“I’d rather not move the heart,” Conway said. “We are very short of time.”
“I am not a doctor,” the Nidian said crossly. “This repair should properly be performed on a workbench, or at least in an area with room for my admittedly small elbows. Working in close contact with living tissue is … is repugnant to me. However, my tools are sterile in readiness for such emergencies.”
“Do you feel nauseous?” Conway asked worriedly. He had visions of the little being choking inside its helmet.
“No,” the Nidian said, “just irritated.”
Conway withdrew his Melfan instruments to give the technician more room to work. A nurse had clipped a tray of Earth-human DBDG instruments to the frame beside him, and by the time he had selected the ones he would need the Nidian had freed the jammed valve. Conway was thanking the little being for the speed of the repair when Hossantir broke in.
“I’m restarting the artificial heart,” it said.
“No, wait,” Conway said sharply. He was looking at the monitor and getting a feeling-a very vague feeling that was not strong enough even to be called a hunch-that any delay at all would be dangerous. “I don’t like the vital signs. There is nothing there which should not be there, considering that the flow from the artificial heart was interrupted, initially by the jammed connector valve and later when the system was shut down during the repair. I realize that if the artificial heart is not restarted within the next few minutes, irreversible changes leading to termination will take place in the brain. Even so, I have the feeling that we should not restart but go instead for an immediate resection of the replacement orgao …
He knew that Hossantir would want to object and take the safer course, that of restarting the artificial heart and waiting until they were sure that the patient’s circulation had returned to optimum, and then proceed as originally planned. Normally Conway would not have argued against this, because he, too, preferred not to take unnecessary risks. But there was something niggling at the back of his mind, or one of his minds, something about the effect of longterm trauma on certain gravid, heavy-gravity life-forms, and the feeling was so persistent that he had to act on it. And while he had been speaking, Conway had unclipped his instruments to show Hossantir, nonverbally so that the Senior’s feelings would not be hurt too much, that he was not about to argue the point.
“… Will you work on the connection to the absorption organ, please,” he ended, “and keep an eye on the monitor.”
Sharing the operative field with the Tralthan, Conway worked quickly and carefully in the restricted space, clamping off the artery beyond the artificial heart connection, detaching it, and reconnecting it to the arterial stub projecting from the replacement organ. Unlike the first, shocking seconds of the earlier hemorrhaging, time seemed to have speeded up. His hands and instruments were well outside the field of the nullifiers, being acted on by four Earth-Gs, so they felt incredibly slow and awkward. Several times his instruments clinked loudly against those of Hossantir. He could sympathize with the surgeon, whoever it had been, who had accidentally knocked that connector valve off its setting. He had to concentrate hard to keep his instruments from leading a life of their own.
He did not watch Hossantir’s work, because the Tralthan knew its stuff and there was no time for surgical sightseeing.
He inserted retaining sutures to hold the artery in position on each end of the connector, which was designed both to hold the ends firmly in position when circulation was restored and to keep the sections of original and replacement tissue apart so as to reduce postoperative rejection problems. There were times when, immunologically speaking, he wondered why a highly evolved and complex organism should be its own worst enemy. Next he began the linkup of the vessel which supplied nutrient from the absorption organ to one of the major heart muscles.
Hossantir had completed its connection and had turned its attention to the minor vessel which supplied one half of the womb when the Hudlar was in female mode-the second, undamaged heart had been performing double duty since the start of the operation. They were short of time, but as yet not dangerously so, when the Tralthan indicated the Monitor with a free appendage.
“Ectopics,” Hossantir said. “One in five, no, one in four. Pressure is reducing. The indications are that the heart will go into fibrillation and arrest very quickly. The defibrillator is ready.”
Conway took a quick look at the visual display where the irregular, ectopic heartbeat broke into the normal rhythm once in every four beats. From experience he knew how soon it could degenerate into a rapid, uncontrollable flutter and, with the subsequent loss of the pumping function, failure. The defibrillator would almost certainly shock it into action again, but that device could not be used while the operation on the replacement heart was in progress. He resumed his work with desperate, careful speed.
So deep was his concentration that all of his minds were becoming involved again, contributing their expertise and at the same time their irritation that it was a set of Earth-human hands which were doing the work and not the assorted manipulators, pincers, and digits of his alter egos. He looked up finally to find that Hossantir and he had finished their connections at the same time. But a few seconds later the other heart went into fibrillation, then arrest. Their time was really short now.
They eased the clamps on the main artery and secondary vessels and watched the flaccid replacement organ swell slowly as it was filled with Forty-three’s blood, checking with their scanners for the formation of air embolisms. There were none, so Conway placed the four tiny electrodes in position preparatory to restarting the replacement heart. Unlike the defibrillator charge needed for the other heart, which would have to penetrate more than ten inches of hard, Hudlar tegument and underlying tissue, these electrodes would be acting directly on the surface muscles of the replacement organ and would be carrying a relatively mild charge.
The defibrillator brought negative results. Both hearts fluttered unsteadily for a few moments and then subsided.
“Again,” Conway said.
“The embryo has arrested,” Hossantir said suddenly.
“I was expecting that,” Conway said, not wanting to sound omniscient, but neither did he have the time for explanations.
Now he knew why he had wanted to complete the replacement connections so fast after the emergency with the valve. It had been not a hunch but a memory from the past when he had been a very junior intern, and the memory was one of his own.
ft had happened during his first lecture on the FROB life-form, which had been given by the Diagnostician-in-Charge of Pathology, Thornnastor. Conway had made a remark to the effect that the species was fortunate in having a standby heart if one should fail. Conway had meant it as a joke, but Thornnastor had jumped on him, figuratively speaking, with all six of its feet for making such a remark without first studying the Hudlar physiology in detail. It had gone on to describe the disadvantages of possessing two hearts, especially when the possessor was a gravid female-mode Hudlar nearing parturition, and the nerve network which controlled the involuntary muscle system was maintaining a delicate balance between the impulses to four hearts, two parental and two embryonic. At that particular stage the failure of one heart could quickly lead to the arrest of the other three.
“And again,” Conway said worriedly. The incident had not been worth remembering then, because major surgery on FROBs was considered to be impossible in those days. He was wondering if survival for this particular Hudlar was impossible now when both of its hearts twitched, hesitated, then settled into a strong, steady beat.