James White - Final Diagnosis

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Final Diagnosis is a 1997 science fiction novel by author James White and is part of the Sector General series.
A man suffering from multiple mysterious illnesses and allergic reactions is labelled a hypochondriac. Finally he is sent to Sector General as a last resort. He befriends his fellow alien patients, telling them his life history. Rather than dismissing his complaints, the attentive hospital doctors develop a theory, and bring him back to his home planet. At the scene of a childhood accident that seems to have started it all, explanations are found.

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Prilicla allowed a moment for her to return to the here and now before going on. “This is the same information I taped for Shech-Rar and friend Stillman, and you may scan the original record at any time. But the proceedings of a Meeting of Diagnosticians might be difficult for a layperson to comprehend, so I will summarize and simplify it for friend Hewlitt’s benefit…

Lonvellin had been discovered alone and unconscious inside an undamaged ship following the release of its distress beacon. Originally it was thought that the being was a criminal guilty of murder and possibly cannibalism, because the translation of the ship’s log indicated the presence on board of another entity, a personal medic of some kind who had apparently been guilty of mistreating its employer and of whom there had been no physical trace. For this reason, and because the patient was a physically massive being who was well armed with natural weapons, it had been admitted and treated under Monitor Corps guard until the truth became known.

Lonvellin had been a warm-blooded oxygen-breather of physiological classification EPLH. Its cranium was protected by an immobile, osseous dome, pierced at regular intervals for visual, aural, and olfactory sensors, set atop a pear-shaped, scaly body possessing five shoulder-level tentacles, four of which terminated in clusters of specialized digits and the other in a heavy, osseous club with which it had, presumably, battered its way to the top of its evolutionary tree. Its method of locomotion was snail-like, but not slow, using a wide apron of muscle around the lower body.

The EPLH presented what appeared to be a widespread and well-developed epithelioma covering the entire body, although a cancerous skin condition of that type did not normally render a patient deeply unconscious. A fast-acting specific suited to the patient’s metabolism was administered subdermally and the early results were good. But within a few minutes the patient became physically disturbed and somehow managed to neutralize the effect of the medication so that the area under treatment returned to its previous condition. During this episode the biosensors reported that the patient had remained deeply unconscious, anesthetized and supposedly incapable of all physical movement. Since the indicated medication was ineffective, the surgical removal of the affected scales was begun but this, too, was resisted. Following the excision of the first few scales, the remainder grew deep root systems which penetrated underlying organs so that their removal was impossible without the risk of inflicting life-threatening damage.

In the hope of finding an explanation for this clinically inexplicable situation, including the fact that it reacted physically while supposedly unconscious and incapable of movement, Conway requested an examination of the patient’s emotional radiation.

“That was where I came in,” Prilicla went on. “We discovered that there was another thinking entity inside Lonvellin, a separate and distinct and fully conscious person who was not being affected by the medication given to the patient and whose presence did not register on their diagnostic instrumentation. Friend Conway, making one of the intuitive leaps that are the mark of future diagnosticians, said that the reason might be that it was both all-pervasive and too small for normal scanner detection. It had formulated a hypothesis based on what little was known or deduced from the examination of the patient, the references to a personal physician in the ship’s log, and the psychological and behavior patterns that were common to the very aged…

Lonvellin was an aging member of an extremely long-lived species. In common with all beings of advanced age it was subject to increasing physiological deterioration in spite of its efforts to maintain itself in optimum physical and mental condition so that it could continue with the planetwide sociological projects which had become its only interest and reason for living. It would have foreseen the time when it would require the services of a skilled medic on a continuous basis, and that quality of medical assistance was unlikely to be available on the type of backward world where Lonvellin was accustomed to doing its work of healing sick planetary cultures.

But somewhere in the recent past-recent because the creature was new to the job and had made mistakes-Lonvellin discovered and Conway had deduced the presence of the ultimate healer.

It was nothing less than an intelligent, organized collection of viruses living within its host and maintaining the body it occupied in perfect health while protecting it against invading pathogens as well as stimulating and directing the natural mechanisms of healing to repair physical injury. But it was a thinking creature inside a body that was deeply unconscious and therefore incapable of thought, and its emotional radiation could not be hidden from an empath like Prilicla. Conway tested his theory by mounting a crude, physical attack on Lonvellin that its natural defenses could not cope with, a spike driven very slowly into the body where there was an underlying vital organ. This tricked the virus creature into collecting itself under the puncture to defend the area with a small, dense, organic plate composed of its own and a small amount of Lonvellin’s body material.

As soon as the process was complete, Conway excised the creature, discovering that its body mass was little more than that of an Earth-human’s closed fist, and placed it in a sealed container for later investigation. The patient’s epithelioma and the newly inflicted surgical wound were treated routinely without any further interference from Lonvellin’s resident physician.

The original problem had been caused by the ignorance of the virus creature, who had been attempting to maintain the host’s physical condition by retaining the dying body scales, which, in Lonvellin’s species, were shed periodically so that new ones could grow. The mistake could be excused by the fact that, in spite of the intelligence of both entities, there was no direct communication between host and symbiote, merely a weak, empathic bond which allowed the transmission of feelings rather than thought.

In spite of the mistake, Lonvellin forgave its personal physician and insisted on having it returned to its former place. Sector General would dearly have loved to investigate this unique lifeform, but ethically the virus creature fell into a grey area between sapient being and disease, so the hospital acquiesced. Lonvellin and its resident physician moved to Etla the Sick, where it and its ship were vaporized. At the time everyone was sure that the virus entity had perished with its patient. That was the state of knowledge when the Meeting of Diagnosticians sent Rhabwar to Etla in the hope of finding an explanation for the Hewlitt-Morredeth incidents. They did not expect the medical team to succeed.

“But now we know that Lonvellin foresaw the possibility of a lethal attack,” Prilicla went on, “and made preparations that would enable its intelligent symbiote to survive. There was limited communication between the two, but I should think that the warning of an imminent nuclear strike furnished by the ship’s sensors, and the terrible knowledge that its immensely long life was about to end, was enough of an emotional shock to drive the virus creature out of its host’s body and into the survival container carried by the escape vehicle. The container was fitted with a time-release delay of one hundred standard years in the hope that, when the contents were released, both the war and the population’s xenophobia would have been long forgotten. But the nuclear strike must have occurred seconds after launch, the escape vehicle was damaged, and the virus creature was released prematurely by an Earth-human child falling out of a tree and smashing the container.”

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