Sector General Omnibus 3 - General Practice

by James White

  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!”

  CHAPTER 25

  “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.”

  “I understand, Doctor,” Thornnastor said. “Maintenance technicians, you know what is required. Lesk-Murog, prepare yourself. Quickly, everyone.”

  A subjective eternity passed before the equipment was set up and the diminutive Lesk-Murog, looking like a plastic-encased, long-tailed rodent with one end of the new suction pipeline attached to its backpack, disappeared headfirst into the entry wound. Conway and Seldal had already cut through the skinsticker’s outer membrane and were excising small pieces and feeding them into the original suction unit, although it was obvious that the black growth was increasing in size in spite of their efforts because the incision continued to widen and tear in both directions. But with the Nidian Senior’s arrival the situation changed at once.

  “This is much better,” said Conway. “We are beginning to make progress now and are excising deeply into the growth. As soon as we have hollowed it out sufficiently, Seldal and Lesk-Murog will go inside and pass the excised material out to me for disposal. Don’t cut such large pieces, doctors, please. If this suction unit blocks we’ll be in real trouble. And watch where you’re swinging that blade, Lesk-Murog, I have no wish to become an amputee. How is the patient?”

  “It is radiating anxiety, friend Conway,” Prilicla said, “with secondary but still strong feelings of excitement. Neither are at levels to cause distress.”

  Since a further reply was unnecessary, Hellishomar and Lioren did not speak.

  The main screen showed glimpses of rapidly moving Earth-human and Nidian hands and a furiously pecking Nallajim beak plying instruments that glittered brightly against the light-absorbent blackness of the growth. While describing the procedure Conway broke off to say that they were feeling more like miners digging for fossil fuel than surgeons engaged on a brain operation. The Diagnostician’s words were complaining but its voice sounded pleased because the environment of inert gas was seriously inhibiting further growth and the work was going well.


  “The cavity has been enlarged sufficiently so that all three of us are now able to work inside and attack the growth independently,” Conway said. “Doctors Seldal and Lesk-Murog are able to stand upright while I am forced to kneel. It is becoming very warm in here. We would be obliged if the inert gas you are pumping was reduced in temperature so as to avoid the risk of heat prostration. The inner surface of the growth’s enclosing membrane has been exposed over several large areas and it is beginning to sag under the weight of the surrounding brain structure. Please increase the internal gas pressure immediately to keep it from collapsing all over us. How is the patient?”

  “No change, friend Conway,” Prilicla said.

  For a time the operation proceeded in silence. It was clear what the surgeons were doing and there was nothing new for Conway to describe, until suddenly he said, “We have discovered the location of the feeder root and are evacuating its liquid content. The root has shrunk to less than half its original circumference and is being withdrawn with negligible resistance. It is very long but appears to be complete. Seldal is making a deep probe to insure that none of it has been left behind. No other roots have been discovered, nor anything resembling connective pathways to a secondary growth.

  “The inner surface of the membrane is now totally exposed,” the Diagnostician went on. “We are excising it in narrow strips that can be accommodated by the suction unit. Of necessity the work at this stage is slow and carefully performed because we are detaching the membrane from the underlying brain structures and must avoid inflicting further damage. It is most important that the patient remain completely immobile.”

  Hellishomar spoke for the first time in nearly three hours. It said, “I will not move.”

  “Thank you,” Conway said.

  More time passed, slowly for the operating team and interminably for the watchers, until finally all activity on the main screen ceased and the Diagnostician spoke again.