adjoining convolutions is clearly evident, but with depth the walls begin to press together. The pressure is not sufficient to be life-threatening, and the effort required to push the surfaces apart is minimal and does not reduce our mobility, but it would seriously hamper any surgical procedure that may become necessary and quickly cause disabling levels of fatigue. Soon we will have to deploy the rings.”

  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?”