Final Diagnosis

CHAPTER 6

The sight of the procession that was emerging from the nurses station brought all other activity and conversations in the ward to a halt. It was led by Senior Physician Medalont, followed by Charge Nurse Leethveeschi, his nameless Hudlar nurse, and a Kelgian and a Nidian intern who were guiding a float containing the multispecies resuscitation equipment between them, and an Earthhuman wearing a green Monitor Corps uniform who brought up the rear. Inevitably they traveled the full length of the ward to gather in a semicircle around his bed.

Coming close to death five hours earlier had not made him feel any less fearful of ETs, nor had it improved his disposition one littie bit.

“What the hell are you going to do to me this time?” he said.

“Nothing that I haven’t already done,” the senior physician replied in a voice that might have been reassuring to another Melfan. “Do not be concerned; I am simply withdrawing another blood sample. Please bare your upper arm.

The Kelgian intern looked at its Nidian colleague, its silvery fur tufting into spikes. It edged the resuscitation trolley closer and added, “If you do nothing, Patient Hewlitt, then neither will we.”

One of the things he had learned from his few brief conversations with the Kelgian patient in the adjoining bed was that members of that species were incapable of telling a lie. To another Kelgian, the continuous, subtle, and expressive movements of their silvery fur displayed what they were feeling and thinking from moment to moment, like a form of visual telepathy; so they did not know or understand the meaning of the word. They had the same difficulty with concepts like tact, politeness, diplomacy, and bedside manners.

Once again Hewlitt felt the tiny circle of metal pressed against his skin. Medalont said, “The instrument currently in contact with your arm contains one very fine, short, recessed needle whose entry you will not feel, and another that is longer and slightly thicker. The first one injects a local anesthetic which desensitizes the underlying nerve endings, and the second withdraws the blood. Good, here it comes. Thank you, Patient Hewlitt. How do you feel?”

“Fine,” Hewlitt replied. “How am I supposed to feel?”

Medalont ignored the question and said, “Are you aware of any changes of sensation, however small, anywhere within your body?”

“No,” he said.

“Any feeling of discomfort in the chest or arms,” it went on, “or difficulty with breathing? Tingling or loss of sensation in the extremities? Headache?”

“No,” said Hewlitt. “There is a numb patch where you took the blood. It feels the same as last time.”

“If present,” said Medalont, “the symptoms would be minor, an early warning of possible trouble to come. They could be so minor, in tact, that you may be unsure whether or not you are imagining them.”

“So far as I know,” said Hewlitt, making an effort to control his temper, “I have no minor, imaginary symptoms.”

The Earth-human in the green uniform smiled briefly and resumed doing and saying nothing.

“Have you any nonphysical symptoms?” Medalont persisted. “An anxiety or fear, perhaps, that could intensify to the point where it might cause stress on the physical level? I realize that I am moving into Lieutenant Braithwaite’s territory, but…

“You are,” said the uniformed man, speaking for the first time. “But feel free, everyone else does.”

Before the senior physician could reply, Hewlitt said, “If you mean am I worried then yes, I feel worried, very worried. Until I came to this place I never had a heart attack, but I don’t think I feel bad enough to frighten myself into another one.”

“Were you feeling frightened before the first one?” asked Medalont.

“No, just sleepy and relaxed,” said Hewlitt. “But right now I’m scared.”

“We won’t allow anything to happen to you this time,” said Medalont, “so try not to worry.

For what seemed like a very long time there was silence from everyone. Leethveeschi’s body pulsed slowly inside its chlorine envelope, the Hudlar’s speaking membrane remained still, the Kelgian’s fur was rippling along its body as if blown by an unfelt wind while its Nidian partner checked the equipment on the resuscitation float, and Medalont opened and closed its pincers once every few seconds like some kind of silent, organic metronome. It was the senior physician who spoke first.

“Charge Nurse, give me your estimate again of the elapsed time between my first withdrawal of blood sample, the monitor’s signaling the patient’s distress, and the sequence of events which followed.”

“Out of consideration for the feelings of the patient,” said Leethveeschi, “who appears to have some understanding of medical nomenclature, it might be better if that information were withheld.”

“And I,” said Medalont, “am hoping that with full information available the patient may be able to shed some light on its own condition. Go on, Charge Nurse.”

“Approximately twelve and a half minutes after you withdrew the blood sample and left,” said Leethveeschi, in a tone as corrosive as the chlorine it was breathing, “the patient’s monitor signaled an emergency condition. Ten seconds later the life signs went flat, completely flat, and sensory response and cerebration began the shutdown characteristic of approaching termination. The nursing staff were outside the station and busy preparing to serve a meal so I responded, preferring not to waste an additional few seconds needed to relay the information to another. Considering the stability of the patient’s condition until then, I suspected that equipment rather than cardiac failure had occurred. When I reached the patient and initiated chest massage forty seconds later it had lost consciousness, and it remained in that condition until the resuscitation team arrived six and one-quarter minutes later—”

“Are you sure about that, Nurse?” Medalont broke in. “In the excitement could subjective factors have caused you to exaggerate? Six minutes is not a good response time.”

“Patient Hewlitt was not responding either,” said Leethveeschi, “and I was watching the clock while I worked. The ward clock is not subject to exaggeration.”

“The charge nurse is right,” said the Nidian medic with a side glance at its partner, “and so are you, Doctor. Normally it would be considered an inexcusably slow response time. But we had an accident on the way, a collision with a food delivery float whose servers moved clear when they saw our flashing lights but left their vehicle in the middle of the ward. There were no casualties-just a mess of other-species meals spread all over the ward floor and nearby beds.

“Patient Hewlitt,” the Kelgian doctor broke in, “chose an inconvenient time to arrest.”

“We had to spend a few minutes checking for equipment damage,” the Nidian doctor went on. “A jolt that would restart a Tralthan’s heart would cook an Earth-human’s in its own…

“Yes, yes,” said Medalont. “After six-plus minutes you revived the patient. What degree of mental or verbal confusion did you observe while it was returning to full consciousness?”

“No, and none,” the other replied. “We did not revive the patient; Charge Nurse Leethveeschi must have done that before we could attach the lines. The patient did not appear to be confused at all. Its first words were to tell the charge nurse to stop hitting it in the chest or it would damage its rib cage. Its words were coherent, well organized, and distinct, if not very respectful.”

“I’m sorry,” said the senior physician. “I had assumed your equipment brought the patient back. Well done, Charge Nurse. I hope the patient was not too disrespectful.”

“I have been called worse names,” said Leethveeschi, “and I was relieved rather than insulted by its response.

“Indeed, yes,” said Medalont. To the Kelgian it went on, “Continue, please.”

“When it was clear that Patient Hewlitt was fully conscious,” it replied, “we joined the charge nurse in asking it questions aimed at discovering whether or not there had been a loss of cerebration. We were still doing that when you returned to ask it more of the same questions. The rest you know.”

“Yes,” said the senior physician. “And after two hours of questioning there was no detectable memory or speech dysfunction or loss of physical coordination. Patient Hewlitt’s monitor registered optimum levels on all life signs, just as it is doing now.

“But now,” Leethveeschi said, with a wet, floppy gesture toward the ward clock, “it is four and a half minutes beyond the time that elapsed between the original blood withdrawal and the onset of the first cardiac episode.”

While the medics were talking, Hewlitt had been trying to think of a way of both apologizing to the charge nurse and thanking it for saving his life, but the meaning of what the loathsome creature had just said drove all thoughts of gratitude from his mind.

“What’s going on here?” he burst out. “Are you just standing around waiting for me to have another bloody heart attack? Or are you disappointed it didn’t happen?”

For a moment there was silence, and stillness except for the Hudlar nurse who moved a tentacle toward him and lowered it again. Then the Medalont said, “We are not disappointed, Patient Hewlitt, but otherwise your assessment of the situation is accurate. The first cardiac incident had to be caused by something, and there was a possibility, admittedly a very slim one, that my extraction of the blood specimen was responsible. Although you were not to receive any medication, I overlooked the fact that a trace quantity of local anesthetic is injected routinely prior to blood withdrawal so as to render the procedure pain-free. The timing and circumstances have now been reproduced, so far without results, which means that we must look elsewhere for the cause. Unless… Your facial skin coloration is darkening, Patient Hewlitt. How do you feel now?”

Ifeel like strangling you, he thought. Aloud, he said, “Fine, Doctor.”

“The monitor confirms,” said Leethveeschi.

“In that case,” said Medalont, looking at the others in turn, “you will maintain monitor surveillance, station the resuscitation team within a two-minute response distance, and allow the patient to compose itself before lunch. Never fear, Patient Hewlitt, we will find out and cure whatever it is that is troubling you. But for the present we will leave you alone.”

“Not entirely alone,” said Braithwaite. “I would like to have a few words with him.”

“As you wish, Lieutenant,” said the senior physician as it and the other two doctors withdrew. Leethveeschi and the Hudlar nurse held back.

“You are not to do anything that will disturb my patient,” said the Jllensan in its most authoritative charge-nurse voice. “Nor will you ask or say anything that is likely to precipitate another medical emergency.

Lieutenant Braithwaite looked from the irate chlorinebreather to the hulking, massively strong body of the Hudlar and back again. “Nurses,” he said, smiling, “I wouldn’t dare.”

When they were alone he sat down on the edge of Hewlitt’s bed and said, “I’m Braithwaite, Other-Species Psychology Department. It makes a nice change to talk to someone who has the right number of limbs and things.”

Hewlitt still felt like strangling or at least verbally assaulting someone, but this Braithwaite character had not said or done anything to make himself a candidate. Not yet. Instead he looked along the ward in the direction of the nurses’ station and the figure of Leethveeschi and ignored the psychologist.

“What are you thinking about?” Braithwaite said when the silence began to drag. He smiled and added, “Is that the kind of question you are expecting me to ask?”

“You didn’t call me Patient Hewlitt like the others,” he replied, turning to face the psychologist. “Was that intentional, or because you don’t think there is anything wrong with me so I’m not a real patient? Or did you forget my name?”

“You need not call me Lieutenant or Braithwaite,” said the other, and the silence returned.

Finally Hewlitt said, “All right, I’ll answer your question. I am thinking about that ghastly charge nurse, and wondering howl can say that I’m sorry for misjudging it and thank it for saving my life.”

Braithwaite nodded. “I’d say that you have the words about right, and all you have to do is say them to Leethveeschi rather than me.

For some reason Hewlitt was finding it difficult to maintain his anger toward this man. He said, “You are here to tell me, or to try to convince me, that my problems are all in my mind. This has happened to me many times, man and boy, so let’s not waste our time being friendly. Yes?”

“No,” said Braithwaite firmly. “I intend to waste time being friendly.”

The lieutenant changed his position on the side of the bed, moving so close that he had to support his weight with one arm stretched across Hewlitt’s thighs. Hewlitt could feel the other’s breath on his face as he said, “Do you mind me sitting here? Would you prefer me to move back, or stand?”

“It’s the extraterrestrials I worry about when they come too close,” he replied. “Just don’t sit on my legs.”

Braithwaite nodded. The polite and seemingly innocent question-and-answer had established the fact that he was not emotionally distressed by the close proximity of another human being, which was a useful psychological datum that eliminated one potential area of trouble. From long experience Hewlitt knew what the other was doing, and the lieutenant was probably intelligent enough to know that Hewlitt knew.

“We both know that yours is not a simple case,” Braithwaite went on, with a glance toward his monitor. “You appear to be completely healthy, while suffering from an intermittent and nonspecific condition which, if the recent cardiac arrest was a symptom, is life-threatening. We also know that a serious problem in the body can have a proportionate effect on the mind, and vice versa, even when there appears, as now, to be no apparent connection between the two. I would like to find and identify that connection, but only if there is one.”

He waited until Hewlitt gave a wary nod, then continued, “Normally a patient is admitted to this hospital because he, she, or it is sick or injured. The problem and clinical solution are usually obvious from the start, and the medics can use the facilities of the Federation’s leading hospital to treat or remove or repair the condition and, in most cases, to send the patient home good as new. But when the problem has or appears to have a psychological component.

“You use your tongue,” Hewlitt finished for him.

“My ears, mostly,” said Braithwaite, ignoring the sarcasm. “Very soon, I hope, you will be doing all the talking. You should begin by describing any unusual events or circumstances that you can remember prior to the first onset of symptoms. Tell me what you as a child were thinking about the situation at the time, not what your doctors and relatives thought later. Go ahead, you talk and I’ll listen.~~

“You want me to tell you all about the times when I wasn’t sick?” said Hewlitt. He inclined his head in the direction of the diet kitchen, where the ward serving floats loaded with meal trays were emerging, and added, “But there isn’t enough… It’s lunchtime.”

Braithwaite sighed and said, “I would like to finish this talk with you as soon as possible, in case Medalont, who has the rank, thinks of doing something more urgent and positive for you. Would you do me a favor by ordering a meal for me? Nothing special, whatever they are giving you will do nicely.”

“But you’re not a patient,” said Hewlitt. “Yesterday I heard Leethveeschi telling an intern not to be a lazy scrassug, whatever that is, and to go to the staff dining hall instead of sneaking food from the ward kitchen. I don’t think the charge nurse will allow it.”

“The charge nurse will allow it,” said the lieutenant, “if you ask to speak to it about a personal matter which you feel is important. After the medical melodrama of five hours ago it will not want to risk a refusal. When it comes, say what you told me you wanted to say to it, that you are sorry for misjudging its actions and are grateful for it saving your life. Then you can say that you feel our talk could be important to your case, and would it be possible for it to order up another DBDG meal for me so that the conversation can continue without interruption.

“Illensans receive a lot of professional compliments from the staff,” Braithwaite went on, “because they are very good at what they do. But not from the patients, who are rarely here long enough to appreciate their good points. It comes of being the only chlorinebreathing, as well as the ugliest, species in the Federation. But if you do as I say, it will be too surprised and pleased to refuse you anything.”

Hewlitt was silent for a moment; then he said, “Lieutenant, you are a selfish, devious, calculating son of a… of a scrassug.

“Of course,” said Braithwaite. “I’m a psychologist.”

He was beginning to sweat at the idea of actually calling the loathsome Leethveeschi to his bedside. He said, “I was thinking of saying those things to it, but later,” he said. “I need more time to work up the nerve.

Braithwaite smiled and pointed at the communicator.