Final Diagnosis


It's a massive hospital space station on the Galactic rim—384 levels, a staff of thousands—where human and alien medicine meet.

But Patient Hewlitt, new to Sector General, doesn't want to meet alien medicine—or alien doctors, or alien nurses, or aliens of any kind. Which is just too bad; he's an interesting case, and he'll have to get used to it.

In the meantime, it's always been an article of faith among Sector General's multispecies staff ...

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It's a massive hospital space station on the Galactic rim—384 levels, a staff of thousands—where human and alien medicine meet.

But Patient Hewlitt, new to Sector General, doesn't want to meet alien medicine—or alien doctors, or alien nurses, or aliens of any kind. Which is just too bad; he's an interesting case, and he'll have to get used to it.

In the meantime, it's always been an article of faith among Sector General's multispecies staff that infections can't pass from one alien race to another. But in this season of anomalies, it looks like they might have their first-ever interstellar virus on their hands, their tentacles, their cilla....

Combining intrigue, ingenious puzzles (and even more ingenious solutions), action, adventure and White's characteristic easy charm, Final Diagnosis is a science-fiction treat.

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Editorial Reviews

From the Publisher
"Wonderful....Suspenseful, imaginative, and humanistic, with a wry humor. Highly recommended."—Starlog

"Marvelously entertaining, and the clever medical mystery that underlies everything is nicely done as well. One of the best entries in this popular and inventive series."—Science Fiction Chronicle

Publishers Weekly - Cahners\\Publishers_Weekly
The genre's longest-lived space operetta celebrates its 35th anniversary with this 10th and typically easygoing entry (after last year's The Galactic Gourmet). White's new protagonist is the diffident and xenophobic Patient Hewlitt, a well-to-do Earth merchant who's at the Sector General medical complex because he's been mysteriously afflicted with a virus capable of interspecies infection. Via a convenient universal translator gadget, all of White's humans and nonhumans present amusingly familiar stereotypes. The most effective sendups are the dictatorial, chlorine-breathing Illensan Charge Nurse Leethveeschi and the officious crustacean Senior Physician Medalont. Less convincing are White's sympathetically drawn aliens, such as the giant butterfly-like empath Senior Physician Prilicla and the mammoth eight-armed hospital chaplain Padre Lioren, who probe Hewlitt's quivering psyche for clues to his ailment. Hewlitt's illness and his distaste for his weird fellow sufferers are eventually simultaneously cured in spite of the pompous medical establishment. Hippocrates might have smiled at this harmless if old-fashioned spoof of an honored profession.
Kirkus Reviews
More about Sector General, Northern Ireland resident White's colossal, multi-species space hospital (The Galactic Gourmet, 1996, etc.). This time, patient Hewlitt (human) arrives at Sector General with chronic, ill-defined symptoms that have baffled and annoyed human doctors for years: He's impotent, hypersensitive to medication of any sort, xenophobic, but otherwise in perfect health. But did he imagine an incident when, as a child, he ate a poisonous fruit and then fell out of a tall tree? His new alien doctors—and his fellow-patients—listen to his case history with fascination and varying degrees of disbelief. The key is planet Etla, where Hewlitt lived as a young boy, so a hospital ship with Hewlitt and his doctors aboard goes to investigate. Hewlitt, it turns out, did indeed fall out of a tree as a child, and in doing so struck and broke a mysterious cylinder that contained biological materials. He was thereupon infected with an intelligent virus that previously served another alien as its physician: Hewlitt is the galaxy's first patient to be infected with his doctor! Reaching Sector General, the virus moved on to new hosts, leaving each in perfect health but provoking fears of an interspecies plague.

A first-class medical puzzle and its absorbing solution, with always a twinkle in the author's eye: thoroughly enjoyable.

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Product Details

  • ISBN-13: 9780812562682
  • Publisher: Tom Doherty Associates
  • Publication date: 7/15/1998
  • Series: Sector General Series
  • Format: Mass Market Paperback
  • Edition description: First Edition
  • Pages: 320
  • Product dimensions: 4.25 (w) x 6.75 (h) x 0.84 (d)

Meet the Author

James White lived in Northern Ireland. He was a popular writer of science fiction for over forty years. He died in 1999.

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The ship's Orligian medical officer did not speak as it escorted him into and along the boarding tube to the hospital entry point, and that was the way Hewlitt wanted it. He did not like extraterrestrials and, on the few occasions when it was necessary, he preferred to discuss his business with them on a long-range communicator that was not fitted with a viewscreen. He did not like this one because the brownish-grey spikes of fur projecting through the gaps in its body covering twitched from time to time, making him itch at the thought of the parasites that might be infesting the creature. He felt a great relief when they left the narrow tube and entered the reception area beyond, because he was able to move farther away from the hairy, unprepossessing entity.

Another extraterrestrial of a type he had never seen before was standing beside an antigravity litter and obviously awaiting their arrival. This one was very large, heavily built, and supported by six thick tentacles, one of which was encircled by a band bearing what was presumably the insignia of rank or identity of the wearer. It wore no other body covering and he was relieved to see that it was hairless, although its personal hygiene was suspect since there were several patches of what looked like dry, flaking paint on the smooth skin of its flanks. He could see two lidless, recessed eyes covered by a hard, transparent material, but no other features apart from a fleshy membrane growing like a cock's comb from the top of its head, and whose purpose was revealed as an organ of speech when the creature moved closer and vibrated it at him.

"I am awaiting the arrival of a DBDG patient," it said. "You are plainly an Earth-human of the DBDG physiological classification, but you do not appear to be traumatized or displaying any lesser form of distress. Perhaps I have made a mistake and you are not—"

"No mistake, Nurse," said the Orligian, breaking in. "I am Surgeon-Lieutenant Turragh-Mar, of the Monitor Corps supply vessel Treevendar, which was requested to convey this patient from its home world to Sector General. But now I must return to my ship without delay. This is Patient Hewlitt, and these are its case notes."

"Thank you, Doctor," said the nurse, accepting the tape and slipping it into a recess on the litter's control panel. "Is there any more recent clinical information that the physician-in-charge should know about?"

Turragh-Mar hesitated, then said, "There has been no change in the patient's clinical condition since it was transferred from the planetary hospital to Treevendar six days ago. It remained as you see it now, apparently in good health. During that time I formed the opinion that, in spite of its long and complicated case history, there is a psychological component to the patient's problem."

"I understand, Doctor," said the nurse. "But Patient Hewlitt can be assured that, however complicated its problem may turn out to be, we will do our best to solve it."

Turragh-Mar gave a short bark that came through its translator only as a short bark. It added, "I wish you luck."

"Patient Hewlitt," said the nurse as the Orligian disappeared into the boarding tube, "please climb onto the litter and make yourself comfortable. I am taking you to Ward Seven on the twenty-ninth level, were you will—"

"I am not climbing into anything!" said Hewlitt, anger and uncertainly and an instinctive dislike of this monstrous creature making his voice louder than he had intended. "There is nothing wrong with me right now, especially with my legs. I shall walk."

"Please believe me, sir," said the nurse, "you will feel much more comfortable in the litter."

"I would be much more comfortable," he replied, "if you would not talk about me as if I was a, a thing. On the way here that hairy Orligian apology for a doctor did it when speaking to other ship's officers, and within seconds of my arrival you were doing it, too. I am a human being, a 'he' or a 'him,' not an 'it.' You will kindly remember that in the future, Nurse."

For a long moment the other neither moved nor spoke. Then it said, "I know that you are human, just as all members of intelligent species think of themselves as being human. From my lectures on other-species anatomy I recognize you as an adult male of the DBDG Earth-human classification, but I must continue to refer to you as an 'it' unless some future clinical condition involving the reproductive organs or associated endocrinology requires me to be specific regarding your gender.

"Unfortunately," the nurse went on, "the identification of an entity's sex is not always as easy as it is in your case, especially among beings like myself, who are able to change sex several times within a life span, or with species who require more than two sexes for procreation. But it is a sensitive area, Patient Hewlitt, and often a wrong identification can be irritating or even, among some species, grossly insulting to the being wrongly identified. I believe that it will feel more comfortable and natural for you to think of me and any other being who is not of your own species as an 'it,' just as we do with you. Now ill you please board the litter."

"Is your species hard of hearing, Nurse?" he said very loudly. "I said that I would walk."

The other did not speak, but it leaned backward slightly so that its enormous weight was balanced on the middle and rear tentacles. The two forelimbs uncurled suddenly, and before he could react, one had wrapped itself around his waist while the other pinioned his legs together at knee level while he was swung high into the air and deposited gently onto the litter. Their grip was firm but not uncomfortable, and he did not try to break free, because the tentacles felt hard, like warm, flexible metal, and immensely strong.

During the brief moment that he was airborne, Hewlitt saw that the limbs encircling him could act as both arms or legs. On the back of each one there was a roughened knuckle on which the creature walked while the more delicate extremity that divided into fingers was curled upward and inward away from the ground. Then the litter's padded body restraints swung inward to immobilize his upper legs, the vehicle's transparent canopy rose from each side but did not close at the top, and a hinged backrest unfolded until he was sitting upright. At least he was being allowed to hear as well as see whatever was going on around him.

Remembering the many previous litter rides in Earth hospitals, when there had been nothing to look at but a boring succession of white corridor ceilings and strip lighting fixtures, he appreciated that.

"Whether they are patients or staff," said the nurse, making no mention of the way it had just manhandled, or something-handled, him, "newcomers usually find traveling the corridors of Sector General on foot to be an intimidating experience at first. You may consider yourself fortunate that as a patient you are not allowed to walk."

"But I am able to walk!" Hewlitt protested as the litter was guided smoothly toward the corridor exit.

"Most of our incoming patients," said the other, "are in no condition to walk, talk, look around them, or argue with their nurse. It is a general rule that cannot be changed because of one exceptional case."

The door opened at their approach. Hewlitt immediately closed his eyes, and it was several seconds before he could force himself to open them again. All at once he was very glad of the thick, transparent canopy surrounding him.

Creatures out of the worst nightmares he had ever experienced, and a few new ones that he would probably have whenever he next went to sleep, were passing in both directions along the wide corridor, and the occasional human being among them only made the others look worse. Some of them were separated by a few yards, but more often they were clumped together into groups moving at different speeds who jostled past each other. There were massive, multitentacled beings terrifying in their great size and obvious physical strength; others who were horrifying and repugnant in the nauseous growths and slime sheen covering their dreadful, misshapen bodies. Some of the shapes were so ridiculous that he had trouble believing his eyes. One of the creatures was covered with silver fur that rippled and tufted continually as it undulated past the litter on about twenty legs. He remembered seeing a picture of one somewhere, and that their home world was called Kelgia. Gradually he was able to identify a few other familiar shapes from the extraterrestrial menagerie that was passing by.

The large, six-legged elephantine being with the four tentacles and immobile dome of a head was a Tralthan; a large, low-slung crustacean with the beautifully marked carapace that clicked past on thin, bony multijointed legs was, he recalled, a Melfan; and the small biped who looked like a half-size Earth-human covered in tightly curled red fur came from the planet Nidia.

The Nidian bumped gently against the side of the litter as it went past. It barked something at his nurse, possibly a reproof for bad driving, which was ignored. Like the cacophony of hooting, chirping, barking, or gobbling conversations going on all around him, it was just so much irritating, organic noise. This meant that the litter's translation device must have been programmed only for the languages of the nurse and himself.

Hewlitt disliked being kept in ignorance of anything that was being said around him. H wondered if he would be allowed a personal multitranslator during his stay in hospital. Probably not. If the medics here were anything like some of the ones he had met on Earth, they would not want their patient to know what was going on.

Especially if they were not sure themselves.

His unpleasant memories of many unsuccessful treatments on his home world were driven from his mind by the sight of a great, hissing metal juggernaut that was heading rapidly toward them on a collision course. He pointed and yelled, "Nurse, look out! Slow down, dammit, and move aside."

The nurse did none of those things, and the metal monster veered aside at the last moment and passed with a few inches to spare. Through the partly open canopy came the hot, odorless smell of escaping steam.

"That was the environmental protection vehicle of an SNLU," said the nurse. "It belongs to a heavy-gravity life-form that evolved in an atmosphere of high-pressure super-heated steam. We were in no danger from it."

The nurse removed one of its tentacles from the litter controls to point along the corridor before going on. "You will already have noticed that the beings you can see fall into two distinct types: those who avoid others, and those who are avoided by others. This is due to differences in medical rank, the insignia of which is displayed on a band worn around a limb or some other prominent bodily extremity. I am giving you this information now because it will also serve as a guide to establishing the relative seniority of the various doctors and nursing staff you will meet during treatment. You will soon be able to tell the difference between the band markings that I wear, which are those of a nurse-in-training, and a charge nurse, an intern, a member of the Psychology Department, a senior physician, or one of the diagnosticians.

"Theoretically," it went on, "the staff member possessing the greater medical seniority has right of way. But there are many who believe that it is stupid to suffer contusions or some lesser bodily discomfort by holding too strictly to this rule and, if the other being is more massive and well muscled than they are, simply get out of its way regardless of differences in rank. That is why nearly everyone gets out of my way. But in the case of a patient like yourself who is presumably in urgent need of treatment, the litter bearing you has priority of passage regardless of the low rank, very low in my case, of the nurse guiding it."

Feeling reassured, Hewlitt looked more closely at the beings around him instead of cowering and closing his eyes at their approach. A person can get used to anything, he was thinking, but a few minutes later he was not so sure.

"What…what was that disgusting, horrible thing that just went past?"

The nurse did not reply until they had turned in to an intersection and the creature was out of sight. Then it said, "That is a physiological classification PVSJ, an Illensan chlorine-breather, wearing the protective envelope necessary in an oxygen-rich environment. They have very sensitive hearing. You would do well to remember that."

Hewlitt could not remember seeing anything that looked like an ear, or an eye or a nose or mouth for that matter; just a spiny, membranous body that looked like a haphazard collection of oily, rotting vegetation writhing within the yellow fog inside the loose, transparent body cover.

"Nurse," he said with great vehemence, "no matter what my future treatment is to be, I do not want a thing like that anywhere near me!"

The nurse's speaking membrane vibrated, but no speech came through its translator. Then it said, "We will arrive in Ward Seven within a few minutes. I expect to be allowed to assist with your nursing care, Patient Hewlitt, and if there is any other way that I can help with nonmedical advice or information you have only to—"

"Aren't there any human doctors and nurses in this place?" he broke in sharply. "I want to be treated by people of my own species."

"There are many Earth-human DBDGs on the medical staff," the nurse replied, "but they might not want to treat you."

For a moment surprise and disbelief rendered him speechless, and not until his litter swung into a narrower and less populated corridor did the nurse answer the question that he had been too angry to ask.

"You are forgetting that this is a multispecies hospital," it said, "and recognized throughout the Galactic Federation to be the biggest and best of its kind. The people who are accepted for positions or advanced training here are selected from the best that their home planets' medical establishments can provide, and their purpose in coming here is to practice other-species medicine and surgery. So you will understand that one of them would not take your case unless specifically ordered to do so for a particular clinical reason. A DBDG Earth-human doctor would not feel that it had come all the way to Sector General just to treat another Earth-human when there are countless millions of those on Earth and the Earth-seeded worlds.

"Your Earth-human doctors and nurses want to work on the juicy ET cases," it went on. "You will come to understand that this is a very good thing, because much more care and attention, as well as higher degree of personal and professional interest, is given to other-species patients. When a same-species doctor is treating its patient, certain clinical shortcuts may sometimes be taken, or incorrect assumptions made, or important symptoms cloaked by overfamiliarity with the patient's physiology. The occasions when mistakes like this occur are rare. But when an other-species medic is in charge of treatment, it takes nothing about its patient for granted. It is forced by the physiological differences to be very careful indeed, so that the incidence of clinical error is even rarer. Please believe me: you will be in very good hands, or whatever other appendages are appropriate.

"And remember, Patient Hewlitt," it added as the litter made another sudden change in direction, into a wide doorway, "to me, you are an ET case—with all that that implies. We've arrived."

Ward Seven was a large, brightly lit room about five times longer than it was wide, Hewlitt saw, with a clear area of floor running between two facing rows of beds. He felt pretty sure that they were beds because, in spite of their weird shapes and sizes and the strange equipment hanging above some of them, there was one at the other end of the room that was suitable for the use of an Earth-human. Just inside the entrance on his left there was a nurses' station and food-service facility enclosed by transparent walls, but the litter moved past it too quickly for him to see who or what was working there.

The space taken up by the combined station and kitchen allowed only eight bed spaces on that side, while there were twelve along the opposite wall. A few of them were enclosed by screens, and the quiet gobbling and barking of alien voices was coming from one of them, but without a translator he could not tell whether it was a medical consultation, friendly gossip, or the sound of an other-species patient in pain. Before he could ask, the litter stopped and he was lifted smoothly and deposited in a sitting position on the chair by his bedside.

The nurse pointed in turn to the three doors in the end wall that paralleled his bed and said, "The first one is the multispecies waste-elimination facility for mobile patients, the second is the bathroom, also multispecies, and the other one is for patients who require assistance to perform these operations. Your bedside cabinet is similar to the one you used on Treevendar, and the few personal effects you were allowed to bring with you will be moved to it later today. You have a call button in case you need attention, and there is a ceiling-mounted sound and vision pickup linked to monitors in the nurses' station in case you need urgent attention but are unable to call for it yourself. Your reading light is directional so that you will not inconvenience other patients during rest periods, and you have an audio plug, an earpiece, and a small viewscreen tuned to the in-hospital entertainment channels. The programs were recorded a long time ago, so you may not want to view them unless you are trying to put yourself to sleep without sedative medication.

"You are in bed eighteen," it continued. "As well as being the most convenient position to the toilet facilities, it is farthest from the ward entrance and the nurses' station. There is a generally held belief within the hospital, which has never been officially denied, that the closer a patient is to the ward entrance, where the doctor on call and the ward nurses can reach it with minimum delay, the more serious is its clinical condition and prognoses. You may like to take some comfort from that knowledge.

"And now, Patient Hewlitt," it went on briskly, "please undress, put on the hospital garment lying across your chair, and get into bed quickly before Charge Nurse arrives. I will remain outside the screen. If you need help, call me."

The nurse and its litter moved aside and the bed screens unrolled silently from their recess in the ceiling.

For what seemed like a long time Hewlitt held the Hospital garment in his hands without moving. It was smooth, white, shapeless, and, like all the others he had known, at least two sizes too small. He did not want to lie in bed dressed in this thing; he wanted to sit in the chair and maintain some feeling of independence by wearing his own impeccably styled clothing. But then he remembered the nurse's vast strength and its closing remark that, if he needed help, he should call it. Had that been a politely worded threat to the effect that if he did not undress himself he would be undressed by force?

He would not give that tentacled monster the satisfaction, or perhaps the pleasure, of undressing one of its juicy ETs.

While he was climbing into bed, Hewlitt heard someone else approaching his bed, someone who made a soft, slithering noise rather than the sound of walking feet as it came. There was an unpleasant background sibilance to the translated words when it spoke.

"Nurse," it said sharply, "your paint is flaking. Give me the patinet's case notes and your report, quickly, then go to your dining area without delay."

"Yes, Charge Nurse," the other replied. "When Treevendar's medical officer, a Monitor Corps surgeon-lieutenant called Turragh-Mar, gave me the case notes, it said that there had been no observable symbtoms or change in Patient Hewlitt's physical condition, but suggested the presence of a psychological component. The only evidence of this was its marked xenophobic reaction displayed during the ride here. I assumed from our earlier conversation that the patient has had very limited—if any—contact with other-species beings, and was likely to be disturbed by the sight of the hospital staff using the intervening corridors; and that my instructions to allow it to see them was intended to prepare it for the closer, in-ward contacts that it would experience later. By the time we reached the ward, the patient seemed to have its xenophobia under partial control, except for one species that it still finds visually distressing.…"

"Thank you, Nurse," the other voice broke in. "Now go at once for a respray before you collapse from hunger at my feet. I will take over from here."

The screens rose and disappeared into the ceiling to reveal the ghastly thing standing at the foot of his bed. Instinctively he pressed himself against the backrest in a vain effort to put more space between them.

"How are we feeling today, Patient Hewlitt?" it said. "I am Charge Nurse Leethveeschi and, as you have already noticed, I am an Illensan.…"

Copyright © 1997 by James White

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