Alan E. Nourse - The Bladerunner (5 page)

"That you, Doctor?" the man's voice said.

"Who wants to know?"

"Merriman. I'm John Merriman. You only met my wife, Eisa."

"Fine," Doc said. "Let's go on in, we're a little late. Billy, bring those packs along."

Going down on the elevator there was no talking. The car stopped at the forty-third floor, and they stepped directly from the elevator into the entry hall of a large apartment module. A woman and two small children were waiting to greet them. The children, apprehensive, clung to their mother. "Come in, Doctor," the woman said. "We were afraid something had happened."

"Nothing serious," Doc said. "Miss Barret was late getting away from the Hospital." He indicated Molly and Billy. "This is my nurse, and my anesthetist; they'll be helping me. Now, how are these children? No new colds or fevers starting up?"

"Nothing," the woman said.

"You've actually checked their temperatures?" Doc said. "Okay, then, let's have a look at them."

From his bag Doc produced stethescope, otoscope, and tongue blades. The older child, a boy of seven, was first. Doc had him strip to the waist and then examined him carefully, checking his ears and throat and listening to his chest. The little girl began to cry when her turn came, but Doc gently shushed her, sitting down and talking to her a bit, showing her how the stethoscope worked and letting her blow the otoscope light on, and presently she allowed him to check her. When he had finished he looked up and nodded to Molly. "Why don't you take them into the other room for a while and tell them what to expect so they won't be scared," he said. "Billy, you get things set up in the kitchen. I want to talk to the parents for a minute." As the others left, he turned his attention to the adult Merrimans. "I've already talked with Elsa here," he said, "but I want John to hear me too. A tonsillectomy and adenoidectomy is not a terribly complex surgical procedure in children of this age, but it's not entirely innocuous either, and problems can turn up under the best of circumstances. To be perfectly honest, I have to warn you that ideally this surgery should be done in a Health Control Hospital under the most choice conditions. We could use a safer anesthesia there, we'd have better control of any surgical problems that might develop, and the children could remain under Hospital observation until they were fully recovered from anesthesia and through the initial danger of bleeding. Doing the surgery here, I can't offer you the best, most ideal circumstances. I don't anticipate trouble, and I'll do everything I can to avoid it, but there is some degree of additional risk that you should know about."

"Doctor, we can't bring ourselves to take them to the Hospital," the woman said, "they're both over five years old, and they've both been treated more than three times in the Clinic. That means that they'd both have to be sterilized before they could qualify for any legal care at all. And for something like this we just can't let them be mutilated like that."

"Well, I know how you feel. I disagree with the Eugenic Control laws, too, or I wouldn't be here. But the laws are the laws, and you have to make the decision; I can't make it for you. Just for the record, the surgery required for legal qualification for Health Control care can't exactly be called mutilation. A vasectomy for a boy is a simple Clinic procedure that doesn't even involve hospitalization. For the girl, a tubal ligation is a little more complex, and might require an overnight stay in the Hospital, but nothing more."

"But the results are always the same, aren't they? Complete, permanent—"

"That's right. That's what the Eugenics Control laws are all about: the prior sterilization of any individual who requires health care services for any reason—excluding children under five, of course, except in cases of known hereditary disease."

"And that's why you're doing the surgery here instead of in a Hospital," John Merriman said heavily. "As far as we're concerned, sterilization of these children is out of the question. Until those laws are changed, we'll go underground. We understand the extra risk, Doctor, and we've both decided we have to take it."

Doc nodded. "Then we understand each other. YouH have to sign releases, of course, to cover me and my assistants in the event of unexpected trouble." He withdrew two printed forms from his bag and handed them to Merriman. "I'm sorry this is necessary, but it really is," he added gently. "Don't be afraid that I'm going to be anything but scrupulously careful—I'll do the best job I know how. But if you decided for some reason to report me to Health Control authorities, you would only be vulnerable for misdemeanor charges for accepting illegal medical services, whereas I could lose my practice license and go to prison for years. I have to have the protection of a release."

"Yes, we understand." Merriman signed the releases, and handed them to his wife for signature. "Then there's also the matter of the fee," he added. "You told Elsa seven hundred?"

"That's right—seven hundred in markers, or nine hundred on your credit card. The extra is to cover the cost and risk and trouble of feeding the credit card funds into the electronic accounting system without raising questions as to its source."

"Well, we have it in markers."

"Good, we much prefer it that way. Now, then, the little girl is the worrier of the two of them, so I think I'll take her first. You two might keep the boy company in the other room; I'll need my helpers with me."

Throughout this exchange, which he had heard a thousand times before, Billy Gimp had been setting up the kitchen area as an impromptu operating room. After releasing the binder on the first of the surgical packs, he had scrubbed hands and arms in the sink, let them dry in the air, and then gowned and gloved himself. Now, as Doc and Molly scrubbed, he set out the instruments, counted sponges, tested the suction machine and prepared sutures to be opened. As soon as Molly was ready he helped her into gown and gloves. She then took over preparation of the surgeon's tray, and Billy, with an increasing sense of ill-ease, turned his attention to preparing the ether mask and opening the anesthetic. The child, groggy and complacent from the premedication Molly had given her in the bedroom, took her place on the table under the best light in the house and submitted to the sterile drapes Molly attached around her hair and neck. Then, at Doc's signal, Billy did his best to emulate what he had seen Dr. Trautman do so many times in giving ether anesthesia, feeling clumsy in the extreme. "This little gauze cup has a funny smell, Jeannie," he said to the child. "Blow into it and try to blow the smell away. That's the way, blow harder!" The child blew, taking deep breaths of the ether as she did so. Momentarily she began to struggle but was quieted by a few words from Molly, and presently the child relaxed into slow, steady, stertorous breathing. "Reflexes, Billy,"

Doc said sharply, watching him closely throughout. "No, no, corneal—that's right. Okay, give her a little more, two or three more whiffs. Now where's the intubation setup?"

"I. . . don't know."

"What do you mean, you don't know?" Doc snapped. "You get the tube ready before you even start the anesthesia. I can't do this child without intubating her."

"Here it is," Molly said gently. "The pack was set up different from last time."

"Well, tell that supplier of yours to get things straight, Billy, and then check them out yourself. The last thing I need at times like this is a bunch of surprises." Still grumbling, Doc double-checked the surgical tray, then checked the child again and placed the breathing tube in place. "Now then, Billy, keep her stable just like that. Molly? Let's go."

As always, when a procedure was started, he was quick, skillful and thorough. For her part, Molly responded like any good scrub nurse, sensitive to Doc's slightest movement or gesture, moving almost instinctively to place the right instrument in his hand at the right time. The small portable suction machine that had come in the pack functioned poorly, as usual, but they made it do, using sponges wherever possible. Within fifteen minutes Doc nodded and stood back. "I think that's it," he said. "Billy, what the hell are you doing pouring on more of that stuff? You should have eased off five minutes ago when you saw me take the curette."

"I was watching the girl," Billy said sullenly.

"Of course you were watching the girl—but you should also be watching me. We don't want to be here all night waiting for these kids to recover." Gently, Doc took the sleeping child up in his arms and carried her into the bedroom where the mother and father were sitting with the groggy premedicated boy. Placing the girl in bed, Doc positioned her, removed the breathing tube and then waited until she was breathing steadily and beginning to stir in recovery from the anesthetic. Then, after giving the mother specific directions for nursing the recovering child, he led the boy out into the kitchen, where Billy and Molly were waiting with fresh surgical garments and drapes.

The second case was somewhat longer and more difficult for Doc, but Billy's job seemed to go easier and he felt a surge of confidence as Doc watched him, checked the child's depth of anesthesia and then said, "Fine, now, not any lower, just touch it from time to time, and be sure to withdraw the mask at the right time." He and Molly proceeded as Billy watched child and doctor. This time, when Doc finally stepped away from the table, the patient was already stirring, and Doc gave a nod of satisfaction. "Better," he said.

"Yes, it was almost easy that time."

"It's always easy when everything goes right. Nine times out of ten I could give the ether myself and forget about having an anesthetist. It's that one time out of ten that gets you, when you need somebody up there with his wits about him. You'll learn, all right, you've just got to do it a few times."

The children's father had been making coffee, and after the boy was back in bed and the girl, now almost fully recovered, was rechecked, Doc accepted a cup gratefully. At the same time he briefed the parents carefully on the postoperative care program he wanted them to follow. "Miss Barret will stay here with the children until she's confident they're out of danger. If you need to reach me after she's gone, ring the service number I've written down here. The service will contact me by belt radio, and I'll return your call, so stay by the phone. I doubt that you'll need to contact me, but if there's any question, I'd rather you called. Got that? Now as to things to watch for, I have them listed in detail on this instruction sheet. Bleeding is the main threat; let me know at once if there's any bleeding or vomiting of black stuff, any at all. Breathing is the other major concern; let me know if there's any wheezing or croupy coughing. And if I tell you to take either of these kids to a Hospital,
take
them. We'd far rather bow to the law, if we have to, than have a child in trouble—or dead."

As Doc gave the instructions, Billy busied himself gathering up instruments, cleaning them and returning them to the flight bag, together with disposable drapes, gowns, gloves and other paraphernalia that couldn't be dropped down an apartment house waste chute. As he worked, he remembered Parrot's message about the new patient. "Doc," he interrupted, "I forgot to tell you. You've got another call to make tonight."

Doc frowned. "Who is that?"

"A new patient that Parrot referred."

"Damn," Doc said. "Billy, you know I can't take on any more people."

"He said this was a special case, a very sick kid."

"Sick with what?"

"He didn't say, exactly. Headache, stiff neck, and high fever, was all he said. But Doc, Parrot wouldn't bother you unless he thought it was important, you know that. There's been a lot of Shanghai flu around. Maybe this is a complication."

"Well, maybe," Doc said. "You don't suppose it's another meningitis case, do you? Seems to me there have been a lot of those, lately. Well, did you bring along an infection kit?"

Billy nodded. "Penicillin, Viricidin, even some gamma globulin. The works."

"Okay, then we'd better move." Doc turned to John Merriman. "We're going to have to leave; can you call us a heli-cab?" As the man went to the phone, Doc went into the bedroom to give Molly final instructions and check the children for the last time. "Stay till you're sure they're all right, and then get a cab home. Billy and I have another call to make. I'll check with you at the Hospital in the morning." He hesitated. "And Molly, ask Central Records for a read-out on meningitis cases admitted to the Hospital during the last week, will you? Use my identification key and tell them to leave the read-out in my box. And if they ask, tell then it's urgent."

By the time Doc rejoined Billy, a red signal on the Merriman's TV indicated that a heli-cab was waiting for them on the roof. Billy zipped the flight bag closed and tucked it under his arm. Then, after Doc had given his final instructions to the Merrimans, he and Billy walked in silence to the elevators.

On the roof the landing lights of the little heli-cab were blinking. Doc walked to the landing pad and climbed aboard. It was not until Billy had rounded to the other side of the vehicle that he saw the dark form of a police copter concealed in the shadow of the ventilators. "Doc!" he shouted. "It's a trap! Move,
get going—"

At his first shout a blinding light flared from the police copter, flooding the rooftop. Billy ducked back toward the stairwell as the heli-cab blades began to turn and Doc's craft lifted from the roof with Doc aboard. Three uniformed men were charging from the police car now, paying no attention to the fleeing heli-cab. Then, as Billy ran for the stairwell, he stumbled on his bad foot and fell flat, sending the flight bag skidding across the rooftop ahead of him.