Alan E. Nourse Super Pack. Alan E. Nourse
But organ-transplantation, with the delicate vascular surgery and micro-surgery that it entailed, was never simple. In incompetent hands, it could turn into a nightmare.
Dal took a deep breath and began running the anatomical atlas tapes through the reader, checking the critical points of Moruan anatomy. Oxygen-transfer system, circulatory system, renal filtration system—at first glance, there was little resemblance to any of the “typical” oxygen-breathing mammals Dal had studied in medical school. But then something struck a familiar note, and he remembered studying the peculiar Moruan renal system, in which the creature’s chemical waste products were filtered from the bloodstream in a series of tubules passing across the peritoneum, and re-absorbed into the intestine for excretion. Bit by bit other points of the anatomy came clear, and in half an hour of intense study Dal began to see how the inhabitants of Morua VIII were put together.
Satisfied for the moment, he then pulled the tapes that described the Moruans’ own medical advancement. What were they doing attempting organ-transplantation, anyway? That was the kind of surgery that even experienced Star Surgeons preferred to take aboard the hospital ships, or back to Hospital Earth, where the finest equipment and the most skilled assistants were available.
There was a signal buzzer, the two-minute warning before the Koenig drive took over. Dal tossed the tape spools back into the bin for refiling, and went forward to the control room.
Just short of two hours later, the Lancet shifted back to normal space drive, and the cold yellow sun of the Moruan system swam into sight in the viewscreen. Far below, the tiny eighth planet glistened like a snowball in the reflection of the sun, with only occasional rents in the cloud blanket revealing the ragged surface below. The doctors watched as the ship went into descending orbit, skimming the outer atmosphere and settling into a landing pattern.
Beneath the cloud blanket, the frigid surface of the planet spread out before them. Great snow-covered mountain ranges rose up on either side. A forty-mile gale howled across the landing field, sweeping clouds of powdery snow before it.
A huge gawky vehicle seemed to be waiting for the ship to land; it shot out from the huddle of gray buildings almost the moment they touched down. Jack slipped into the furs that he had pulled from stores, and went out through the entrance lock and down the ladder to meet the dark furry creatures that were bundling out of the vehicle below. The electronic language translator was strapped to his chest.
Five minutes later he reappeared, frost forming on his blue collar, his face white as he looked at Dal. “You’d better get down there right away,” he said, “and take your micro-surgical instruments. Tiger, give me a hand with the anaesthesia tanks. They’re keeping a patient alive with a heart-lung machine right now, and they can’t finish the job. It looks like it might be bad.”
*
The Moruan who escorted them across the city to the hospital was a huge shaggy creature who left no question of the evolutionary line of his people. Except for the flattened nose, the high forehead and the fur-less hand with opposing thumb, he looked for all the world like a mammoth edition of the Kodiak bears Dal had seen displayed at the natural history museum in Hospital Philadelphia. Like all creatures with oxygen-and-water based metabolisms, the Moruans could trace their evolutionary line to minute one-celled salt-water creatures; but with the bitter cold of the planet, the first land-creatures to emerge from the primeval swamp of Morua VIII had developed the heavy furs and the hibernation characteristics of bear-like mammals. They towered over Dal, and even Tiger seemed dwarfed by their immense chest girth and powerful shoulders.
As the surface car hurried toward the hospital, Dal probed for more information. The Moruan’s voice was a hoarse growl which nearly deafened the Earthmen in the confined quarters of the car but Dal with the aid of the translator could piece together what had happened.
More sophisticated in medical knowledge than most races in the galaxy, the Moruans had learned a great deal from their contact with Hospital Earth physicians. They actually did have a remarkable grasp of physiology and biochemistry, and constantly sought to learn more. They had already found ways to grow replacement organs from embryonic grafts, the Moruan said, and by copying the techniques used by the surgeons of Hospital Earth, their own surgeons had attempted the delicate job of replacing a diseased organ with a new, healthy one in a young male afflicted with cancer.
Dal looked up at the Moruan doctor. “What organ were you replacing?” he asked suspiciously.
“Oh, not the entire organ, just a segment,” the Moruan said. “The tumor had caused an obstructive pneumonia—”
“Are you talking about a segment of lung?” Dal said, almost choking.
“Of course. That’s where the tumor was.”
Dal swallowed hard. “So you just decided to replace a segment.”
“Yes. But something has gone wrong, we don’t know what.”
“I see.” It was all Dal could do to keep from shouting at the huge creature. The Moruans had no duplication of organs, such as Earthmen and certain other races had. A tumor of the lung would mean death ... but the technique of grafting a culture-grown lung segment to a portion of natural lung required enormous surgical skill, and the finest microscopic instruments that could be made in order to suture together the tiny capillary walls and air tubules. And if one lung were destroyed, a Moruan had no other to take its place. “Do you have any micro-surgical instruments at all?”
“Oh, yes,” the Moruan rumbled proudly. “We made them ourselves, just for this case.”
“You mean you’ve never attempted this procedure before?”
“This was the first time. We don’t know where we went wrong.”
“You went wrong when you thought about trying it,” Dal muttered. “What anaesthesia?”
“Oxygen and alcohol vapor.”
This was no surprise. With many species, alcohol vapor was more effective and less toxic than other anaesthetic gases. “And you have a heart-lung machine?”
“The finest available, on lease from Hospital Earth.”
All the way through the city Dal continued the questioning, and by the time they reached the hospital he had an idea of the task that was facing him. He knew now that it was going to be bad; he didn’t realize just how bad until he walked into the operating room.
The patient was barely alive. Recognizing too late that they were in water too deep for them, the Moruan surgeons had gone into panic, and neglected the very fundamentals of physiological support for the creature on the table. Dal had to climb up on a platform just to see the operating field; the faithful wheeze of the heart-lung machine that was sustaining the creature continued in Dal’s ears as he examined the work already done, first with the naked eye, then scanning the operative field with the crude microscopic eyepiece.
“How long has he been anaesthetized?” he asked the shaggy operating surgeon.
“Over eighteen hours already.”
“And how much blood has he received?”
“A dozen liters.”
“Any more on hand?”
“Perhaps six more.”
“Well, you’d better get it into him. He’s in shock right now.”
The surgeon scurried away while Dal took another look at the micro field. The situation was bad; the anaesthesia had already gone on too long, and the blood chemistry record showed progressive failure.
He stepped down from the platform, trying to clear his head and decide the right thing to do.
He had done micro-surgery before, plenty of it, and he knew the techniques necessary to complete the job, but the thought of attempting it chilled him. At best, he was on unfamiliar ground, with a dozen factors that could go wrong. By now the patient was a dreadful risk for any surgeon. If he were to step in now, and the patient died, how would he explain