"White, James - Sector General 06 - Star Healer.PDB" - читать интересную книгу автора (White James)

“I’m relieved to hear that,” Conway said, looking frantically to O’Mara for help. It was beginning to sound as if the SNLU Diagnostician was going out of its super-cooled, crystalline mind. But the Chief Psychologist ignored him.
“...My enthusiasm stems from the DBDG Earth-human tape which has been occupying an undue portion of my mind since I began talking to you,” the SNLU went on, “and which belonged to a very fine surgeon who was inordinately fond of activities associated with reproduction. For this reason I find your DBDG female most disturbing. It possesses the ability to communicate nonverbally, and perhaps unconsciously, during ambulation, and the mammary area is particularly-”
“With me,” Conway broke in hastily, “it is that Hudlar trainee in the FROB infants’ ward.”
It turned out that several of the Diagnosticians present were carrying Hudlar physiology tapes and were not averse to discussing the nurse’s professional competence and physical attributes at length, but the SNLU cut them short.
“This discussion must be giving Conway the wrong impression about us,” Semlic said, its external vision pickups swiveling to include everyone in the room. “It might conceivably lower the high opinion Conway has of Diagnosticians, whose deliberations it would expect to be on a more rarefied professional level. Let me reassure it on your behalf that we are simply showing our latest potential member that the majority of its problems are not new and have been solved, in one way or another, and usually with the help of colleagues who are more than willing to assist it at any time.”
“Thank you,” Conway said.
“Judging by the continued silence of the Chief Psychologist,” Semlic went on, “you must be coping fairly well up to now. But there is some small assistance I may be able to render you, and it is environmental rather than personal. You may visit my levels at any time, the only proviso being that you remain in the observation gallery.
“Few, indeed, are the warm-blooded, oxygen-breathers who take a professional interest in my patients,” the SNLU added, “but if you should be the exception, then special arrangements will have to be made.”
“No, thank you,” Conway said. “I could not make any useful contribution to subzero crystalline medicine just now, if ever.”
“Nevertheless,” the methane-breather went on, “should you visit us, be sure to increase your audio sensitivity and switch off your translator, then listen. A number of your warm-blooded colleagues have derived a certain amount of comfort from the result.”
“Cold comfort,” O’Mara said dryly, and added, “We are devoting an unfair proportion of our time to Conway’s personal problems rather than to those of his patients.”
Conway looked around at the others, wondering how many of them were carrying FROB physiology tapes. He said, “There is the Hudlar geriatric problem. Specifically, the decision whether to involve the patient in a dangerous multiple amputation procedure which, if successful, will prolong life for a comparatively short time, or to allow nature to take its course. In the former event the quality of the prolonged life leaves much to be desired.”
Ergandhir’s beautifully marked exoskeletal body moved forward in its frame, and the lower mandible moved in time with its translated words. “That is a situation I have run against many times, as have we all, and with species other than the Hudlars. The result in my own case has been, to use a Melfan metaphor, a badly chipped carapace. Essentially it is an ethical decision, Conway.”
“Of course it is!” one of the Kelgians said before Conway could reply. “The decision will be a close and personal one. However, from my knowledge of the Doctor concerned the probability is that Conway will opt for surgical intervention rather than a clinical observation of the patient to the terminal phase.”
“I am inclined to agree,” Thornnastor said, speaking for the first time. “If a situation is inherently hopeless, it is better to do something rather than nothing. And with an operating environment making it difficult for other species to work effectively, an experienced Earth-human surgeon might expect good results.”
“Earth-human DBDGs are not the best surgeons in the Galaxy,” the Kelgian joined in again, its rippling fur indicating to those carrying DBLF tapes the feelings which were concealed by its unsubtle mode of speech. “The Tralthans, Melfans, Cinrusskins, we Kelgians are more surgically adept in certain circumstances. But there are situations where this dexterity cannot be brought to bear because of environmental conditions...
“The operating theater must suit the patient,” a voice broke in, “and not the Doctor.”
“...Or physiological factors in the surgeon,” the Kelgian went on. “Protective garments or vehicles required to work in hostile environments inhibit the finer movements of manipulatory appendages and digits, and remotely controlled manipulators lack precision or are subject to malfunction at the most critical times. The DBDG hand, however, can be protected against a large number of hostile environments by a ridiculously thin glove which does not inhibit digital movements, and the supporting musculature is such that they can operate with minimal loss of efficiency in the presence of elevated pressure and gravity. The hands remain operational even when projecting a short distance beyond the field of the gravity nullifiers. Although crudely formed and comparatively restricted in their movements, the DBDG hands can go anywhere, surgically speaking, and-”
“Not everywhere, Conway,” Semlic broke in. “I’ll thank you to keep your superheated hands off my patients.”
“Diagnostician Kursedth is being diplomatic, for a Kelgian,” Ergandhir said. “It is complimenting you while explaining why you are likely to get more than your share of the nasty jobs.”
“I guessed as much,” Conway said, laughing.
“Very well,” Thornnastor said. “We shall now consider the urgent matter of the Menelden casualties. If you will kindly regard your displays, we will discuss their present clinical condition, projected treatment and the assignments of surgical responsibility. .
The polite inquiries, sympathy, and advice which, Conway now realized, had cloaked a searching examination of his feelings and professional attitudes, were over for the time being. Thornnastor, the hospital’s most experienced and senior Diagnostician, had taken charge of the meeting.
“...You can see that the majority of the cases,” the Tralthan went on, “have been assigned to Senior Physicians of various physiological classifications whose capabilities are more than equal to the tasks. Should unforeseen difficulties arise, one of ourselves will be called on to assist. A much smaller number of casualties, the really nasty cases, will be our direct responsibility. Some of you have been given only one of these patients, for reasons which will become obvious when you study the case notes, and others have been given more. Before you begin organizing your surgical teams and planning the procedures in detail, are there any comments?”
For the first few minutes they were all too busy studying the details of the cases assigned to them to have anything useful to say, and the initial comments were more in the nature of complaints.
“These two cases you’ve given me, Thornnastor,” Ergandhir said, tapping one of its hard, sharply tapered pincers against its display screen. “They have so many compound and comminuted fractures between them that if they survive at all, they will be carrying so much wiring, pins, and plating that induction will elevate their body temperatures every time they approach a power generator. And what were two Orligian DBDGs doing there anyway?”
“Wreckage subsistence casualties,” the pathologist replied. “They were members of the rescue team from the nearby Orligian processing plant. You are always complaining that you never get enough DBDG surgical experience.”
“You’ve given me just one case,” Diagnostician Vosan said. The Crepellian octopod turned to regard Thornnastor, then it made a noise which did not translate before adding, “Rarely have I seen such a discouraging clinical picture, and I shall certainly have my hands full, all eight of them, with this one.”
“It was the number and dexterity of your manipulatory appendages,” Thornnastor replied, “which impelled me to assign the case to you in the first place. But the time for discussion grows short. Are there any other comments before we move to procedures?”
Ergandhir said quickly, “During the intercranial work, on one of my patients in particular, emotional radiation monitoring would be distinctly advantageous.”
“And I,” Vosan said, “would find it useful during the preoperative phase to check on the level of unconsciousness and required anesthesia.”
“And I! And I!” clamored several of the others, and for a moment there were too many voices talking at once for the translators to handle them. Thornnastor gestured for silence.
“It seems,” the Tralthan said, “that the Chief Psychologist must remind you once again of the physiological and psychological capabilities of our one and only medically qualified empath. Major?”
O’Mara cleared his throat and said dryly, “I have no doubt that Doctor Prilicla would be willing and anxious to help all of you, but as a Senior Physician who is being considered for elevation to Diagnostician status, it is in the best position to judge where and when its empathy can be used to best effect. There is also the fact that while it is useful to have an empathic sensitive constantly monitoring the condition of a deeply unconscious patient during an operation, the patient does not really require it and the only benefit lies in the mental comfort and reassurance of the surgeon.
“There is also the fact,” the Chief Psychologist went on, ignoring the untranslatable sounds of protest from around the table, “that our empath functions best when among people who like and fully understand it. This being so, it should be clear to you that Prilicla is allowed a wide degree of latitude in its choice, not only in the cases it takes but in the surgeons it agrees to assist. And so, if the person who has worked with Senior Physician Prilicla since it joined us as a junior intern, and who helped it during its early medical training, if this Doctor requested the assistance of Prilicla during an operation, it would not be refused. Isn’t that so, Conway?”
“I, yes, I expect so,” Conway stammered. He had not been listening closely for the past few minutes, because his mind had been on his cases, his close to hopeless cases, and on thoughts of open professional rebellion.
“Do you need Prilicla?” O’Mara asked quietly. “You have first refusal. If you do not need, as opposed to merely want, the assistance of your empathic friend, say so. A line of your colleagues who do need Prilicla will form rapidly on the left.”
Conway thought for a moment, trying to coordinate and evaluate the input from his other mind components. Even the friendly and perpetually frightened Khone was radiating sympathy for his cases, and previously the mere sight of an uninjured Hudlar was sufficient to throw it into a panic reaction. Finally, he said, “I do not think that an empath would be of much help to these cases. Prilicla cannot work miracles, and at least three separate acts of supernatural intervention would be needed if these cases are to make it. And even then, well, I very much doubt that the patients or their close relatives will thank us.”
“You can refuse the cases,” O’Mara said quietly, “but you will have to give us a better reason than that they appear to be hopeless. As we have mentioned before, as a Diagnostician on probationary status you will be given what seems like an unfair share of such cases. This is to accustom you to the idea that the hospital must deal with partial successes and failures as well as nice, tidy, and complete cures. Up until now you have never had to concern yourself with problems of aftercare, have you, Conway?”
“I realize that,” he replied angrily, because it sounded as though he was being criticized for past successes, or being accused of grandstanding in some obscure fashion. And then he began to wonder if his anger was due to there being a certain amount of truth in the accusation. More quietly, he went on, “Perhaps I’ve been lucky.. .“
“As well as surgically adept,” Thornnastor interjected.
..... In the past with cases which could only be complete successes or utter failures,” he went on. “But these patients . . . Even with the life-support systems in continuous operation it seems to me that they are only technically alive, and I would need Prilicla’s empathic faculty simply to verify that fact.”
“Prilicla sent these casualties to us,” one of the Kelgians said who had not previously spoken. “Clearly, it did not consider them hopeless. Are you in difficulties deciding on procedure, Conway?”
“Certainly not!” Conway said sharply. He went on. “I know Prilicla and Cinrusskins tend to be incurable optimists. Unpleasant ideas like the thought of failure with a patient, or a case that is hopeless from the start, are utterly foreign to it. There have been times when it shamed me into feeling the same way. But now I am being realistic. It appears to me that two, perhaps three of these four cases are little more than not quite dead specimens for investigation by Pathology.”
“At last you are showing signs of accepting your situation, Conway,” Thornnastor said in its slow, ponderous voice. “You may never again be able to concentrate your entire mind and capabilities on a single patient, and you must learn to accept failure and make your failures contribute to your future successes. It is possible that you will lose all four of your patients, or you may save all of them. But no matter what procedure and treatment you decide upon, and the good or bad results which ensue, you will use your multiply augmented mind to learn whether or not that same mind is stable enough to endure and maintain control over your procedures, whether personally performed or delegated.
“You will also bear constantly in mind,” the senior Diagnostician went on, “the fact that while treating your four cases from the Menelden emergency list, you have other concerns. The FROB geriatric problem, our presently unsatisfactory organ replacement postoperative difficulties, the approaching parturition of your Protector, and even, if its presence suggests a new viewpoint or procedure on any of these problems, the data provided by the nonerasable mind of your Gogleskan friend. And if you are bearing all these things in mind, and my own Earth-human mind partner is unhappy with that phrase because it is what your DBDGs call a pun, you have already realized that FROB replacement surgery will play a vital part in the treatment of your four cases, and any failure could provide ready access to the organs needed to ensure the success of a not quite so hopeless case.
“We all find it difficult to accept failure, Conway,” Thornnastor continued, “and your past record will make it less easy for you. But these cases are not being assigned to you for psychological reasons. Your level of competence as a surgeon warrants-”
“What our overtalkative colleague is saying, once again,” one of the Kelgians broke in, its fur tufting with impatience, “is that good Doctors are given the worst patients. And now, may I discuss my two cases before they both terminate, from old age?”