Dark Running (Fourth Fleet Irregulars Book 4) (50 page)

‘What does he say?’ he asked, and then, quickly clarifying, ‘on his MA?’

Every member of the Fleet was required to complete a Medical Affidavit as part of signing into service. It detailed, amongst other things, the circumstances under which they would not wish their life to be artificially prolonged. Alex himself had signed such a document, specifying that he would not want to be kept alive in a persistent vegetative state, and that a Do Not Resuscitate order must be put in place if he had such serious brain damage that he would no longer be able to function as an independent adult. If Ali Jezno had done the same – and those were fairly common stipulations amongst spacers – that would weight the argument pretty heavily on Rangi’s side.

‘But that’s just it, skipper,’ Rangi said, looking quite startled for a moment as he realised that he had failed to mention the reason they had come to see the captain. ‘Ali hasn’t specified his wishes beyond ‘DNR if PVS’, but he
has
ticked the box giving you power of attorney. Well – ‘Current Commanding Officer’, of course, but right now, obviously, that’s you. We need you to decide. But please, sir, I
know
Ali has gone. Nearly half his frontal cortex has been blown away. Everything that made him him is
gone
. You can’t repair that. You can’t fix it. There are limits to what we can do, limits to what we
should
do.’

Alex held up a hand, seeing from the way he was talking that Rangi would go on indefinitely, becoming more impassioned as he stood on his deeply spiritual views. As Rangi faltered reluctantly into silence, Alex looked back at Simon, considering.

‘You said ‘unlawful’,’ he observed.

‘Yes, it’s a matter of civil law,’ Simon told him. ‘And kind of a grey area. Views on it are so varied, culturally, that the MEA has left it to individual worlds to decide where they set the bar on that, as to what’s allowed and what isn’t. Chartsey is reviewing at the moment, based on the surgery I did on Jaymes Winthrop.’

Alex nodded. ‘But is this against the law on Therik, Simon?’

It was the medic’s turn to look bewildered.

‘Huh?’

‘It’s important,’ Alex explained. ‘We’re bound to obey the laws of our base-world, see. That’s not just regs, it’s enshrined in the Fleet constitution as a fundamental principle. In any situation where there’s a difference in planetary laws, we have to comply with our base-world’s.’

‘But that’s ludicrous,’ Simon objected. ‘That would mean that if two Fleet ships met out in space, something like this would be legal on one and not on the other.’

‘True, it can be a bit confusing,’ Alex agreed, with a dry note. ‘But that is better than having squadrons in port at odds with the system authorities because they’re violating their laws. And this
is
, you know, fundamental stuff, respect for the sovereignty of member worlds, not something I am prepared to go against. So I will need to check if this
is
legal on Therik, okay?’

‘I’ll look now,’ Simon said, and accessed a comp, punching in coding with an imperious finger. ‘No, we’re okay,’ he said, with a satisfied look. ‘They seem quite enlightened on Therik.’ His tone was so patronising that Alex raised an eyebrow, at which Simon grinned. ‘Sorry – I’m a Chartsey boy, myself,’ he said. ‘Every other world seems provincial to me – kind of like travelling back in time, too, as the further you get out of Chartsey the more behind the times they are in, well, just about everything – tech, fashions, attitudes. Therik seems pretty progressive, medically, though – decisions that look like they’ve been made by doctors, not politicians. So yes, we’re good to go, no legal issues.’

‘All right,’ Alex said. ‘What are your best and worst case outcomes?’ He held up a hand to him, too, preventing Simon from leaping in with instant assurances. ‘
Honestly
, now, give me a realistic probability of Mr Jezno’s quality of life.’

‘Best outcome?’ Simon didn’t hesitate. ‘I get him back ninety nine per cent functionality – he has some memory loss and drops maybe five to ten points from his IQ, but he is able to pick up his life, reconnect with his loved ones and lead an active, productive life. He’d need to re-train to get back to work, and it is possible, realistically, that he won’t be able to recover enough to get back to work in space. I feel sure, though, that he could be back at work in a groundside role within a few months.’

He paused, momentarily. ‘Worst case? He drops so much IQ that he becomes cognitively dysfunctional, perhaps as low as eighty four on the Reyder-Shicht Scale…’ he saw that that meant nothing to Alex and decided against trying to explain it to the layman. ‘He would be, effectively, like a small child,’ he said.

Alex winced, but Simon didn’t give him time to respond. ‘But that is a very very small probability of a desperately awful ‘worst case’ outcome, as you asked for, being totally honest,’ he said. ‘I could try to argue that even that worst case scenario gives him life, the capacity to love and be happy, and I could also point out that families would almost always prefer to have a survivor needing care than a corpse to mourn. But for me, there
is
no question here. I can save him, I
know
I can. We could sit here debating medical ethics and the possible existence of the soul for the rest of the day, but what it comes down to is this – I can save him. I
can
. So will you trust me and let me do this, or not?’

Alex could see two paths opening up ahead of him. In one he followed the orthodox, regulated path and told Simon they had to comply with the current guidance on medical ethics however out of date Simon might consider them to be. In that path, he had to write the letter to Ali Jezno’s family and the reports for the inquest which would be held once they got back to Therik. In that path, they would acquire a small memorial plaque to be placed beneath their ID in the main entry airlock, honouring Petty Officer A Jezno, killed in action.

In the other path, he would have to explain his decision to the inevitable Fleet enquiry and very probably to the Medical Ethics Authority, too, under a tsunami of outrage from all directions over what he’d allowed Simon to do. The word ‘zombification’ would trigger highly emotive reactions even amongst people who generally didn’t know much about the Fourth, or care. The public and political fallout would be horrendous. Worse, though, far worse, was the possibility that the wreck of what had once been Ali Jezno might one day look at him with haunted eyes and say, ‘You should have let me die.’

There were perhaps four seconds when neither medic spoke – something quite remarkable in itself – and Alex considered his options. When he looked back at Simon, a decision was forming.

‘You are absolutely sure of your ability to do this?’ he queried. ‘And in no way experimenting on my crewman, here?’

‘Alex!’ Simon looked shocked. ‘No, of course not! I mean, okay, technically I suppose, the procedure would still be regarded as experimental, but I am in no way treating Ali Jezno as an experiment. Nor is this an emotional decision – he is a mate of mine, too, I like him a lot and yes I
am
upset about what’s happened to him, but that is not steering my medical judgement. If you want it in writing I can give you a detailed analysis of his condition and on what basis I believe I can save him, but that will of necessity be so technical – medically technical – that only a handful of other consultant neurosurgeons could understand it. Rangi certainly can’t – he’s a good kid but this is
way
above his level of skill and understanding. So what it comes down to, absolutely, is ‘Do you trust me, or not?’’

Seventeen

There was a stunned silence throughout the ship as Alex finished telling them about his decision regarding Ali Jezno. Even the officers on the command deck were just staring at him, some amazed, others frankly appalled.

‘I agree,’ said Buzz, after that one moment of deathly hush. ‘It is the only thing you can do, in fairness to Ali.’

His opinion was just that. Unless he intended to challenge Alex’s fitness to command, this was not a decision Buzz had any say in. Alex had not consulted him before making his choice. That, after all, was in the nature of command decisions. Still, he appreciated Buzz’s immediate, steadfast support.

‘I…’ Jonas Sartin hesitated, but he knew his duty and faced up to it manfully. ‘I
am
sorry, sir – for the record, I want to state that I personally support your decision, one hundred per cent. But you know my position, here – as IA officer, my duty is prescribed. So I
have
to go on record with a logged advisory that to allow this is contrary to medical procedure laid down in regulations.’ He saw Alex’s nod and carried on, apologetic but determined. ‘I must also, I’m sorry, register a concern at the decision to keep O/S Triesse in stasis for three days, as this, too, is contrary to established Fleet medical procedure.’

Alex had not appreciated that, though when Jonas reminded him of it he recalled that there were, indeed, regulations about how long casualties should be kept in stasis. The stasis bags did not hold them in
complete
suspended animation, after all, merely slowed everything down to the absolute minimum the human body could survive. There would be increasing deterioration as time went by – the longest anyone had survived stasis was a month, but every hour was important and the principle of getting the patient on the operating table as quickly as possible was very well established. Alex had assumed that the medics needed three days in order to prepare for the surgery needed to save Banno’s life, which would justify that decision. As Jonas spoke, though, he passed him a formal Internal Affairs ‘notice of concern’ which pointed out that the medics had the ability to bring Banno Triesse out of stasis and perform life-saving surgery on him after just four hours. That was the time it would take to grow sufficient cloned material to repair his liver and intestines, all badly damaged in the explosion. He was also going to need reconstructive surgery on one leg, and a complete clone-graft on the other. That was what would take the time, Alex saw. The medics were intending to clone the leg before they got him out of stasis, to carry out all the surgery in one marathon endeavour. This was, indeed, contrary to established Fleet and indeed civilian medical procedure. Normally the procedure would be to get the patient stabilised enough to survive on life support machines, then to work through surgeries on priority. Providing either a cloned or prosthetic leg would be very low down on that list and might not happen for weeks in a case with such severe injuries as this.

Simon, though, was evidently watching the command feed, as Alex was still reading the Internal Affairs concern when the medic’s response flashed up beside it. In tones of clear and irritated impatience, Simon stated that he had made his decision based on the psychological impact on the patient – it was the difference, as he observed, between Banno waking up in a life support tank to find himself in bits and missing a leg, or waking up in a bunk, fully restored.

‘This is what
I
mean by holistic medicine,’ he declared, tersely. ‘Treating this man’s body with no regard for the trauma that treatment will cause him is barbaric. I have established that the deterioration in his condition over three days in stasis is more than amply compensated for by the psychological benefits of waking him healed, and whole. And no, I will not get him out of stasis and keep him under sedation till his injuries are healed; the side effects of that level of anaesthesia are deleterious in themselves and there is evidence that some patients
still
experience trauma at some level of consciousness. While he is in stasis, there is no effective brain activity. It is in his own best interest to keep him in stasis till we’re ready to operate and I will defend that decision against any protest that you care to bring.’

A second memo popped on screen, from Rangi Tekawa.

‘I concur with Dr Penarth and support his decision as consultant, entirely.’

Alex logged his own decision in favour of the medics, and nodded to Jonas.

‘Concern noted, Mr Sartin,’ he said. ‘However, we are fortunate in having the services of one of the League’s foremost neurosurgeons, so it is, I feel, appropriate to defer to his medical judgement in such matters.’

‘Thank you, skipper,’ Jonas looked relieved, not just at the skipper’s response but at the understanding looks he was getting from the other officers. They all knew how hard it was to have the Internal Affairs role, forced to challenge the skipper on any deviation from policy or established procedure, even when they might well agree with that decision wholeheartedly. ‘But can I ask, sir, how long it will be before we know if the surgery on Petty Officer Jezno has been successful, or
how
successful it has been?’

‘They intend to operate tomorrow,’ Alex said. ‘They will be able to tell us at the end of that how successful the surgery has been in physical terms, but it may be some days before we know…’ he hesitated for a moment, not wanting to say ‘how much of him is left’. ‘how successful the outcome will be in terms of functionality,’ he said, deliberately official.