The lecturer was a Nidian who had been intro- I duced as Senior Physician Cresk-Sar. While it was speaking, it prowled up and down the line of trainees like some small, hairy, carnivorous beast, which meant that every few minutes it passed Cha Thrat so closely that she wanted to either fold her limbs in defensive mode or run away.
To minimize verbal confusion during meetings with other-species entities, it was saying, and to avoid in-advertently giving offense, it is assumed that all members of the medical and support staff who do not belong to your own particular species are sexless. Whether you are addressing them directly or discussing them in their absence, you will always think of them as an 'it'. The only exception to this rule is when an other-species patient is being treated for a condition directly related to its sex, in which case the doctor must know whether it is male or female, or one of the multisexed species, if the proper treatment is to be carried out.
I am a male Nidian DBDG, Cresk-Sar went on, but do not think of me as 'he' or 'him'. Think of me as'it'.”
As the disgusting, hairy shape moved to within a few paces of her before turning away again, Cha Thrat thought that she would have no difficulty in thinking of this Senior Physician as it.”
With the intention of finding someone less repulsive to look at, she turned her eyes toward the trainee closest to her—one of the three silver-furred Kelgians attending the lecture. It was strange, she thought, how the Ni-dian's fur made her cringe inwardly while the equally alien covering of the Kelgian relaxed and calmed her like a work of great art. The fur was in constant motion, with long, slow ripples moving from the creature's conical head right down to its tail, with occasional cross-eddies and wavelets appearing, as if the incredibly fine pelt was a liquid stirred by an unfelt wind. At first she thought the movements were random, but a pattern of ripples and eddies seemed to be developing the more closely shewatched.
What are you staring at? the Kelgian said suddenly, its translated words overlaid by the moaning and hissing sounds of its native speech. Do I have a bald patch, or something?”
I'm sorry, I had not meant to give offense, Cha Thrat said. Your fur is beautiful and I couldn't help ad-| miring it the way it moves—”
Pay attention, you two! the Senior Physician saidj sharply. It moved closer, looked up at each of them in turn, then went prowling down the line again.
Cresk-Sar's fur, the Kelgian said softly, is a sight.'] It makes me think that invisible and no doubt imaginary ; parasites are about to change their abode. It gives me a terrible psychosomatic itch.”
This time Cresk-Sar gave them another long look, made an irritated, snuffling sound that did aot translate, and continued with what it was saying.
... There is a great deal of illogical behavior associated with sexual differences, it went on, and I must emphasize once again, unless the sex of a particular entity has a direct bearing on its course of treatment, the subject must be ignored if not deliberately avoided. Some of you may consider that such knowledge of another species would be helpful, conversationally useful during off-duty meetings or, as often happens in this place, when a particularly interesting piece of gossip is circulating. But believe me, in this area, ignorance is a virtue.”
Surely, said a Melfan trainee halfway down the line, there are interspecies social occasions, shared meals or lectures, when it would be a gross act of bad manners to ignore another intelligent and socially aware person's gender. I think that—”
And / think, Cresk-Sar said with a bark, or laugh, that you are what our Earth-human friends call a gentleman. You haven't been listening. Ignore the difference. Consider everyone who is not of your own species as neuter. In any case, you would have to observe some of our other-species people very closely to tell the differ-ence, and that in itself could cause serious embarrassment. In the case of Hudlar life-mates, who alternate between male and female mode, the behavior patterns are quite complex.”
What would happen, the Keigian beside her said, if they should go, completely or partly, out of synchronization?”
From the line of trainees there were a number of different sounds, none of which registered on her translator. The Senior Physician was looking at the Kelgian, whose fur, for some reason, had begun to move in rapid, irregular ripples.
I shall treat that as a serious question, Cresk-Sar said, although I doubt that it was intended as such. Rather than answer it myself, I shall ask one of you to do so. Would the Hudlar trainee please step forward. So that, Cha Thrat thought, is a Hudlar. It was a squat, heavy life-form with a hard, almost featureless dark-gray skin, discolored by patches of the dried paint she had seen it spraying on itself before they had entered the lecture theater, and she had decided then that it was extremely careless in its application of cosmetics. The body was supported on six heavy tentacles, each of which terminated in a cluster of flexible digits, curled inward so that the weight was borne on heavy knuckles and the fingers remained clear of the floor.
There were no body openings that she could see, not even in the head, which contained eyes protected by hard, transparent shells and a semicircular membrane that vibrated to produce the creature's words as it turned toward them.
It is very simple, respected colleagues, the Hudlar said. While I am presently male, Hudlars are all sexually neutral until puberty, after which the direction taken is dependent on social-environmental influences,sometimes quite subtle influences that do not involva body contact. A picture of an attractive male-mode Hudi lar might impel one from neuter toward female mode, or the other way around. A conscious choice can be made if the career one intends to follow favors a particular sexj Unless one is mated, the postpuberty sex choice is fixed for the remainder of one's life.
When two adults become life-mates, the Hudlar went on, that is, when they join for the purpose of becoming parents and not simply for temporary pleasure, the sex changes are initiated shortly after conception. By the time the child is born the male has become much less aggressive, more attentive and emotionally oriented ward its mate, while its mate is beginning to lose the female characteristics. Following parturition, the process continues, with the father-that-was taking responsibility for the child while progressing to full female mode, and the mother develops all the male characteristics that will enable it to be a father-to-be.
There is, of course, a time during which both life-mates are emotional neuters, the Hudlar added, but this is a period of the pregnancy when physical coupling is contraindicated.”
Thank you, the Senior Physician said, but held up a small, hairy hand to indicate that the Hudlar should remain where it was. Any further comments, questions?”
It was looking at the Kelgian beside her, the one who had asked the original question, but Cha Thrat spoke on impulse.
It seems to me that the Hudlars are fortunate, she said, in that they are not troubled by the situation of the members of one sex considering themselves innately superior to the other, as is the case on Sommaradva..
And on too many other worlds of the Federation,” the Kelgian interjected, the fur rising into tufts behind itshead.
... I thank the Hudlar for its explanation, Cha Thratwent on, but I was surprised to find that it is presently a male. My first thought, based on observation of what I mistakenly assumed to be cosmetic paint on its body, was that it was female.”
The Hudlar's speaking membrane began to vibrate, but Cresk-Sar held its hand up for silence and said, What are your second thoughts?”
Confused, she stared at the hairy little creature, wondering what she was expected to say.
Come, come, Cresk-Sar barked. Tell us what other thoughts, observations, assumptions, mistaken or otherwise, have been going through your Sommaradvan mind regarding this life-form. Think and speak clearly.”
Cha Thrat turned all her eyes on it in a way that, had it been a Sommaradvan, would have elicited an immediate verbal and physical response. She said, My first thoughts were as described. My second was that it might be Hudlar males rather than females, or perhaps both, who wear decorative paint. Then I observed that the being's movements were careful, as if it was afraid of injuring nearby people and equipment, the movements of a gentle being of immense physical strength. That taken in conjunction with the low, squat form of the body, with six rather than two or four limbs, suggested that it was a native of a dense, heavy-gravity world with comparable atmospheric pressure, where an accidental fall would be damaging. The very hard but flexible skin, which is unbroken by any permanent body orifices for the intake or elimination of food, suggested that the paint which I had observed the Hudlar spraying onto itself might be a nutrient solution.”
The eyes of Cresk-Sar, and the variegated visual sen-sors of the other trainees, were watching her steadily. Nobody spoke.
Hesitantly she added, Another thought, wonderful and exciting but, I expect, pure supposition, is that if this heavy-gravity, high-pressure creature can live unprotected in the hospital surroundings, its body must be capable of containing its own very high internal pressures, and an even lower pressure environment should not inconvenience it. .
It might be possible, she went on, expecting a storm of ridicule from the Nidian Senior, for it to work unprotected in space. This would mean that—”
At any moment, Cresk-Sar said, holding its hand up, you will give me its physiological classification coding, even though we haven't covered that yet. Is this the first time you've seen a Hudlar?”
I saw two of them in the dining hall, she replied, but at the time I was too confused to know what I was seeing.”
May your confusion continue to diminish, Cha Thrat, Cresk-Sar said. Turning its head toward the others, it went on, This trainee has displayed the qualities of observation and deduction that, when trained and refined, will enable you to live among, understand, and . treat your other-species colleagues and patients. However, I would advise you not to think of a particular life-form as a Nidian, a Hudlar, a Kelgian, a Melfan, or a I Sommaradvan, that is, by their planets of origin, but by • their physiological classifications, DBDG, FROB, DBLF, ELNT, or DCNF. That way you will always be ; reminded of their pressure, gravity, and atmosphere requirements, basic metabolism and other physiological needs, and know immediately when there is a potential environmental threat to them or to yourselves.”
It continued, Should a PVSJ, a chlorine-breathingnative of Illensa, accidentally rupture its pressure envelope, the risk to the being concerned and to any oxygen-breathing D, E, and F prefixes in the vicinity would be extreme. And, if you are ever called to a space rescue situation, there may be times when an urgent and accurate identification of the casualty's physiological classification, and therefore its life-support requirements, may depend on a single limb or small area of body surface glimpsed under shifting wreckage.
You must train yourselves to be aware, instinctively, of all the differences of the people around you, Cresk-Sar went on, giving a low laugh-bark, if only to know whom it is safe to jostle in the corridors. And now I will take you to the wards for your initial patient experience before my next class in—”
What about the classification system? said the silver-furred Kelgian—the DBLF, Cha Thrat corrected herself—beside her. If it is as important as you say it is, surely you are lacking in the qualities of a teacher not to have explained it to us.”
Cresk-Sar walked slowly toward the speaker, and she wondered if she could possibly reduce the verbal violence to come by asking the Senior Physician another and more politely worded question. But for some reason the Nidian completely ignored the DBLF and spoke instead to Cha Thrat.
You will already have observed, it said, that these Kelgian DBLF life-forms are outspoken, ill-mannered, rude, and completely lacking in tact...”
You should talk, Cha Thrat thought.
... But there are good psychophysiological reasons for this, it went on. Because of inadequacies in the Kelgian speech organs, their spoken language lacks modulation, inflection, and all emotional expression. But they are compensated by their highly mobile fur that acts, so far as another Kelgian is concerned, as a perfect but uncontrollable mirror to the speaker's emotional state. As a result the concept of lying, of being diplomatic, tactful, or even polite is completely alien to them. A DBLF says exactly what it means or feels, because the fur reveals its feelings from moment to moment and to do otherwise would be sheer stupidity. The opposite also holds true, because politeness and the verbal circumlocution used by many species confuses and irritates them.
You will find some of the personalities here as alien as the persons, it continued. Considering the fact that you have met only one other-species being before your arrival here, your behavior today makes me sure that you will have not trouble in adapting to—”
Teacher's pet, the DBLF said, its fur tufting into spikes. I was the one who asked the question, remember?”
That you did, Cresk-Sar replied, looking at the wall chronometer. Tapes covering the life-form physiological classification system will be sent to your quarters sometime today. You must study the visual material they con- -| tain, carefully and repeatedly, and use your translators on the spoken commentary. But now I have time only to outline the basics of the system.”
It turned suddenly and resumed its place facing them, Plainly the answer to the question was being directed,! toward everyone.
Unless you have already been attached to one of the smaller, multienvironment hospitals, Cresk-Sar said, you will normally have encountered off-world patients one species at a time, probably on a short-term basis as a result of a ship accident, and you would refer to them by their planets of origin. But I must stress once again, the rapid and accurate identification of incoming patients isvital, because all too often they are in no condition to furnish the necessary physiological data themselves. Here we have evolved a basic, four-letter physiological classification system that enables us to provide the required life-support and initial treatment pending a more detailed investigation, if that should be necessary, by Pathology. It works like this.
The first letter denotes the level of physical evolution reached by the species when it acquired intelligence, it continued. The second indicates the type and distribution of limbs, sense organs, and body orifices, and the remaining two letters refer to the combination of metabolism and food and air requirements associated with the home planet's gravity and atmospheric pressure, which in turn gives an indication of the physical mass and protective tegument possessed by the being.”
Cresk-Sar barked softly before saying Usually I have to remind our other-species trainees at this point that the initial letter of their classification should not be allowed to give them feelings of inferiority, because the degree of physical evolution is controlled by environmental factors and bears little relation to the degree of intelligence...”
Species with the prefix A, B, or C, it went on to explain, were water-breathers. On most worlds, life had originated in the sea, and these beings had developed intelligence without having to leave it. D through F were warm-blooded oxygen-breathers, into which group most of the intelligent races of the Federation fell, and the G and K types were also oxygen breathing, but insectile. The Ls and Ms were light-gravity, winged beings.
Chlorine-breathing life-forms were contained in the O and P groups, and after these came the more exotic, the more highly evolved physically, and the downright weird types. Into these categories fell the radiation-eaters, the ultra-cold-blooded or crystalline beings, and entities ca-pable of modifying their physical structure at will. However, those beings possessing extrasensory powers, telekinesis, or teleportation sufficiently well developed to make ambulatory or manipulatory appendages unnecessary were given the prefix V regardless of their size, shape, or environmental background.
'There are anomalies in the system, the Senior Physician continued, and these must be bjamed on the lack of imagination and foresight of the originator. The AACP life-form, for example, has a vegetable metabolism. Normally the A prefix denotes a water-breather, there being nothing lower on our evolutionary coding scale than the piscatorial life-forms. But the double-A prefix, the AACPs, are mobile, intelligent vegetables, and plant life evolved before the fish.
And now, it said, looking at the chronometer again, you will meet some of these weird and wonderful and perhaps horrifying creatures. It is the hospital's policy to give you the earliest possible opportunity of getting to know and work with the patients and staff members. Regardless of your position or seniority in your home-planet hospitals, your rank here will be that of Junior or Trainee Nurse—until, that is, you can convince me that your professional competence warrants a higher rating.
I am not easy to convince, Cresk-Sar added as it began moving toward the exit. Follow me, please.”
It was not easy to follow the Senior Physician because it moved fast for such a small being, and Cha Thrat had the feeling that the other trainees were more experienced in navigating the hospital corridors than she was. But then she noticed that the Hudlar—the FROB—was falling behind as well.
For obvious reasons, the FROB said as they drew level, the people here give me plenty of room. If youwere to stay directly behind me, together we might significantly increase our speed.”
She had a sudden and shocking feeling of unreality, as if she had been plunged into a nightmare world that was both terrifying and wonderful, a world in which courtesy was being shown by a horrendous beast that was capable of tearing her apart without straining a muscle on one of its six tentacles. But even if this were a dream, the proper response had to be made.
You are most considerate, she said. Thank you. The being's membrane vibrated but the sound did not translate. Then it said, About the nutrient paint you noticed earlier, to complete your information and to show how close your deductions were to the actuality, the paint is not necessary at home. There the atmosphere is so dense and thickly packed with edible, floating organisms that it resembles a semiliquid soup, a food source that, because of our high metabolic rate, is absorbed continuously. As you can see, the last paint application has almost disappeared and is due for renewal.”
Before she could reply, one of the Kelgian DBLFs fell back and said, I was nearly walked on by a Tralthan just now. This looks like a good idea. There's room for one more.”
It moved closer to Cha Thrat so that they were both protected by the Hudlar's massive body. Choosing her words carefully, she said, I do not wish to give offense, but I cannot tell the difference between one Kelgian and another. Are you the DBLF whose fur I was admiring during the lecture?”
Admiring, you used the right word! the Kelgiansaid, its fur running in concentric waves from head totail. Don't worry about it. If we had more than oneSommaradvan, I couldn't tell the difference either.”
Suddenly the Hudlar stopped and, looking past itsspeaking membrane, she saw why. The whole group ofl trainees had halted and Cresk-Sar was beckoning to af Melfan and the other two Kelgians.
This is a Tralthan post-op recovery ward, it said.l You two will report here after lectures every day until] instructed otherwise. You don't need protective suits,; the air is breathable, and trace quantities of Tralthan) body odor should be ignored. Go in, you're expected.”
When the party was on its way again she noticed aJ few of the trainees detaching themselves without being told, and assumed that they had joined the class earlier and had already been assigned wards. One of them was her Hudlar crowd controller. Very soon the group had shrunk until there was only the DBLF and herself left, and Cresk-Sar was pointing at the Kelgian.
This is a PVSJ medical ward, it said briskly. You will be met inside the lock antechamber and instructed in the use of your protective envelope before going through. You will then—”
But they're chlorine-breathers in there! the Kelgian protested, its fur standing out in spikes. Can't you give me a ward where I can at least breathe the air? Do you try to make it as difficult as possible for the new people? What happens if I accidentally rupture my suit?”
To answer your questions in turn, the Senior Physician replied, No. You've discovered that. And the nearby patients would have their existing injuries complicated by oxygen contamination.”
What about me, stupid?”
You, Cresk-Sar said, would suffer chlorine poisoning. And what the Charge Nurse would do to you if you recovered doesn't bear thinking about.”
She had to concentrate so hard on keeping pace with the Senior Physician as they descended three levels, and traversed seemingly endless and overpopulated corri-dors, that there was no chance to ask what she would be expected to do. But then Cresk-Sar stopped at an enormous lock entrance that was visually identified in the Galactic Federation's principal written languages—but which did not, of course, include Sommaradvan—and answered the unasked question.
This is the hospital's AUGL ward, it said. You will find that the patients, all natives of the ocean work! of Chalderescol, are among the most visually fearsome beings you are ever likely to encounter. But they are harmless so long as you—”
The A prefix^ Cha Thrat broke in urgently, denotes water-breathers.”
Correct, the Nidian said. What's wrong? Is there a problem O'Mara didn't tell me about? Are you uncomfortable or afraid in water?”
No, Cha Thrat said. 1 enjoy swimming, on the surface. The problem is my lack of a protective garment.”
Cresk-Sar barked and said, There is no problem. The more complex protective equipment for heavy-gravity, high-pressure, and elevated temperature work needs time to produce, but a simple, water-impermeable, contoured envelope with air and communication systems is an easy job for the fabricator. Your suit is waiting for youinside.”
This time the Senior Physician went with her, explaining that, as she was a new life-form to the hospital, it had to ensure that her equipment functioned properly and comfortably. But in the event, it was the being waiting for them in the lock antechamber who immediately took charge and did all the talking.
Cha Thrat, it said briskly, I am Charge Nurse Hredlichli, a PVSJ. Your protective envelope is in two pieces. Climb into the lower half, pulling on one leg at a time, in whichever order you find most convenient,using the heavier arms encircling your waist. Use the same four arms to pull on the top half, inserting the head; and four shoulder-mounted arms first. You will think that the limb end-sections are small, but this is to ensure a tight fit and maximum sensitivity for the digits. Don't seal the waist joint until you know that your air supply is working. When you are sealed in, I'D show you the systems checks that must be performed at every dressing. Then you will remove the envelope and put it on again, repeating the process until we are both happy with your performance. Please begin.”
Hredlichli circled her, giving advice and directions during the first three dressings, and then seemed to ignore her while it talked to the Senior Physician. The spiney, membraneous body, looking like a haphazard collection of oily, unhealthy vegetation, was obscured by the yellow chlorine fog inside the being's protective envelope. It was impossible to tell where the Charge Nurse's attention was directed, because Cha Thrat had been unable to locate its eyes.
We are seriously understaffed at present, Hredlichli was saying, with three of my best nurses on special post-op recovery cases to the exclusion of all else. Are you hungry?”
Cha Thrat felt that the question was for her, but was unsure of the type of answer to give—the subservient, self-negating reply expected by a ruler or the accurate, truthful kind due a warrior-level colleague. Ignorant as she was of Hredlichli's exact status, she did her best to combine the two.
I am hungry, she replied, using the opportunity to test her suit's communicator, but the condition is not yet so advanced that it would impair me physically.”
Good! said Hredlichli. As a junior-in-training you will soon discover that practically everyone and every-thing takes precedence over you. If this causes emotional tension, which may be expressed as verbal resentment or anger, try not to release it until you are out of my ward. You will be allowed to visit your dining hall, for a strictly limited period, as soon as someone returns to relieve you. And now I think you know how your suit works...”
Cresk-Sar turned toward the entrance. Lifting one tiny, hairy hand, it said, Good luck, Cha Thrat.”
... So we'll go inside to the Nurses' Station, it went on, seeming to ignore the departing Nidian. Double-check your suit seals and follow me.”
She found herself in a surprisingly small compartment that had one transparent wall giving a view into a dim green world where the difference between the inhabitants and the decorative vegetation designed to make them feel at home was unclear. The other three sides of the room were covered by storage units, monitor screens, and equipment whose purpose she could not even guess at. The entire ceiling was devoted to brightly colored signs and geometrical shapes.
We have a very good staff and patient safety record in this ward, the Charge Nurse went on, and I don't want you to spoil it. Should you damage your suit and be in danger of drowning, however, mouth-to-mouth resuscitation is not advisable between oxygen- and chlorine-breathers, so you must move quickly to one of the emergency air chambers marked so —she indicated one of the ceiling designs— and await rescue. But the accident, or should I say the serious inconvenience, that you must guard against is pollution by patient body wastes. Filtration or replacement of the water volume in a ward this size is a major maintenance operation that would hamper our work and get us talked about in derogatory fashion all over the hospital.”
I understand, Cha Thrat said.
Why had she come to this awful place, she wondered, ] and could she justify to herself her immediate resignation? In spite of the warnings from O'Mara and Cresk-Sar that she would be starting at the lowest level, this was not work for a Sommaradvan warrior-surgeon. If word of what she was expected to do were to get back to her erstwhile colleagues, she would be forced into the life of a recluse. But these people were not likely to tell her people about it because, to them, such activities were so commonplace as to be unworthy of mention. Perhaps she would be found unsuitable or incompetent and dismissed from the hospital with this demeaning and unpleasant episode secret and her honor intact. But she was dreading what was coming next.
But it was not nearly as bad as she had expected.
The patients usually know in advance when they need to evacuate, Hredlichli went on, and will call the nurse with time to spare. Should you be called for this purpose, the equipment you require is stored in the compartment with its door marked like this. A frondlike arm appeared inside its protective envelope, pointing to another distinctively marked panel on the ceiling, then to its distant, brightly lit twin that shone through the green dimness of,the ward. It went on, But don't worry, the patient will know all about the operation of the equipment and will prefer to help itself. Most of them dislike using the thing, you'll find that Chalders embarrass easily, and any who are not immobilized will prefer to use the room marked with that symbol. It is a long, narrow compartment barely large enough to contain one Chalder and is operated by the user. Extraction and filtration of the wastes is automatic, and if anything goes wrong it is a Maintenance problem.”
Hredlichli's appendage rose again to point toward theconfusion of shapes at the other end of the ward. If you need help with a patient, ask Nurse Towan. Most of its time is being spent with a seriously ill patient, so don't distract it unnecessarily. Later today I shall instruct you on the Chalder optimum pulse rate, pressure, and body temperature, and how and where to obtain them. The vital signs are taken and recorded at regular intervals, the frequency depending on the condition of the patient. You will also be shown how to sterilize and dress surgical wounds, which is not a simple job on a water-breather, and in a few days you may be allowed to do it yourself. But first you must get to know your patients.”
The appendage was pointing at a doorless opening into the main ward. A sudden paralysis seemed to be affecting all twelve of Cha Thrat's limbs, and she tried desperately to delay any movement by asking questions. Nurse Towan, she said. What species is it? An AMSL, the Charge Nurse replied. A Creppel-lian octopoid, and Sector General qualified, so you have nothing to worry about. The patients know that we are being assigned a new-species trainee and are expecting you. Your body configuration is well suited to the water medium, so I suggest that you go in and begin by teaching yourself how to move about the ward.”
Please, a further question, Cha Thrat said desperately. The AMSL is a water-breather. Why aren't all of the medical attendants here water-breathers? Wouldn't it be simpler if they were Chalders, the same species astheir patients?”
You haven't even met a patient and already you're trying to reorganize the ward! Hredlichli said, producing another appendage from somewhere and gesticulating with them both. There are two reasons why we don't do as you suggest. One is that very large patients can be effectively treated by small medics, and SectorGeneral was designed with precisely that situation in mind. The second is structural. Personnel accommodation and recreation space is at a premium here, and can you imagine how much of it would be taken up by the life-support requirements of, say, a basic medical and nursing staff of one hundred water-breathing Chalders? But enough of this, the Charge Nurse said impatiently. Go into the ward and act as if you know what you're doing. We'll talk later. If I don't go for lunch this instant, they'll find me in a corridor dead from malnutrition ...”
It seemed like a very long time before she was able to venture into the green immensity of the ward, and then she swam only as far as a structural support less than five body-lengths from the entrance. The harsh, angular contours of the metal had been visually softened by irregular areas of paint and the attachment of artificial foliage, Cha Thrat saw as she swam around it, no doubt to make it resemble the vegetation of the home world.
Hredlichli had been right; she was able to adapt quickly to movement in water. When she kicked out with her feet and simultaneously swept the four mid-arms downward, she spurted forward and coasted for three body-lengths. When one or two of the mid-arms were held steady and the hands angled, quite delicate directional and positional control was possible. Previously she had never been able to remain under water for more than a few moments, and she was beginning to really enjoy the sensation. She continued to circle the structural member, moving up and down its entire length and examining the artificial vegetation even more closely. There were clusters of what could have been underwater fruit, which glowed with multihued light at her approach, revealing themselves to be a part of the ward lighting system. But the pleasures of discovery were short-lived.
One of the long, dark-green, motionless shadows lying along the floor of the ward had detached itself and was rushing silently toward her. It slowed, took monstrous, terrifying, three-dimensional form and began to circle her slowly as she had been circling the structuralsupport.
The creature was like an enormous, armored fish with a heavy, knife-edged tail, a seemingly haphazard arrangement of stubby fins, and a thick ring of ribbon tentacles projecting from the few gaps in its organic body-armor. The tentacles lay flat along its sides when it was moving forward, but they were long enough to reach beyond the thick, blunt wedge of the head. One tiny, lidless eye watched her as it circled closer.
Suddenly the head divided to reveal a vast pink cavern of a mouth edged with row upon row of enormous white teeth. It drifted closer, so that she could even see the periodic fogging of the water around its gills. The mouth opened even wider. Hello, Nurse, it said shyly.
Chapter 5
ChaThrat was not sure whether the AUGL ward's duty roster had been drawn up by Charge Nurse Hredlichli or a seriously deranged computer overlooked by the Maintenance staff, and she could not ask without calling into question someone's level of mental compe-tence. It was unbalanced, she thought, whether it re*i ferred to the roster, some anonymous Maintenance entity, or Hredlichli itself. After six days and two and a half nights darting about like an overworked minnow among her outsized Chalders, she had been given two whole days in which she could do whatever she liked— provided that part of the free time was spent at her studies.
The proportion suggested by their noxious Nidian tutor, Cresk-Sar, was ninety-nine percent.
Sector General's corridors held fewer terrors for her now, and she was trying to decide whether to go exploring or continue studying when her door signal sounded.
Tarsedth? she called. Come in.”
I hope that question refers to my purpose in calling, the Kelgian trainee said as it undulated into the room, and not another expression of doubt regarding my ideality. You should know me by new!”
Cha Thrat also knew that no reply was often the best reply.
The DBLF came to a halt in front of the viewscreen and went on. What's that, an ELNT lower mandible? You're lucky, Cha Thrat. You've gotten the hang of this physiological classification business a lot faster than the rest of us, or is it just that you study every waking minute? When Cresk-Sar pulled that three-second visual on us and you identified it as a blow-up of an FGLI large metatarsal and phalange before the picture was off the screen—”
You're right, I was lucky, Cha Thrat broke in. We had Diagnostician Thornnastor in the ward two days earlier. There was a small misunderstanding, a piece of clumsiness on my part, while we were presenting the patient for examination. For a few moments I had a veryclose look at a Tralthan large toe while the foot was trying not to step on me.”
And I suppose Hredlichli jumped on you with all five of those squishy things it uses for feet?”
It told me... Cha Thrat began, but Tarsedth's mouth and fur had not stopped moving.
I'm sorry for you, it went on. That is one tough chlorine-breather. It was Charge Nurse on my PVSJ ward before it applied for other-species duty with the Chalders, and I've been told all about it, including something that happened between it and a PVSJ Senior Physician on Level Fifty-three. I wish I knew what did happen. They tried to explain it to me but who knows what is right, wrong, normal, or utterly scandalous behavior where chlorine-breathers are concerned? Some of the people in this hospital are strange.”
Cha Thrat stared for a moment at the thirty-limbed, silvery body that sat like a furry question mark in front of the viewscreen. I agree, she said.
Returning to the original question, Tarsedth said, Are you in trouble with Hredlichli? About your clumsiness when a Diagnostician was in the ward, I mean? Will it report you to Cresk-Sar?”
I don't know, Cha Thrat replied. After we'd finished the evening surgical round, it said that I should take myself out of its sight for the next two days, and no doubt I would enjoy that as much as it would. Did I tell you that it allows me to change some of the surgical dressings now? Under its supervision, of course, and the wounds concerned are almost healed.”
Well, Tarsedth said, your trouble can't be too serious if it's having you back again. What are you going to do with your two days? Study?”
Not all the time, she replied. 1 want to explore the hospital, the areas where my protective suit will take me,that is. Cresk-Sar's high-speed tour and lecture sessions don't give me enough time to stop and ask questions.”
The Kelgian dropped another three or four sets of limbs to the floor, a clear indication that it was about to leave.
You'll be living dangerously, Cha Thrat, it said. I'm content to learn about this medical madhouse a little at a time; that way I'm less likely to end up as one of the casualties. But I've been told that the recreation level is well worth a visit. You could start your explorations from there. Coming?”
Yes, she said. There at least the heavies will be relaxing and at rest, and not charging along the corridors like mobile disasters waiting to happen to us.”
Later, Cha Thrat was to wonder how she could have been so wrong.
The signs over the entrance read:recreation level, species DBDG, DBLF, DBPK, DCNF, EGCL, ELNT, FGLI, FROB. species GKMN GLNO at own risk.
For members of the staff whose written languages were not represented, the same information was repeated endlessly via translator.
DCNF, Tarsedth said. They've got your classification up there already. Probably a routine updating by Personnel.”
Probably, Cha Thrat said. But she felt very pleased and, for the first time, important.
After days spent in crowded hospital corridors, her tiny room, and the even more cramped confines of the suit she had to wear in the tepid, green depths of the AUGL ward, the sheer size of the place made her feel insecure and unsteady. But the spaciousness, the opensky, and the long distances were apparent rather than real, she soon realized, and the initial shock diminished quickly to become a feeling of pleased surprise.
Trick lighting and some inspired landscaping had given the recreation level its illusion of tremendous spaciousness. The overall effect was of a small tropical beach enclosed on two sides by cliffs and open to a sea that stretched out to a horizon rendered indistinct by heat haze. The sky was blue and cloudless, and the water of the bay was deep blue shading to turquoise where the waves ran onto the bright, golden sand of the beach.
Only the light from the artificial sun, which was too reddish for Cha Thrat's taste, and the alien greenery fringing the beach and cliffs kept it from looking like a tropical bay anywhere on Sommaradva.
But then, space was at a premium in Sector General, she had been told before her first visit to the dining hall, and the people who worked together had to eat together. Now it seemed that they were expected to play togetheras well.
Realistic cloud effects are difficult to reproduce, Tarsedth volunteered, so rather than risk them looking artificial, they don't bother trying. The Maintenance person who suggested I come here told me that. It also said that the best thing about the place was that the gravity was maintained at half Earth-normal, which is close enough to half Kelgia- and Sommaradva-normal. The people who like to rest actively can be more active, and the others find the sand softer to lie on—Watch out!”
Three Tralthans on a total of eighteen massive feet went thundering past them and plowed into the shallows, scattering sand and spray over a wide area. The half-G conditions that allowed the normally slow and ponderous FGLIs to jump about like bipeds also kept the sand theyhad disturbed airborne for a long time before it settled back to the beach. Some of it had not settled because Cha Thrat was still trying to blink it out of her eyes.
Over there, Tarsedth said. We can shelter between the FROB and the two ELNTs. They don't look as if they are very active resters.”
But Chat Thrat did not feel like lying still and doing nothing but absorb artificial sunlight. She had too much on her mind, too many questions of the kind that could not be asked without the risk of giving serious offense, and she had found in the past that strenuous physical activity rested the mind—sometimes.
She watched a steep, low-gravity wave roll in and break on the beach. Not all of the turbulence in the bay was artificial—it varied in proportion to the number, size, and enthusiasm of the swimmers. The most favored sport, especially among the heaviest and least streamlined life-forms, was jumping into the bay from one of the springboards set into the cliff face. The boards, which seemed to her to be dangerously high until she remembered the reduced gravity, could be reached through tunnels concealed within the cliff. One board, the highest of them'all, was solidly braced and without flexibility, probably to avoid the risk of an overenthu-siastic diver fracturing its cranium on the artificial sky.
Would you like to swim? she asked suddenly. That is, I mean, if DBLFs can.”
We can, but I won't, the Kelgian said, deepening the sandy trench it had already dug for itself. It would leave my fur plastered flat and unable to move for the rest of the day. If another DBLF came by I wouldn't be able to talk to it properly. Lie down. Relax.”
Cha Thrat folded her two rear legs and gently collapsed into a horizontal position, but it must have beenobvious even to her other-species friend that she was not relaxed.
Are you worried about something? Tarsedth asked, its fur rippling and tufting in concern. Cresk-Sar? Hred-lichli? Your ward?”
Cha Thrat was silent for a moment, wondering how a Sommaradvan warrior-surgeon could explain the problem to a member of a species whose cultural background was completely different, and who might even be a servile. But until she was sure of Tarsedth's exact status, she would consider the Kelgian her professional equal, and speak.
I do not wish to offend, she said carefully, but it seems to me that, in spite of the wide-ranging knowledge we are expected to acquire, the strange and varied creatures we care for, and the wonderful devices we use to do it, our work is repetitious, undignified, without personal responsibility, invariably performed under direction, and well, servile. We should be doing something more important with our time, or such a large proportion of it, than conveying body wastes from the patients to the disposal facility.”
So that's what's bothering you, Tarsedth said, twisting its conical head in her direction. A deep, incised wound to the pride.”
Cha Thrat did not reply, and it went on. Before I left Kelgia I was a nursing superintendent responsible for the nursing services on eight wards. Same-species patients, of course, but at lettst I had come up through nursing. Some of the other trainees, yourself included, were doctors, so I can imagine how they—and you—feel. But the servile condition is temporary. It will be relieved when or if we complete our training to Cresk-Sar's satisfaction. Try not to worry about it. You are learning other-speciesmedicine, if you excuse the expression, from the bottom up.
Try taking more interest in the other end of the patient, Tarsedth added, instead of concerning yourself with the plumbing all the time. Talk to them and try to understand how their minds work.”
Cha Thrat wondered how she could explain to the Kelgian, who was a member of what seemed to be an advanced but utterly disorganized and classless civilization, that there were things that a warrior-surgeon should and should not do. Even though the medical fraternity on Sommaradva could not have cared less what happened to her, in Sector General she had been forced by circumstances into behavior that was wrong, in both the negative and positive sense, for someone of her professional status. She was acting above and below her level of competence, and it worried her.
I do talk to them, she said. One especially, and it says that it likes talking to me. I try not to favor any particular patient, but this one is more distressed than the others. I shouldn't be talking to it as I'm not qualified to treat it, but nobody else can or will do anything for the patient.”
Tarsedth's fur rippled with concern. Is it terminal? I don't know. I don't think so, Cha Thrat replied. It's been a ward patient for a very long time. Seniors examine it sometimes with advanced trainees present, and Thornnastor spoke to it when the Diagnostician was in the ward with another patient, but not to ask about its condition. I haven't access to its case history, but I'm pretty sure that the medication prescribed for it is palliative rather than curative. It is not neglected or ill treated so much as politely ignored. I'm the only one who will listen to its symptoms, so it talks to me at every opportu-nity. I shouldn't talk to it, not until I know what's wrong with it, because I'm not qualified.”
The movement of Tarsedth's fur settled down to a more even rhythm as it said, Nonsense! Everybody is qualified to talk, and a bit of verbal sympathy and encouragement can't harm your patient. But if its condition is incurable, your ward water would be teeming with Diagnosticians and Seniors intent on proving otherwise. That's the way things work here; nobody gives up on anybody. And your patient's problem will give you something to think about while you do the less attractive jobs. Or don't you want to talk to it?”
Yes, Cha Thrat said, I'm very sorry for the great, suffering brute, and I want to help it. But I'm beginning to wonder if it is a ruler, in which case I should not be talking to it.”
Whatever it is, or was, on Chalderescol, Tarsedth said, has no bearing, or shouldn't have, on its treatment as a patient. What harm can a little nonmedical sympathy and encouragement do either of you? Frankly, I don't see your difficulty.”
Patiently Cha Thrat said again, I'm not qualified.”
Tarsedth's fur was moving in a manner that denoted impatience. I still don't understand you. Talk, don't talk to it. Do whatever you want to do.”
I have talked to it, Cha Thrat said, and that's what worries me— Is something wrong?”
Can't it leave me alone! said Tarsedth, its fur tufting into angry spikes. I'm sure that's Cresk-Sar coming this way, and it's seen our trainee badges. The first question it will ask is why we aren't studying. Can't we ever escape from its infuriating 'I have .questions for you' routine?”
The Senior Physician detached itself from a group of two other Nidians and a Melfan who had been movingtoward the water's edge and stopped, looking down at them.
I have questions for both of you, it said inevitably, but unexpectedly went on. Are you able to relax in this place? Does it enable you to forget all about your work? Your Charge Nurses? Me?”
How can we forget about you, Tarsedth said, when you're here, and ready to ask us why we're here?”
The Kelgian's seeming rudeness was unavoidable, Cha Thrat knew, but her reply would have to be more diplomatic.
The answer to all four questions is, not entirely, she said. We were relaxing but were discussing problems relating to our work.”
Good, Cresk-Sar said. I would not want you to forget your work, or me, entirely. Have you a particular problem or question that I can answer for you before I rejoin my friends?”
Tarsedth was burrowing deeper into the artificial sand and pointedly ignoring their tutor who, now that it was off duty, seemed to Cha Thrat to be a much less obnoxious Nidian. Cresk-Sar deserved a polite response, even though the recent topic of discussion, the psychological and emotional problems associated with the removal of other-species body wastes, was not an area in which a Senior Physician would have firsthand experience. Perhaps she could ask a general question that would satisfy both the social requirements of the situation and her own curiosity.
As trainees, Cha Thrat said, we are assigned to the less pleasant, nonmedical ward duties, in particular those involving organic wastes. These are an unpleasant but necessary by-product common to all species whose food is ingested, digested, and eliminated. However,there must be wide differences in the chemical composition of other-species wastes. Since the hospital was designed so far as was possible to be a closed ecological system, what becomes of all this material?”
Cresk-Sar seemed to be having difficulty with its breathing for a moment, then it replied, The system is not completely closed. We do not synthesize all our food or medication and, 1 am pleased to tell you, there are no intelligent life-forms known to us who can exist on their own or any other species' wastes. As for your question, I don't know the answer, Cha Thrat. Until now the question has never come up.”
It turned away quickly and went back to its Melfan and Nidian friends. Shortly afterward the ELNT started to make clicking sounds with its mandibles while the furry DBDGs barked, or perhaps laughed, loudly. Cha Thrat could not find anything humorous in the question. To the contrary, she found the subject actively unpleasant. But the loud, untranslatable noises coming from the group showed no sign of stopping—until they were drowned out by the sharp, insistent, and even louder sounds coming from the public address system.
Emergency, it blared across the recreation level and from her translator. Code Blue, AUGL ward. All named personnel acknowledge on nearest communicator and go immediately to the AUGL ward. Chief Psychologist O'Mara, Charge Nurse Hredlichli, Trainee Cha Thrat. Code Blue. Acknowledge and go at once to—”
She missed the rest of it because Cresk-Sar had come back and was glaring down at her. It was neither barking nor laughing.
Move yourself! it said harshly. I'll acknowledge the message and go with you. As your tutor I am responsible for your medical misdeeds. Hurry.”
As they were leaving the recreation level it went on, A Code Blue is an emergency involving extreme danger to both patients and medical staff, the kind of trouble during which untrained personnel are ordered to stay clear. But they have paged you, a trainee, and, of all people, Chief Psychologist O'Mara. What have you done!
Cha Thrat and the Senior Physician arrived at the AUGL ward minutes before O'Mara and Charge Nurse Hredlichli, and joined the other three nurses on duty—two Kelgian DBLFs and a Melfan ELNT—who had abandoned their patients to take shelter in the Nurses' Station.
This normally reprehensible behavior was not being considered as a dereliction of medical duty, the tutor explained, because it was the first time in the hospital's wide experience in staff-patient relations that a Chalder had become violently antisocial.
In the green dimness at the other end of the ward a long, dark shadow drifted slowly from one side-wall to the other, as Cha Thrat had seen many of the mobile, bored, and restless Chalders doing while she had been on duty. Except for a few pieces of decorative greenery detached and drifting untidily between the supports, the ward looked peaceful and normal.
What about the other patients, Charge Nurse?”
Cresk-Sar asked. As the Senior Physician present it had overall medical responsibility. Is anyone hurt?”
Hredlichli swam along the line of monitors and said, Disturbed and frightened, but they have sustained no injuries, nor has their food and medication delivery system been damaged. They've been very lucky.”
Or the patient is being selective in its violence— O'Mara began, then broke off.
The long shadow at the other end of the ward had foreshortened and was enlarging rapidly as it rushed toward them. Cha Thrat had a glimpse of fins blurred by rapid motion, ribbon tentacles streaming backward, and the serried ranks of gleaming teeth edging the enormous, gaping mouth before it crashed against the transparent wall of the Nurses' Station. The wall bulged inward alarmingly but did not collapse.
It was too large for the dooriess entrance, she saw, but it changed position and moved three of its tentacles inside. They were not long enough or strong enough to pull anyone outside to the mouth, although one of the Kelgian nurses had a few anxious moments. Disappointed, the Chalder turned and swam away, with detached vegetation eddying its wake.
O'Mara made a sound that did not translate, then said, Who is the patient, and why was trainee Cha Thrat called?”
It is the long-stay patient, AUGL-One Sixteen, the Melfan nurse replied. Just before it became violent it was calling for the new nurse, Cha Thrat. When I told the patient that the Sommaradvan would be absent for a few days, it stopped communicating and has not spoken to us since, even though its translator is still in position and working. That is why the trainee's name was included when I called in the Code Blue.”
Interesting, the Earth-human said, turning its atten-lion to Cha Thrat. Why did it want you especially, and why should it start taking the ward apart when you weren't available? Have you established a special relationship with AUGL-One Sixteen?”
Before she could reply, the Nidian said urgently, Can the psychological ramifications wait, Major? My immediate concern is for the safety of the ward patients and staff. Pathology will give us a fast-acting anesthetic and a dart gun to pacify the patient, and then-you can—”
A dart gun! one of the Kelgians said, its fur rippling in scorn. Senior Physician, you are forgetting that your dart has to travel through water, which will slow it down, and then penetrate that organic suit of armor One Sixteen wears! The only sure way of placing the dart effectively would be to shoot it into the soft tissues of the inner mouth. To place it accurately, the person using the gun would have to be very close and might find itself following the dart into the open mouth, with immediately fatal results. 1 am not volunteering!”
Before Cresk-Sar could reply, Cha Thrat turned to the Senior Physician and said, If you will explain what exactly it is that I must do, I shall volunteer for this duty.”
You lack the training and experience to— began the Nidian, and broke off as O'Mara held up its hand for silence.
Of course you will volunteer, O'Mara said quietly. But why, Cha Thrat? Are you exceptionally brave? Are you naturally stupid? Do you have an urge to commit suicide? Or are you, perhaps, feeling a measure of responsibility and guilt?”
Major O'Mara, Hredlichli said firmly, this is not the time for apportioning responsibility or undertaking deep analysis. What is to be done about Patient One Sixteen? And my other patients?”
You're right, Charge Nurse, O'Mara said. I shalldo it my way, by attempting to pacify and reason with One Sixteen. I've spoken to it many times, enough for it to tell me apart from other Earth-humans if I wear this lightweight suit. While I'm working with it I may also need to talk to Cha Thrat, so stay by the communicator, trainee.”
No need, I'll go with you, Cha Thrat said firmly. Silently she began the mental and moral exercises that were supposed to help reconcile her to an untimely ending of her life.
And I, O'Mara said, making another sound that did not translate, will be too busy with our demented friend to stop you. Come along, then.”
But it is only a trainee, O'Mara! Cresk-Sar protested. And in a lightweight suit it might recognize you, all right, as a convenient piece of plastic-wrapped meat. This life-form is omnivorous and until recently they—”
Cresk-Sar, the Earth-human said, as it swam toward the entrance. Are you trying to worry me?”
Oh, very well, the Nidian said. But I, too, shall do things my way, in case you can't talk yourselves through this problem. Charge Nurse, signal immediately for a four-unit patient transfer team with heavy-duty suits, dart guns, and physical restraints suitable for a fully conscious and uncooperative AUGL...”
The tutor was still talking as Cha Thrat swam into the ward behind O'Mara.
For what seemed a very long time they hung silent and motionless in the middle of the ward, watched by an equally still and silent patient from the cover of a patch of torn artificial greenery. O'Mara had told her that they should not do anything that One Sixteen might construe as a threat, that they must therefore appear defenseless before it, and that the first move was up to the patient. Cha Thrat thought that the Earth-Human was probablyright, but her whole body was slippery with perspiration, and much warmer than could be explained by the temperature of the green, lukewarm water outside her protective suit. Plainly she was not yet completely reconciled to the ending of her existence.
The voice of the Senior Physician in her suk 'phones made her twitch in every limb.
The transfer team is here, Cresk-Sar said quietly. Nothing much is happening at your end. Can I send them in to move the other patients into OR? It will be a tight squeeze in there, but they will be able to receive treatment and be comfortable for a few hours, and you will have One Sixteen all to yourselves.”
Is the treatment urgent? O'Mara asked softly.
No, Cha Thrat said, answering the question before Cresk-Sar could relay it to the Charge Nurse. Just routine observation and recording of vital signs, wound dressing changes, and administration of supportive medication. Nothing really urgent.”
Thank you, Trainee, Hredlichli said in a tone as corrosive as the atmosphere it breathed, then went on. I have been Charge Nurse here for a short time, Major O'Mara, but I feel that I, too, have the patient's trust. I would like to join you.”
No, to both of you, the Earth-human said firmly. I don't want our friend to be frightened or unsettled by too many comings and goings within the ward. And Hredlichli, if your protective suit were to rupture, contact with water is instantly lethal to a chlorine-breather, as you very well know. With us oxygen-breathers, we can drown in the stuff if help doesn't reach us in time, but it isn't poisonous or— Uh-oh!”
Patient AUGL-One Sixteen was silent but no longer still. It was rushing at them like a gigantic, organic tor-pedo, except that torpedoes did not have suddenly opening mouths.
Frantically they swam apart so as to give the attacking Chalder two targets instead of one, the theory being that while it was disposing of one the other might have enough time to make it to the safety of the Nurses' Station. But this was planning for a remote contingency, the Earth-human had insisted. O'Mara would not believe that AUGL-One Sixteen, who was normally so shy and timid and amenable, was capable of making a lethal attack on anyone.
On this occasion it was right.
The vast jaws snapped shut just before the Chalder swept through the gap that had opened between them. Then the great body curved upward and over them, dove, and began swimming around them in tight circles. Turbulence sent them spinning and twisting like leaves at the center of a whirlpool. Cha Thrat did not know whether it was circling them in the vertical or horizontal plane, only that it was so close that she could feel the compression waves every time the jaws snapped shut, which was frequently. She had never felt so helpless and disoriented and frightened in all her life.
Stop this nonsense, Muromeshomon! she said loudly. We are here to help you. Why are you behavinglike this?”
The Chalder slowed but continued to circle them closely. It mouth gaped open and it said, You cannot help me, you have said that you are not qualified. Nobody here can help me. I do not wish to harm you, or anyone else, but I am frightened. I am in great pain. Sometimes I want to hurt everyone. Stay away from me or I will hurt you...”
There was a muffled, underwater clang as its tail flicked out and struck her air tanks a glancing blow,sending her spinning again. An Earth-human hand grasped one of her waist limbs, steadying her, and she saw that the patient had returned to its dark corner and was watching them.
Are you hurt? O'Mara asked, releasing its grip. Is your suit ail right?”
Yes, Cha Thrat said, and added, It left very quickly. I'm sure the blow was accidental.”
The Earth-human did not reply for a few moments, then it said, You called Patient One Sixteen by name. I am aware of its name because the hospital requires this information for possible notification of the next-of-kin, but I would not consider using its name unless there were very exceptional circumstances, and then only with its permission. But somehow you have learned its name and are using it as lightly and thoughtlessly as you would Cresk-Sar's or Hredlichii's, or my name. Cha Thrat, you must never—”
It told me its name, Cha Thrat broke in. We exchanged names while we were discussing my observations regarding the inadequacy of its treatment.”
You discussed... O'Mara said incredulously. It made an untranslatable noise and went on. Tell me what exactly you said to it.”
Cha Thrat hesitated. The AUGL had left its dark corner and was moving toward them again, but slowly. It stopped halfway down the ward and hung with its fins and tail still and the ribbon tentacles spread like an undulating, circular fan around it, watching and probably listening to every word they said.
On second thought, don't tell me, O'Mara said angrily. I'll tell you what I know about the patient first, then you can try to reduce my level of ignorance. That way we will avoid repetition and save time. I don't know how much time it will give us to talk without anotherinterruption. Not a lot, I suspect, so I'll have to speak quickly...”
Patient AUGL-One Sixteen was a long-stay patient whose time in Sector General exceeded that of many of the medical staff. The clinical picture had been and still remained obscure. Several of the hospital's top Diagnosticians had examined it, finding signs of strain in certain areas of the patient's body plating that partly explained its discomfort—a being who was largely exoskeletal, lazy, and something of a glutton could only put on weight from the inside. The generally agreed diagnosis was hypochondria and the condition incurable.
The Chalder had become seriously ill only when there was talk of sending it home, and so the hospital had acquired a permanent patient. It did not mind. Visiting as well as hospital medics and psychologists had given it a going over, and continued to do so, as did the interns and nurses of all the life-forms represented on the staff. It had been probed, pried into, and unmercifully pounded by trainees of varying degrees of gentleness, and it loved every minute of it. The hospital's teaching staff were happy with the arrangement and so was the Chalder.
Nobody mentions going home to it anymore, O'Mara ended. Did you?”
Yes, Cha Thrat said.
O'Mara made another untranslatable noise and she went on quickly. This explains why the nurses ignored it when other patients needed treatment, and supports my own diagnosis of an unspecified ruler's disease that—”
Listen, don't speak! the Earth-human said sharply. The patient seemed to be drifting closer. My depart-mep^has tried to get to the root causes of One Sixteen's hypochondria, but I was not required to solve its problem so it remained unsolved. This sounds like an excuse,and it is. But you must understand that Sector General is not and can never be a psychiatric hospital. Can you imagine a place like this where a large proportion of the multispecies patients, the mere sight of which gives sane people nightmares, are physically fit and mentally disturbed? Can you imagine the problems of other-species treatment and restraint? It is difficult enough to be responsible for the mental well-being of the staff without adding disturbed patients, even a harmlessly disturbed patient like One Sixteen, to my load. When a medically ill patient displays signs of mental instability it is kept under close observation, restrained if necessary, and returned to its own people for the appropriate treatment as soon as it is physically well enough to be discharged.”
I understand, Cha Thrat said. The explanation excuses you.”
The Earth-human grew pinker in the face, then said, Listen carefully, Cha Thrat, this is important. The Chalders are one of the few intelligent species whose personal names are used only between mates, members of the immediate family, or very special friends. Yet you, an other-species stranger, have been told, and have spoken aloud, One Sixteen's personal name. Have you done this in ignorance? Do you realize that this exchange of names means that anything you may have said to it, or any future action you may have promised, is as binding as the most solemn promise given before the highest imaginable physical or metaphysical authority?”
Do you realize now how serious this is? O'Mara went on in a tone of quiet urgency. Why did it tell you its name? What, exactly, was said between you?”
She could not speak for a moment because the patient had moved very close, so close that she could see the individual points of its six rows of teeth. A strangely detached and uncaring portion of her mind wonderedwhat evolutionary imperative had caused the upper three rows to be longer than the lower set. Then the jaw snapped shut with a boney crash that was muffled by the surrounding water, and the caring part of her mind wondered what it would sound like if a limb or her torso were between those teeth.
Have you fallen asleep? O'Mara snapped. No, she said, wondering why an intelligent being had asked such a stupid question. We talked because it was lonely and unhappy. The other nurses were busy with a post-op patient and I was not. I told it about Som-maradva and the circumstances that led to me coming here, and some of the things I would be able to do if I qualified for Sector General. It said that I was brave and resourceful, not sick and old and increasingly fearful likeitself.
It said that many times it dreamed of swimming free in the warm ocean of Chalderescol, she went on, instead of this aseptic, water-filled box with its plastic, inedible vegetation. It could talk about the home world to other AUGL patients, but much of their post-op recovery time was spent under sedation. The medical staff were pleasant to it and would talk, on the rare occasions when they had time to do so. It said that it would never escape from the hospital, that it was too old and frightened and sick.”
Escape? O'Mara said. If our permanent patient has begun to regard the hospital as a prison, that is a very healthy sign, psychologically. But go on, what were you saying to it?”
We spoke of general subjects, she replied. Our worlds, our work, our past experiences, our friends and families, our opinions—”
Yes, yes, the Earth-human said impatiently, looking at One Sixteen, who was edging closer. I'm not inter-ested in the small talk. What did you say that might have brought on this trouble?”
Cha Thrat tried to choose the words that would describe the situation concisely, accurately, and briefly as she replied, It told me about the space accident and injuries that brought it here originally, and the continuing but irregular episodes of pain that keep it here, and of its deep unhappiness with its existence generally.
I was uncertain of its exact status on Chalderescol, she went on, but from the way it had described its work I judged it to be an upper-level warrior, at least, if not a ruler. By that time we had exchanged names, so I decided to tell it that the treatment being provided by the hospital was palliative rather than curative, and it was being treated for the wrong sickness. I said that its malady was not unknown to me and, although I was not qualified to treat the condition, there were wizards on Sommaradva capable of doing so. I suggested, on several occasions, that it was becoming institutionalized and that it might be happier if it returned home.”
The patient was very close to them now. Its massive mouth was closed but not still, because there was a regular chewing motion that suggested that the teeth were grinding together. The movement was accompanied by a high-pitched, bubbling moan that was both frightening and strangely pitiful.
Go on, O'Mara said softly, but be very careful what you say.”
There is little more to tell, Cha Thrat said. During our last meeting I told it that I was leaving for a two-day rest period. It would speak only of the wizards, and wanted to know if they could cure its fear as well as the pains. It asked me as a friend to treat it, or send for one of our Sommaradvan brothers who would be able to cureit. I told it that I had some knowledge of the spells of the wizards, but not enough to risk treating it, and that I lacked the status and authority to summon a wizard to the hospital.”
What was the response to that? O'Mara asked.
None, Cha Thrat said. It would not speak to methereafter.”
Abruptly they were looking into the AUGL's open mouth, but it was keeping its uncomfortably short distance as it said, You were not like the others, who did nothing and promised nothing. You held out the hope of a cure by your wizards, then withdrew it. You cause me pain that is many times worse than that which keeps me here. Go away, Cha Thrat. For your own safety, goaway.”
The jaws crashed shut and it swept around them and headed for the other end of the ward. They could not see clearly but, judging by the voices coming from the Nurses' Station, it seemed intent on wrecking the place.
My patients! Charge Nurse Hredlichli burst out. My new treatment frames and medication cabinets...”
According to the monitors, Cresk-Sar broke in, the patients are still all right, but they've been lucky. I'm sending in the transfer team now to knock out One Sixteen. It will be a bit tricky. Both of you get back here,quickly.”
No, wait, O'Mara said. We'll try talking to it again. This is not a violent patient and I don't believe that we are in any real danger. On Cha Thrat's frequency it added, But there is always a first time for being wrong.”
For some reason a picture from Cha Thrat's childhood rose suddenly to the surface of her adult mind. She saw again the tiny, many-colored fish that had been herfavorite pet, as it circled and butted desperately and hopelessly against the glass walls of its bowl. Beyond those walls, too, lay an environment in which it would quickly asphyxiate and die. But that small fish, like this overlarge one, was not thinking of that.
When One Sixteen gave you its name, O'Mara said with quiet urgency, it placed a binding obligation on both of you to help the other in every way possible, as would a life-mate or a member of your family. When you mentioned the possibility of a cure by your Sommarad-van wizards, regardless of the efficacy of such other-species treatment, you were expected to provide the wizard regardless of any effort, cost, or personal danger to yourself.”
There were noises of tearing metal and the complaining voices of the other AUGLs being transmitted through the green water, and Hredlichli sounded very agitated. O'Mara ignored them and went on. You must keep faith with it, Cha Thrat, even though your wizards might not be able to help One Sixteen any more than we can. And I realize that you haven't the authority to call in one of your wizards. But if Sector General and the Monitor Corps were to put their combined weight behind you—”
They wouldn't come to this place, Cha Thrat said. Wizards are notoriously unstable people, but they are not stupid— It's coming back!”
This time One Sixteen was coming at them more slowly and deliberately, but still too fast for them to swim to safety, nor could the transfer team with their anesthetic darts reach them in time to do any good. There was no sound from the patients in the ward and the beings watching from the Nurses' Station. As the AUGL loomed closer she could see that its eyes had theferal, manic look of a wounded predator, and slowly it was opening its mouth.
Use its name, dammit! O'Mara said urgently. Mu-Muromeshomon, she stammered. My—my friend, we are here to help you.”
The anger in its eyes seemed to dim a little so that they reflected more of its pain. The mouth closed slowly and opened again, but only to speak.
Friend, you are in great and immediate danger, the AUGL said. You have spoken my name and told me that the hospital cannot cure me with its medicines and machines, and it no longer tries, and you will not help me even though you have said that a cure is possible. If our positions were reversed I would not act, or refuse to act, as you have done. You are an unequal friend, without honor, and I am disappointed and angry with you. Go away, quickly, and protect your life. I am beyond help.”
No! Cha Thrat said fiercely. The mouth was opening wider, the eyes were showing a manic gleam once more, and she realized that when the AUGL attacked, she would be its first victim. Desperately she went on. It is true that I cannot help you. Your sickness does not respond to the healer's herbs or the surgeon's knife, because it is a ruler's disease that requires the spells of a wizard. A Sommaradvan wizard might cure you but, since you are not yourself a Sommaradvan, there is no certainty. Here there is the Earth-human, O'Mara, a wizard with experience of treating rulers of many different life-forms. I would have approached it about your case at once but, being a trainee and unsure of the procedure, I was about to request a meeting for another, an unimportant, reason during which I would have spoken of you in detail...”
The AUGL had closed its mouth but was moving its jaws in a way that could be indicating anger or impatience. She went on quickly. In the hospital I have heard many people speak of O'Mara and his great powers of wizardry—”
I'm the Chief Psychologist, dammit, O'Mara broke in, not a wizard. Let's try to be factual about this and not make more promises we can't possibly keep!”
You are not a psychologist! Cha Thrat said. She was so angry with this Earth-human who would not accept the obvious that for a moment she almost forgot about the threat from One Sixteen. Not for the first time she wondered what obscure and undefined ruler's disease it was that made beings who possessed high intelligence, and The Power in great measure, behave so stupidly at times. Less vehemently, she went on. On Sommaradva a psychologist is a being, neither servile-healer nor warrior-surgeon, who tries to be a scientist by measuring brain impulses or bodily changes caused by physical and mental stress, or by making detailed observations of behavior. A psychologist tries to impose immutable laws in an area of spells and nightmares and changing realities, and tries to make a science of what has always been an art, an art practiced only by wizards.”
They were both watching her, eyes unblinking, motionless. The patient's expression had not changed but the Earth-human's face had gone a much deeper shade of pink.
A wizard will use or ignore the instruments and tabulations of the psychologist, she continued, to cast spells that influence the complex, insubstantial structures of the mind. A wizard uses words, silences, minute observation, and intuition to compare and graduallychange the sick, internal reality of the patient to the external reality of the world. That is the difference between a psychologist and a wizard.”
The Earth-human's face was still unnaturally dark. In a voice that was both quiet and harsh it said, Thank you for reminding me.”
Formally Cha Thrat said, No thanks are required for that which needs to be done. Please, may I remain here to watch? Before now I have never had the chance to see £ wizard at work.”
What, the AUGL asked suddenly, will the wizard do to me?”
It sounded curious and anxious rather than angry, and for the first time since entering the ward she began to feel safe.
Nothing, O'Mara said surprisingly. I shall do nothing at all...”
Even on Sommaradva the wizards were full of surprises, unpredictable behavior and words that began by sounding irrelevant, ill chosen, or stupid. What little of the literature that was available to one of the warrior-surgeon level, she had read and reread. So she composed herself and, with great anticipation, watched and listened while the Earth-human wizard did nothing at all.
The spell began very subtly with words, spoken in a manner that was anything but subtle, describing the arrival of AUGL-One Sixteen at the hospital as the commanding officer and sole survivor of its ship. The vessels of water-breathing species, and especially those of the outsize denizens of Chalderescol, were notoriously unwieldy and unsafe, and it had been exonerated of all blame for the accident both by the Monitor Corps investigators and the authorities on Chalderescol—but not by itself. This was realized when the patient's physical inju-ries had healed and it continued to complain of severe psychosomatic discomfort whenever the subject of returning home was discussed.
Many attempts were made to make the patient realize that it was punishing itself, cutting itself off from its home and friends, for a crime that was very probably imaginary, but without success—it would not con-, sciously admit that it had committed a crime, so telling it that it was not guilty had no effect. A Chalder's most prized possession was its personal integrity, and as an authority that integrity was unassailable. AUGL-One Sixteen was a sensitive, intelligent, and highly qualified being who, outwardly, was a submissive and cooperative patient. But where its particular delusion was concerned it was as susceptible to influence as the orbit of a major planet.
And so Sector General had acquired a permanent patient, an AUGL specimen in perfect health and a continuing and strictly unofficial challenge to its Department of Psychology, because only in the hospital could it be pain-free and relatively happy.
Silently Cha Thrat apologized to the Earth-human for thinking that it had been negligent, and listened in admiration as the speil took positive form.
And now, O'Mara went on, due to a combination of circumstances, a significant change has occurred. The talks with transient AUGL patients have made you increasingly homesick. Your anger over your neglect by the medical staff has been growing because, subconsciously, you yourself were beginning to suspect that you were not sick and their attention was unnecessary. And then there was the unwarranted, but for you fortunate, interference by Trainee Cha Thrat, who confirmed your suspicion that you were not being treated as a patient. You have much in common with our outspokentrainee, it continued. Both of you have reasons, real or imaginary, for not wanting to go home. On Sommaradva as on Chalderescol, personal integrity and public honor are held in high regard. But the trainee is woefully ignorant of the customs of other species and, when you took the unprecedented step of saying your name to a non-Chalder, it disappointed and hurt you grievously by continuing to act toward you as had the other members of the staff. You were driven to react violently but, because of the constraints imposed by your personality type, the violence was directed at inanimate objects.
But, the Earth-human went on, the simple act of giving your name to this sympathetic and untutored Sommaradvan, whom you had known only a few days, is the clearest possible indication of how badly you wanted help to get away from the hospital. You do still want to go home?”
AUGL-One Sixteen replied with another high-pitched, bubbling sound that did not translate. Its eyes watched only the Earth-human, and the muscles around its closed jaws were no longer clenched into iron rigidity.
It was a stupid question, O'Mara said. Of course you want to go home. The trouble is, you are afraid and also want to stay here. A dilemma, obviously. But let me try to solve it by telling you that you are once again a patient here, subject to the hospital regimen and my own special and continuing treatment, and until I pronounce you cured you will not go home...”
On the surface the situation had not changed, Cha Thrat thought admiringly. The hospital still retained its permanent AUGL patient, but now there was doubt about the permanency of the arrangement. Now it fully understood its position and had been given a choice, to stay or leave, and its departure date was unspecified so as to relieve its natural fears about leaving. But it was nolonger completely satisfied with its life in the hospital, and already the Earth-human wizard was altering its internal reality by gently stressing the rehabilitative aspects of the therapy. Material would be provided by the Monitor Corps on the changes that had occurred on the home world in its absence, which would be useful if it decided to leave and informative should it stay, and there would be regular and frequent visits by O'Mara itself and other persons it would specify.
Oh, yes, she thought as it talked on, this Earth-human wizard was good.
The transfer team and their anesthetic dart guns had long since left the Nurses' Station, which meant that Cresk-Sar and Hredlichli must have decided that the danger from AUGL-One Sixteen had passed. Looking at the passive and distress-free patient who was hanging on O'Mara's every word, she was in entire agreement with them.
... And you should now realize, the Earth-human was saying, that if you want to go, and can convince me that you are able to adapt to home-planet life, I shall with great pleasure and reluctance kick you out. You have been a patient for a very long time and, among many members of the senior staff, our professional concern has developed into the personal variety. But the best thing that a hospital can do for a friend is to send it away, as quickly as possible, cured.
Do you understand? O'Mara ended.
For the first time since the Earth-human had begun talking to it, AUGL-One Sixteen turned its attention to Cha Thrat. It said plaintively, I am feeling much better, I think, but confused and worried by all that I must do. Was that a spell? Is O'Mara a good wizard?”
Cha Thrat tried to control her enthusiasm as she said, It is the beginning of a very fine spell, and it is said that a really good wizard makes its patient do all the hardwork.”
O'Mara made another one of its untranslatable noises and signaled Hredlichli that it was safe for the nurses to return to their patients. As they turned to leave AUGL-One Sixteen, who was once again its friendly and docile self, the Chalder spoke again.
O'Mara, it said formally, you may use my name. When they were again in the air of the lock antechamber and all but Hredlichli had their visors open, the Charge Nurse said angrily, I don't want that—that interfering sitsachi anywhere near me! I know that One Sixteen is going to get better and leave sometime, and I'm glad about that. But just look at the place! Wrecked, it is! I refuse to allow that trainee in my ward. That'sfinal!”
O'Mara looked at the chlorine-breather for a moment, then in the quiet, unemotional tones of a ruler it said, It is, of course, within your authority to accept or refuse any trainee. But Cha Thrat, whether or not it is accompanied by me, will be granted visiting facilities whenever and as often as the patient itself or myself consider it necessary. I do not foresee a lengthy period of treatment. We are grateful for your cooperation, Charge Nurse, and no doubt you are anxious to return to your duties.”
When Hredlichli had gone, Cha Thrat said, There was no opportunity to speak until now, and I am unsure how my words will be received. On Sommaradva good work is expected of a wizard or any high-level ruler, so that the praise of a subordinate for a superior is unnecessary and insulting. But in this case—”
O'Mara held up a hand for silence. It said, Anything you say whether complimentary or otherwise, will haveno effect on what is to happen to you, so save your breath.
You are in serious trouble, Cha Thrat, it went on grimly. The news of what happened here will soon be all over the hospital. You must understand that to a Charge Nurse the ward is its kingdom, the nursing staff its subjects, and troublemakers, including trainees who exercise too much initiative too soon, are sent into exile, which can, in effect, mean home or to another hospital. I'd be surprised if there is a single Charge Nurse willing to accept you for practical ward training.”
The Earth-human paused, giving her a moment to assimilate its words, then went on. You have two options. Go home, or accept a nonmedical and servile position with Maintenance.”
In a more sympathetic tone than she had ever heard it use before, Cresk-Sar said, You are a most promising and diligent trainee, Cha Thrat. If you were to take such a position you would still be able to visit and talk to One Sixteen, and attend my lectures, and watch the teaching channels during your free time. But without practical ward experience you could not hope to qualify here.
If you don't resign, the Senior Physician went on, it may well be that you will discover firsthand the answer to the question you asked me this morning on the recreation level.”
Cha Thrat remembered that question very well, and the amusement it had caused among the tutor's friends. She also remembered her initial feelings of shock and shame when her duties as a trainee nurse had been explained to her. Nothing could be more demeaning for a warrior-surgeon than that, she had thought at the time, but she had been wrong.
I am still ignorant of the laws governing the hospi-tal, she said. But 1 realize that I have transgressed them in some fashion and must therefore accept the consequences. I shall not take the easy option.”
O'Mara sighed and said, It is your decision, ChaThrat.”
Before she could reply, the Nidian Senior Physician was talking again. Putting it into Maintenance would be a criminal waste, the tutor protested. It is the most promising trainee in its class. If we were to wait until the Hredlichli outcry died down, or until the grapevine is overloaded with another scandal, you might be able to find a ward that would take it for a trial period and—”
Enough, O'Mara said, visibly relenting. I don't believe in having second thoughts because the first are usually right. But I'm tired and hungry and I, too, have had enough of your trainee.
There is such a ward, it went on. FROB Geriatric, which is chronically understaffed and may be desperate enough to accept Cha Thrat. It is not a ward where I would normally assign a trainee who is not of the patients' own species, but I shall speak to Diagnostician Conway about it at the first opportunity.
Now go away, it ended sourly, before I cast a spell consigning both of you to the center of the nearest whitedwarf.”
As they were heading for the dining hall, Cresk-Sar said, It's a tough ward and, if anything, the work is even harder than a job in Maintenance. But you can say whatever you like to the patients and nobody will mind. Whatever else happens, you can't get into troublethere.”
The Nidian's words were positive and reassuring, butits voice carried undertones of doubt.
She was given two extra days off duty, but whether they were a reward for her help with AUGL-One Sixteen or because it took that long for O'Mara to arrange for her transfer to FROB Geriatric, Cresk-Sar would not say. She paid three lengthy visits to One Sixteen in the AUGL ward, during which her reception was enough to turn its tepid water to ice, but she would not risk returning to the recreation level or exploring the hospital. There was less chance of getting into trouble if she stayed in her room and watched the teaching channels.
Tarsedth pronounced her certifiably insane and wondered why O'Mara had not confirmed this diagnosis.
Two days later she was told to present herself at FROB Geriatric in time for morning duty and to make herself known to the DBLF nurse in charge. Cresk-Sar said that it would not need to introduce her on this occasion because Charge Nurse Segroth, and probably every other being on the hospital staff, would have heard all about her by now. That may have been the reason why, on her meticulously punctual arrival, she was given no opportunity to speak.
This is a surgical ward, Segroth said briskly, indicating the banks of monitors occupying three walls of the Nurses' Station. There are seventy Hudlar patients and 90a nursing staff of thirty-two counting yourself. All the nurses are warm-blooded oxygen-breathers of various species, so you will not need environmental protection other than a gravity compensator and nasal filters. The FROBs are divided into pre- and post-op patients, segregated by a light- and soundproof partition. Until you learn your way around you will not concern yourself, or go anywhere near, a post-op patient.”
Before Cha Thrat had time to say that she understood, the Kelgian ran on. We have an FROB trainee and classmate here who will, I'm sure, be happy to answer any questions you are afraid to ask me.”
Silvery fur puckered into irregular waves along its flanks in a way, she had learned from observing Tarsedth, that indicated anger and impatience. It continued. From what I've heard of you, Nurse, you are the type who will already have studied the available Hudlar material and will be eager to make a contribution. Don't even try. This is a special project of Diagnostician Conway, we are breaking new surgical ground here, so your'knowledge is already out of date. Except for those times when you are required by O'Mara for AUGL-One Sixteen, you will do nothing but watch, listen, and occasionally perform a few simple duties at the direction of the more experienced nurses or myself.
I would not want to be embarrassed, she ended, by you producing a miracle cure on your first day.”
It was easy to pick out her FROB classmate from among the other nurses on duty—they were either Kelgian DBLFs or Melfan ELNTs—and even easier to tell it apart from all the FROB patients. She could scarcely believe that there was such a horrifying difference between a mature and an aged Hudlar.
Her classmate's speaking membrane vibrated quietly on her close approach. It said, I see you've survivedyour first encounter with Segroth. Don't worry about the Charge Nurse; a Kelgian with authority is even less charming than one without. If you do exactly as it tells you, everything will be fine. I'm glad to see a friendly, familiar face in the ward.”
It was an odd thing to say, Cha Thrat thought, because Hudlars did not possess faces as such. But this one was trying hard to reassure her and she was grateful for that. It had not, however, called he'r by name, and whether the omission was deliberate or due to an oversight she did not know. Perhaps the Hudlars and Chalders had something in common besides great strength. Until she was sure that their names could be used without giving offense, they could call each other Nurse or Hey, you!”
I'm spraying and sponging-off at the moment, the Hudlar trainee said. Would you like to strap on a spare nutrient tank and follow me around? You can meet some of our patients.”
Without waiting for her reply, it went on. This one you won't be able to talk to because its speaking membrane has been muffled so that the sounds it makes will not distress the other patients and staff. It is in considerable discomfort that does not respond very well to the pain-killing medication, and, in any case, it is incapable of coherent speech.”
It was immediately obvious that this was not a well Hudlar. Its six great tentacles, which normally supported the heavy trunk in an upright position for the whole of its waking and sleeping life, hung motionless over the sides of its support cradle like rotted tree trunks. The hard patches of callus—the knuckles on which it walked while its digits were curled inward to protect them against contact with the ground—were discolored, dry, and cracking. The digits themselves, usually so steadyand precise in their movements, were twitching in continual spasm.
Large areas of its back and flanks were caked with partially absorbed nutrient paint, which would have to be washed off before the next meal could be sprayed on. As she watched, a milky perspiration was forming on its underside and dripping into the suction pan under its cradle.
What's wrong with it? Cha Thrat asked. Can it, is it being cured?”
Old age, the nurse said harshly. In a more controlled and clinical tone it went on. We Hudlars are an energy-hungry species with a greatly elevated metabolic rate. With advancing age it is the food absorption and waste elimination mechanisms, both of which are normally under voluntary control, that are first to suffer progressive degeneration. Would you respray this area as soon as I've washed off the dried food, please?”
Of course, Cha Thrat said.
This in turn causes a severe impairment in the circulation to the limbs, the Hudlar went on, leading to increasing deterioration in the associated nerve and muscle systems. The eventual result is general paralysis, necrosis of the limb extremities, and termination.”
It used the sponge briskly and moved clear to enable Cha Thrat to apply fresh nutrient, but when it resumed speaking its voice had lost some of its former clinical calm.
The most serious problem for the Hudlar geriatric patient, it said, is that the brain, which requires a relatively small proportion of the available energy, remains organically unimpaired by the degenerative process until a few moments after its double heart has ceased to function. Therein lies the real tragedy. Rare indeed is the Hudlar mind that can remain stable inside a body whichC.B.E.----5is disintegrating painfully all around it. You can understand why this ward, which has been recently extended for the Conway Project, is the closest that the hospital comes to providing treatment for psychologically disturbed patients.
At least, it added, forcing a lighter tone as they moved to the next patient, that was so until you started analyzing your AUGL-One Sixteen.”
Please don't remind me of that, Cha Thrat said.
There was another thick, cylindrical muffler encasing the next patient's speaking membrane, but either the sounds the Hudlar was making were too loud for it or the equipment was faulty. Much of what it was saying, which was clearly the product of advanced dementia and great pain, was picked up by her translator.
I have questions, Cha Thrat said suddenly. By implication they may be offensive to you, and perhaps critical of Hudlar philosophical values and professional ethics. On Sommaradva the situation within the medical profession may be different. I do not wish to risk insulting you.”
Ask, the other nurse said. I shall accept your apology, if required, in advance.”
Earlier I asked if these patients could be cured, she said carefully, and you have not yet replied. Are they incurable? And if so, why were they not advised to self-terminate before their condition reached this stage?”
For several minutes the Hudlar continued to sponge stale nutrient from the second patient's back without speaking, then it said, You surprise but do not offend me, Nurse. I cannot myself criticize Sommaradvan medical practice because, until we joined the Federation a few generations ago, curative medicine and surgery were unknown on my world. But do I understand correctly that you urge your incurable patients to self-terminate?”
Not exactly, Cha Thrat replied. If a servile-healer • or warrior-surgeon or a wizard will not take personal responsibility for curing a patient, the patient will not be cured. It is given all the facts of the situation, simply, accurately, and without the kindly but misguided lying and false encouragement that seem to be so prevalent among the nursing staff here. There is no attempt to exert influence in either direction; the decision is left entirely to the patient.”
While she was speaking the other had stopped working. It said, Nurse, you must never discuss a patient's case with it in this fashion, regardless of your feelings about our medical white lies. You would be in very serious trouble if you did.”
I won't, Cha Thrat said. At least not until, or unless, the hospital once again gives me the position and responsibilities of a surgeon.”
Not even then, the Hudlar said worriedly. I don't understand, she said. If I accept total responsibility for a patient's cure—”
So you were a surgeon back home, the other nurse broke in, obviously wanting to avoid an argument. I, too, am hoping to take home a surgical qualification.”
Cha Thrat did not want an argument, either. She said, How many years will that take?”
Two, if I'm lucky, the Hudlar replied. I don't intend going for the full other-species surgical qualification, just basic nursing and the FROB surgical course, taken concurrently. I joined the new Conway Project, so I'll be needed at home as soon as I can possibly make it. And to answer your earlier question, it added. Believe it or not, Nurse, the condition of the majority of these patients will be alleviated if not cured. They will be able to lead long and useful lives that will be pain-free, mentally and, within limits, physically active.”
I'm impressed, Cha Thrat said, trying to keep the incredulity she felt from showing in her voice. What is the Conway Project?”
Rather than listen to my incomplete and inaccurate description, the Hudlar replied, it would be better for you to learn about the project from Conway itself. It is the hospital's Diagnostician-in-Charge of Surgery, and it will be lecturing and demonstrating its new FROB major operative techniques here this afternoon.
I shall be required to observe the operation, it went on. But we will need surgeons so badly and in such large numbers that you would only have to express an interest in the project, not actually join it, to be invited to attend. It would be reassuring to have someone beside me who is almost as ignorant as I am.”
Other-species surgery, Cha Thrat said, is my principal interest. But I've only just arrived in the ward. Would the Charge Nurse release me from duty so soon?”
Of course, the FROB said as they were moving to the next patient. Just so long as you do nothing to antagonize it.”
I won't, she said, then added, at least, not deliberately.”
There was no muffler around the third patient's speaking membrane, and a few minutes before their arrival it had been having an animated conversation about its grandchildren with a patient across the ward. Cha Thrat spoke the ritual greeting used by the healers on Sommaradva and, it seemed, by every medic in the hospital.
How are you feeling today?”
Well, thank you, Nurse, the patient replied, as she knew it would.
Plainly the being was anything but well. Although it was mentally alert and the degenerative process had notyet advanced to the stage where the pain-killing medication had no effect, the mere sight of the surface condition of the body and tentacles made her itch. But, like so many of the other patients she had treated, this one would not dream of suggesting that her ability was somehow lacking by saying that it was not well.
When you've absorbed some more food, she said while her partner was busy with its sponge, you will feel even better.”
Fractionally better, she added silently. I haven't seen you before, Nurse, the patient went on. You're new, aren't you? I think you have a most interesting and visually pleasing shape.”
The last time that was said to me, Cha Thrat said as she turned on the spray, it was by an overardent young Sommaradvan of the opposite sex.”
Untranslatable sounds came from the patient's speaking membrane and the great, disease-wasted body began twitching in its cradle. Then it said, Your sexual integrity is quite safe with me, Nurse. Regrettably, I am too old and infirm for it to be otherwise.”
A Sommaradvan memory came back to her, of seriously wounded and immobilized warrior-patients of her own species trying to flirt with her during surgical rounds, and she did not know whether to laugh or cry.
Thank you, she said. But I may need further reassurance in this matter when you become convalescent ...”
It was the same with the other patients. The Hudlar nurse said very little while the patients and Cha Thrat did all the talking. She was new to the ward, a member of a species from a world about which they knew nothing, and a subject, therefore, of the most intense but polite curiosity. They did not want to discuss themselves or their distressing physical conditions, they wanted to talkabout Cha Thrat and Sommaradva, and she was pleased to satisfy their curiosity—at least about the more pleasant aspects of her life there.
The constant talking helped her to forget her growing fatigue and the fact that, in spite of the gravity compensators reducing the weight of the heavy nutrient tank to zero, the harness straps were making a painful and possibly permanent impression on her upper thorax. Then suddenly there were only three patients left to sponge and feed, and Segroth had materialized behind them.
If you work as well as you talk, Cha Thrat, the Charge Nurse said, I shall have no complaints. To the Hudlar, it added, How is it doing, Nurse?”
It assists me very well, Charge Nurse, the FROB trainee replied, and without complaint. It is pleasant and at ease with the patients.”
Good, good, Segroth said, its fur rippling in approval. But Cha Thrat belongs to another one of those species that require food at least three times a day if a pleasant disposition is to be maintained, and the midday meal is overdue. Would you like to finish the rest of the patients by yourself, Nurse?”
Of course, the Hudlar said as Segroth was turning away.
Charge Nurse, Cha Thrat said quickly. I realize that I've only just arrived, but could I have permission to attend the—”
The Conway lecture, Segroth finished for her. Naturally, you'll find any excuse to escape the hard work of the ward. But perhaps I do you an injustice. Judging by the conversations I have overheard on the sound sensors, you have displayed good control of your feelings while talking with the patients and, considering your surgical background, the practical aspects of the lecture should not worry you. However, if any part ofthe demonstration distresses you, leave at once and asunobtrusively as possible.
Permission would normally be refused a newly joined trainee like yourself, it ended, but if you can make it to the dining hall and back inside the hour, you may attend.”
Thank you, Cha Thrat said to the Kelgian's already departing back. Quickly she began loosening the nutrient tank harness.
Before you go, Nurse, the Hudlar trainee said, would you mind using some of that stuff on me? I'mstarving!”
Cha Thrat was among the first to arrive and stood— Hudlars did not use chairs, so the FROB lecture theater did not provide them—as close as possible to the operating cradle while she watched the place fill up. There was a scattering of Melfan ELNTs, Kelgian DBLFs, and Tralthan FGLIs among those present, but the majority were Hudlars in various stages of training. She was hemmed in by FROBs, so much so that she did not think that she would be able to leave even if she should want to, and she assumed—she still could not tell them apart —that the one standing closest to her was her partner of the morning.
From the conversations going on around her it was obvious that Diagnostician Conway was regarded as a very important being indeed, a medical near-deity in whose mind resided, by means of a powerful spell and the instrumentation of O'Mara, the knowledge, memories, and instincts of many other-species personalities. Having seen the hapless condition of the FROB ward's pre-op patients, she was looking forward with growing anticipation to seeing it perform.
In appearance Conway was not at all impressive. It was an Earth-human DBDG, slightly above average inheight, with head fiir that was a darker gray than the wizard O'Mara's.
It spoke with the quiet certainty of a great ruler, and began the lecture without preamble.
For any of you who may not be completely informed regarding the Hudlar Project, and who may be concerned with the ethical position, let me assure you that the patient on which we will be operating today, its fellows in the FROB ward, and all the other geriatric and pre-geriatric cases waiting in great distress on the home world, are all candidates for elective surgery.
The number of cases is so great—a significant proportion of the planetary population, in fact—that we cannot possibly treat them in Sector General...”
As the Earth-human Diagnostician talked on, Cha Thrat became increasingly disheartened by the sheer magnitude of the problem. A planet that contained, at any given time, many millions of beings in the same horrifying condition as the patients she had been recently attending was an idea that her mind did not want to face. But it became clear that Conway had faced it and was working toward an eventual solution—by training large numbers of the medically untutored Hudlars, assisted by other-species volunteers, to help themselves.
Initially, Sector General would provide basic tuition in FROB physiology, pre- and postoperative nursing care, and training in just one simple surgical procedure. The successful candidates, unless they displayed such an unusually high aptitude that they were offered positions on the staff, would return home to establish their own training organizations. Within three generations there would be enough own-species specialist surgeons to make this dreadful and hitherto unavoidable scourge of the Hudlars a thing of the past.
The sheer scale and what appeared to be the utter,criminal irresponsibility of the project shocked and sickened Cha Thrat. Conway was not training surgeons, it was turning out vast numbers of conscienceless, organic machines! She had been surprised when the Hudlar trainee had mentioned the time required for qualification, and it was possible that the hospital's tutors would be able to provide the necessary practical training during that short period. But what about the long-term indoctrination, the courses of mental and physical exercises that would prepare the candidates for the acceptance of responsibility and pain, and the long, presurgery novitiate? As the Diagnostician talked on, there was no mention of these things.
This is incredible! Cha Thrat said suddenly. Softly the Hudlar beside her said, Yes, indeed. But be quiet, Nurse, and listen.”
The degree and extent of the suffering among aging FROBs is impossible to imagine or describe, the Earth-human was saying. If the majority of the other races in the Federation were faced with the same problem, there would be one simple, if completely unsatisfactory, answer for the individuals concerned. But the Hudlars, unfortunately or otherwise, are philosophically incapable of self-termination.
Would you bring in Patient FROB-Eleven Thirty-two, please.”
A mobile operating frame driven by a Kelgian nurse glided to a stop in front of the Diagnostician. It held the patient—one of the Hudlars she had sprayed that mom-ing—already prepared for surgery.
The condition of Eleven Thirty-two, the Earth-human went on, is too far advanced for surgical intervention to reverse the degenerative processes completely. However, today's procedure will ensure that the remainder of the patient's life will be virtually pain-free, which, in turn, means that it will be mentally alert, and, it will be able to lead a useful if not very active life. With Hudlars who elect for surgery before the onset of the condition, and there are few members in the age groups concerned who do not so elect, the results are immeasurably better.
Before we begin, it continued, unclipping the deep scanner, I would like to discuss the physiological reasons behind the distressing clinical picture we see before us...”
What miracle of irresponsible and illegal surgery, Cha Thrat wondered sickly, could make Eleven Thirty-two well again?But her curiosity was outweighed by a growing fear. She did not know whether or not she could bear to hear the answers that this terrible Earth-person would give, and still retain her sanity.
In common with the majority of the life-forms known to us, the Diagnostician continued, the primary cause of the degenerative process known as aging is caused by increasing loss of efficiency in the major organs and an associated circulatory failure.
With the FROB life-form, it went on, the irreversible loss of function and the abnormal degree of calcification and fissuring in the extremities is aggravated by the demand for nutrient, which is no longer available.
From your FROB physiology lectures, it continued, you know that a healthy adult of the species possesses an extremely high metabolic rate that requires a virtually continuous supply of nutrient, which is metabolized, via the absorption mechanism, to supply major organs such as the two hearts, the absorption organs themselves, the womb when the entity is in gravid female mode, and, of course, the limbs. These six immensely strong limbsform the most energy-hungry system of the body, and demand close to eighty percent of the total nutrient metabolized.
If this excessive demand is removed from the energy equation, the Diagnostician said slowly and emphatically, the nutrient supply to less-demanding systems is automatically increased to optimum.”
There was no longer any doubt in Cha Thrat's mind regarding the surgical intentions of the Earth-human, but still she was trying to convince herself that the situation was not quite as bad as it seemed. With quiet urgency she asked, Do this life-form's limbs regenerate?”
That is a stupid question, the Hudlar beside her said. No, if such were the case, the limb musculature and circulation would not have degenerated to their present state in the first place. Please be quiet, Nurse, and listen.”
I meant the Earth-human's limbs, Cha Thrat said insistently, not the patient's.”
No, the Hudlar impatiently said. When she tried to ask other questions, it ignored her.
Conway was saying, The major problem encountered while performing deep surgery on any life-form evolved for heavy gravity and high atmospheric pressure conditions is, of course, internal organ displacement and decompression damage. But with this type of operation there is no real problem. The bleeding is controlled with clamps, and the procedure is simple enough for any of you advanced trainees to perform it under supervision.
In fact, the Diagnostician added, showing its teeth suddenly, I shall not even lay a cutter on this patient. The responsibility for the operation will be collectively yours.”
A quiet, polite uproar greeted the Earth-human'swords and the trainees surged closer to the barrier, imprisoning Cha Thrat within a barricade of metal-hard Hudlar bodies and tentacles. So many conversations were going on at once that several times her translator was overloaded, but from what she did hear it seemed that they were all in favor of this utterly shameful act of professional cowardice, and stupidly eager rather than afraid to take surgical responsibility.
She had never in her wildest and most fearful imaginings expected anything like this, nor thought to prepare herself for such a vicious and demoralizing attack on her ethical code. Suddenly she wanted away from this nightmare with its group of demented and immoral Hudlars. But they were all too busy flapping their speaking membranes at each other to hear her.
Quiet, please, Diagnostician Conway said, and there was silence. I don't believe in springing surprises, pleasant or otherwise, but sooner or later you Hudlars will be performing multiple amputations like this on your home world hour after hour, day after day, and I feel that you should get used to the idea sooner rather than later.”
It paused to look at a white card it was holding in one hand, then said, Trainee FROB-Severity-three, you will begin.”
Cha Thrat had an almost overwhelming urge to shout and scream that she wanted out and far away from this hellish demonstration. But Conway, a Diagnostician and one of the hospital's high rulers, had commanded silence, and the discipline of a lifetime could not be broken—even though she was far from Sommaradva. She pushed silently against the wall of Hudlar bodies enclosing her on three sides, but her attempts to pass through were ignored if they were even noticed. Everyone's eyes were focused exclusively on the operating cradle and pa-tient FROB-Eleven Thirty-two and, in spite of her attempts to look elsewhere, hers were turned in the same direction.
It was obvious from the start that Seventy-three's problem was psychological rather than surgical, and caused by the close proximity of one of the hospital's foremost Diagnosticians watching every move it made. But Conway was being both tactful and reassuring during its spoken commentary on the operation. Whenever the trainee seemed hesitant, it managed to include the necessary advice and directions without making the recipient feel stupid and even more unsettled.
There was something of the wizard in this Diagnostician, Cha Thrat thought, but that in no way excused its unprofessional behavior.
'The Number Three cutter is used for the initial incision and for removing the underlying layers of muscle, Conway was saying, but some of us prefer the finer Number Five for the venous and arterial work, since the smoother edges of the incisions make suturing much easier as well as aiding subsequent healing.
The nerve bundles, it went on, are given extra length and covered with inert metal caps, and are positioned just beneath the surface of the stump. This facilitates the nerve impulse augmentors that will later control the prosthetics...”
What, Cha Thrat wondered aloud, are prosthetics?”
Artificial limbs, the Hudlar beside her said. Watch and listen; you can ask questions afterward.”
There was plenty to see but less to hear because Trainee FROB-Seventy-three was working much faster and no longer seemed to be in need of the Diagnostician's covert directions. Not only could Cha Thrat lookdirectly at the operative field, but the internal scanner picture was also being projected onto a large screen above and behind the patient, so that she could watch the careful, precise movements of the instruments within the limb.
Then suddenly there was no limb—it had fallen stiffly, like the diseased brnch of a tree, into a container on the floor—and she had her first view of a stump. Desperately she fought the urge to be physically sick.
The large flap of tegument is folded over the stub limb, Conway was saying, and is attached by staples that dissolve when the healing process is complete. Because of the elevated internal pressure of this life-form and the extreme resistance of the tegument to puncturing by needle, normal suturing is useless and it is advisable, in fact, to err on the generous side where the staples are concerned.”
There had been unsavory rumors of cases like this on Sommaradva, traumatic amputation of limbs during a major industrial or transportation accident, after which the casualty had survived, or insisted on surviving. The wounds had been discreetly tidied up, usually by young, nonresponsible and as yet unqualified warrior-surgeons or even, if nobody else was available, by an amenable servile-healer. But even when the warriors concerned had sustained the wounds as a result of an act of bravery, the matter was hushed up and forgotten as quickly as possible.
The casualties went into voluntary exile. They would never dream of revealing their disabilities or deformities to the public gaze, nor would they have been allowed to do so. On Sommaradva they had too much respect for their bodies. And for people to parade around with me-chanical devices replacing their limbs was abhorrent and unthinkable.
Thank you, Seventy-three, that was well done, the Earth-human said, glancing once again at its white card. Trainee Sixty-one, would you like to show us what you can do?”
Abhorrent and repulsive though it was, Cha Thrat could not take her eyes from the operating cradle while the new FROB demonstrated its surgical prowess. The depth and positioning of every incision and instrument was burned into her memory as if she were watching some horrid but fascinating perversion. Sixty-one was followed by two other advanced trainees, and patient FROB-Eleven Thirty-two was left with only two of its six limbs remaining in place.
There is still a fair degree of mobility in one of the forelimbs, Conway said, and, considering the advanced age and reduced mental adaptability, I feel that it should be left intact for psychological as well as physiological reasons. It may well be that the increased blood and available nutrient supply due to the absence of the other limbs will partially improve the muscle condition and circulation in this one. As you can see, the other forelimb has degenerated virtually to the point of necrosis and must be removed.
Trainee Cha Thrat, it added, will perform the amputation.”
Suddenly they Were all looking at her, and for a moment Cha Thrat had the ridiculous feeling that she was in the center of a three-dimensional picture, frozen in this nightmare for all eternity. But the real nightmare lay a few minutes in the future, when she would be forced into a major professional decision.
Her partner from the ward vibrated its speaking mem-brane quietly. This is a great professional compliment, Nurse.”
Before she could reply, the Diagnostician was speaking again, to everyone.
It said, Cha Thrat is a native of a newly discovered world, Sommaradva, where it was a qualified surgeon. It has prior experience of other-species surgery on an Earth-human DBDG, a life-form that it had encountered for the first time only a few hours earlier. In spite of this, the work was skillfully done, Senior Physician Edanelt tells me, and undoubtedly saved the entity's limb and probably its life. And now it can further increase its other-species surgical experience with a much less difficult procedure on an FROB.”
Encouragingly it ended, Come forward, Cha Thrat. Don't be afraid. If anything should go wrong, I will be here to help.”
There was a great, cold fear inside her mixed with the helpless anger of having to face the ultimate challenge without adequate spiritual preparation. But the Diagnostician's concluding words, suggesting that her natural fear might somehow keep her from doing the work, filled her with righteous anger. It was a hospital ruler and, no matter how misguided and irresponsibile its orders to her had seemed, they would be obeyed—that was the law. And no Sommaradvan of the warrior class would show fear before anyone, and that included a group of other-species strangers. But still she hesitated.
Impatiently the Earth-human said, Are you capable of performing this operation?”
Yes, she said.
Had it asked her if she wanted to perform the operation, Cha Thrat thought sadly as she moved toward the cradle, the answer would have been different. Then, jwith the incredibly sharp FROB Number Three cutter in her hand, she tried again.
What, she asked quickly, is my precise responsibility in this case?”
The Earth-human took a deep breath and let it out slowly, then said, You are responsible for the surgical removal of the patient's left forelimb.”
Is it possible to save this limb? she asked hesitantly. Can the circulation be improved, perhaps by surgical enlargement of the blood vessels, or by—”
No, said Conway firmly. Please begin.”
She made the initial incisions and proceeded exactly as the others had done, without further hesitation or need of prompting by the Diagnostician. Knowing what was to happen, she suppressed her fear and steadfastly refused to worry about or feel the pain until the moment it would engulf her. She was utterly determined now to show this strange, highly advanced but seemingly nonre-sponsible medic how a truly dedicated warrior-surgeon of Sommaradva was expected to behave.
As she was inserting the last few staples into the flap covering the stump, the Diagnostician said warmly, That was fast, precise, and quite exemplary work, Cha Thrat. I am particularly impressed by— What are you doingT'She thought that her intentions were obvious as soon as she lifted the Number Three cutter. Sommaradvan DCNFs did not possess forelimbs as such but, she thought proudly, the removal of a left-side medial limb would satisfy the professional requirements of the situation. One quick, neat slice was enough, then she looked at it lying in the container among the Hudlar limbs and gripped the stump tightly to control the bleeding.
Her last conscious memory of the episode was ofDiagnostician Conway shouting above the general uproar into the communicator.
FROB lecture theater on the double, it was saying urgently. One DCNF, a traumatic amputation, self-inflicted. Ready the OR on Level Forty-three, dammit, and assemble a microsurgery team!”