Sector General Omnibus 3 - General Practice (30 page)

“And you would like me to use my empathic faculty,” Prilicla asked, “to tell you what they feel?”
“Yes,” Lioren said, with so much feeling that the Cinrusskin trembled for a moment. “I hoped that you, Doctor, might have detected urges, instincts, feelings about themselves, their offspring, or their present situation. My ignorance regarding their thinking and motivations is total. I would like to be able to do or say something to them that, as with an emotionally disturbed entity about to jump from a high building, would make them want to live instead of die. What is it that they fear, or need, that would make them want to survive?”
“Friend Lioren,” Prilicla said without hesitation, “they fear death, like every other self-aware creature, and they want to survive. There were no indications, even in the most serious cases, of a wish for individual death or racial self-destruction, and they should not be—”
“I am sorry,” Lioren broke in. “My earlier remark about allowing them to commit racial suicide—”
“They were words spoken because of helplessness and frustration, friend Lioren,” Prilicla said, in the gentlest of interruptions, “that were completely contradicted by your underlying emotional radiation at the time. There was no need for an apology then or for your embarrassment now.
“And I had been about to say,” it went on, “that the Cromsaggar should not be criticized for their lack of cooperation, and the strong feelings of ingratitude until we know why they feel so ungrateful. These feelings were strongly present in all of the adult patients I monitored during transportation to Sector General and while I was present at the subsequent attempts to question them. They know we are trying to help them, but will not help us with clinical or personal information about themselves. When the interrogation was intensified they became agitated and fearful, and a marked if temporary remission of symptoms was observed at these times.”
“I have made the same observation,” Lioren said, “and assumed that it was the transfer of focus from a material condition to an immaterial one, the psychological mechanism which can sometimes make
faith healing effective. I did not consider it an important datum.”
“You are probably correct,” Prilicla said. “But Chief Psychologist O’Mara is of the opinion that the marked remission due to the fear stimulus, combined with their fanatical refusal to communicate with us beyond the exchange of a few words, indicates the presence of an extremely strong and deep-rooted conditioning about which the Cromsaggar, as individuals, may be unaware. Friend O’Mara likens it to the racial group psychoses afflicting the Gogleskans, and says that it is trying to probe a very sensitive area that is surrounded by a very thick wall of mental scar tissue, and advises everyone concerned to proceed slowly and carefully.”
The Gogleskan psychosis forced them into avoiding direct physical contact with each other for the greater part of their adult lives, which was certainly not the problem with the Cromsaggar. Trying to control his feelings of impatience, Lioren said, “If we do not quickly find a cure for this plague, your Chief Psychologist will run out of subjects for his slow and careful investigation. What progress has been made since your last visit?”
“Friend Lioren,” Prilicla said gently, “significant progress has been made. However, I sense and wholly agree with your need to avoid wasting time, so I suggest that Pathologist Murchison makes its report to you in person rather than having it relayed through myself, since you will doubtless have questions and I, because of my selfish need to surround myself with pleasant emotional radiation, have the unfortunate habit of accentuating the positive aspects of any situation.”
Lioren’s original reason for wanting a private meeting with Prilicla no longer seemed valid, and he could not reject the other’s suggestion without seriously embarrassing both himself and the empath. He had the feeling, which was no doubt shared by the empath, that somehow he had lost the initiative.
 
 
Pathologist Murchison was a warm-blooded oxygen-breather of physiological classification DBDG with a body that, although considerably
shorter and less massive than Lioren’s own, had the soft, lumpy and topheavy aspect of many of the Earth-human females. It was Thornnastor’s principal assistant, when not required for special ambulance-ship duty, and its words were clear and concise and its manner respectful without being subservient. It also had the slightly irritating habit of answering questions before Lioren could ask them.
The identification, isolation, and neutralization of other-species pathogens, Pathologist Murchison said, was a routine procedure for Thornnastor’s department, but the behavioral characteristics of the Cromsaggar virus—its mechanisms of transmission, infection, incubation, and propagation—remained undetectable to all of the normal investigative techniques. It was only in recent days, when the discovery had been made that the virus was either inherited at conception or transmitted by the mother prior to birth, that some progress had been made.
“The effects on the adult Cromsaggar are known to you,” Murchison went on, “and the present indications are that every member of the species is infected. In the preterminal stage there is a livid rash and skin eruptions covering most of the body, accompanied by progressive and massive debilitation and lassitude which is sometimes overcome, temporarily, by strong emotional stimuli such as fear and danger. The effects on the children are less apparent and this led to the initial assumption that the young were immune, which they are not.
“We have since discovered,” it continued, “that severe debility and lassitude are also present in the young, although it is difficult to be precise since we have no idea of how active a young, noninfected Cromsaggar should be. And, incredible though it might seem, neither can we be precise about the ages of these child patients. There is physiological and verbal evidence which suggests that many of them are not nearly as young as they appear, and that our age estimates should be extended by a factor of two or three because, in addition to its general debilitating effect, the plague retards the overall physiological development and greatly delays the onset of puberty. Probably there are psychological effects, as well, which might explain their grossly antisocial adult behavior,
but again, this must remain speculative since you have yet to find a normal, disease-free Cromsaggar.”
“I doubt whether such an entity exists,” Lioren said. “But you spoke of having verbal as well as physiological evidence. These people absolutely refuse to give information about themselves. How was it obtained?”
“A large proportion of the cases you sent us were young or, as we now know, not yet physically mature,” Murchison replied. “The adult patients remain completely uncooperative, but O’Mara was able to open dialogue with a few non-adults, who were much less reticent about themselves. Because of this immature viewpoint, adult motivations still remain unclear, and the picture of the Cromsaggar culture that is emerging is confusing and fraught with—”
“Pathologist Murchison,” Lioren interrupted, “my interest is in the clinical rather than the cultural picture, so please confine yourself to that. My reason for asking
Rhabwar
to transfer so many young or not so young patients to the hospital was that they were among the large numbers left parentless or without adults to care for them. As well as suffering from undernourishment or exposure, conditions which are treatable, they displayed symptoms of respiratory distress associated with elevated temperature, or a wasting disease affecting the peripheral vascular and nervous systems. If Thornnastor’s investigation into the plague is showing no results, what of these other and, I would think, clinically less complex conditions which seem to affect only the young?”
“Surgeon-Captain Lioren,” the pathologist said, using Lioren’s name and rank for the first time, “I did not say that no progress is being made.
“All of the non-adult cases are being investigated and significant progress is being made,” it went on quickly. “In one of them, the condition presenting respiratory distress symptoms, there has been a minor but positive response to treatment. But the main effort is being directed toward finding a specific for the adult condition, because it has become evident that if the massive debilitation and growth-retarding effects of the plague were removed, the diseases currently afflicting the pre-adult
Cromsaggar would be countered by their bodies’ natural defense mechanisms and would no longer be life-threatening.”
If that much was known, Lioren thought, then progress was indeed being made.
“The trials conducted so far,” Murchison continued, “have been inconclusive. Initially the medication was introduced in trace quantities and the patients’ condition monitored routinely for fifty standard hours before the dosage was increased, until on the ninth day, within a few moments of the injection being given, both patients lost consciousness.”
It paused for a moment to look at Prilicla then, seeming to receive a signal undetectable by Lioren, resumed. “Both patients were placed in isolation some distance from the others and each other. This was done so as to minimize same-species interference in their emotional radiation. Doctor Prilicla reported that the level of unconsciousness was extraordinarily deep, but that there was no sign of the subconscious distress that would have been present had they been drifting into termination. It suggested that the unconsciousness might be recuperative since it had many of the characteristics of sleep following a lengthy period of physical stress and that nutrient should be given intravenously. A few days after this was done there was a minor remission of symptoms in both cases, and evidence of slight tissue regeneration, although both patients remained deeply unconscious and in a critical condition.”
“Surely that means—!” Lioren began, and broke off as Murchison held up one hand as if it and not himself had the rank. But suddenly he was too excited to verbally tear its insubordinate head off as he should.
“It means, Surgeon-Captain,” Murchison said, “that we must proceed very carefully and, if the first two test subjects regain consciousness rather than drifting into termination, we must closely monitor their clinical and psychological condition before the trial is extended to the other patients. Diagnostician Thornnastor and everyone in its department believes, and Doctor Prilicla feels sure, that we are on the way to finding the cure. But until we are certain we must exercise patience for a time until—”
“How much time?” Lioren demanded harshly.
Prilicla’s fragile body was shaking as if a strong wind was blowing through the casualty deck, but Lioren could no more have controlled the emotional storm of impatience, eagerness, and excitement that raged within him than he could have flown on the empath’s fragile wings. He would apologize to Prilicla later, but now all that he could think of was the steadily dwindling number of Cromsaggar who still clung to life on this plague world, and who might now have a chance to remain alive. More quietly, he asked, “How long must I wait?”
“I don’t know, sir,” the pathologist said. “I only know that
Tenelphi
has been ordered to remain at flight readiness at Sector General until the medication has been approved for general use, so as to bring you the first production batch without delay.”
R
habwar
departed with its casualty deck filled principally with non-adult Cromsaggar. There were many adult cases in
Vespasian
’s sick bay—and in the widely dispersed medical stations that Lioren visited every day—who were in a much more serious condition, but the future survival of any species lay with its young, and those fortunate enough to be under the care of Thornnastor would be the first to be cured.
He ignored the polite but increasingly sarcastic messages from Colonel Skempton, the administrative head of Sector General, reminding him that the hospital was unable to accept the entire Cromsag population, depleted though it might be, for hospitalization, and that they had already received more than enough members of that species for the purposes of clinical investigation. The entire
Rhabwar
crew would have been aware of Skempton’s uncoded messages and the pressure on ward accommodation that had prompted them, but Prilicla had raised no objections to transporting the additional twenty patients.
Prilicla must be the least objectionable entity in the known galaxy, Lioren thought, unlike the Cromsaggar, who were his patients but who would never be his friends—unless there was a species-wide personality reconstruction by the Galactic Federation’s many deities, of whose existence he had the gravest doubts.
Nevertheless, he spent all of his time, when he was not engaged in eating or sleeping, visiting the worst of his massively unlikable patients or encouraging the two hundred Corps medics and food technicians scattered across the continent who were trying, not always with success, to keep them alive. Always he hoped for a change of attitude, a willingness to talk to him and give information that would enable him to help them or that a tiny crack would show in their impenetrable wall of noncooperation, but in vain. The Cromsaggar, adult and young alike, continued dying at a steadily increasing rate because, like Sector General, he did not have the facilities to feed intravenously the entire population.
Occasionally, and in spite of the surface and orbital surveillance, they managed to die at each others’ hands.
It had happened while he had been flying over one of the forest settlements that had long since been searched and declared empty of intelligent life, but that must have been because the occupants had taken to the trees to elude the searchers. Lioren spotted the small-scale war being waged by six of them in a grassy clearing between two buildings. By the time the flier, which would have carried a crew of four Nidians had it not been for his long Tarlan legs, had circled back to land and Dracht-Yur had helped him extricate himself from the tiny vessel’s seating, the hand-to-hand fighting was over and four Cromsaggar lay still on the ground.
In spite of the numerous bites and digitally inflicted wounds covering the bodies, they were able to identify them as three dead males and one female whose life expectancy would be measured in seconds. Dracht-Yur pointed suddenly to the ground nearby where two separate trails of crushed and blood-spattered grass converged toward the open door of one of the buildings.
The advantage of a longer stride meant that Lioren went through the entrance seconds ahead of the Nidian, and his first sight of the two writhing, bloody bodies locked together in mortal combat on the floor reinforced the anger and disgust he felt at such animal behavior between supposedly intelligent beings. Moving forward, he quickly interposed his medial arms between the tightly pressed bodies and tried to push them
apart. Only then did he make the disconcerting discovery that they were not, as he had first thought, two males fighting each other to the death but a male and female indulging in a sexual coupling.
Lioren released them and backed away quickly, but suddenly they broke apart and launched themselves at him just as Dracht-Yur arrived and blundered into his rear legs. The weight of the combined attack toppled him over backward so that he sprawled flat on the floor with the two Cromsaggar on top of him and the Nidian somewhere underneath. Within moments he was fighting for his life.
After the first few days on Cromsag had shown the natives to be too severely weakened by the plague to warrant the use of heavy protective suits, all Corps personnel had taken to wearing their cooler and less restrictive shipboard coveralls, which gave protection only against the sun, rain, and insect bites.
It was with a sense of outrage that Lioren realized that for the first time in his life the hands—not to mention the feet, knees, and teeth—of another person had been raised in anger against him. On Tarla disputes were not settled in this barbaric fashion. And even though the number of his limbs equaled the total of theirs, they did not behave like plagueweakened Cromsaggar. They were inflicting serious damage to his body and causing him more pain than he had ever thought it possible to feel.
As he fended off the more disabling body blows and tried desperately to keep the two Cromsaggar from pulling off his dirigible eyesupports, Lioren was aware of Dracht-Yur wriggling from underneath him and crawling toward the door. He was pleased when his attackers ignored it, because the Nidian’s small, furry limbs had neither the muscle power nor the reach to make a useful contribution to the struggle. A few seconds later he caught a glimpse of the Nidian’s head enclosed by a transparent envelope, heard the expected soft explosion of a bursting sleep-gas bulb, and felt the bodies of his attackers go suddenly limp and collapse on top of him before rolling slowly onto the floor.
For the few moments that the bodies, covered as they were by livid patches of discoloration and the oozing sores characteristic of preterminal plague victims, made heavy and almost intimate contact with him,
it was a great relief to remember that one world’s pathogens were ineffective against the members of off-planet species.
Designed as it was for maximum effect on the Cromsaggar metabolism, the anesthetic gas produced similar if less immediate results on other warm-blooded oxygen-breathers. Lioren was unable to move, but he was aware of the Nidian growling and barking urgently into its headset while it applied dressings to the worst of his wounds. Presumably it was telling the pilot of their flier to send for medical assistance, but his own translator pack had been damaged in the struggle and he could not understand a word. This did not worry him unduly, because the intense discomfort of his many injuries had faded to the mildest of irritations and the hard floor beneath him felt like the softest of sleeping pits. But his mind was clear and seemed unwilling to follow his body into sleep.
Interrupting the two Cromsaggar in the sex act had been a serious mistake, but an understandable one because none of his people had witnessed the occurrence of anything like a sexual coupling since arriving on Cromsag, and everyone, himself included, had assumed that the species had become too physically debilitated by the plague to make much of such activity possible. And their reaction, the sheer strength and ferocity of their attack, had surprised and shocked him.
During the very short breeding season on Tarla such activity, especially among the aging who had been lifemates for many years, was a cause for celebration and public display rather than a matter for concealment—although he knew that many species within the Federation, races who were otherwise highly intelligent and philosophically advanced, considered the mating process to be a private matter between the beings concerned.
Naturally, Lioren had no personal experience in this area, since his dedication to the healing arts precluded him indulging in any pleasure which would allow emotional factors to affect the clinical objectivity of his mind. If he had been an ordinary Tarlan male, an artisan or a member of one of the noncelibate professions interrupted in similar circumstances, there would have been a verbal impoliteness, but certainly not violence.
Distressing and distasteful as the incident had been, Lioren’s mind would not rest in its search to find a reason for such an unreasonable reaction, however alien or uncivilized that reason might be. Could it be that, gravely ill and seriously injured as they had been in the fighting outside, they had crawled into the house to seek a moment of mutual pleasure together before dying? He knew that the coupling must have been by mutual agreement, because the Cromsaggar mechanics of reproduction were physiologically too complicated for the attentions of one partner to be forced on another.
That did not rule out the possibility that the coupling was the end result of the fighting, the bestowal of a female’s favor on a warrior victorious in battle. There were many historical precedents for such behavior, although not, thankfully, in the history of Tarla. But that reason was unsatisfactory because both male and female Cromsaggar fought, although not each other.
Lioren made a mental note to prepare a detailed report of the incident for the cultural contact specialists who would ultimately have to produce a solution to the Cromsaggar problem, if any of the species survived and it was invited to join the Federation.
The four separate images of the room, including the one of Dracht-Yur working on the other casualties, that his immobilized eyes were still bringing him dimmed suddenly into blackness, and he remembered a feeling of mild irritation before he fell asleep in midthought.
 
 
Dracht-Yur confined him to the sick bay on
Vespasian
until the worst of his injuries healed, reminding him, as only a hairy, small-minded, and sarcastic dwarf of a Nidian could, that until then the relationship between them was one of doctor and patient and that in the present situation it was the Surgeon-Lieutenant who had the rank.
It could not, however, no matter how often it stressed the advisability of post-trauma rest and mental recuperation, bind Lioren’s jaw closed or keep him from setting up a communication system by his bedside.
Time passed like a pregnant
strulmer
climbing uphill, and the medical situation on Cromsag worsened until the daily death rate climbed from one hundred to close on one-fifty, and still
Tenelphi
did not come. Lioren sent a necessarily brief hyperspace radio signal to Sector General, prerecorded and repeated many times so that its words could be reconstructed after fighting their way through the interference of the intervening stars, requesting news. He was not surprised when it was ignored, because the expenditure of power needed for a lengthy progress report would have been wasteful indeed. All that he was telling them was that he and the medical and support personnel on Cromsag were beginning to feel so helpless and angry and impatient that the condition verged on the psychotic, but the hospital probably knew that already.
Five days later he received a reply stating that
Tenelphi
had been dispatched and was estimating Cromsag in thirty-five hours. It was carrying medication, as yet incompletely tested for long-term effects, which was a specific against the grosser, more life-threatening symptoms of the plague, and that the details of the pathological investigation and directions for treatment accompanied the medication.
During the excitement that ensued Lioren went over his plans for fast distribution. Dracht-Yur relented to the extent of allowing him to transfer from sick bay to the communications center of
Vespasian
, but not to risk compounding his injuries by traveling the air or surface of Cromsag in vehicles totally unsuited to the Tarlan physiology. But the general feeling of relief and euphoria lasted only until the arrival of
Tenelphi
.
The scout ship carried more than enough of the antiplague specific, which required only a single, intravenous application, to treat every Cromsaggar on the planet, but Lioren was forbidden to use it until additional field trials had been carried out.
According to Chief Pathologist Thornnastor, the physiological results following a minimum dosage had been very good, but there were indications of possibly damaging side effects. Symptoms of mental confusion and periods of semiconsciousness had been observed. These might prove to be temporary, but further investigation was required.
The single injection was followed by a slight but continuing reduction in symptoms, a slow improvement in the vital signs, and evidence of tissue and organs regeneration throughout the body in the days which ensued. During the periods of semiconsciousness the test subjects had requested and consumed food in quantities which, considering stomach size and the clinical condition of the patients involved, seemed unusually large. There was a steady increase in body weight.
The non-adult subjects had responded in similar fashion, including the periods of unconsciousnessness interspersed with episodes of semi-consciousness and mental confusion, except that with the young the food demand in relation to their smaller size had been greater. Daily measurement had shown a steady increase in growth, both in body mass and limb dimensions.
It was thought probable that with the gradual remission of the condition the non-adult patients, whose physical growth had been retarded by the plague, were returning to optimum size for their ages. The periods of unconsciousness and impaired thinking were in response to a demand by the body for maximum rest during these periods of regeneration and were of little clinical importance. The medication was being used in minimum quantities, but a very small increase in the dosage of one test subject resulted in a strengthening and acceleration of the effects already noted. In spite of the excellent physiological results so far, the associated episodes of mental confusion were cause for concern lest a side effect of the medication led to long-term brain damage.

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