The Black Doctor’s voice had grown shrill, almost out of control. But now suddenly he broke off, his mouth still working, and his face went deathly white. The finger he was pointing at Dal wavered and fell. He clutched at his chest, his breath coming in great gasps and staggered back into the chair. “Something’s happened,” his voice croaked. “I can’t breathe.”
Dal stared at him in horror for a moment, then leaped across the room and jammed his thumb against the alarm bell.
The Trial
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.
“Coronary,” Jack said grimly.
Dal nodded. “The question is, just how bad.”
“Get the cardiograph in here. We’ll soon see.”
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.
Tiger injected some medicine to ease the pain, and started oxygen to help the labored breathing, but the old man’s color 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.
“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.”
There was a sound across the room, and the Black Doctor motioned feebly to Tiger. “The cardiogram,” he gasped. “Let me see it.”
“There’s nothing for you to see,” Tiger said. “You mustn’t do anything to excite yourself.”
“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.”
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.”
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.”
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 gets here the odds are a thousand to one against his surviving the surgery.”
“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.”
“Maybe he’ll hold on better than we think,” Dal said. “Let’s watch and wait.”
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.
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.”
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.
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?”
“It’s no good. He’ll never make it for five more hours.”
“What about right now?”
Tiger shook his head. “It’s a terrible surgical risk.”
“But every minute of waiting makes it worse, right?”
“That’s right.”
“Then I think we’ll stop waiting,” Dal said. “We have a prosthetic heart in condition for use, don’t we?”
“Of course.”
“Good. Get it ready now.” It seemed as though someone 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.”
Tiger stared at him. “Are you sure that you want to do this?”
“I never wanted anything less in my life,” Dal said fervently. “But do you think he can survive until a Hospital Ship arrives?”
“No.”
“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.”
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.
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. “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.”
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.”
*
Dal knew from the moment he made the decision to go ahead that the thing he was undertaking was all but hopeless.
There