He moved his analysis of the farm plant samples up his mental priority list. He was becoming convinced many of the problems with the biosphere could be related to deficiencies or surpluses of trace elements. The plants, on analysis, would be a good check of such problems.
He looked again at his checklist.
He couldn’t find any excuse to avoid his patient any longer.
Siobhan Libet was slung in her sleeping bag, and her cramped little quarters had been made over as a kind of miniature hospital ward. The place was cluttered, but it was clean and smelled fresh, if a little antiseptic. That was thanks to Mott, Rosenberg knew. As far as he was aware neither Benacerraf nor Angel ever ventured in here.
Libet was unconscious. She’d been that way for three days now.
He pulled the door closed behind him, and started his examination.
Siobhan’s problems were multiple, and linked.
The effects of microgravity were marked in Libet, who, after all, hadn’t been able to get to the centrifuge for a hundred and sixty days. Her skeletal muscles were deeply atrophied. The wasting of her cardiac muscles seemed to have stabilized at about eight percent. That was higher than the crew’s average, and Rosenberg worried about eventual cardiac arrest. Libet’s hemoglobin was down by fifteen percent, enough to mark her out for treatment, on Earth, as an anemic. That hemoglobin count meant less oxygen being carried to the debilitated heart and skeletal muscles.
Her white cell count was down too, so her ability to fight off infection was reduced. Rosenberg was administering interferon to her, a protein involved in the immune system — production of which was also suppressed.
A couple of simple tests showed him that Libet’s flexor muscles had lost around twenty percent of their strength, the extensors twenty-five percent. Even the cell structure of her muscle fibers was changing, he knew; microgravity was working on her right down to a micro-anatomical level.
Libet’s bone calcium continued to wash out in her urine, at a half percent a month. Rosenberg thought there was a danger of her inner spongy bone, the trabeculae, vanishing altogether, without hope of regeneration. He didn’t have any way of monitoring the build-up of some of that calcium in Libet’s kidneys, which could lead ultimately to kidney stones. And on top of all of that, Libet was working her way through the classic symptoms of acute radiation sickness.
In the first few days after the solar storm incident Libet had suffered from nausea, pain, a loss of appetite, extreme fatigue, vomiting. After a couple of weeks she had started to suffer diarrhea, hemorrhaging from the mucous membranes in her nose, mouth and other parts of her body, and hair loss, from patches all over her scalp.
Libet had taken a dose of around five hundred rem. The textbooks said her chances of survival in the short term were less than fifty percent; and in the long term — when effects like cancer had time to work through — even more marginal…
He suspected she’d done well to survive so long, even to stay conscious.
He looked at Libet’s face. He could see tears leaking steadily, and when he raised a lid, her eye was bloodshot. That was partly due to the changed fluid balance, and partly to the dustiness of the air: in microgravity, dust didn’t settle out. The eyes produced tears, and blink reflexes cut in, intended to wash foreign bodies off the eye, into the lacrimal duct and into the nose. The nose was supposed to run, then, to wash the particles out of the system. But in microgravity there was no gravity feed to the lacrimal duct. The blinking could only redistribute particles over the eye; Libet’s cornea was, as a result, red and scratched. And the particles which were forced into Libet’s lacrimal duct did not run out of her nose, because her nose was almost stopped up by excessive mucous secretions.
If she ever pulled through this he didn’t want Libet to emerge with eye damage. So he had set Mott the task of bathing Libet’s eyes, and treating them with various drops…
Complex, messy, unanticipated problems.
As he worked, Rosenberg thought about death.
If — when — Siobhan Libet died, it would be Rosenberg who would have to sign her death certificate.
He would have to perform the autopsy.
He would have to provide standard and X-ray documentation, and subject tissue samples to toxicologic, bacteriologic and biochemical analysis; he’d have to take samples from the liver, a kidney, the brain, a lung, cerebrospinal fluid, vitreous humor, hair, skin, spleen and the skeletal muscles…
The legal position wasn’t very clear.
NASA spaceflight crews were judged to be federal agency radiation workers, and so were covered by Occupational Safety and Health Administration radiation protection measures. But those measures had not been drawn up for spaceflight, and NASA had prepared its own standards for crew dosage. As far as he could make out, because of get-out clauses, there were actually no radiation exposure standards for human exploration missions.
For sure, though, they hadn’t adhered to the ALARA principle that the standards laid down: exposure As Low As Reasonably Achievable.
If the law suits started flying, Rosenberg might even be asked to preserve the body. That would mean, as far as he could see, mummification.
Jesus. What a situation.
In the course of his med training, Rosenberg had had some preliminary introduction to psychology. It wasn’t exactly a subject he was interested in, but what he had learned had pretty much confirmed his preconceptions about NASA: that the psychological preparation of NASA crews, including this one, was pitiful.
Nobody had figured out how they should respond to a situation like this. What would they do if someone died? Hold a service? If so, what denomination? And if they had to store the evidence, what were they supposed to do with the mummified body?
Maybe the worst problem was that the five of them had, prior to Libet’s accident, come to some kind of accommodation with each other, and with their situation. But the injury to Libet during the solar storm, and now her likely death — the loss of her skills, her muscles, her dedication to the farm, her contribution to the collective personality of the crew — was likely to destabilize them all, he feared.
Or worse. It might destroy them altogether.
…In sleep, her skin was smoothed out, almost glowing in the soft light of her cabin’s reading lamp. She looked young, trouble-free, save for the occasional grimace, pain echoes which crossed her face.
It was an odd thing, but he’d never really gotten to know Libet, in the years they’d spent together training for this mission, even the months they’d been cooped up together in this hacked-up Space Shuttle. To him she was a kind of sketch, a collection of barely understood traits: her readiness to laugh, her obvious sense of wonder, her youthful impatience to fly in space, her relationship with Mott.
But then, he hadn’t really gotten to know any of the rest of the crew, except in so far as their interests crossed his own. It was only now, when he had been forced more or less to suspend his own work on the Titan data and had been reduced to a kind of low-level nurse for Libet, that he had started to see her as some kind of human being.
There was a person in there, he realized now: an interior presence as deep and complex as his own, inside this shell of damaged flesh. And she was suffering.
He hadn’t quite understood his own reaction when he saw how Mott, in her distress, held Libet, and how Libet responded to her. He had been baffled, angry, as if Mott was intruding.
It was a funny thing, but it was as if, out here, so isolated from all but this ill-assorted handful of people, Rosenberg was starting to gain some kind of psychic connection with his fellow humans, for the first time in his adult life. And it wasn’t all that hard for him to figure out why he had gotten so angry at Nicola Mott, Libet’s grieving lover.