“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?”
CHAPTER 14
The first three hours were spent on preparatory work, tidying up the traumatic amputations performed by flying metal at the accident site, charting the extent of the internal injuries, checking on the readiness of the operating teams, and, in spite of the cooling unit in his suit, sweating.
At this stage in the proceedings his work was chiefly supervisory, so his increased output of perspiration was unconnected with physical activity and was what O’Mara referred to as psychosomatic sweating, a condition which the Chief Psychologist would tolerate only on rare occasions.
When one of the patients died preoperatively, Conway’s feelings lacked the intensity he had been expecting in that situation. The prognosis on that particular Hudlar had been very poor in any event, so when the sensors indicated termination it was not a surprise. The Melfan, Illensan, Kelgian, Tralthan, and Gogleskan components of his mind registered low-key professional regret at the loss; the Hudlar alter ego felt more strongly, but its sorrow was tinged with relief because it knew how drastically curtailed would have been the patient’s quality of life had it survived, and because the other three cases were occupying so much of his attention, Conway’s own reaction lay somewhere in between.
He maintained the cadaver’s respiration and cardiac functions so that its undamaged organs and limbs, what few of them remained, would be in optimum condition for transplantation. A small part of his mind wondered if the Hudlar’s parts were used for replacement surgery on its more fortunate colleagues, could it truly be considered to be dead? Which led, inevitably, to a minor conflict within his multiple mind between the Hudlar component and the others regarding the treatment of the physical remains after death.
For reasons which were not fully understood even by the members of the species themselves, the Hudlars, although in all other respects a race of highly intelligent, sensitive, and philosophically advanced beings, were unique in that they did not honor or show the slightest degree of respect for their recently deceased. The memory of the person while alive was treasured by its friends, and commemorated in various fashions, but these records invariably omitted any reference to the fact that the being concerned had died. The life and accomplishments of the entity were remembered; the death was studiously ignored, and the deceased disposed of quickly and without ceremony, as if it was a piece of unsightly litter.
In this case the Hudlar idiosyncrasy was a distinct advantage, because it removed the often time-consuming necessity for obtaining the consent of the next of kin for organ removal and transplant.
Realizing suddenly that he was mentally sidetracking himself and wasting time, Conway gave the signal to begin.
He joined the operating frame around FROB-Three, who was the patient with the fractionally better chance of making it, taking the observer’s position beside Senior Physician Yarrence, the Kelgian surgeon who had charge of the team. His original intention had been to head the team on the recently deceased FROB-Eighteen’s operation, but that patient’s demise meant that he could now keep a close watch on the three operations, all of which were urgent and critical enough to require simultaneous rather than consecutive performance. The members of his original team had been divided up between Yarrence, Senior Physician Edanelt, the Melfan in charge of FROB-Ten, and the Tralthan Senior Hossantir who had taken FROB-Forty-three.
Even though the FROB life-form was capable of living and working in gravity-free and airless conditions, this was only possible when the immensely tough and flexible tegument remained intact. When the skin had been pierced and the underlying blood vessels and organs exposed, as had occurred in several areas with this patient, deep surgery was impossible unless the natural gravity and pressure environment was reproduced. To do otherwise was to invite massive hemorrhaging and organ displacement due to the high pressure of the internal fluids. For this reason the OR staff were forced to wear gravity repulsors set to four Gs and heavy-duty protective suits whose gauntlets had been replaced by tight-fitting operating membranes designed to minimize the effects of the high external pressure.
They clustered around the patient like a shoal of ungainly fish, Conway thought, about to begin their surgical nibbling.
“The rear limbs have escaped with superficial damage and will heal naturally,” Yarrence said, more for the benefit of his recorders than for Conway. “The two midlimbs and left forelimb have been lost, and the stumps will require surgical trimming and capping in preparation for the fitting of prosthetics. The right forelimb is still attached but has been so badly crushed that in spite of efforts to reestablish circulation to the affected areas, necrosis has taken place. This limb will also require removal and capping …
The FROB in his mind stirred restively and seemed to be raising objections, but Conway did not speak because he had no clear idea of what it was objecting to.
Of the stump,” the Kelgian Senior went on. “There is a metal splinter which has been driven into the right thoracic area with associated damage to a major vein, the bleeding from which has been incompletely controlled by the application of external pressure. This situation must be rectified urgently. There is also cranial damage, a large depressed fracture which is compressing the main nerve trunk and affecting mobility in the rear limbs. Subject to approval” … Yarrence glanced briefly in Conway’s direction we shall remove the damaged forelimb, which will allow easier access for the teammembers working in the cranial area, and prepare the stumps for—”
“No,” Conway said firmly. He could not see anything but the Kelgian’s conical head inside the heavy protective garment, but he could imagine the silvery fur tufting in anger as he went on. Do not cap the forelimb stumps, but prepare them instead for a transfer and transplant of the rear limbs. Otherwise your procedure as outlined is approved.”
“The risk to the patient is increased,” Yarrence said sharply, “and the operational time will be extended by at least twenty percent. Is this desirable?”
Conway was silent for a moment, thinking about the quality of life of the patient following the success of the simple as opposed to the more complex operation. Compared with the immensely strong and precisely controlled forelimbs possessed by a normal FROB, the telescoping, hinged, and swiveling prosthetic was ridiculously weak and inefficient. As well, Hudlar amputees found them aesthetically displeasing and distressing when the forelimbs-which were the members most conveniently placed to the eyes and used for the more delicate physical manipulations, including the long and involved preliminaries to mating-were artificial. Transplanting the rear limbs forward, although risky considering the weakened state of the patient, was infinitely preferable, because if the operation were successful, it would provide the FROB with forelimbs which would be only fractionally less sensitive and precise than the originals. Since the limbs would be coming from the same entity, there would be no immune system involvement or tissue rejection problems.