Star Surgeon



The three doctors huddled around the teletype, watching as the decoded message was punched out on the tape. "It started coming in just now," Tiger said. "And they've been beaming the signal in a spherical pattern, apparently trying to pick up the nearest ship they could get. There's certainly some sort of trouble going on."

The message was brief, repeated over and over: REQUIRE MEDICAL AID URGENT REPLY AT ONCE. This was followed by the code letters that designated the planet, its location, and the number of its medical service contract.

Jack glanced at the code. "Morua VIII," he said. "I think that's a grade I contract." He began punching buttons on the reference panel, and several screening cards came down the slot from the information bank. "Yes. The eighth planet of a large Sol-type star, the only inhabited planet in the system with a single intelligent race, ursine evolutionary pattern." He handed the cards to Tiger. "Teddy-bears, yet!"

"Mammals?" Tiger said.

"Looks like it. And they even hibernate."

"What about the contract?" Dal asked.

"Grade I," said Tiger. "And they've had a thorough survey. Moderately advanced in their own medical care, but they have full medical coverage any time they think they need it. We'd better get an acknowledgment back to them. Jack, get the ship ready to star-jump while Dal starts digging information out of the bank. If this race has its own doctors, they'd only be hollering for help if they're up against a tough one."

Tiger settled down with earphones and transmitter to try to make contact with the Moruan planet, while Jack went forward to control and Dal started to work with the tape reader. There was no argument now, and no dissension. The procedure to be followed was a well-established routine: acknowledge the call, estimate arrival time, relay the call and response to the programmers on Hospital Earth, prepare for star-drive, and start gathering data fast. With no hint of the nature of the trouble, their job was to get there, equipped with as much information about the planet and its people as time allowed.

The Moruan system was not distant from the Lancet's present location. Tiger calculated that two hours in Koenig drive would put the ship in the vicinity of the planet, with another hour required for landing procedures. He passed the word on to the others, and Dal began digging through the mass of information in the tape library on Morua VIII and its people.

There was a wealth of data. Morua VIII had signed one of the first medical service contracts with Hospital Earth, and a thorough medical, biochemical, social and psychological survey had been made on the people of that world. Since the original survey, much additional information had been amassed, based on patrol ship reports and dozens of specialty studies that had been done there.

And out of this data, a picture of Morua VIII and its inhabitants began to emerge.

The Moruans were moderately intelligent creatures, warm-blooded air breathers with an oxygen-based metabolism. Their planet was cold, with 17 per cent oxygen and much water vapor in its atmosphere. With its vast snow-fields and great mountain ranges, the planet was a popular resort area for oxygen-breathing creatures; most of the natives were engaged in some work related to winter sports. They were well fitted anatomically for their climate, with thick black fur, broad flat hind feet and a four-inch layer of fat between their skin and their vital organs.

Swiftly Dal reviewed the emergency file, checking for common drugs and chemicals that were poisonous to Moruans, accidents that were common to the race, and special problems that had been met by previous patrol ships. The deeper he dug into the mass of data, the more worried he became. Where should he begin? Searching in the dark, there was no way to guess what information would be necessary and what part totally useless.

He buzzed Tiger. "Any word on the nature of the trouble?" he asked.

"Just got through to them," Tiger said. "Not too much to go on, but they're really in an uproar. Sounds like they've started some kind of organ-transplant surgery and their native surgeon got cold feet halfway through and wants us to bail him out." Tiger paused. "I think this is going to be your show, Dal. Better check up on Moruan anatomy."

It was better than no information, but not much better. Fuzzy huddled on Dal's shoulder as if he could sense his master's excitement. Very few races under contract with Hospital Earth ever attempted their own major surgery. If a Moruan surgeon had walked into a tight spot in the operating room, it could be a real test of skill to get him—and his patient—out of it, even on a relatively simple procedure. But organ-transplantation, with the delicate vascular surgery and micro-surgery that it entailed, was never simple. In incompetent hands, it could turn into a nightmare.

Dal took a deep breath and began running the anatomical atlas tapes through the reader, checking the critical points of Moruan anatomy. Oxygen-transfer system, circulatory system, renal filtration system—at first glance, there was little resemblance to any of the "typical" oxygen-breathing mammals Dal had studied in medical school. But then something struck a familiar note, and he remembered studying the peculiar Moruan renal system, in which the creature's chemical waste products were filtered from the bloodstream in a series of tubules passing across the peritoneum, and re-absorbed into the intestine for excretion. Bit by bit other points of the anatomy came clear, and in half an hour of intense study Dal began to see how the inhabitants of Morua VIII were put together.

Satisfied for the moment, he then pulled the tapes that described the Moruans' own medical advancement. What were they doing attempting organ-transplantation, anyway? That was the kind of surgery that even experienced Star Surgeons preferred to take aboard the hospital ships, or back to Hospital Earth, where the finest equipment and the most skilled assistants were available.

There was a signal buzzer, the two-minute warning before the Koenig drive took over. Dal tossed the tape spools back into the bin for refiling, and went forward to the control room.

Just short of two hours later, the Lancet shifted back to normal space drive, and the cold yellow sun of the Moruan system swam into sight in the viewscreen. Far below, the tiny eighth planet glistened like a snowball in the reflection of the sun, with only occasional rents in the cloud blanket revealing the ragged surface below. The doctors watched as the ship went into descending orbit, skimming the outer atmosphere and settling into a landing pattern.

Beneath the cloud blanket, the frigid surface of the planet spread out before them. Great snow-covered mountain ranges rose up on either side. A forty-mile gale howled across the landing field, sweeping clouds of powdery snow before it.

A huge gawky vehicle seemed to be waiting for the ship to land; it shot out from the huddle of gray buildings almost the moment they touched down. Jack slipped into the furs that he had pulled from stores, and went out through the entrance lock and down the ladder to meet the dark furry creatures that were bundling out of the vehicle below. The electronic language translator was strapped to his chest.

Five minutes later he reappeared, frost forming on his blue collar, his face white as he looked at Dal. "You'd better get down there right away," he said, "and take your micro-surgical instruments. Tiger, give me a hand with the anaesthesia tanks. They're keeping a patient alive with a heart-lung machine right now, and they can't finish the job. It looks like it might be bad."

The Moruan who escorted them across the city to the hospital was a huge shaggy creature who left no question of the evolutionary line of his people. Except for the flattened nose, the high forehead and the fur-less hand with opposing thumb, he looked for all the world like a mammoth edition of the Kodiak bears Dal had seen displayed at the natural history museum in Hospital Philadelphia. Like all creatures with oxygen-and-water based metabolisms, the Moruans could trace their evolutionary line to minute one-celled salt-water creatures; but with the bitter cold of the planet, the first land-creatures to emerge from the primeval swamp of Morua VIII had developed the heavy furs and the hibernation characteristics of bear-like mammals. They towered over Dal, and even Tiger seemed dwarfed by their immense chest girth and powerful shoulders.

As the surface car hurried toward the hospital, Dal probed for more information. The Moruan's voice was a hoarse growl which nearly deafened the Earthmen in the confined quarters of the car but Dal with the aid of the translator could piece together what had happened.

More sophisticated in medical knowledge than most races in the galaxy, the Moruans had learned a great deal from their contact with Hospital Earth physicians. They actually did have a remarkable grasp of physiology and biochemistry, and constantly sought to learn more. They had already found ways to grow replacement organs from embryonic grafts, the Moruan said, and by copying the techniques used by the surgeons of Hospital Earth, their own surgeons had attempted the delicate job of replacing a diseased organ with a new, healthy one in a young male afflicted with cancer.

Dal looked up at the Moruan doctor. "What organ were you replacing?" he asked suspiciously.

"Oh, not the entire organ, just a segment," the Moruan said. "The tumor had caused an obstructive pneumonia—"

"Are you talking about a segment of lung?" Dal said, almost choking.

"Of course. That's where the tumor was."

Dal swallowed hard. "So you just decided to replace a segment."

"Yes. But something has gone wrong, we don't know what."

"I see." It was all Dal could do to keep from shouting at the huge creature. The Moruans had no duplication of organs, such as Earthmen and certain other races had. A tumor of the lung would mean death ... but the technique of grafting a culture-grown lung segment to a portion of natural lung required enormous surgical skill, and the finest microscopic instruments that could be made in order to suture together the tiny capillary walls and air tubules. And if one lung were destroyed, a Moruan had no other to take its place. "Do you have any micro-surgical instruments at all?"

"Oh, yes," the Moruan rumbled proudly. "We made them ourselves, just for this case."

"You mean you've never attempted this procedure before?"

"This was the first time. We don't know where we went wrong."

"You went wrong when you thought about trying it," Dal muttered. "What anaesthesia?"

"Oxygen and alcohol vapor."

This was no surprise. With many species, alcohol vapor was more effective and less toxic than other anaesthetic gases. "And you have a heart-lung machine?"

"The finest available, on lease from Hospital Earth."

All the way through the city Dal continued the questioning, and by the time they reached the hospital he had an idea of the task that was facing him. He knew now that it was going to be bad; he didn't realize just how bad until he walked into the operating room.

The patient was barely alive. Recognizing too late that they were in water too deep for them, the Moruan surgeons had gone into panic, and neglected the very fundamentals of physiological support for the creature on the table. Dal had to climb up on a platform just to see the operating field; the faithful wheeze of the heart-lung machine that was sustaining the creature continued in Dal's ears as he examined the work already done, first with the naked eye, then scanning the operative field with the crude microscopic eyepiece.

"How long has he been anaesthetized?" he asked the shaggy operating surgeon.

"Over eighteen hours already."

"And how much blood has he received?"

"A dozen liters."

"Any more on hand?"

"Perhaps six more."

"Well, you'd better get it into him. He's in shock right now."

The surgeon scurried away while Dal took another look at the micro field. The situation was bad; the anaesthesia had already gone on too long, and the blood chemistry record showed progressive failure.

He stepped down from the platform, trying to clear his head and decide the right thing to do.

He had done micro-surgery before, plenty of it, and he knew the techniques necessary to complete the job, but the thought of attempting it chilled him. At best, he was on unfamiliar ground, with a dozen factors that could go wrong. By now the patient was a dreadful risk for any surgeon. If he were to step in now, and the patient died, how would he explain not calling for help?

He stepped out to the scrub room where Tiger was waiting. "Where's Jack?" he said.

"Went back to the ship for the rest of the surgical pack."

Dal shook his head. "I don't know what to do. I think we should get him to a hospital ship."

"Is it more than you can handle?" Tiger said.

"I could probably do it all right—but I could lose him, too."

A frown creased Tiger's face. "Dal, it would take six hours for a hospital ship to get here."

"I know that. But on the other hand...." Dal spread his hands. He felt Fuzzy crouching in a tight frightened lump in his pocket. He thought again of the delicate, painstaking microscopic work that remained to be done to bring the new section of lung into position to function, and he shook his head. "Look, these creatures hibernate," he said. "If we could get him cooled down enough, we could lighten the anaesthesia and maintain him as is, indefinitely."

"This is up to you," Tiger said. "I don't know anything about surgery. If you think we should just hold tight, that's what we'll do."

"All right. I think we'd better. Have them notify Jack to signal for a hospital ship. We'll just try to stick it out."

Tiger left to pass the word, and Dal went back into the operating room. Suddenly he felt as if a great weight had been lifted from his shoulders. There would be Three-star Surgeons on a Hospital Ship to handle this; it seemed an enormous relief to have the task out of his hands. Yet something was wriggling uncomfortably in the back of his mind, a quiet little voice saying this isn't right, you should be doing this yourself right now instead of wasting precious time....

He thrust the thought away angrily and ordered the Moruan physicians to bring in ice packs to cool the patient's huge hulk down to hibernation temperatures. "We're going to send for help," Dal told the Moruan surgeon who had met them at the ship. "This man needs specialized care, and we'd be taking too much chance to try to do it this way."

"You mean you're sending for a hospital ship?"

"That's right," Dal said.

This news seemed to upset the Moruans enormously. They began growling among themselves, moving back from the operating table.

"Then you can't save him?" the operating surgeon said.

"I think he can be saved, certainly!"

"But we thought you could just step in—"

"I could, but that would be taking chances that we don't need to take. We can maintain him until the hospital ship arrives."

The Moruans continued to growl ominously, but Dal brushed past them, checking the vital signs of the patient as his body temperature slowly dropped. Tiger had taken over the anaesthesia, keeping the patient under as light a dosage of medication as was possible.

"What's eating them?" he asked Dal quietly.

"They don't want a hospital ship here very much," Dal said. "Afraid they'll look like fools all over the Confederation if the word gets out. But that's their worry. Ours is to keep this bruiser alive until the ship gets here."

They settled back to wait.

It was an agonizing time for Dal. Even Fuzzy didn't seem to be much comfort. The patient was clearly not doing well, even with the low body temperatures Dal had induced. His blood pressure was sagging, and at one time Tiger sat up sharply, staring at his anaesthesia dials and frowning in alarm as the nervous-system reactions flagged. The Moruan physicians hovered about, increasingly uneasy as they saw the doctors from Hospital Earth waiting and doing nothing. One of them, unable to control himself any longer, tore off his sterile gown and stalked angrily out of the operating suite.

A dozen times Dal was on the verge of stepping in. It was beginning to look now like a race with time, and precious minutes were passing by. He cursed himself inwardly for not taking the bit in his teeth at the beginning and going ahead the best he could; it had been a mistake in judgment to wait. Now, as minutes passed into hours it looked more and more like a mistake that was going to cost the life of a patient.

Then there was a murmur of excitement outside the operating room, and word came in that another ship had been sighted making landing maneuvers. Dal clenched his fists, praying that the patient would last until the hospital ship crew arrived.

But the ship that was landing was not a hospital ship. Someone turned on a TV scanner and picked up the image of a small ship hardly larger than a patrol ship, with just two passengers stepping down the ladder to the ground. Then the camera went close-up. Dal saw the faces of the two men, and his heart sank.

One was a Four-star Surgeon, resplendent in flowing red cape and glistening silver insignia. Dal did not recognize the man, but the four stars meant that he was a top-ranking physician in the Red Service of Surgery.

The other passenger, gathering his black cloak and hood around him as he faced the blistering wind on the landing field, was Black Doctor Hugo Tanner.

Moments after the Four-star Surgeon arrived at the hospital, he was fully and unmistakably in command of the situation. He gave Dal an icy stare, then turned to the Moruan operating surgeon, whom he seemed to know very well. After a short barrage of questions and answers, he scrubbed and gowned, and stalked past Dal to the crude Moruan micro-surgical control table.

It took him exactly fifteen seconds to scan the entire operating field through the viewer, discussing the anatomy as the Moruan surgeon watched on a connecting screen. Then, without hesitation, he began manipulating the micro-instruments. Once or twice he murmured something to Tiger at the anaesthesia controls, and occasionally he nodded reassurance to the Moruan surgeon. He did not even invite Dal to observe.

Ten minutes later he rose from the control table and threw the switch to stop the heart-lung machine. The patient took a gasping breath on his own, then another and another. The Four-star Surgeon stripped off his gown and gloves with a flourish. "It will be all right," he said to the Moruan physician. "An excellent job, Doctor, excellent!" he said. "Your technique was flawless, except for the tiny matter you have just observed."

It was not until they were outside the operating room and beyond earshot of the Moruan doctors that the Four-star surgeon turned furiously to Dal. "Didn't you even bother to examine the operating field, Doctor? Where did you study surgery? Couldn't you tell that the fools had practically finished the job themselves? All that was needed was a simple great-vessel graft, which an untrained idiot could have done blindfolded. And for this you call me clear from Hospital Earth!"

The surgeon threw down his mask in disgust and stalked away, leaving Dal and Tiger staring at each other in dismay.

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