<h2><SPAN name="chapter13" id="chapter13"></SPAN>CHAPTER 13</h2>
<h3>THE TRIAL</h3>
<p>Red Doctor Dal Timgar knew at once that there would
be no problem in diagnosis here. The Black Doctor
slumped back in his seat, gasping for air, his face twisted in
pain as he labored just to keep on breathing. Tiger and Jack
burst into the room, and Dal could tell that they knew
instantly what had happened.</p>
<p>"Coronary," Jack said grimly.</p>
<p>Dal nodded. "The question is, just how bad."</p>
<p>"Get the cardiograph in here. We'll soon see."</p>
<p>But the electrocardiograph was not needed to diagnose
the nature of the trouble. All three doctors had seen the
picture often enough—the sudden, massive blockage of circulation
to the heart that was so common to creatures with
central circulatory pumps, the sort of catastrophic accident
which could cause irreparable crippling or sudden death
within a matter of minutes.</p>
<p>Tiger injected some medicine to ease the pain, and started
oxygen to help the labored breathing, but the old man's color<SPAN name="page166" id="page166"></SPAN>
did not improve. He was too weak to talk; he just lay helplessly
gasping for air as they lifted him up onto a bed. Then
Jack took an electrocardiograph tracing and shook his head.</p>
<p>"We'd better get word back to Hospital Earth, and fast,"
he said quietly. "He just waited a little too long for that
cardiac transplant, that's all. This is a bad one. Tell them
we need a surgeon out here just as fast as they can move,
or the Black Service is going to have a dead physician on
its hands."</p>
<p>There was a sound across the room, and the Black Doctor
motioned feebly to Tiger. "The cardiogram," he gasped.
"Let me see it."</p>
<p>"There's nothing for you to see," Tiger said. "You
mustn't do anything to excite yourself."</p>
<p>"Let me see it." Dr. Tanner took the thin strip of paper
and ran it quickly through his fingers. Then he dropped it
on the bed and lay his head back hopelessly. "Too late," he
said, so softly they could hardly hear him. "Too late for
help now."</p>
<p>Tiger checked his blood pressure and listened to his heart.
"It will only take a few hours to get help," he said. "You
rest and sleep now. There's plenty of time."</p>
<p>He joined Dal and Jack in the corridor. "I'm afraid he's
right, this time," he said. "The damage is severe, and he
hasn't the strength to hold out very long. He might last long
enough for a surgeon and operating team to get here, but
I doubt it. We'd better get the word off."</p>
<p>A few moments later he put the earphones aside. "It'll
take six hours for the nearest help to get here," he said.
"Maybe five and a half if they really crowd it. But when
they get a look at that cardiogram on the screen they'll just
throw up their hands. He's got to have a transplant, nothing
less, and even if we can keep him alive until a surgical team<SPAN name="page167" id="page167"></SPAN>
gets here the odds are a thousand to one against his surviving
the surgery."</p>
<p>"Well, he's been asking for it," Jack said. "They've been
trying to get him into the hospital for a cardiac transplant
for years. Everybody's known that one of those towering
rages would get him sooner or later."</p>
<p>"Maybe he'll hold on better than we think," Dal said.
"Let's watch and wait."</p>
<p>But the Black Doctor was not doing well. Moment by
moment he grew weaker, laboring harder for air as his
blood pressure crept slowly down. Half an hour later the
pain returned; Tiger took another tracing while Dal checked
his venous pressure and shock level.</p>
<p>As he finished, Dal felt the Black Doctor's eyes on him.
"It's going to be all right," he said. "There'll be time for
help to come."</p>
<p>Feebly the Black Doctor shook his head. "No time," he
said. "Can't wait that long." Dal could see the fear in the
old man's eyes. His lips began to move again as though there
were something more he wanted to say; but then his face
hardened, and he turned his head away helplessly.</p>
<p>Dal walked around the bed and looked down at the
tracing, comparing it with the first one that was taken.
"What do you think, Tiger?"</p>
<p>"It's no good. He'll never make it for five more hours."</p>
<p>"What about right now?"</p>
<p>Tiger shook his head. "It's a terrible surgical risk."</p>
<p>"But every minute of waiting makes it worse, right?"</p>
<p>"That's right."</p>
<p>"Then I think we'll stop waiting," Dal said. "We have a
prosthetic heart in condition for use, don't we?"</p>
<p>"Of course."</p>
<p>"Good. Get it ready now." It seemed as though someone<SPAN name="page168" id="page168"></SPAN>
else were talking. "You'll have to be first assistant, Tiger.
We'll get him onto the heart-lung machine, and if we don't
have help available by then, we'll have to try to complete
the transplant. Jack, you'll give anaesthesia, and it will be
a tricky job. Try to use local blocks as much as you can,
and have the heart-lung machine ready well in advance.
We'll only have a few seconds to make the shift. Now let's
get moving."</p>
<p>Tiger stared at him. "Are you sure that you want to do
this?"</p>
<p>"I never wanted anything less in my life," Dal said fervently.
"But do you think he can survive until a Hospital
Ship arrives?"</p>
<p>"No."</p>
<p>"Then it seems to me that I don't have any choice. You
two don't need to worry. This is a surgical problem now,
and I'll take full responsibility."</p>
<p>The Black Doctor was watching him, and Dal knew he
had heard the conversation. Now the old man lay helplessly
as they moved about getting the surgical room into preparation.
Jack prepared the anaesthetics, checked and rechecked
the complex heart-lung machine which could artificially
support circulation and respiration at the time that the
damaged heart was separated from its great vessels. The
transplant prosthetic heart had been grown in the laboratories
on Hospital Earth from embryonic tissue; Tiger removed
it from the frozen specimen locker and brought it
to normal body temperature in the special warm saline bath
designed for the purpose.</p>
<p>Throughout the preparations the Black Doctor lay watching,
still conscious enough to recognize what was going on,
attempting from time to time to shake his head in protest
but not quite succeeding. Finally Dal came to the bedside.<SPAN name="page169" id="page169"></SPAN>
"Don't be afraid," he said gently to the old man. "It isn't safe
to try to delay until the ship from Hospital Earth can get
here. Every minute we wait is counting against you. I think
I can manage the transplant if I start now. I know you don't
like it, but I am the Red Doctor in authority on this ship.
If I have to order you, I will."</p>
<p>The Black Doctor lay silent for a moment, staring at Dal.
Then the fear seemed to fade from his face, and the anger
disappeared. With a great effort he moved his head to nod.
"All right, son," he said softly. "Do the best you know how."</p>
<hr class="shorter" />
<p>Dal knew from the moment he made the decision to go
ahead that the thing he was undertaking was all but hopeless.</p>
<p>There was little or no talk as the three doctors worked at
the operating table. The overhead light in the ship's tiny
surgery glowed brightly; the only sound in the room was
the wheeze of the anaesthesia apparatus, the snap of clamps
and the doctors' own quiet breathing as they worked desperately
against time.</p>
<p>Dal felt as if he were in a dream, working like an automaton,
going through mechanical motions that seemed completely
unrelated to the living patient that lay on the operating
table. In his training he had assisted at hundreds of organ
transplant operations; he himself had done dozens of cardiac
transplants, with experienced surgeons assisting and guiding
him until the steps of the procedure had become almost
second nature. On Hospital Earth, with the unparalleled
medical facilities available there, and with well-trained teams
of doctors, anaesthetists and nurses the technique of replacing
an old worn-out damaged heart with a new and healthy one
had become commonplace. It posed no more threat to a<SPAN name="page170" id="page170"></SPAN>
patient than a simple appendectomy had posed three centuries
before.</p>
<p>But here in the patrol ship's operating room under emergency
conditions there seemed little hope of success. Already
the Black Doctor had suffered violent shock from the damage
that had occurred in his heart. Already he was clinging
to life by a fragile thread; the additional shock of the surgery,
of the anaesthesia and the necessary conversion to the heart-lung
machine while the delicate tissues of the new heart were
fitted and sutured into place vessel by vessel was more than
any patient could be expected to survive.</p>
<p>Yet Dal had known when he saw the second cardiogram
that the attempt would have to be made. Now he worked
swiftly, his frail body engulfed in the voluminous surgical
gown, his thin fingers working carefully with the polished
instruments. Speed and skill were all that could save the
Black Doctor now, to offer him the one chance in a thousand
that he had for survival.</p>
<p>But the speed and skill had to be Dal's. Dal knew that,
and the knowledge was like a lead weight strapped to his
shoulders. If Black Doctor Hugo Tanner was fighting for
his life now, Dal knew that he too was fighting for his life—the
only kind of life that he wanted, the life of a physician.</p>
<p>Black Doctor Tanner's antagonism to him as an alien, as
an incompetent, as one who was unworthy to wear the
collar and cuff of a physician from Hospital Earth, was
common knowledge. Dal realized with perfect clarity that
if he failed now, his career as a physician would be over;
no one, not even himself, would ever be entirely certain
that he had not somehow, in some dim corner of his mind,
allowed himself to fail.</p>
<p>Yet if he had not made the attempt and the Black Doctor<SPAN name="page171" id="page171"></SPAN>
had died before help had come, there would always be those
who would accuse him of delaying on purpose.</p>
<p>His mouth was dry; he longed for a drink of water, even
though he knew that no water could quench this kind of
thirst. His fingers grew numb as he worked, and moment
by moment the sense of utter hopelessness grew stronger in
his mind. Tiger worked stolidly across the table from him,
inexpert help at best because of the sketchy surgical training
he had had. Even his solid presence in support here did
not lighten the burden for Dal. There was nothing that
Tiger could do or say that would help things or change
things now. Even Fuzzy, waiting alone on his perch in the
control room, could not help him now. Nothing could help
now but his own individual skill as a surgeon, and his bitter
determination that he must not and would not fail.</p>
<p>But his fingers faltered as a thousand questions welled up
in his mind. Was he doing this right? This vessel here ...
clamp it and tie it? Or dissect it out and try to preserve it?
This nerve plexus ... which one was it? How important?
How were the blood pressure and respirations doing? Was
the Black Doctor holding his own under the assault of the
surgery?</p>
<p>The more Dal tried to hurry the more he seemed to be
wading through waist-deep mud, unable to make his fingers
do what he wanted them to do. How could he save ten
seconds, twenty seconds, a half a minute? That half a minute
might make the difference between success or failure,
yet the seconds ticked by swiftly and the procedure was
going slowly.</p>
<p>Too slowly. He reached a point where he thought he
could not go on. His mind was searching desperately for
help—any kind of help, something to lean on, something to
brace him and give him support. And then quite suddenly<SPAN name="page172" id="page172"></SPAN>
he understood something clearly that had been nibbling at
the corners of his mind for a long time. It was as if someone
had snapped on a floodlight in a darkened room, and he saw
something he had never seen before.</p>
<p>He saw that from the first day he had stepped down from
the Garvian ship that had brought him to Hospital Earth
to begin his medical training, he had been relying upon
crutches to help him.</p>
<p>Black Doctor Arnquist had been a crutch upon whom he
could lean. Tiger, for all his clumsy good-heartedness and
for all the help and protection he had offered, had been a
crutch. Fuzzy, who had been by his side since the day he
was born, was still another kind of crutch to fall back on,
a way out, a port of haven in the storm. They were crutches,
every one, and he had leaned on them heavily.</p>
<p>But now there was no crutch to lean on. He had a quick
mind with good training. He had two nimble hands that
knew their job, and two legs that were capable of supporting
his weight, frail as they were. He knew now that he had to
stand on them squarely, for the first time in his life.</p>
<p>And suddenly he realized that this was as it should be.
It seemed so clear, so obvious and unmistakable that he wondered
how he could have failed to recognize it for so long.
If he could not depend on himself, then Black Doctor Hugo
Tanner would have been right all along. If he could not do
this job that was before him on his own strength, standing
on his own two legs without crutches to lean on, how could
he claim to be a competent physician? What right did he
have to the goal he sought if he had to earn it on the strength
of the help of others? It was <i>he</i> who wanted to be a Star
Surgeon—not Fuzzy, not Tiger, nor anyone else.</p>
<p>He felt his heart thudding in his chest, and he saw the
operation before him as if he were standing in an amphitheater<SPAN name="page173" id="page173"></SPAN>
peering down over some other surgeon's shoulder.
Suddenly everything else was gone from his mind but the
immediate task at hand. His fingers began to move more
swiftly, with a confidence he had never felt before. The
decisions to be made arose, and he made them without hesitation,
and knew as he made them that they were right.</p>
<p>And for the first time the procedure began to move. He
murmured instructions to Jack from time to time, and placed
Tiger's clumsy hands in the places he wanted them for
retraction. "Not there, back a little," he said. "That's right.
Now hold this clamp and release it slowly while I tie, then
reclamp it. Slowly now ... that's the way! Jack, check that
pressure again."</p>
<p>It seemed as though someone else were doing the surgery,
directing his hands step by step in the critical work that had
to be done. Dal placed the connections to the heart-lung
machine perfectly, and moved with new swiftness and confidence
as the great blood vessels were clamped off and the
damaged heart removed. A quick check of vital signs, chemistries,
oxygenation, a sharp instruction to Jack, a caution
to Tiger, and the new prosthetic heart was in place. He
worked now with painstaking care, manipulating the micro-sutures
that would secure the new vessels to the old so
firmly that they were almost indistinguishable from a healed
wound, and he knew that it was going <i>right</i> now, that
whether the patient ultimately survived or not, he had made
the right decision and had carried it through with all the
skill at his command.</p>
<p>And then the heart-lung machine fell silent again, and
the carefully applied nodal stimulator flicked on and off, and
slowly, at first hesitantly, then firmly and vigorously, the
new heart began its endless pumping chore. The Black Doctor's
blood pressure moved up to a healthy level and stabilized;<SPAN name="page174" id="page174"></SPAN>
the gray flesh of his face slowly became suffused with
healthy pink. It was over, and Dal was walking out of the
surgery, his hands trembling so violently that he could
hardly get his gown off. He wanted to laugh and cry at the
same time, and he could see the silent pride in the others'
faces as they joined him in the dressing room to change
clothes.</p>
<p>He knew then that no matter what happened he had vindicated
himself. Half an hour later, back in the sickbay, the
Black Doctor was awake, breathing slowly and easily without
need of supplemental oxygen. Only the fine sweat standing
out on his forehead gave indication of the ordeal he had
been through.</p>
<p>Swiftly and clinically Dal checked the vital signs as the
old man watched him. He was about to turn the pressure
cuff over to Jack and leave when the Black Doctor said,
"Wait."</p>
<p>Dal turned to him. "Yes, sir?"</p>
<p>"You did it?" the Black Doctor said softly.</p>
<p>"Yes, sir."</p>
<p>"It's finished? The transplant is done?"</p>
<p>"Yes," Dal said. "It went well, and you can rest now.
You were a good patient."</p>
<p>For the first time Dal saw a smile cross the old man's face.
"A foolish patient, perhaps," he said, so softly that no one
but Dal could hear, "but not so foolish now, not so foolish
that I cannot recognize a good doctor when I see one."</p>
<p>And with a smile he closed his eyes and went to sleep.</p>
<hr class="longer" />
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