Introduction

The one profession that is never out of a job is a good doctor (second most job secure is a good cook).

However, while incompetent cooks are merely fired, incompetent doctors on the other hand, face perils ranging from having their license revoked to lawsuits. If their bungling actually kills the patient doctors may even face frontier justice (e.g., thrown out the airlock sans space suit).

People might think it is romantic to go homesteading with just their spouse and kids on a remote planetary colony with no doctor or nuthin', right up to the point where they suffer a tooth-ache, broken limb, or a sudden attack of appendicitis. Ain't so romantic now, eh Jeremiah Johnson? Doctors are vital.

On near future solar system exploration ships a doctor will be indispensable. A Mars expedition could be out of range of a hospital for about 2.7 years.

And you will need multiple doctors on board a military spacecraft going into battle.

Doctors/Medics are never risked on any hazardous non-medical task or possibly dangerous environment. A first-in scout mission on a newly discovered planet could be in deep doo-doo if the doctor takes a stroll and is suddenly eaten by the Giant Trap-Door Spideroid (link trigger warning: spiders). The doc has to stay inside the ship, where it is relatively safe, no matter how much they are suffering from cabin fever.

In addition to standard illness and injury, spacecraft doctors will have to deal with Drop Sickness, Toxic Booze, Psychological Problems, Vacuum Exposure, and Old Astronaut Syndrome

RISKING THE MEDIC

The Patrol ship Starfire, Vegan registry,came into her last port at early morning. She made a bad landing, for two of her eroded tubes blew just as the pilot tried to set her down. She had bounced then, bounced and buckled, and now she lay on her meteor-scarred side.

Ranger Sergeant Kartr nursed his left wrist in his right hand and licked blood from bitten lips. The port wall of the pilot’s cubby had become the floor and the latch of its door dug into one of his shaking knees.

Of his companions, Latimir had not survived the landing. One glance at the crazy twisted angle of the astrogator’s black head told Kartr that. And Mirion, the pilot, hung limply in the torn shock webs before the control board. Blood rilled down his cheeks and dripped from his chin. Did dead men continue to bleed? Kartr didn’t think so.

Must get out and find the medico to look at Mirion. The pilot should not be moved until they knew the extent of his injuries—

Then Kartr remembered. The medico wasn’t around any more. Hadn’t been with them since three—or was it four?—planets back. The ranger shook his aching head and frowned. That loss of memory was almost worse than the pain in his arm. He mustn’t lose his grip!

Three planet landings back—that was it! When they had beaten off the Greenies’ rush after the ship’s nose blaster had gone dead on them, Medico Tork had gone down, a poison dart right through his throat.

From STAR RANGERS by Andre Norton (1953)
NOT DOCTORS: CORPSMEN AND MEDICS

(ed note: Pay attention to Ms. Linsky, she used to be a real-live military nurse)

I do, however, want to call his attention to a presumption he (Winchell Chung) has made, which I don't know is justified. Notably, that ships will carry doctors.

Why do I not know if this assumption is justified? Well, for a couple of reasons. First of all, because the vast majority of American warships do not have doctors aboard... they have Hospital Corpsman such as I once was. During WWII, hospital corpsmen aboard ships would even perform emergency appendectomies, usually on the mess deck (as Mr. Chung notes) using bent spoons as retractors. Talk about meatball surgery!

Hospital Corpsmen and their Army brothers, "Medics," receive initial training at "A School," an 18-week course. (You can also strike into the rate, as I did, but that's another discussion altogether). They receive ongoing OJT and "C Schools" throughout their career, as they go up in experience and rank. By the time a Corpsman / Medic has served a twenty year career, they may be qualified to receive the civilian designation of "Physician's Assistant," to practice medicine in the civilian field, under the supervision of a doctor.

Which brings me to my next point: advanced-practice nurses. With a master's degree, a nurse may become a nurse practitioner, a nurse midwife, a nurse anesthetist, and so forth. Again, these practitioners are nominally supervised by a physician (either an M.D. or a D.O.), but such supervision may be hundreds of kilometers away, here on Earth today.

So why would a ship prefer one of those options? A corpsman, as mentioned, receives an 18-week course, and is paid as an enlisted person. Nurses (the military only accepts baccalaureate prepared nurses; associates degree nurses are simply well-educated Corpsmen / Medics) are officers, and Doctors are officers who start service as O2 or O3 paygrades.

Plus, in space, it takes a long time to get anywhere. During that time, a corpsman who starts the voyage as an E4 may have hundreds of hours of available time to study advanced subjects, to work in simulation, and to advance in competence and paygrade. In essence, you're training your medical people during the time you're paying them to be there, anyway. And although you're paying them to be there, you're really hoping their skills won't be needed, so why not spend the time they might be reading romances on training, instead?

Additionally, there's the time to create the medical professional. I've mentioned a couple of times that Hospital Corpsman A School is 18 weeks long. Nursing school for a BSN is six semesters in most programs, followed by a year of practice as an RN, which then opens up MSN programs that can lead to advanced practice nursing in another four semesters or so. (The Doctor of Nursing Practice (DNP) degree is beginning to become popular, but I honestly know very little about it, or about the differences in scope of practice between DNP and MSN advanced practice nurses).

Physician's Assistant programs are likewise master's degree programs, but again, outside my scope of attention, so I don't know a lot about them. It seems to me that PAs have a very similar scope of practice to Nurse Practitioners, but I haven't really looked into it.

Both M.D. and D.O. (in the United States, at any rate) are three-year post-baccalaureate programs, which then also require internship and residency.

In short, a corpsman requires an initial investment in five or six months of training, while a PA or NP requires five or six years, and an MD or DO up to ten years before they're fully qualified to practice.

Consider also the state of expert systems aboard your ship. IBM has recently demonstrated Watson in an oncology role, with substantially higher correct diagnoses of cancer than human oncologists.

I suspect that future starships will mostly be crewed with people trained to render immediate, on-site first aid, to stabilize the victim, and get them into an auto-doc. The machine will then analyze the situation, display their analysis and reasoning to the Corpsman, ask for review / approval, and take whatever action is required once that approval is given.

There may be doctors aboard Capital ships or bases, but onboard a forward deployed cruiser? Corpsmen.

From Navy veteran and nurse JENNIFER LINSKY (2016)

Sickbay

What's in the sickbay? What you'd expect: medical supplies, diagnostic equipment, maybe a sick bed or two, maybe a suspended animation cryo-freeze to put a seriously ill or injured crewperson on ice until the ship can make it to port. On a military ship, the sick bay may have its own separate life support system.

It might have the luxury of a surgical bed, or the doctor might have to make do with a table in the mess deck. (This is why there is a tradition on military ships for off-duty personnel removing their headgear while on the mess deck. It is a sign of respect for the crewmembers who have in the past, or may in the future, suffer and die there.) During combat, the mess deck become the emergency triage/operating room.

DOCTORS CABIN + SICKBAY

Unlike the other officers' cabins, which were fitted with more sophisticated equipment occupying much less space, Mercer's did not give much room for him to move. From the entry lock, the floor grill stretched ten feet to the curved plastic canopy that ran from below his feet to what was nominally the ceiling and gave, in the ship's present mode, a one hundred and eighty degree view of the inside of the outer hull, complete with structural members and brightly colored cable runs. The floor grill, which was just under three feet wide, separated two vertical tiers of bunks, eight on one side and five on the other. This was because the lowest one of the five was Mercer's, and he, being the doctor, needed much more than the twelve inches which divided patients' bunks.

A passenger unfortunate enough to come down with an infectious disease could be isolated from the living quarters and other patients, because the bunks were each fitted with an individual air supply and a hinged flap which sealed in the patient. Mercer did not suffer from claustrophobia, but he thought that any patient needing to spend more than a few days in one of those bunks would have to be kept under heavy sedation if he wasn't to blow his organic computer.

From LIFEBOAT by James White (1972)
CEGA SICKBAY

CENTRALIZED EARTH GOVERNMENT AND ADMINISTRATION SICKBAY

Cramped conditions are commonplace on a boat. A boat's sick bay is thus a masterful arrangement of medical equipment. Everything has a place. Symbols on cabinet doors identify what items are to be kept inside. This allows medics to readily find items in an otherwise unfamiliar sick bay.

Micro-gravity conditions create many challenges to traditional medicine. Aside from combating muscle and bone degeneration, space medics have to cope with fluid properties. Under gravity, blood can be easily drained — not so in micro-gravity, where it will float away. Suspended vacuum hoses scoop up the blood as it leaves the patient before it can get into the equipment.

FIRST ORBITAL HOSPITAL

(ed note: Cot-Vee = Cargo Orbital Transfer Vehicle {COTV}, Pot-Vee = Personnel Orbital Transfer Vehicle {POTV})

     "Okay, T.K., look at it this way. Those three hundred people in LEO Base can get back to Earth in less than an hour if necessary; we'll have lifeboats, so to speak, in case of an emergency. But out there at GEO Base, it's a long way home. Takes eight hours or more just to get back to LEO, where you have to transfer from the deep-space passenger ship to a StarPacket that can enter the atmosphere and land. It takes maybe as long as a day to get back to Earth from GEO Base— and there's a lot of stress involved in the trip."
     Hocksmith paused, and seeing no response from the doctor, added gently, "We can get by with a simple first-aid dispensary at LEO Base, T.K., but not at GEO Base. I'm required by my license from the Department of Energy as well as by the regulations of the Industrial Safety and Health Administration, ISHA, to set up a hospital at GEO Base."
     He finished off his drink and set the glass down. "If building this powersat and the system of powersats that follow is the biggest engineering job of this century, T.K., then the GEO Base hospital's going to be the biggest medical challenge of our time. It'll be in weightlessness; it'll have to handle construction accidents of an entirely new type; it'll have to handle emergencies resulting from a totally alien environment; it'll require the development of a totally new area of medicine— true space medicine. The job requires a doctor who's worked with people in isolated places—like the Southwest or aboard a tramp steamer. It's the sort of medicine you've specialized in. In short, T.K., you're the only man I know who could do the job . . . and I need you."

     John Curry, comptroller of Eden Corporation, looked disturbed as he scanned the sheet of budget figures Tom had submitted to him several days before. "Doctor, I didn't realize you'd have to set up a complete hospital at GEO Base."
     "We'll need a complete trauma center, as well as an intensive care unit," Tom explained. "I'll also have to be prepared to handle something more than runny noses; I'll need a pathology lab and a blood lab. I'll need radiology equipment because I can't send an employee back to the Jornada with broken bones I don't know about; the accelerations of return and atmospheric entry could kill a person if we didn't know where the break was and take steps to protect him against acceleration. If we could let him come back to Earth at all. We might have to let him heal up there."
     Curry drummed his fingers on his desk top while he studied the budget sheet once again. "But a ten-bed hospital? Isn't that rather large for a construction-site operation, Doctor?"
     "That's fewer beds per thousand people than the state of New Mexico has right now—and you know this state's desperately short of hospital beds," Tom told him bluntly. "I'm going to be twenty-two thousand miles away with no possibility of getting help in an emergency and no way to get an injured or sick person back to the ground in less than a day. And those time estimates are under the best conditions with Pot-Vees and StarPackets on hand and ready to move."

     "The cost of the equipment doesn't bother me," Curry went on. "We'll work that out so it's a capital expense properly written off in a way that'll keep the IRS happy and the government auditors pleased. What's difficult is the cost of getting the equipment there." (ed note: every gram counts)
     "I know," Tom admitted. "That's why I've tried to choose equipment that weighs as little as possible. In some cases I've specified new equipment that has yet to be tried and proved. I've got to take certain risks, however, because I understand the costs of getting the equipment to GEO Base as well as the costs in terms of electrical and cooling energy to operate it once it's there." He was glad that Dan Hills had been so helpful in going over the engineering aspects of his GEO Base clinic. Things he took for granted on Earth became serious problems at GEO Base. For example, he had to consider thermal efficiency of equipment, since the heat load of GEO Base had to remain in balance. Calories coming in had to balance calories going out; otherwise, equipment heat losses would literally burn the place up. The drawings of the GEO Base hospital already showed the hex module festooned with heat radiators.
     "I wish there were some way to beat some of these lift costs," Curry remarked, shaking his head. "When we get rolling on the two-per-year production phase, that won't be so important. But the start-up costs of this pilot-plant phase are all out of proportion."
     Tom thought about how he might have to handle things at the H-Bar-S Ranch if there were a number of injured or sick people and no way to get equipment in or patients out. It was a problem he had faced before. "Uh, John, maybe I can skimp a few things to start with if have outstanding communications links."
     Curry began to nod slowly. "I think I see what you mean, Doctor. GEO Base will have a communications capability with a large number of broad-band, high bit-rate channels. Uh, would a high bit-rate computer link and an interactive video system help?"
     "That's what I was thinking about," Tom acknowledged.
     "What could you eliminate if you had good communications capabilities?"
     "Some of the analysis equipment. If I have rapid access to one of the medical computer networks, I could squirt raw data to lab facilities here on Earth. I could also eliminate most of that microfilm medical data I specified, because then I could tie in with any computerized medical library here ... or I could go interactive on a video channel with one or more specialists if I ran into something where I needed consultation."
     Curry reached down into his desk, pulled his terminal to desk-top level, keyed it, and looked at the display. "We can set you up with any number of nets. How about GALEN—General Analytical and Library Electronic Network?"
     "Never heard of it."
     "One of the best medical nets going, it says here."

     Tom had worked out eight basic medical areas he would have to be prepared for. First, there were the usual job-related injuries that were physical: cuts, bruises, burns, abrasions, and even severed limbs. Then there were the pathological aspects, basically public health measures to block entry of infectious bacteria and viruses into space facilities as well as to counteract them when they did sneak in, as they always managed to do.
     He also had to be prepared for what he termed the congenital afflictions—appendicitis, tonsilitis, cholecystitis, toothaches, etc. There would also be stress-related illnesses manifesting themselves in hypertension, cardiac problems, and psychosomatic conditions—plus psychological problems caused by isolation and phobias such as the one Ross Jackson had mentioned with the Gemini astronaut.
     He had to keep watch for biochemical problems that might be exacerbated or brought on by dietary deficiencies, glandular imbalances, and so forth, plus the medical problems created by social interaction, because there were certain to be fights and alcoholism, and even some drug abuse, strict as the preflight inspection might be. Tom knew enough about human nature to realize somebody would either manage to sneak the stuff up or cobble together a vacuum still.
     But the biggest problems were still environmental, the medical aspects of the space environment itself. At GEO Base, he knew he couldn't take a lot of things for granted, earthly things like food, water, temperature, atmosphere, and radiation. These were items that really had him worried.

     Four people were jammed into First-Aid when he arrived, and the place was filled with a pink mist. All four people wore pressure suits, but three were without helmets. The exception was a short, stocky person whose utterly relaxed position, afloat in the compartment, spelled "unconscious" to Tom.
     "Get that off!" Tom snapped to a young woman who was holding the man by his pressure helmet. "What happened here?' Then he saw that the right leg of the man's pressure suit terminated at the lower end of the calf, just above the ankle. So that was the source of the pink mist.
     "Fred was working on the power-control junction and must have had a suit radio failure," the young woman remarked. There was no panic in her voice. "Some yo-yo was trying to mate the attach points of another submodule, and he didn't see Fred's leg in the way. When I saw it and yelled, Fred didn't hear me. His radio must have been out."
     The man's foot was sheared through just above the ankle, and it had not been a clean severance. Somebody had acted fast out there, and the conipartmentation of the pressure suit had saved the man. A rough tourniquet of electrical cable had been wound around his leg, the only thing that had prevented the pressure in his suit from pumping all his blood out into vacuum. Nonetheless, he had lost a lot of blood.

     Moving in a hurry in weightlessness was difficult and bordered on the impossible because Tom wasn't used to it. Several times he pushed off too robustly and ended up banging hard against bulkheads or cabinets. The equipment he removed from cabinets wouldn't behave itself. Fitzsimmons was in shock, and it was important that Tom get oxygen and stimulants into the man immediately, but the hose on the oxygen mask wound itself all over the place. Finally, with Lucky Hertzog's help, he managed to get the oxygen mask securely in place.
     There was no way that an IV was going to work, Tom discovered. Without gravity, it wouldn't drip. He thought of injection, then discovered he couldn't get the air bubbles out of the syringe in the usual manner. He ended up swinging it at the end of his arm and squirting most of the injection into the compartment before he felt it had been deaerated enough to prevent an embolism. Getting the IV working was strictly a lash-up, and he didn't have time to be neat. He had to start lactate of Ringer going right away, followed by whole blood—if there was any—followed by closing or cauterizing the severed blood vessels that, in spite of the tourniquet, were still seeping. He called in one of the men from the passageway and instructed him on how to inject the IV solution gently and slowly into Fitzsimmons' arm.
     No whole blood was available in the First-Aid Center. Tom cursed himself for not specifying that there be some. It was, therefore, vitally important that he tie off the blood vessels as quickly as possible.

     When Torn couldn't find any sutures in the cabinets, he yelled for the remaining man waiting in the passageway. "You, get up to my quarters and bring back my flight kit. I don't know the compartment number—ask a steward. And hurry!"
     After ten minutes passed and the man had not returned, Tom was in a bind. He had to stop the bleeding. "I've got to cauterize! Is there a welding torch around here?"
     "Nobody in his right mind would do oxyacetylene welding here," Lucky told him.
     "If I don't, this man's going to die from blood loss!"
     "How about an arc welder?"
     "Get it in here!" Tom didn't know how he was going to cauterize the stump of a leg with an electric arc welder, but he would try to figure something out. Unfortunately, there wasn't an arc welder within three hex modules of First-Aid.
     Tom didn't panic, but he was slowly coming to the conclusion that his worst fears would be realized. He was going to lose this man because he hadn't been able to assess the medical requirements of a space facility accurately.
     Lucky Hertzog released Fitzsimmons' head and moved toward the compartment door, maneuvering easily in zero-g.
     "Where are you going?" Tom asked.
     "You've got to seal that stump, right?"
     "Right, but—"
     "I'm going over to the beam builder three modules away. I'll bring back enough activated epoxy to cover that whole stump." And she was gone.
     But the man returned with Tom's bag before Lucky did. Tom kept packaged sutures and needles in his kit, along with the necessary surgical tools. He always tried to go prepared to handle emergencies, a habit born from his life in the Southwest, where towns and doctors were far apart.
     Tom was in the process of tying off arteries when Lucky Hertzog floated in, both hands full of a lump of curing epoxy.
     "How long before that cures?"
     "About fifteen minutes, Doc. It's got maybe ten minutes' working life left."
     "Okay, I can get these arteries tied off by then. Stand by."
     But doing so wasn't as easy as he had thought. Blood spurted everywhere. It was almost impossible to keep the working area clear of blood, which formed drops and globules, its surface tension making it creep along the exterior of every object it touched. But he managed to get the main arteries tied, then formed a base to the stump with the glob of epoxy.
     The procedure worked. The blood flow stopped, and Tom was able to remove the tourniquet. It hadn't been sterile, and it hadn't been neat, but Fitzsimmons was still alive.
     Then his heart stopped in shock from general loss of blood.
     "CPR!" Tom snapped.
     He quickly discovered CPR wouldn't work in weightlessness. When he punched down on Fitzsimmons' chest, he and Fitzsimmons flew apart.
     Lucky quickly jammed Fitzsimmons' body into a locker along one side of the compartment and jammed herself in with him. With her back against one side of the locker and his against the other, she began CPR.
     "Spell me," she gasped to Tom after about five minutes, during which time he had been trying to get the leads of the defibrillator untangled. One of her men moved in and took over, leaving Tom to his struggle.
     But between Lucky Hertzog and her two workers, they managed to get Fitzsimmons' heart going again without the need for Tom to defibrillate—a risky business in the metal-walled compartment.

From SPACE DOCTOR by Lee Correy (G. Harry Stine) 1981
AQUEOUS IMMERSION SURGICAL SYSTEM 1

DRAINING an infected abscess on Earth is a straightforward procedure. On a spaceship travelling to the moon or Mars, it could kill everyone on board.

Blood and bodily fluids cannot be contained in zero gravity, which means there is currently no way to perform surgery in space without contaminating the cabin. This makes an extended stay problematic, says James Antaki at Carnegie Mellon University in Pittsburgh, Pennsylvania. “Based on statistical probability, there is a high likelihood of trauma or a medical emergency on a deep space mission,” he says.

Antaki is part of a team of US researchers developing an astro-surgical tool that could help. The Aqueous Immersion Surgical System, or AISS, is a transparent box that creates a watertight seal when it is placed over a wound and pumped full of sterile saline solution, says George Pantalos at the University of Louisville in Kentucky.

The saline solution is held under pressure inside the AISS to prevent blood from seeping out of the wound. Airtight holes allow surgeons to access the submerged wound using handheld and orthoscopic instruments.

By varying the pressure within the AISS, the device could also be used to siphon up and recycle blood. “You won’t have a blood bank in space, so if there is bleeding you want to save as much blood as you can,” says James Burgess, also at Carnegie Mellon, who came up with the concept.

From SPACE SURGERY POSSIBLE WITH ZERO-GRAVITY TOOL by Will Ferguson (2012)
AQUEOUS IMMERSION SURGICAL SYSTEM 2

Imagine a medical emergency on a flight to the moon, an asteroid or Mars—it may not be as catastrophic as the crisis in the film Gravity, but perhaps an astronaut is bleeding. Surgery can always be challenging, but it would be even more so in microgravity, because blood droplets can float, potentially obscuring a caregiver’s field of view. Now researchers have tested a novel way to potentially control bleeding during surgery in space by isolating wounds under transparent watertight domes filled with fluid.


For the past three decades scientists have explored ways surgery could be performed in space. The main problem is that sans gravity, blood could drift into the eyes, nose and throat as well as potentially spread disease among the crew. It could also splatter inside spacecraft cabins and perhaps muck up vital electronics. In 1984 researchers reported one system that would essentially wrap plastic bags around wounds to attempt to control bleeding, and another tested in 1993 would fully enclose patients in rigid transparent boxes. Surgeons could stick their hands and tools into either containment system to operate. A critical shortcoming of both strategies was that blood could paint the container walls and obscure the view.

Neurosurgeon James Burgess at Allegheny General Hospital in Pittsburgh came up with the idea of placing a transparent dome over a wound and then filling it with fluid such as saline solution. The fluid’s pressure could slow and even stop bleeding until a surgeon can seal the wound. "A hydrostatic pressure is like a force field—it's what a science fiction writer might imagine," says researcher James Antaki, a biomedical engineer at Carnegie Mellon University. "The idea is simultaneously revolutionary and common sense, the definition of an inventive solution to the problem, like the upside-down ketchup bottle."

Ports in the dome could allow insertion of conventional or endoscopic surgical tools. Moreover, "a suction tool can also be directed to where the bleeding is to clear the surgeon's field of view," Pantalos says.

Although Burgess originally came up with the idea to help keep delicate tissues from drying out during brain and spinal surgery, along with control profuse bleeding that can happen during operations, Pantalos and his colleagues reasoned this Aqueous Immersion Surgical System (AISS) could also help in microgravity. "We have begun to feel satisfied that the concept is applicable in almost in any surgical situation—on Earth or in space," Burgess says. The AISS poses a number of tricky challenges. For instance, the researchers want to maintain constant pressure under the dome when suctioning blood away by pumping in fluid at roughly the same rate—otherwise pressure drops could worsen bleeding whereas increases could push fluid into the body and cause swelling.

Drugs

There are all sorts of drugs in science fiction, some medical and some not.

Keep in mind that all drugs are poisons, and all poisons are drugs. The only distinguishing feature is the dosage. One aspirin can cure a hedeache but when your child eats a whole bottle you have to rush them to the emergency room to get their stomach pumped.

In my personal opinion, medications that would make the owner of the drug patent rich beyond the dreams of avarice would include a cure for male-pattern baldness and a diet pill that would allow you to pig-out on whatever food you wanted and still look buff and cut like a Hollywood star.

There are many methods of drug delivery and pharmaceutical formulation. Drugs can be administered orally (peroral) by pills, tablets, capsules, softgels or syrup. They can be breathed in via inhalers, or injected intradermally with hypodermic needles and syringes. Pretty much every single body orifice has some sort of drug using it for entry: eye-drops for the eyes, ear-drops for the ears, nasal spray for the nose, suppositories for, well, you know, pessaries for you'd better look that up. Plus dozens more methods you can read all about here.

If you get fancy one can do intradermal injections via air with a jet injector (though Doctor McCoy calls it a hypospray). In Isaac Asimov's The Caves of Steel they use "hypo-slivers", pointy shards of solid drug that are inserted under the skin like a medical splinter of wood (science-fictional but probably impractical).

Topical creams are usually for delivering medicine to the skin not through the skin, since said skin is remarkably good at preventing drugs from penetrating. The few drugs that can penetrate are sometimes administered by a transdermal patch.

And of course assassins spend a lot of time inventing surprising and unexpected ways to get poison into their victims.


HANGOVER CURES
If you drank too much alcohol the night before, waking up is not going to be pretty. Hangover cures include "alcodote" from H. Beam Piper's SPACE VIKING and the "vitamin gunk" from Jerry Pournelle's PRINCE OF MERCENARIES.
VITAMIN GUNK

     “We have a concoction. Vitamins. Tonic. Other stuff. Works every time. Would you care for some?”
     “Captain, I would kill for a glass of that. Or two glasses. Please?”
     Owensford grinned. “This way.” He led Lysander to a small bar at the far end of the officers’ mess, and ushered him to a table. Billings, two Night Befores, please.”
     “Sir.” The bartender was an old man, but he carried himself like a soldier. His left hand was a prosthetic adapted to bartending. He grinned and set two tall glasses on the table, went back, and brought a pitcher of water.
     “You sip it,” Owensford said. “Then down at least two glasses of water. Works like a charm.”
     Lysander sipped, and grimaced.
     “I didn’t say it tasted good,” Owensford said.

     “This late, we’re lucky to get anything at all. Anyway, you look a lot more chipper than you did half an hour ago.”
     “I’m going to take the formula for that vitamin gunk back to Sparta. We’ll make it a government monopoly and after five years we’ll be able to abolish taxes.” He clinked his coffee mug against hers.

From PRINCE OF MERCENARIES by Jerry Pournelle (1989)
ALCODOTE-VITAMIN PILLS

“Get a little rest, for a couple of hours. Then draw some alcodote-vitamin pills from the medic. As soon as things are secured, there'll be parties all over the ship, and we'll be expected to look in on every one of them, have a drink, and say ‘Well done, boys!’”

From SPACE VIKING by H. Beam Piper (1963)
SOBERING-EFFECT

"I wish I didn' have to do this—" Basurero shuddered and took from the shelf a jar labeled SOBERING-EFFECT, THE ORIGINAL INSTANT CURE FOR INEBRIATION—NOT TO BE TAKEN WITHOUT A DOCTOR'S PRESCRIPTION AND A LIFE INSURANCE POLICY. He extracted a polka-dotted, walnut-sized pill, looked at it, shuddered, then swallowed it with a painful gulp. His entire body instantly began to vibrate, and he closed his eyes as something went gmmmmph deep inside him and a thin trickle of smoke came from his ears. When he opened his eyes again they were bright red but sober. "What is it?" he asked hoarsely.

From BILL THE GALACTIC HERO by Harry Harrison (1965)
KILLALC PILLS

As we walked to the officers' club I was in no mood for communication, which Otrov probably blamed on my recent demotion. What to do? Drink seemed to be in order, it wasn't noon yet, and it would be wisest to wait until evening to crack out of the base. Face the problems as they arose. Right now I was in a perfect position to imbibe drink with my new peer group and gather information at the same time. Which, after all, was the reason that I was here in the first place. Before leaving I had slipped a tube of killalc pills into my pocket. One of these every two hours would produce a massive heartburn, but would also grab onto and neutralize most of the alcohol as soon as it hit the stomach. I would drink deep and listen. And stay sober. As we walked through the garish doorway of the club I slipped one out and swallowed it.

From THE STAINLESS STEEL RAT'S REVENGE by Harry Harrison (1970)
MEDICAL

Antimicrobials are medications used to treat microbial infections. They include antibiotics, antifungals, antivirals, antiparasitics, and various non-pharmaceutical treatments. Overuse of a particular antibiotic can cause antimicrobial resistance, rendering that antibiotic useless.

In the RPG Traveller, Panacea drug augments healing and Medical Slow drug puts the user into a coma for one day during which they experience a month's worth of healing.

In the RPG Space Opera, a person at death's door can be administered the drug Thanokalamine. This will arrest decay of all body tissue (including the brain and nervous system) long enough to get them to a hospital with Death Revival capability. Shrewd people in dangerous lines of work wear PMS personal medisensor bracelets that monitor their body's vital signs, injecting thanokalamine at need. The comic Murphy's Rules asks the awkward question: how can the drug circulate through the body if the victim's heart has already stopped? A less drastic drug Quicktime Regen rapidly increases wound healing rates.

In the real world there are some drugs that can protect somewhat against acute radiation exposure. And NASA is trying to find a treatment for the serious effects of microgravity exposure.

Star Trek had "tri-ox compound." It is a intravenous medicine used for rapidly oxygenating the blood cells of a living being. Useful if the patient had their space suit oxygen tanks run dry or are otherwise suffocating. As with so many other scifi concepts predicted by Star Trek, this one came true. Doctor McCoy saved Captain Kirk's life with this in The Tholian Web. He did it a second time by pretending to inject Kirk with Tri-ox in the guise of compensating athletic performance in the relatively low oxygen atmosphere of the planet Vulcan (but instead slipped Kirk a mickie). However tri-ox would have made Kirk's blood flush with oxygen. Which means Olympic coaches everywhere are desperately trying to get their hands on the real world version of the stuff to give their athletes an edge.

UNIVERSAL ANTIBIOTIC

(ed note: Burton has been infected with the deadly Andromeda Strain. He has a request.)


      At that moment, Burton said over the intercom, "Listen. I want you to try something for me."
     Stone flicked on the microphone. "What?"
     "Kalocin," Burton said.
     "No." Stone's reaction was immediate.
     "Dammit, it's my life."
     "No," Stone said.
     Hall said, "Maybe we should try—"
     "Absolutely not. We don't dare. Not even once."

     Kalocin was perhaps the best-kept American secret of the last decade. Kalocin was a drug developed by Jensen Pharmaceuticals in the spring of 1965, an experimental chemical designated UJ44759W, or K-9 in the short abbreviation. It had been found as a result of routine screening tests employed by Jensen for all new compounds.
     Like most pharmaceutical companies, Jensen tested all new drugs with a scatter approach, running the compounds through a standard battery of tests designed to pick up any significant biologic activity. These tests were run on laboratory animals— rats, dogs, and monkeys. There were twenty-four tests in all.
     Jensen found something rather peculiar about K-9. It inhibited growth. An infant animal given the drug never attained full adult size.
     This discovery prompted further tests, which produced even more intriguing results. The drug, Jensen learned, inhibited metaplasia, the shift of normal body cells to a new and bizarre form, a precursor to cancer. Jensen became excited, and put the drug through intensive programs of study.
     By September 1965, there could be no doubt: Kalocin stopped cancer. Through an unknown mechanism, it inhibited the reproduction of the virus responsible for myelogenous leukemia. Animals taking the drug did not develop the disease, and animals already demonstrating the disease showed a marked regression as a result of the drug.

     The excitement at Jensen could not be contained. It was soon recognized that the drug was a broad-spectrum antiviral agent. It killed the virus of polio, rabies, leukemia, and the common wart. And, oddly enough, Kalocin also killed bacteria.

     And fungi. And parasites.

     Somehow, the drug acted to destroy all organisms, built on a unicellular structure, or less. It had no effect on organ systems— groups of cells organized into larger units. The drug was perfectly selective in this respect.
     In fact, Kalocin was the universal antibiotic. It killed everything, even the minor germs that caused the common cold. Naturally, there were side effects— the normal bacteria in the intestines were destroyed, so that all users of the drug experienced massive diarrhea— but that seemed a small price to pay for a cancer cure.
     In December 1965, knowledge of the drug was privately circulated among government agencies and important health officials. And then for the first time, opposition to the drug arose. Many men, including Jeremy Stone, argued that the drug should be suppressed.

     But the arguments for suppression seemed theoretical, and Jensen, sensing billions of dollars at hand, fought hard for a clinical test. Eventually the government, the HEW, the FDA, and others agreed with Jensen and sanctioned further clinical testing over the protests of Stone and others.
     In February 1966, a pilot clinical trial was undertaken. It involved twenty patients with incurable cancer, and twenty normal volunteers from the Alabama state penitentiary. All forty subjects took the drug daily for one month. Results were as expected: normal subjects experienced unpleasant side effects, but nothing serious. Cancer patients showed striking remission of symptoms consistent with cure.

     On March 1, 1966, the forty men were taken off the drug. Within six hours, they were all dead.

     It was what Stone had predicted from the start. He had pointed out that mankind had, over centuries of exposure, developed a carefully regulated immunity to most organisms. On his skin, in the air, in his lungs, gut, and even bloodstream were hundreds of different viruses and bacteria. They were potentially deadly, but man had adapted to them over the years, and only a few could still cause disease.
     All this represented a carefully balanced state of affairs. If you introduced a new drug that killed all bacteria, you upset the balance and undid the evolutionary work of centuries. And you opened the way to superinfection, the problem of new organisms, bearing new diseases.

     Stone was right: the forty volunteers each had died of obscure and horrible diseases no one had ever seen before. One man experienced swelling of his body, from head to foot, a hot, bloated swelling until he suffocated from pulmonary edema. Another man fell prey to an organism that ate away his stomach in a matter of hours. A third was hit by a virus that dissolved his brain to a jelly.
     And so it went.

     Jensen reluctantly took the drug out of further study. The government, sensing that Stone had somehow understood what was happening, agreed to his earlier proposals, and viciously suppressed all knowledge and experimentation with the drug Kalocin.

From THE ANDROMEDA STRAIN by Michael Crichton (1969)
INJECTING LIFESAVING OXYGEN INTO A VEIN (tri-ox compound)

(ed note: technical term is apparently Intravenous Oxygen or Injectable Oxygen)

      Boston, Mass. - Patients unable to breathe because of acute lung failure or an obstructed airway need another way to get oxygen to their blood—and fast—to avoid cardiac arrest and brain injury.  A team led by researchers at Boston Children’s Hospital has designed tiny, gas-filled microparticles that can be injected directly into the bloodstream to quickly oxygenate the blood.
     The microparticles consist of a single layer of lipids (fatty molecules) that surround a tiny pocket of oxygen gas, and are delivered in a liquid solution.  In a cover article in the June 27 issue of Science Translational Medicine, John Kheir, MD, of theDepartment of Cardiology at Boston Children’s Hospital, and colleagues report that an infusion of these microparticles into animals with low blood oxygen levels restored blood oxygen saturation to near-normal levels, within seconds. 
     When the trachea was completely blocked— a more dangerous “real world” scenario—the infusion kept the animals alive for 15 minutes without a single breath, and reduced the incidence of cardiac arrest and organ injury. 

     The microparticle solutions are portable and could stabilize patients in emergency situations, buying time for paramedics, emergency clinicians or intensive care clinicians to more safely place a breathing tube or perform other life-saving therapies, says Kheir.
     “This is a short-term oxygen substitute—a way to safely inject oxygen gas to support patients during a critical few minutes,” he says. “Eventually, this could be stored in syringes on every code cart in a hospital, ambulance or transport helicopter to help stabilize patients who are having difficulty breathing.”
     The microparticles would likely only be administered for a short time, between 15 and 30 minutes, because they are carried in fluid that would overload the blood if used for longer periods, Kheir says.
     Kheir also notes that the particles are different from blood substitutes, which carry oxygen but are not useful when the lungs are unable to oxygenate them. Instead, the microparticles are designed for situations in which the lungs are completely incapacitated. 

     Kheir began investigating the idea of injectable oxygen in 2006, after caring for a little girl who sustained a severe brain injury resulting from a severe pneumonia that caused bleeding into her lungs and severely low oxygen levels. Despite the team’s best efforts, she died before they could place her on a heart-lung machine. Frustrated by this, Kheir formed a team to search for another way to deliver oxygen.
     “Some of the most convincing experiments were the early ones,” he says.  “We drew each other’s blood, mixed it in a test tube with the microparticles, and watched blue blood turn immediately red, right before our eyes.”
     Over the years, Kheir and his team have tested various concentrations and sizes of the microparticles to optimize their effectiveness and to make them safe for injection. “The effort was truly multidisciplinary,” says Kheir. “It took chemical engineers, particle scientists and medical doctors to get the mix just right.” 
     In the studies reported in the paper, they used a device called a sonicator, which uses high-intensity sound waves to mix the oxygen and lipids together. The process traps oxygen gas inside particles averaging 2 to 4 micrometers in size (not visible without a microscope). The resulting solution, with oxygen gas making up 70 percent of the volume, mixed efficiently with human blood.
     “One of the keys to the success of the project was the ability to administer a concentrated amount of oxygen gas in a small amount of liquid,” Kheir says. “The suspension carries three to four times the oxygen content of our own red blood cells.”
     Intravenous administration of oxygen gas was tried in the early 1900s, but these attempts failed to oxygenate the blood and often caused dangerous gas embolisms. 
     “We have engineered around this problem by packaging the gas into small, deformable particles,” Kheir explains. “They dramatically increase the surface area for gas exchange and are able to squeeze through capillaries where free gas would get stuck.

From INJECTING LIFESAVING OXYGEN INTO A VEIN by Boston Children’s Hospital (2012)
HIBERNATION

In the RPG Traveller Fast drug puts the user into hibernation for 60 days during which they require only 1 day's worth of oxygen and food.

In Arthur C. Clarke's CHILDHOOD'S END the drug Narcosamine is used to induce hibernation, reducing consumables required for prolonged spaceflight.

In Jack Williamson's LIFEBURST the drug Metabrake is used to induce hibernation to assist surviving space disasters. Survivors need to recover in sick-bay, while counteractants are used to flush the metabrake out of the patient's system. In his earlier novel TRAPPED IN SPACE he calls it a "deep-sleep shot", and it is calibrated to wear off at a given point in time. When the shot wears off, medical attention is required immediately.

And in any science fiction featuring suspended animation or hibernation un-named drugs are commonly used to initiate the process.

In the real world, spaceflight researchers are studying how to induce hibernation. Methods being studied include Therapeutic Hypothermia (temperature-based hibernation), Chemical/Drug-based (hydrogen sulfide or activating adenosine receptors), and Brain Synaptic-based.

NARCOSAMINE

He took out the little syringe, already loaded with the carefully prepared solution. Narcosamine had been discovered during research into animal hibernation: it was not true to say — as was popularly believed — that it produced suspended animation. All it caused was a great slowing-down of the vital processes, though metabolism still continued at a reduced level. It was as if one had banked up the fires of life, so that they smoldered underground. But when, after weeks or months, the effect of the drug wore off, they would burst out again and the sleeper would revive. Narcosamine was perfectly safe. Nature had used it for a million years to protect many of her children from the foodless winter.

From CHILDHOODS END by Sir Arthur C. Clarke
METABRAKE

Metabrake. A drug regimen used to induce human hibernation during space emergencies. It lowers body temperature and slows all metabolic processes, reducing needs for oxygen, water, and food. Side effects varied, sometimes fatal. Survival depends on age, health, tissue mass, competent medical care, and duration of coma. In exceptional cases, revival has been successful after almost a year.

From LIFEBURST by Jack Williamson (1984)
DEEP-SLEEP SHOT

     “Buzz isn’t sure what he can do,” she said. “But it’s going to hurt, when he explores the wound. Buzz says we ought to give him something to put him to sleep, but there’s nothing in the aid kit.”
     “I can stand some pain,” Ty whispered.
     “Wait!” Jeff broke in. “Can’t we use a deep-sleep shot?”
     Buzz whistled at Lupe.
     “Buzz has heard about deep sleep,” she said. “He wants to know more about it.”
     “It was invented to help men live through accidents in space,” Jeff said. “It slows life to the very point of death. In deep sleep, you need no food or warmth or even air. You can wake up from it, if you get care in time.”
     Buzz whistled quickly, and Lupe said, “He wants to see the drug.”
     Jeff showed Buzz a sealed green package in the medical kit, then broke the seal to pull out a small needle and a timer.
     “The needle is marked in hours,” Jeff told him. “You set the slide for the weight of the patient. The smallest shot gives about three hours of deep sleep. The whole needle gives a thousand hours. That’s the limit. The timer tells when care has to be started.”

From TRAPPED IN SPACE by Jack Williamson (1968)
ANTI-ACCELERATION

In Poul Anderson's THE STAR FOX and in George O. Smith's VENUS EQUILATERAL series the drug Gravanol helps prevent damage if one is exposed to prolonged periods on a planet with more than 1.0 g of gravity, or multi-gravity acceleration on a spacecraft.

In The Expanse spacecraft pilots who need to function at accelerations higher than 1.0 g will go on "the juice". A set of auto-injectors built into the acceleration couch will pivot to the pilot's carotid arteries.

THE JUICE

"Alex, how long?" Holden asked for the third time in ten minutes.

"We're over an hour out. Want to go on the juice?" Alex said.

Going on the juice was pilot-speak for a high-g burn that would knock an unmedicated human unconscious. The juice was the cocktail of drugs the pilot's chair would inject into him to keep him conscious, alert, and hopefully stroke-free when his body weighed five hundred kilos. Holden had used the juice on multiple occasions in the navy, and coming down afterward was unpleasant.

"Not unless we have to," he said.

(ed note: if the apparent body weight is 500 kg, I figure the acceleration is on the order of seven gees)

From LEVIATHAN WAKES from The Expanse by "James S.A. Corey" 2011.
Stimulants

Stimulants aka psychostimulants or "uppers". They induce temporary improvements in either mental or physical functions or both. Effects may include enhanced alertness, wakefulness, and locomotion. They range from caffeine (coffee), amphetamine, cocaine, to methamphetamine (crystal meth).

In Joe Haldeman's THE FOREVER WAR soldiers going too long without sleep can take stimtab, with the understanding that you will pay a metabolic price when it wears off. At that point you can take a second stimtab, but the price increases. You can stay awake and energetic for hundreds of hours on stimtabs but aberrations of judgement and perception snowballed after the second. Eventually you will take freaky hallucinations at face value, and find yourself fidgeting for hours deciding whether to have breakfast.

In David Drake's HAMMER'S SLAMMERS series, the soldiers take a stimulant called a "popper" for the same reasons, and with similar consequences.

In the RPG Space Opera, the drug Tempo will artificially restore lost stamina for 8 hours then for the next 4 hours they are at risk for unexpectedly falling unconscious. The drug Expeditor restores some lost stamina and give artificial extra energy for one hour, after it wears off they are at risk for falling unconscious for the next hour.

MORPHOGEN

     "I wish I had slept." He held up a hand as soon as he had said that. "Not that I'm in bad shape. I'm not complaining. Have you ever taken a morphogen?"
     "Never heard of it. Is it some kind of drug?"
     "Yes. Relatively new. It's not the sleep you need, you know. One doesn't rest in sleep to any greater extent than one would by stretching out comfortably with the eyes open. Less, maybe. It's the dreams we need. We've got to have dreaming time, otherwise cerebral coordination breaks down and you begin to have hallucinations and, eventually, death."
     "The morphogen makes you dream? Is that it?"
     "Exactly. It knocks you out for half an hour of solid dreaming and then you're set for the day. Take my advice, though, and stay away from the stuff unless it's an emergency."
     "Why? Does it leave you tired?"
     "No. Not particularly tired. It's just that the dreams are bad. The morphogen vacuums the mind; cleans out the mental garbage-pit accumulated during the day; and it's quite an experience. Don't do it. But, I had no choice. That map had to be prepared and I spent all night at it."

From FANTASTIC VOYAGE by Isaac Asimov (1966)
SOPORIFIC
Soporific aka hypnotics, sleeping pills, knockout drops. Their purpose is to initiate, sustain, or lengthen sleep. Some are used as surgical anesthesia. They are closely related to sedatives aka tranquilizers, which just calm you down.
Recreational
In E.E."Doc" Smith's LENSMAN series, Thionite is an addictive drug which will make the user experience the hallucination of every desire they ever had becoming true. In Adous Huxley's BRAVE NEW WORLD, the upper crust is kept tranquillized by a perfectly safe euphoric drug called Soma. Occasionally in science fiction one will see such things as weaponized LSD or other hallucinogen used to impair enemy soldiers by giving them hallucinations.
POISONS

Poisons are used to kill people. For most poisons, there exists an antidote that will prevent the poison from killing the victim if it is administered in time. Technically a "toxin" is a poison that is produce by a plant or animal in nature (instead of being brewed up in a chemical lab by an assasin). A "venom" is a toxin that an animal injects by a bite or sting.

The old rule-of-thumb is: If you bite an animal and you die, the animal is poisonous. If the animal bites you and you die, the animal is venomous.

In Frank Herbert's DUNE, once a person is dosed with a species of Residual Poison it stays in the body forever. The victim must receive a daily dose of the antidote for the rest of their lives to prevent death. This puts them at the mercy of the poisoner. And since they are not technically poisons, waving a poison snooper over food laced with antidote will return a null reading.

PROLONGED LIFESPAN

In James Blish's CITIES IN FLIGHT series, "anti-agathic" drugs prolong a person's lifespan, as long as they are administered (term is derived from Greek agathos, “good,” presumably mistaken for thanatos, “death”). Others include the Digestive of Gerald Kersh's "WHATEVER HAPPENED TO CORPORAL CUCKOO?", antiagathic drug from Traveller, boosterspice from Larry Niven's "KNOWN SPACE" series, antigerone in John Wyndham's TROUBLE WITH LICHEN, stroon / santaclara from Cordwainer Smith's INSTRUMENTALITY OF MANKIND series, and of course the spice Melange from Frank Herbert's DUNE novels.

In Robert Forward's FLIGHT OF THE DRAGONFLY aka ROCHEWORLD, the drug No-Die slows the aging process to one-fourth the normal rate. Unfortunately it temporarily lowers intelligence by roughly the same factor. For the 42 year slower-than-light interstellar mission, the planners chose astronauts with higher than normal IQ so that No-Die only lowered their intelligence to that of a small child. The crew was looked after by the ship's computer, until the destination was reached. This allowed the crew to arrive with an average biological age of 40 years instead of 72.

Obviously the existence of such drugs will have a drastic affect on society.

IMMORTALITY INDUCER

Immortality Inducer: It doesn’t look like much, an immortagen.

Most of the time, it looks like a pint of grayish fluid in a bag, a little saline, with a faint rainbow sheen. Intravenous tubing included. Responsible medical supervision not included.

But inject it into your veins — ah, then the magic happens. It splices, it lyses. It unwraps storage plasmids and writes then into your chromosomes, injects nanocytes into your cells, builds nanogenic artificial lymph glands to keep your system stocked with roaming nanocytes, and even tidies up your gross morphology a bit, especially if you were already old. (While you develop a high fever and a really nasty set of aches and pains for a week or two — the more so the more gross work it has to do. Don’t even ask what your excreta look like.)

And then you live forever.

INTERROGATION

These are super-duper versions of "truth serum". They include babble juice from Robert Heinlein's DOUBLE STAR, truth drug from Traveller, TC-6 from Roger Zelazny's THE EVE OF ROMOKO, Telol (aka "tell-all") from the Star Frontiers RPG, fast-penta from Lois McMaster Bujold's MILES VORKOSIGAN series and "moment of truth" from James Schmitz's LION LOOSE.

Related are the Focus Drugs from The Expanse. They are not used on the person being questioned, instead they are used by the interrogator. It turns them into a super-duper human lie detector. They can spot fractional second changes of expression and other tells exhibited by the person being questioned. When Expanse co-author Daniel Abraham was asked about focus drugs he said: "Well, it’s a nootropic drug. We don’t specify exactly what it is, but it’s job is to increase focus, to cut away the distractions and to allow people to hyper-focus on whatever it is that they’re doing Um, it’s not unlike what we do with Ritalin."

TIME DISTORTION

In the RPG Traveller, "Slow" drug paradoxically accelerates the user's perception and motion by a factor of two (e.g., user can fire their sidearm twice in the time it takes their opponent to fire once) but drug causes medical damage to the user. The name is due to the fact that to the user the entire world seems to be moving in slow motion. Other speed-up drugs include tempus from Robert Heinlein's THE PUPPET MASTERS, Scalosian water from the classic Trek episode Wink of an Eye, and the title drug from H. G. Well's The New Accelerator. The time accelerator in Arthur C. Clarke's All the Time in the World can speed up a person by a factor of about 500,000 but it is a physical device not a drug.

Drugs that slow the user down include the title drug from Grant Allen's Pausodyne (suspended animation), the S-Space protocol of Charles Sheffield's BETWEEN THE STROKES OF NIGHT (2,000:1), the "Fast" drug from the RGP Traveller (60:1), and hibernation/suspended animation drugs

COMBAT
In the RPG Traveller, Combat drug increases a soldier's endurance and strength, but does cause medical damage to the user. And of course in Marvel Comics, Captain American was created using the Super-Soldier Serum.
Psionic

The mutagen ephemerol from the movie SCANNERS causes pregnant women to give birth to children with psionic powers. In the RPG Traveller, Psi-Booster drug temporarily increases an already psionic person's power a little, Psi-Double drug temporarily increases a psi's power a lot, and Psi-Special drug hourly increases a psi's power up to the maximum, then drops back to normal. The spice Melange from Frank Herbert's DUNE novels sometimes grants the psionic ability of seeing the future.

And in many science fiction novels there are drugs that suppress psionic powers, used by the authorities to control psionic people. Otherwise the cops can't keep teleporters from escaping their jail cells. In Babylon 5 all telepaths have to either join the Psi Corps and be subjected to their discipline, or a Psi Cop shows up once a week to give you an injection suppressing your telepathy and giving you the thorazine shuffle.

INTELLIGENCE
Drugs that amplify intelligence (temporarily or permanently) are technically called Nootropics (aka smart drugs, memory enhancers, neuro enhancers, cognitive enhancers, and intelligence enhancers). They include R-47 from Gordon Dickson's THE R-MASTER, “VC” (viral coefficient) from John Brunner's THE STONE THAT NEVER CAME DOWN, "Hormone K Treatment" from Ted Chiang's UNDERSTAND, Methuen Treatment from L. Sprage de Camp's THE EXHALTED, NZT-48 from the movie LIMITLESS and CPH4 from the movie LUCY.
IQ BOOSTERS

THE IQ BOOSTERS WORKED SWIFTLY, SURGING UP through the arteries in her neck, seeking the outer layers of the neocortex. Manufactured from algae that had been genetically tricked into producing human enzymes, one set of boosters more than tripled the rate at which nerves recharged and fired, while other substances increased the growth of new nerve connections and modulated energy efficiency. It was the increase in firing frequency that had the first and most profound effect. After only two days on the boost, Tarn and her crew were connecting disparate and seemingly unrelated facts faster than they had ever before in their entire lives, possibly faster than any human beings since the beginning of time.

One side effect of her newly acquired abilities was that she could now clearly see the flicker of her liquid crystal display pad, which usually cycled too quickly for the human eye to register. Watching the pad (especially in the 3-D mode) became an activity guaranteed to trigger migraine, and she worried that there might be other unanticipated effects. Yet they were all being forced to think faster, to redesign their own brain chemistries, and, whenever necessary, to experiment upon themselves. They had no choice.

From THE KILLING STAR by Charles Pellegrino and George Zebrowski

Medical Gear

MEDICAL KITS

In wilderness areas the crew will carry first-aid kits (containing much more than just a few band-aids and aspirin), and doctors/paramedics will carry portable medical kits. First-aid kits will also be located in damage control storage lockers in strategic parts of the spacecraft or lander.

In Harry Harrison's DEATHWORLD series, people carried little medikits. These require no medical training to use. When pressed over a puncture wound, the infection and poison analyzer will detect toxins and the medikit's tiny computer will automatically select and inject the required antidote(s). Assuming that the user has been vigilant about keeping all the antidote reservoirs filled, of course. Otherwise it will just beep a warning that it is out of the medicine you need, you moron. The user can also press a button to inject a temporary stimulant, though this is for emergency use only. The same goes for the sedation button and pain killer button.

In Larry Niven and Jerry Pournelle's THE GRIPPING HAND, elderly Horace Bury's wheelchair has a "diagnostic sleeve." It also does not require any medical training to use. When put on the arm, the sleeve does a quick automated medical examination including blood tests. The medical computer does a diagnosis and injects medications as required. If it detects a more serious problem it will sound the alert to call a doctor.

In the TV show Earth 2, doctors used a DiaGlove (diagnostic glove). This is a multiple medical tool for use by doctors on their patients, it requires extensive medical and surgical training in order to use. It can check a patient's heart rate, pulse, EKG, temperature, and do several types of blood tests. It can do ultrasound and MRI scans. It has integral tools that a doctor can use for basic surgical functions like laser incisions, cauterizing wounds, and suturing wounds shut. It can even administer defibrillator jolts if the patient suffers a cardiac arrest. It does not do any computerized diagnosis, that is the human doctor's job.

In the RPG Space Opera crew can wear a Personal Medisensor. This is a strap-on wrist unit the same size as a large wristwatch (ask your parents what a wristwatch was, kids). It constantly monitors the physical condition of the user and displays medical data with a holographic display (but it takes medical training to interpret the data). More to the point, if the user suddenly dies, the medisensor automatically injects a dose of Thanokalamine drug to keep their body fresh until their buddies can get them to a hospital with life revival capabilities.

In the RPG Champions Gadgets! supplement, there was a gadget called an AutoPepper heroes and villains wear on their bodies. If the wearer is knocked unconscious, the autopepper injects stimulants to wake them up and healing drugs to help with damage.

In Frank Herbert's DUNE novels, members of wealthy families prolong their life-span by always scanning their meals with a poison snooper before eating a single bite. The snooper will beep a warning if an enemy (or ambitious offspring) has slipped a deadly poison into the food or drink. This is so common that they have special words for poison placed in food (Chaumas) as opposed to poison placed in drink (Chaumurky). There were hand-held portable poison snoopers for eating on the go, and large models attached to the ceilings of the family dining halls.

WRIST MEDIKIT

MediKit

Personal First Aid Device

  • Manufacturer: Andwella Intelligent Robotics, Andwella/Andwella
  • Technological Level: 12
  • Weight: 2000 grams
  • Length: 100 millimeters
  • Width: 20 millimeters
  • Height: 75 millimeters
  • Price: 1500 Imperial Credits
  • Resupply Price: 500 Imperial Credits

The AIR MediKit is a portable diagnostic and treatment device for personal first aid use. Using probes and skin monitors, the MediKit diagnoses the metabolic states of the patient and immediately injects the proper drugs to aid in recovery; analgesics, antitoxins, stimulants, sedatives, etc. This requires no decision at all on the part of the operator who only has to place the Kit against the patient's skin (usually the forearm or thigh area) and press the activate button. Microprocessor intelligence assures proper diagnosis.

Limited to first aid only, the MediKit is nevertheless very effective and reliable as long as it is properly supplied with drugs and chemicals (resupply is available on any world of Tech Level 9 or greater). The Kit constant-ly checks its supply of chemicals and power, and warns the user with "Low" and "Depleted" indicator lights. Another feature of the Kit is the "Trauma" light which indicates that due to MediKit diagnosis, the patient is suffering from serious illness and must be treated by a physician or autodoc immediately. The AIR MediKit is issued with clips to be placed on the owner's belt, and can be recharged in 8 hours at any standard 110 volt power outlet.

From MERCHANTS & MERCHANDISE by Donald Rapp (1981)

MEDICAL TRICORDER

There are quite a few real-world medical devices that could be called "medical tricorders" with very little exaggeration.


In the real world, in 2011 the X Prize Foundation announced the Tricorder X Prize. The constest is to develop a mobile device that can diagnose patients as well as or better than a panel of board certified physicians.

As of 2016, of the 40 teams that initially entered the competition who were reduced to 10 finalists, there are two teams still in the running.

Both contestants are using a mobile device for the brains (since smart phones and tablets are fundamentally small computers) that connect with diagnostic peripherals via Bluetooth (since wires just get tangled up). Both entries have tutorial videos in their mobile device, as well as printed instruction sheets. In theory the devices require zero medical training, just familiarity with smartphones and tablets.

Final Frontier Medical Devices is led by brothers Basil and George Harris, founders of Basil Leaf Technologies. Their tricorder is an iPad Mini talking via Bluetooth with a series of 3D printed diagnostic sensors. component.

Dynamical Biomarkers Group is led by Chung-Kang Peng of the Harvard Medical School. Their tricorder is centered around a box. The box has a modified HTC smartphone on top, and houses several medical sensors that connect to the phone via Bluetooth. Medical sensors include blood-glucose and urine test modules. The box is also the charger for all the sensors, with the box being energized by a standard USB cable. This is because one of the contest rules is the tricorder must be capable of monitoring a patient's vital signs for a full day.

Both entries will be tested over the next few months at the University of California, San Diego and scored. The winner will be announced around mid 2017. Naturally win or lose, both teams plan to bring their product to market, though obtaining certification from the FDA is going to be a nightmare. The XPrize foundation will try to help but against bureaucracy the gods themselves contend in vain.

Dynamical Biomarkers Group might have better luck obtaining certification in China. They have a somewhat less stringent process, and the government would be eager to bring such medical help to the remote regions of the country.

(ed note: MarkusB is an electronic hobbyist trying to create a simplistic tricorder)

As I have always been fascinated by medical electronics and medical mathematics and was sickened by a thrombosis on left calf a month ago, which nearly killed me because I didn't took the pain and the tumefaction serious for several days, I recently started to develop a simple form of a medical tricoder.

My tricorder has currently only two sensors: an infrared thermometer (MLX90614) to measure the body temperture on the forehead and a PPG (Photoplethysmograph) sensor to measure pulse/heart rate on the ear lobe.


During my research I was astonished, how many medical information can be computed by only knowing the body temperature, pulse rate, gender and age. By far the most interesting discovery was the use of naive Bayes classifier in automated medical diagnosis. Also very interesting are the following fever diagnoses, which are not too difficult to translate into an according algorithm: fever in adults and fever in infants and children.

From Medical tricorder by MarkusB (2014)

In Star Trek, doctors use medical tricorders (a tricorder optimized for medical use) to diagnose ailments (the pocket-sized medical scanner is a more portable but does not report as much detail). A device called an anabolic protoplaser is used to heal wounds by repairing torn veins and arteries and uniting the nerves and muscle fibers using some technobabble radiation. Hyposprays inject medications using jets of air instead of needles, this was cutting-edge science fiction in the time of the original Star Trek but is now common in the real world. In the field Starfleet doctors would carry a medkit containing essential medical tools.

According to the Star Fleet Medical Reference Manual, a medical tricorder has a compartment in the lower section containing a bare-bones emergency surgical kit.


MEDICAL TOOLS

When it comes to surgery, the tool schema is much like that of engineering tools. Surgical tools mainly fall into one of two categories. They cut one thing into two or they join two things into one. They subtract or add (the ancient alchemists called it "Solve et coagula", or analysis and synthesis). In Star Trek, the lasers scalpels cut things into two, and the anabolic protoplasers (somehow) cause body tissues to grow back together. The implication is that the protoplasers somehow use lasers to hyperstimulate anabolism (cell division). Which is total technobabble. In the real world the closest thing to a protoplaser is the skin-cell gun used for burns, but that requires stem cells harvested from the patient.

There are a few tools in other categories: Diagnostic, Measuring, and Supportive. The tricorder and medical scanner is the diagnostic tool (medical database and expert system) and the measuring tool (x-ray and MRI scans). Surgical supportive tools are not shown in Star Trek but in the real world they include retractors, clamps, and forceps. And of course an array of pharmaceutical drugs used to diagnose, cure, treat, or prevent disease.

Surgery is difficult in the field because for best results it requires a sterile area to operate in, and anesthesia for the patient. Star Trek surgical kits include a magic drug called "sterilite" which technobabblically protects the surgical patient from becoming infected when operated on in an unsterile environment. And another magic drug called "melanex" which technobabblically induces safe anesthesia. In the real world, anesthesia is a tricky dangerous procedure that must be closely monitored to prevent harming or killing the patient. The drugs used must be carefully matched to the patient's allergies and genetic make-up.

DEBRIDING GLOVE

(ed note: Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. I was going to include a link to the Wikipedia article but the images there were too disturbing.

Mercenaries Churchie and Dwyer were cooking moonshine over a wood fire in the fox hole when their position came under bombardment. To avoid being killed by the bombs they had to lie in the wood fire. Afterwards the medic uses a debriding glove to remove the severely burned tissue to prepare for a coating of spray skin. The medic is curious about how the troopers got the burns, but the troopers are not talking.)

"Well, you might at least give me something for the pain," Churchie grumbled. He lowered himself again onto the cot that doubled as an operating table.

"I'm going to give you something," Bertinelli said. "I'm going to give you a square meter less skin if you don't shut up and lie still." He touched the deep burn over Dwyer's right shoulder blade. The mesh of sensors and tiny hooks in the debriding glove's pad began to purr. Under the control of a microprocessor in the wristlet, the glove was lifting off dead tissue to prepare the area for antiseptic and a covering of spray skin. In the same mild voice, the Corpsman added, "I can see the bombs starting fires and blowing the trash into your shelter. But I'm damned if I see why you thought you had to lie in it. And I'd like to know what you found to bathe in that had such a pong, too."

From THE FORLORN HOPE by David Drake (1984)

TECHNOBABBLE SURGICAL TOOLS

In the techno-magic area, there are many instances of science fictional technology of some kind of technobabble ray that instantly heals wounds that would ordinarily require surgery and a long convalescence. They are all pretty much fantasy, aside from the before-mentioned skin-cell gun.

Other devices emit technobabble rays that instantly cure disease, mostly by using some handwaving way to kill only the harmful bacterial/viruses but leaving untouched the vital microorganisms the body needs to function (such as the digestive bacteria in the colon). Killing all the bacteria could result in massive diarrhea at best, or an exotic death at worse. Perhaps even instant death, since the vital mitochondrion who produce the ATP cell fuel are more or less bacteria that symbiotically live inside the body's cells.

Such an antiseptic ray would have to be aim-able. Intestinal bacteria inside the bowels are vital and should be spared from the antiseptic ray. But the same bacteria released into the abdominal cavity by gastrointestinal perforation (say by a sword or gunshot) can cause death by sepsis. So it would be counterproductive to make the antiseptic ray such that E. coli bacteria are immune.

Star Trek
The previously mentioned Anabolic Protoplaser emits a ray that a surgeon can use to cause tissue, blood vessels and nerves to grow together and merge in seconds. The Dermal Regenerator is a weaker version used to heal minor skin wounds, such as cuts and burns. The Bone-knitting Laser instantly fixes broken bones.
Battlestar Galactica
In the episode Saga of a Star World Dr. Payne uses a colored ray with sparklies from some unnamed machine to heal Cassiopea's broken arm.
Star Rangers aka The Last Planet by Andre Norton
Medicos have a piece of equipment called a "renewer ray" which heals broken bones and tissues.
The Mote in God's Eye by Larry Niven and Jerry Pournelle
Imperial starship sickbays have a piece of equipment called a "regeneration stimulators" that can cause tissue to grow back together. But first you have to surgically remove all the gangrene.
The Weapon from Beyond by Edmond Hamilton
If a raiding Star Wolf space viking gets a minor wound in battle, they just slap a "heal-patch" on it. But for serious injuries, they have to lie under the medical rays of a "heal-lamp".
ANABOLIC PROTOPLASER

     McCoy's fingers probed lightly around the broken spear shaft that protruded from the boy's side.
     "Sara, put a represser on that," he ordered.
     The woman removed a small, oblong object and placed it near the wound. She pressed a button on the instrument and, instantly, the flow of blood stopped under the influence of a low-power force-field.
     "Suction," McCoy said.
     Sara pressed a flexible hose to the wound and the blood was drawn away.
     "Now, I can see what I'm doing," McCoy murmured. "Sara, prepare an automatic IV, universal hemo factors, one liter," he ordered a moment later.
     Snapping open a small kit, Ensign George removed a telescoping metal rod with a collapsible tripod base. Next, a plastic pouch containing a dark powder was hung at the top of the rod. She poured a liter of water from a storage jug into it. The powder dissolved almost instantly, and a red fluid began to run through a plastic tube into a needle which had been inserted in the boy's left arm.
     "Good," McCoy said, his eyes glancing up briefly. "Now a type oh-oh scalpel."
     Ensign George handed the instrument to McCoy and he pressed the tip of the slim cylinder against the boy's side. A short, bloodless incision appeared under the ragged hole around the spear shaft.
     "Probe," he ordered.
     Sara handed him a flexible, light-carrying tube with tiny waldoes on it, and he inserted it into the small incision below the wound. Plugging a lead from the other end into the medical tricorder, he studied the display on the instrument's tiny screen.
     "Take a look, Jim."
     "Ugly," Kirk said, looking at the black silhouette of the barbed spear point which had torn through the chest muscles and was buried in spongy gray lung tissue. "How are you going to get that thing out?"
     "Watch. Minilaze, Sara," he ordered.
     She handed him the tiny cutting tool. He made a clean incision through the tissue that had closed in around the barbs, the beam cauterizing as it cut. Then, grasping hold of the short, splintered stub, he gently pulled the head out.
     "Sara, anabolic protoplaser, type zero."
     He applied the tip of the instrument to the interior of the wound, slowly working it outward to repair torn veins and gashed arteries, and unite nerves and muscle fibers. Soon, all that was left was the closing of the jagged tear where the spear had gone in and the small incision below it.
     "Type two protoplaser."
     "Bones, wait," Kirk said, breaking his long silence. "I have the impression this is the boy's first battle; he only looks about fourteen or fifteen."
     "So?" McCoy asked.
     "How about giving him something to remember?"
     "Like old Heidelberg, eh?"
     "Something like that, Bones."
     "If Starfleet finds out, they may lift my license," McCoy said, adjusting the protoplaser and setting to work.
     When he finished, he looked at a puckered scar that made a semicircle on the boy's chest where the shaft had been. He made a quick scan with the medical tricorder and then switched it off.
     "That'll give him some status with the other boys," he said. "And with a little rest, some hot soup, he'll be back on his feet in a day or two. Now the head wound."
     He studied the torn flesh critically. "Good thing they shave their heads. Saves me the trouble of depilating him."
     When he had finished, McCoy injected Alt with another dose of universal antibiotic and a stimulant to counteract the anesthesia. By the time the boy began to come around, the Federation medikit was safely back in its hidden compartment.

From SPOCK, MESSIAH! by Theodore Cogswell and Charles Spano (1976)
STAR RANGER

     "You have a renewer ray?" he asked, drawing his arm out of the sling.
     "We have. How long it will continue to function locked to these city currents is another question. We cannot be sure of anything. I am Medico Lasilo Tre. A break?" His fingers were already busy about Kartr's wrist, unfastening the bandages Zinga had put on that morning.
     "I don't know. Ah—" Kartr sucked in his breath as Tre began probing the bruised and purple flesh.
     Then the ranger was pushed down on a stool at the edge of the renewer beam, his throbbing arm stretched out under the concentrated ray, feeling again the draw of those invisible healing motes. Twice Tre snapped off the current and came to examine the hurt with delicate finger tips—only to turn it on again after shaking his head. The third time he was satisfied. Kartr lifted his arm gingerly and flexed first his fingers and then his wrist. Although he had once before been under the ray—to renew a leg almost chewed to pieces—the wonder of the restoration was as great as ever. He pulled off his sling and grinned happily at the medico.

From STAR RANGERS by Andre Norton (1953)
THE MOTE IN GOD'S EYE

     They had to send for a surgeon's mate to undress him. The medic snipped at the armor cloth embedded in his left arm and muttered. "Hold still, sir. That arm's cooked good." His voice was disapproving. "You should have been in sick bay a week ago."
     "Hardly possible," Rod answered. A week before, MacArthur had been in battle with a rebel warship, who'd scored more hits than she ought to have before surrendering. After the victory Rod was prize master in the enemy vessel, and there weren't facilities for proper treatment there. As the armor came away he smelled something worse than week-old sweat. Touch of gangrene, maybe.
     "Yes sir." A few more threads were cut away. The synthetic was as tough as steel. "Now it's gonna take surgery, Commander. Got to cut all that away before the regeneration stimulators can work.

From THE MOTE IN GOD'S EYE by Larry Niven and Jerry Pournelle (1974)


Contents of NASA's Shuttle first aid medical kit:

  1. bag
  2. blood-pressure cuff
  3. sterile drape
  4. flashlight
  5. disposable oral thermometers
  6. tongue depressors
  7. insertable airway
  8. cotton balls
  9. tourniquet
  10. Foley catheter (you don't want to know)
  11. sterile gloves
  12. fluorescein strips
  13. otoscope and ophthalmoscope heads
  14. stethoscope
  15. lubricant jelly
Apollo Medical Accessories Kit
Constant Wear
Garment Harness Plug
3
ECG Sponge Packages14
Electrode Bag1
Electrode Attachment
Assembly
100
Micropore Disc50
Sternal Harness3
Axillary Harness1
Electrode Paste1
Oral Thermometer1
pH Paper1
Urine Collection
Roll-On Cuffs
6
Lunar Module Medical Kit
Rucksack1
Stimulent Pills (Dexedrine)4
Pain Pills (Darvon)4
Decongestan Pills (Actifed)8
Diarrhea Pills (Lomotil)12
Aspirin12
Band-Aids6
Compress Bandages2
Eye Drops (Methylcellulose)1
Antibiotic Ointment (Neosporin)1
Sleeping Pills (Seconal)6
Anesthetic Eye Drops1
Nose Drops (Afrin)1
Urine Collection Roll-On Cuffs6
Pronestyl12
Injectable Drug Rucksack1
ID Kit Cardiac (Lidocaine)8
INSIDE THE AID BAG OF A U.S. ARMY COMBAT MEDIC

KipKaro, medic in the U.S. Army, displays the contents of a combat medic's bag (go to his imgur album to see the full-sized images). Naturally it is optimized for medical emergencies commonly encountered on a battlefield.

Auto Doc

"Autodoc" is short for "automatic doctor". It is a science-fictional high tech device shaped like a coffin that a patient enters. Once inside a medical computer diagnoses the patient and cures with the administration of appropriate medication and/or surgery. Just the thing if you cannot afford a real human doctor. Or for an army support ship that expects to be tasked with handling sudden influxes of large numbers of casualties.

They would be incredibly useful, but they do not exist in the real world, nor are they likely to exist anytime soon. No only are the technological challenges daunting, but liability insurance will make them prohibitively expensive until it is proven they have a higher success rate than human doctors. Whereupon they will face stiff resistance from human doctors facing job loss.

Autodocs appear in The Ethics of Madness by Larry Niven, A Plague of Demons by Keith Laumer, The Polity novels of Neal Asher, and the Liaden Universe novels by Sharon Lee and Steve Miller.

A PLAGUE OF DEMONS

     “Emergency override!” it said sharply. “Sensing instruments indicate you require immediate medical attention.” There was a sound behind me; I turned. As if in a dream, I saw a white-sheeted cot deploy from a wall recess, roll across the room, hunting a little, then come straight on and stop beside me.
     “Place yourself on the cot, with your head at the equipment end.” The voice echoed from far away.
     I made a vast effort, pushed myself clear of the chair, fell across the bed. I was struggling to get myself on it when I felt a touch, twisted to see padded, jointed arms grasp me and gently but firmly hoist me up and lay me out, facedown. The sheet was smooth and cool under my face.
     “You will undergo emergency diagnosis and treatment,” the voice said. “An anesthetic will be administered if required. Do not be alarmed.”
     I caught just one whiff of neopolyform; then I was relaxing, letting it all go, sliding down a long, smooth slope into dark sea.

     Two bosomy angels with hands like perfumed flower petals were massaging my weary limbs and crooning love songs in my ears, while not far away someone was cooking all my favorite dishes, making savory smells that put just that perfect edge on my appetite.
     The cloud I was lying on was floating in sunshine, somewhere far from any conceivable discord, and I lay with my eyes closed and blissfully enjoyed it. I deserved a rest, I realized vaguely, after all I’d gone through — whatever that was. It didn’t seem important. I started to reach out to pat one of the angels, but it was really too much trouble …
     There was a twinge from my left arm. I almost remembered something unpleasant, but it eluded me. The arm pained again, more sharply; there seemed to be only one angel now, and she was working me over in a businesslike way, ignoring my efforts to squirm free. The music had ended and the cook had quit and gone home.
     I must have slept right through the meal; my stomach had a hollow, unloved feeling. That angel was getting rougher all the time; maybe she wasn’t an angel after all; possibly she was a real live Swedish masseuse, one of those slender, athletic blonde ones you see in the pictonews —
     Ouch! Slender, hell. This one must have weighed in at a good two-fifty, and not an ounce of fat on her. What she was doing to my arm might be good for the muscle tone, but it was distinctly uncomfortable. I’d have to tell her so — just as soon as this drowsy feeling that was settling over me went away …
     It had been a long trip, and the jogging of the oxcart was getting me down. I could feel burlap against my face; probably a bag of potatoes, from the feel of the lumps. I tried to shift to a more comfortable position, but all I could find were bard floorboards and sharp corners. I had caught my arm under one of the latter; there must have been a nail in it; it caught, and scraped, and the more I pulled away the more it hurt —

     My eyes came open and I was staring at a low, gray-green ceiling perforated with tiny holes in rows, with glare strips get every few feet. There were sounds all around: busy hummings and clicks and clatters.
     I twisted my head, saw a panel speckled over with more fights than a used heli-lot, blinking and winking and flashing in red, green, and amber …
     I lowered my sight. I saw my arm, held out rigidly by padded metal brackets.
     Things like dentists’ drills hovered over it, and I caught a glimpse of skin pinned back like a tent-fly, red flesh, white bone, and the glitter of clamps, set deep in a wound like the Grand Canyon.
     “Your instructions are required,” a deep, uninflected voice said from nowhere. “The prognosis computed on the basis of inmediate amputation is 81 percent positive. Without amputation, the prognosis is 7 percent negative. Please indicate the course to be followed.”
     I tried to speak, got tangled up in my tongue, made another effort.
     “Wha’s … that… mean … ?”
     “The organism will not survive unless the defective limb is amputated. Mutilation of a human body requires specific operator permission.”
     “Cu’ … my arm … off … ?”
     “Awaiting instructions.”
     “Die… ‘f you don’t… ?”
     “Affirmative.”
     “Permission… granted…”
     “Instructions acknowledged,” the voice said emotionlessly. I had time to get a faint whiff of something, and then I was gone again …

     This time, I came out of it with a sensation that took me a moment or two to analyze — a cold-water, gray-skies, no-nonsense sort of feeling. For the first time in days — how many I didn’t know — the fine feverish threads of delirium were lacking in the ragged fabric of my thoughts.
     I took a breath, waited for the familiar throb of pain between my temples, the first swell of the sea-sickness in my stomach. Nothing happened.
     I got my eyes open and glanced over at my left arm; it was strapped to a board, swathed in bandages to the wrist, bristling with metal clips and festooned with tubing.
     I felt an unaccountable surge of relief. There had been a dream — a fantastic dialogue with a cold voice that had asked…
     In sudden panic, I moved the fingers of the hand projecting from the bandages.
     They twitched, flexed awkwardly. With an effort, I reached across with my right hand, touched the smooth skin of the knuckles of the other … Under my fingers, the texture was cool, inhumanly glossy — the cold gloss of polyon. I raked at the bandages, tore them back - An inch above the wrist, the pseudoskin ended; a pair ot gleaming metal rods replaced the familiar curve of my forearm. A sort of animal whimper came from my throat. I clenched my lost fist — and the artificial hand complied.

From A PLAGUE OF DEMONS by Keith Laumer (1965)
THE MECHANIC

(ed note: The good ship Shark is a hydrofoil boat that manages schools of synthetic organisms called "zeolite whales" or zeowhales. These harvest copper and other elements by straining seawater. Marco Mancini is the on-board molecular mechanic. Rick Stubbs is an 18 year old working off his standard 2 year labor draft requirement so as to be eligible for higher education.)

“It’s still handy, though, to know how to work with the real thing (DNA backbone instead of synthetic zeolite) —after all, you know as well as I do that the reason you have a life expectancy of about a hundred and fifty years is that your particular gene pattern is on file in half a cubic meter of zeolite mesh in Denver under a nice file number …”

“026-18-5633” muttered the boy under his breath.

“ … which will let any halfway competent molecular mechanic like me grow replacement parts and tissues if and when you happen to need them.”

“I know all that, but it still seems dangerous to poke around making little changes in ordinary life forms,” replied Rick. “There must be fifty thousand people like you in the world, who could tailor a dangerous virus, or germ, or crop fungus in a couple of weeks of lab and computer work, and whose regular activities produce things like that iron-feeder which can mutate into dangerous by-products.”

“It’s also dangerous to have seven billion people on the planet, practically every one of whom knows how to light a fire,” replied Mancini. “Dangerous or not, it was no more possible to go from Watson and Crick (this injustly ignores the vital contributions of Rosalind Franklin) and the DNA structure to this zeowhale without the intermediate development than it would have been to get from the Wright brothers and their powered kite to the two-hour transatlantic ramjet without building Ford tri-motors and DC-3’s in between. We have the knowledge, it’s an historical fact that no one can effectively destroy it, so we might as well use it. The fact that so many competent practitioners of the art exist is our best safeguard if it does get a little out of hand at times.”


The boy looked thoughtful.

“Maybe you have something there,” he said slowly. “But with all that knowledge, why only a hundred and fifty years? Why can’t you keep people going indefinitely?”

“Do you think we should?” Mancini countered with a straight face. Rick grinned.

“Stop ducking. If you could, you would—for some people anyway. Why can’t you?” Mancini shrugged.

“Several hundred million people undoubtedly know the rules of chess.” He nodded toward the board on Dandridge’s control table. “Why aren’t they all good players? You know, don’t you, why doctors were reluctant to use hormones as therapeutic agents even when they became available in quantity?”

“I think so. If you gave someone cortisone it might do what you wanted, but it might also set other glands going or slow them down, which would alter the levels of other hormones, which in turn … Well, it was a sort of chain reaction which could end anywhere.”

“Precisely. And gene-juggling is the same only more so. If you were to sit at the edge of the hatch there and let Gil close it on you, I could rig the factors in your gene pattern so as to let you grow new legs; but there would be a distinct risk of affecting other things in your system at the same time. In effect, I would be taking certain restraints which caused your legs to stop growing when they were completed off your cell-dividing control mechanisms—the sort of thing that used to happen as a natural, random effect in cancer. I’d probably get away with it—or rather, you would—since you’re only about nineteen and still pretty deep in what we call the stability well. As you get older, though, with more and more factors interfering with that stability, the job gets harder—it’s a literal juggling act, with more and more balls being tossed to the juggler every year you live.

“You were born with a deep enough stability reserve to keep yourself operating for a few decades without any applied biochemical knowledge; you might live twenty years or ninety. Using the knowledge we have, we can play the game longer; but sooner or later We drop the ball. It’s not that we don’t know the rules; to go back to the chess analogy, it’s just that there are too many pieces on the board to keep track of all at once.”

Stubbs shook his head. “I've never thought of it quite that way. To me, it’s always been just a repair job, and I couldn’t see why it should be so difficult.”

Mancini grinned. “Maybe your cultural grounding didn’t include a poem called the ‘Wonderful One-Hoss Shay.’ Well, we’ll be a couple of hours getting back to the Guppy. There are a couple of sets of analysis runs sitting with us here. Maybe, if I start trying to turn those into language you can follow, you’ll have some idea of why the game is so hard before we get there. Maybe, too”—his face sobered somewhat&mdash“you’ll start to see why, even though we always lose in the end, the game is so much fun. It isn’t just that our own lives are at stake, you know; men have been playing that kind of game for two million years or so. Come on.”


(ed note: The hydrofoil boat proceeds to full speed of sixty-five knots [120 kph or 75 mph]. Abruptly, a rogue steel-eating bacteria finishes chewing through the starboard aft hydrofoil leg, causing a catastrophic failure. The boat smacks into the water and does a cartwheel before coming to rest. The entire crew has severe injuries.)

His words, as it happened, were getting out (Mancini had no idea if the emergency radio was transmitting). The Conger, the nearest of the Shark’s sister fish-tenders, had already started toward them; she had about forty kilometers to come. On the Guppy the senior mechanic had fulfilled Mancini’s prediction; he had already made contact with Denver, and Rick Stubbs’ gene code was about to start through the multiple-redundant communication channels used for the purpose—channels which, fortunately, had just been freed of the saturation caused by a serious explosion in Pittsburgh, which had left over five hundred people in need of major repair. The full transmission would take over an hour at the highest safe scanning rate; but the first ten minutes would give enough information, when combined with the basic human data already in the Guppy’s computers, to permit the synthesis of replacement blood.

(ed note: The crew is rescued and taken to a hospital.)

In spite of tradition, Rick Stubbs knew where he was when he opened his eyes. The catch was that he hadn’t the faintest idea how he had gotten there. He could see that he was surrounded by blood-transfusion equipment, electronic circulatory and nervous system monitoring gear, and the needle-capillary-and-computer maze of a regeneration unit, though none of the stufi seemed to be in operation. He was willing to grant from all this that he had been hurt somehow; the fact that he was unable to move his head or his right arm supported this notion. He couldn’t begin to guess, however, what sort of injury it might be or how it had happened.

He remembered talking and working with Mancini at the latter’s lab bench. He could not recall for certain just what the last thing said or done might be, though; somehow the picture merged with the foggy struggle back to consciousness which had culminated in recognition of his surroundings.

     He could see no one near him, but this might be because his head wouldn’t turn. Could he talk? Only one way to find out.
     “Is anyone here? What’s happened to me?” It didn’t sound very much like his own voice, and the efiort of speech hurt his chest and abdomen; but apparently words got out.
     “We’re all here, Rick. I thought you’d be switching back on about now.” Mancini’s face appeared in Stubbs’ narrow field of vision.
     “We’re all here? Did everyone get hurt somehow? What happened?”
     “Slight correction—most of us are here, one’s been and gone. I’ll tell you as much as I can; don’t bother to ask questions, I know it must hurt you to talk. Gil was here for a while, but he had just had a few bruises and is back on the job. The rest of us were banged up more thoroughly. My right leg was a jigsaw puzzle; Bert had an interesting time with it. I thought he ought to take it off and start over, but he stuck with it, so I got off with five hours of manual repair and two in regeneration instead of a couple of months hooked up to a computer. I’m still splinted, but that will be for only a few more days.
     “No one knows yet just what happened. Apparently the Shark hit something going at full clip, but no one knows yet what it was. They’re towing her in; I trust there’ll be enough evidence to tell us the whole story.”
     “How about the other fellows?”
     “Ishi is plugged in. He may need a week with computer regeneration control, or ten times that. We won’t be able to assess brain damage until we find how close to consciousness he can come. He had a bad skull fracture. The captain was knocked out, and some broken ribs I missed on the first-aid check did internal damage. Bert is still trying to get him off without regeneration, but I don't think he’ll manage it.”
     “You didn’t think he could manage it with you, either."
     “True. Maybe it’s just that I don’t think I could do it myself, and hate to admit that Jellinge is better at my own job than I am.”
     “How about Joe?”
     “Both arms broken and a lot of bruises. He’ll be all right. That leaves you, young fellow. You’re not exactly a critical case, but you are certainly going to call for professional competence. How fond are you of your fingerprints?”
     “What? I don’t track.”
     “Most of your right hand was sliced off, apparently by flying glass from my big culture flask. Ben Tulley from the Conger, which picked us up, found the missing section and brought it back; it’s in culture now.”
     “What has that to do with fingerprints? Why didn’t you or Mr. Jellinge graft it back?”
     “Because there’s a good deal of doubt about its condition. It was well overan hour after the accident before it got into culture. You know the sort of brain damage a few minutes without oxygen can do. I know the bone, tendon, and connective tissue in a limb is much less sensitive to that sort of damage, but an hour is a long time, chemically speaking. Grafting calls for healing powers which are nearly as dependent on genetic integrity as is nerve activity; we’re just not sure whether grafting is the right thing to do in your case. It’s a toss-up whether we should fasten the hand back on and work to make it take, or discard it and grow you a new one. That’s why I asked how much you loved your fingerprints.”
     “Wouldn’t a new hand have the same prints?”
     “The same print classification, which is determined genetically, but not the same details, which are random.”
     “Which would take longer?”
     “If the hand is in shape to take properly, grafting would be quicker—say a week. If it isn’t, we might be six or eight times as long repairing secondary damage. That’s longer than complete regeneration would take.”
     “When will you start?”
     “As soon as I’ve had some sleep. Your blood is back to normal, your general pattern is in the machine; there’s nothing else to hold us up. What sort of books do you like?”
     “Huh?”

“That head’s going to be in a clamp for quite a while. You may or may not like reading, but the only direction you can look comfortably is straight up. Your left hand can work a remote control, and the tape reader can project on the ceiling. I can’t think of anything else to occupy you. Do you want some refreshing light fiction, or shall I start you on Volume One of ‘Garwood’s Elementary Matrix Algebra for Biochemists?’ ”

A regeneration controller is a bulky machine, even though most of it has the delicacy and structural intricacy possible only to pseudolife—and, of course, to “real” life. It’s sensors are smaller in diameter than human red blood cells, and there are literally millions of them. Injectors and samplers are only enough larger to take entire cells into their tubes, and these also exist in numbers which would make the device a hopeless one to construct mechanically. Its computer-controller occupies more than two cubic meters of molecular-scale “machinery” based on a synthetic zeolite framework. Mating the individual gene record needed for a particular job to the basic computer itself takes nearly a day; it would take a lifetime if the job had to be done manually, instead of persuading the two to “grow” together.

Closing the gap between the optical microscope and the test tube, which was blanketed under the word “protoplasm” for so many decades, also blurred the boundary between such initially different fields as medicine and factory design. Marco Mancini and Bert Jellinge regarded themselves as mechanics; what they would have been called a few decades earlier is hard to say. Even at the time the two had been born, no ten Ph.D.’s could have supplied the information which now formed the grounding of their professional practice.

When their preliminary work—the “prepping”—on Rick Stubbs was done, some five million sensing tendrils formed a beard on the boy’s face, most of them entering the skin near the edges of the injured portions. Every five hundred or so of these formed a unit with a pair of larger tubes. The sensors kept the computer informed of the genetic patterns actually active from moment to moment in the healing tissue—or at least, a statistically significant number of them. Whenever that activity failed to match within narrow limits what the computer thought should be happening, one of the larger tubes ingested a single cell from the area in question and transferred it to a large incubator—“large” in the sense that it could be seen without a microscope—just outside Rick’s skin. There the cell was cultured through five divisions, and some of the product cells analyzed more completely than they could be inside a human body. If all were well after all, which was quite possible because of the limitations of the small sensors, nothing more happened.

If things were really not going according to plan, however, others of the new cells were modified. Active parts of their genetic material which should have been inert were inerted, quiet parts which should have been active were activated. The repaired cells were cultivated for several more divisions; if they bred true, one or more of them was returned to the original site—or at least, to within a few microns of it. Cell division and tissue building went on according to the modified plan until some new discrepancy was detected.

Most of this was, of course, automatic; too many millions of operations were going on simultaneously for detailed manual control. Nevertheless, Mancini and Jellinge were busy. Neither life nor pseudolife is infallible; mutations occur even in triply redundant records. Computation errors occur even—or especially—in digital machines which must by their nature work by successive-approximation methods. It is much better to have a human operator, who knows his business, actually see that connective tissue instead of epidermis is being grown in one spot, or nerve instead of muscle cells in another.

Hence, a random selection of cells, not only from areas which had aroused the computer’s interest but from those where all was presumably going well, also traveled out through the tubes. These went farther than just to the incubators; they came out to a joint where gross microscopic study of them by a human observer was possible. This went on twenty-four hours a day, the two mechanics chiefly concerned and four others of their profession taking two-hour shifts at the microscope. The number of man-hours involved in treating major bodily injury had gone up several orders of magnitude since the time when a sick man could get away with a bill for ten dollars from his doctor, plus possibly another for fifty from his undertaker.

The tendrils and tubes farthest from the damaged tissue were constantly withdrawing, groping their way to the action front, and implanting themselves anew, guided by the same chemical clues which brought leukocytes to the same area. Early versions of the technique had involved complex methods of warding off or removing the crowd of white cells from the neighborhood; the present idea was to let them alone. They were good scavengers, and the controller could easily allow for the occasional one which was taken in by the samplers.

So, as days crawled by, skin and fat and muscle and blood vessels, nerves and bones and tendons, gradually extended into their proper places in Stubbs’ face and hand. The face, as Mancini had predicted, was done first; the severed hand had deteriorated so that most of its cells needed replacement, though it served as a useful guide.


“Maybe I should have taken a new hand,” he said. “With new prints I might have gotten away with a bank robbery, and out short the time leading to my well-earned retired leisure.”

Don’t you believe it,” returned Mancini grimly. “Your new prints would be on file along with your gene record and retinal pattern back in Denver before I could legally have unplugged you from the machine. I had to submit a written summary of this operation before I could start, even as it was. Forget about losing your legal identity and taking up crime.”


“But it’s all right, Rick—the hand will be back in service soon, and it shouldn’t take you many weeks to learn to write with it again—”

“What?”

“It is a new set of nerves, remember. They’re connected with the old ones higher up in your hand and arm, but even with the old hand as a guide they probably won’t go to exactly the same places to make contact with touch transducers and the like. Things will feel different, and you’ll have to learn to use a pen all over again.”

From THE MECHANIC by Hal Clement (1966)
TRAVELLER AUTODOC

AutoDoc

Medical Trauma Aid Device

  • Manufacturer: Andwella Intelligent Robotics, Andwella/Andwella
  • Technological Level: 13
  • Weight: 600 kilograms
  • Length: 2.8 meters
  • Width: 2.5 meters
  • Height: 1 meter
  • Price: 100,000 Imperial Credits
  • Resupply Price: 10,000 Imperial Credits

The AIR AutoDoc Independent Medical Treatment Center is a device in which the patient is placed in prone position. With probes and scanners, the AutoDoc will analyze the status of the patient and report same, along with suggested treatments which can be implemented. Supposedly "anyone" can operate the device, but Medical skills can aid the operator.

The 'Doc can diagnose and treat up to ten patients before resupply—purchase of a package of drugs and antitoxins at any "A" Starport of Tech Level 10 or better. This resupply includes examination by an electronic and computer technician and maintenance of equipment.

The AutoDoc can also act as a Low Berth to place critical patients in suspension until more complete treatment can be secured. The AutoDoc is capable of all of the following: accomplishing all types of first aid; minor operations such as appendectomies, suturing, and dental work; can be programmed for a specific environment or metabolism (new program tapes at 500 Imperial Credits each); has demonstrated a 72% reliability in diagnosing unusual diseases and viruses.

From MERCHANTS & MERCHANDISE by Donald Rapp (1981)
ROBOMEDIC

His arms were drawn out stiffly, and hurt; his feet and legs hurt too, and he couldn't move them, and there was this prickling at his brow. And he was blind.

No; his eyes were just closed. He opened them, and there was a white wall in front of him, patterned with a blue snow-crystal design, and he realized that it was a ceiling and that he was lying on his back. He couldn't move his head, but by shifting his eyes he saw that he was completely naked and surrounded by a tangle of tubes and wires, which puzzled him briefly. Then he knew that he was not on a bed, but on a robomedic, and the tubes would be for medication and wound drainage and intravenous feeding, and the wires would be to electrodes imbedded in his body for diagnosis, and the crown-of-thorns thing would be more electrodes for an encephalograph. He'd been on one of those things before, when he had been gored by a bisonoid on the cattle range.

From SPACE VIKING by H. Beam Piper (1962)
MEDICAL MECH

"[Kenebuck] whistled, and something about the size of a small dog, but made of smooth, black metal, slipped out from behind a sofa nearby and slid on an aircushion over the carpeting to their feet. Ian looked down. It was a sort of satchel with an orifice in the top from which two metallic tentacles protruded slightly.

'A medical mech', he said.

'Yes,' said Kenebuck, 'cued to respond to the heartbeats of anyone in the room with it...Even if you killed me, this could get to me in time to keep it from being permanent...'"

From WARRIOR by Gordon R. Dickson (1965)

"Who needs a real doctor when you got my machines and their scary needles?"

—"Doctor" Zed's Med Vendor, Borderlands

In The Future or sometime soon, you won't need a steady hand to heal people, some machine is already doing it for you. In a futuristic setting there will be machines that fix human bodies automatically. If a human doctor is participating in it at all, he will only press buttons and won't even touch a scalpel.

The appearance of these machines can range from complex apparatus to seemingly magic circles.

For a huge list of examples click here

AUTODOC entry from TV Tropes

Regeneration Tanks

A fond sci-fi wish is to grant human beings the same ability found in some animals: to re-grow amputated limbs and such. Traditionally this take the form of a medical tank the patient floats in, but sometimes it is genetically engineered as an innate ability.

In science fiction the concept dates back at least to 1939 in E. E. "Doc" Smith's Gray Lensman, but the idea dates back to the time when the first pre-human noticed those autotomy lizards that shed their tail and later re-grow them. In the late 1960s there was some science news about the amazing regeneration powers of newts, in 1969 Frank Herbert mentioned "Axolotl Tanks" in Destination: Void , Dune Messiah, and The God Makers. In the Herbert novels Axolotl Tanks are also used for human cloning.

PHILLIPS REGENERATION TREATMENT

      “Come in, Kinnison,” Haynes invited. “Lacy wants to see you a minute, too. Doctor Phillips—Lensman Kinnison, Unattached. His name isn’t Phillips, of course; we gave him that in self-defense, to keep from trying to pronounce his real one.”
     Phillips, the Posenian, was as tall as Kinnison, and heavier. His figure was somewhat human in shape, but not in detail. He had four arms instead of two, each arm had two opposed hands, and each hand had two thumbs, one situated about where a little finger would be expected. He had no eyes, not even vestigial ones. He had two broad, flat noses and two toothful mouths; one of each in what would ordinarily be called the front of his round, shining, hairless head; the other in the back. Upon the sides of his head were large, volute, highly dirigible ears. And, like most races having the faculty of perception instead of that of sight, his head was relatively immobile, his neck being short, massive, and tremendously strong.
     “Right, my boy—surprisingly and pleasingly right!” Lacy exclaimed. “Why can’t you adopt that attitude, Haynes, and learn enough words so you can understand what a man’s talking about? But to reduce it to monosyllabic simplicity, Phillips is studying a thing that has baffled us for thousands of years. The lower forms of cells are able to regenerate themselves; wounds heal, bones knit. Higher types, such as nerve cells, regenerate imperfectly, if at all; and the highest type, the brain cells, do not do so under any conditions.
     His old friend interrupted. “We got the idea perfectly. The question is, why can’t human beings repair nerves or spinal cords, or grow new ones? If such a worthless beastie as a starfish can grow a whole new body to one leg, including a brain, if any, why can’t a really intelligent victim of simple infantile paralysis—or a ray—recover the use of a leg that is otherwise in perfect shape?

     “Phillips,” the Surgeon-Marshal began, “explain to this warhorse, in words of as few syllables as possible, what you are doing.”
     “The original problem was to discover what hormone or other agent caused proliferation of neural tissue…”
     “Wait a minute, I’d better do it,” Lacy broke in. “Besides, you wouldn’t do yourself justice. The first thing he found out was that the problem of repairing damaged nervous tissue was inextricably involved with several other unknown things, such as the original growth of such tissue, its relationship to growth in general, the regeneration of lost members in lower forms, and so on. You see, Haynes, it’s a known fact that nerves do grow, or else they could not exist; and in lower forms of life they regenerate. Those facts were all he had, at first. In higher forms, even during the growth stage, regeneration does not occur spontaneously. Phillips set out to find out why.
     “The thyroid controls growth, but does not initiate it, he learned. This fact seemed to indicate that there was an unknown hormone involved—that certain lower types possess an endocrine gland which is either atrophied or non-existent in higher types. If the latter, it was no landing. He reasoned, however, since higher types evolved from lower, that the gland in question might very well exist in a vestigial state. He studied animals, thousands of them, from the germ upward. He exhausted the patience of the Posenian authorities; and when they cut off his appropriation, on the ground that the thing was impossible, he came here. We felt that if he were so convinced of the importance of the work as to be willing to spend his whole life on it, the least we could do would be to support him. We gave him carte blanche.”
     “The man is a miracle of perseverance, a keen observer, a shrewd reasoner, and a mechanic par excellence—a born researcher. So he finally found out what it must be—the pineal. Then he had to find the stimulant. Drugs, chemicals, the spectrum of radiation; singly and in combination. Years of plugging, with just enough progress to keep him at it. Visits to other planets peopled by races human to two places or more; learning everything that had been done along that line. When you fellows moved Medon over here (the Medonians made a giant FTL drive and drove the planet from Lundmark's Nebula to the Milky Way galaxy like it was a giant starship) he visited it as routine, and there he hit the jackpot. Wise himself is a surgeon, and the Medonians have had warfare and grief enough to develop the medical and surgical arts no end.”
     “They knew how to stimulate the pineal, but their method was dangerous. With Phillips’ fresh viewpoint, his wide-knowledge, and his mechanical genius, they worked out a new and highly satisfactory technique. He was going to try it out on a pirate slated for the lethal chamber, but von Hohendorff heard about it and insisted on being the guinea pig. Got up on his Unattached Lensman’s high horse and won’t come down. So here we are.”
     Haynes relented enough to let von Hohendorff go first, and both were given the necessary injections. The commandant was then strapped solidly into a chair; his head was immobilized with clamps.
     The Posenian swung his needle-rays into place; two of them, each held rigidly upon micrometered racks and each operated by two huge, double, rock-steady hands. The operator looked entirely aloof—being eyeless and practically headless, it is impossible to tell from a Posenian’s attitude or posture anything about the focal point of his attention—but the watchers knew that he was observing in microscopic detail the tiny gland within the old Lensman’s skull.
     Then Haynes. “Is this all there is to it, or do we come back for more?” he asked, when he was released from his shackles.
     “That’s all,” Lacy answered. “One stimulation lasts for life, as far as we know. But if the treatment was successful you’ll come back—about day after tomorrow, I think—to go to bed here. Your spare equipment won’t fit and your stumps may require surgical attention.”
     Sure enough, Haynes did come back to the hospital, but not to go to bed. He was too busy. Instead, he got a wheel-chair and in it he was taken back to his now boiling office. And in a few more days he called Lacy in high exasperation.
     “Know what you’ve done?” he demanded. “Not satisfied with taking my perfectly good parts away from me, you took my teeth too! They don’t fit—I can’t eat a thing! And I’m hungry as a wolf—I don’t think I was ever so hungry in my life! I can’t live on soup, man; I’ve got work to do. What are you going to do about it?”
     “Ho-ho-haw!” Lacy roared. “Serves you right—von Hohendorff is taking it easy here, sitting on top of the world. Easy, now, sailor, don’t rupture your aorta. I'll send a nurse over with a soft-boiled egg and a spoon. Teething—at your age—Haw-ho-haw!
     “I had no idea, Admiral Haynes, that you… that there…” she paused.
     “That I was so much of a rebuild?” complacently. “Except in the matter of eyes—which he doesn’t need anyway—our mutual friend Kinnison has very little on me, my dear. I got so handy with the replacements that very few people knew how much of me was artificial. But it’s these teeth that are taking all the joy out of life. I’m hungry, confound it! Have you got anything really satisfying that I can eat?”

     And all this activity centered in one vast building and culminated in one man—Port Admiral Haynes, Galactic Councillor. And Haynes could not get enough to eat because he was cutting a new set of teeth!
     He cut them, all thirty two of them. Arm and leg, foot and hand grew perfectly, even to the nails. Hair grew upon what had for years been a shining expanse of pate. But, much to Lacy’s relief, it was old skin, not young, that covered the new limbs. It was white hair, not brown, that was dulling the glossiness of Haynes’ bald old head. His trifocals, unchanged, were still necessary if he were to see anything clearly, near or far.
     “Our experimental animals aged and died normally,” he explained graciously, “but I was beginning to wonder if we had rejuvenated you two, or perhaps endowed you with eternal life. Glad to see that the new parts have the same physical age as the rest of you—it would be mildly embarrassing to have to kill two Gray Lensmen to get rid of them.”

From GRAY LENSMAN by E. E. "Doc" Smith (1939)
LIMB REGENERATION

      I stripped and backed into the clamshelled suit. The new ones were a hell of a lot more complicated, with all the new biometrics and trauma maintenance. But well worth the trouble of hooking up, in case you got blown apart just a little bit. Go home to a comfortable pension with heroic prosthesis. They were even talking about the possibility of regeneration, at least for missing arms and legs. Better get it soon, before Heaven filled up with fractional people. Heaven was the new hospital/rest-and-recreation planet.

     These new ships were ugly as hell. Just an open framework with clamps to hold you in place, swiveled lasers fore and aft, small tachyon powerplants below the lasers. Everything automated; the machine would land us as quickly as possible and then zip off to harass the enemy. It was a one-use, throwaway drone. The vehicle that would come pick us up if we survived was cradled next to it, much prettier.
     I wasn’t worried, of course. Abstractedly, I wished I hadn’t taken the pill.
     “Prepare for ejection,” the machine’s female-mechanical voice said. “Five, four…”
     The ship’s lasers started firing, millisecond flashes freezing the land below in jerky stroboscopic motion. It was a twisted, pockmarked jumble of fissures and random black rocks, a few meters below our feet. We were dropping, slowing.
     “Three—” It never got any farther. There was a too-bright flash and I saw the horizon drop away as the ship’s tail pitched down—then clipped the ground, and we were rolling, horribly, pieces of people and ship scattering. Then we slid pinwheeling to a bumpy halt, and I tried to pull free but my leg was pinned under the ship’s bulk: excruciating pain and a dry crunch as the girder crushed my leg; shrill whistle of air escaping my breached suit; then the trauma maintenance turned on snick, more pain, then no pain and I was rolling free, short stump of a leg trailing blood that froze shiny black on the dull black rock. I tasted brass and a red haze closed everything out, then deepened to the brown of river clay, then loam and I passed out, with the pill thinking this is not so bad…

     The suit is set up to save as much of your body as possible. If you lose part of an arm or a leg, one of sixteen razor-sharp irises closes around your limb with the force of a hydraulic press, snipping it off neatly and sealing the suit before you can die of explosive decompression. Then “trauma maintenance” cauterizes the stump, replaces lost blood, and fills you full of happy-juice and No-shock. So you will either die happy or, if your comrades go on to win the battle, eventually be carried back up to the ship’s aid station.
     Finally I woke up in a regular bay. I was strapped down and being fed through a tube, biosensor electrodes attached here and there, but no medics around. The only other person in the little room was Marygay, sleeping on the bunk next to me. Her right arm was amputated just above the elbow.
     I didn’t wake her up, just looked at her for a long time and tried to sort out my feelings. Tried to filter out the effect of the mood drugs. Looking at her stump, I could feel neither empathy nor revulsion. I tried to force one reaction, and then the other, but nothing real happened. It was as if she had always been that way. Was it drugs, conditioning, love? Have to wait to see.
     One knock on the door and Dr. Foster barged in. He examined Marygay’s stump and then mine. He stuck thermometers in our mouths so we couldn’t talk. When he spoke, he was serious and blunt.
     “I’m not going to sugarcoat anything for you. You’re both on happyjuice up to your ears, and the loss you’ve sustained isn’t going to bother you until I take you off the stuff. For my own convenience I’m keeping you drugged until you get to Heaven. I have twenty-one amputees to take care of. We can’t handle twenty-one psychiatric cases.
     “Enjoy your peace of mind while you still have it. You two especially, since you’ll probably want to stay together. The prosthetics you get on Heaven will work just fine, but every time you look at his mechanical leg or you look at her arm, you’re going to think of how lucky the other one is. You’re going to constantly trigger memories of pain and loss for each other…You may be at each other’s throats in a week. Or you may share a sullen kind of love for the rest of your lives.
     “Or you may be able to transcend it. Give each other strength. Just don’t kid yourselves if it doesn’t work out.”

     They took the most severely wounded first, so it was several days before I went into surgery. Afterwards, I woke up in my room and found that they had grafted a prosthesis onto my stump, an articulated structure of shiny metal that to my untrained eye looked exactly like the skeleton of a leg and foot. It looked creepy as hell, lying there in a transparent bag of fluid, wires running out of it to a machine at the end of the bed.
     An aide came in. “How you feelin’, sir?” I almost told him to forget the “sir” bullshit, I was out of the army and staying out this time. But it might be nice for the guy to keep feeling that I outranked him.
     “I don’t know. Hurts a little.”
     “Gonna hurt like a sonuvabitch. Wait’ll the nerves start to grow.
     “Nerves?”
     “Sure.” He was fiddling with the machine, reading dials on the other side. “How you gonna have a leg without nerves? It’d just sit there.”
     “Nerves? Like regular nerves? You mean I can just think ‘move’ and the thing moves?”
     “’Course you can.” He looked at me quizzically, then went back to his adjustments.
     What a wonder. “Prosthetics has sure come a long way.”
     “Pross-what-ics?”
     “You know, artificial—”
     “Oh yeah, like in books. Wooden legs, hooks and stuff.”
     How’d he ever get a job? “Yeah, prosthetics. Like this thing on the end of my stump.”
     “Look, sir.” He set down the clipboard he’d been scribbling on. “You’ve been away a long time (a couple of hundred years, due to relativity). That’s gonna be a leg, just like the other leg except it can’t break.
     “They do it with arms, too?”
     “Sure, any limb.” He went back to his writing. “Livers, kidneys, stomachs, all kinds of things. Still working on hearts and lungs, have to use mechanical substitutes.

     The guy wasn’t kidding about the pain. And it wasn’t just the new leg, though that hurt like boiling oil. For the new tissues to “take,” they’d had to subvert my body’s resistance to alien cells; cancer broke out in a half-dozen places and had to be treated separately, painfully.
     I was feeling pretty used up, but it was still kind of fascinating to watch the leg grow. White threads turned into blood vessels and nerves, first hanging a little slack, then moving into place as the musculature grew up around the metal bone.
     I got used to seeing it grow, so the sight never repelled me. But when Marygay came to visit, it was a jolt—she was ambulatory before the skin on her new arm had started to grow; looked like a walking anatomy demonstration. I got over the shock, though, and she eventually came in for a few hours every day to play games or trade gossip or just sit and read, her arm slowly growing inside the plastic cast.
     I’d had skin for a week before they uncased the new leg and trundled the machine away. It was ugly as hell, hairless and dead white, stiff as a metal rod. But it worked, after a fashion. I could stand up and shuffle along.
     They transferred me to orthopedics, for “range and motion repatterning”—a fancy name for slow torture. They strap you into a machine that bends both the old and new legs simultaneously. The new one resists.

From THE FOREVER WAR by Joe Haldeman (1975)
BIOGEL

      Shed Garvey, the medical tech, was hunched over his lab table, debriding the stump of Cameron Paj’s left arm, when Holden walked in. A month earlier, Paj had gotten his elbow pinned by a thirty-ton block of ice moving at five millimeters a second. It wasn’t an uncommon injury among people with the dangerous job of cutting and moving zero-g icebergs, and Paj was taking the whole thing with the fatalism of a professional. Holden leaned over Shed’s shoulder to watch as the tech plucked one of the medical maggots out of dead tissue (do not Google this unless you have a strong stomach. The same goes for Googling "debriding").
     "What’s the word? " Holden asked.
     "It's looking pretty good, sir," Paj said. “I've still got a few nerves. Shed’s been tellin' me about how the prosthetic is gonna hook up to it.”
     “Assuming we can keep the necrosis under control,” the medic said, “and make sure Paj doesn't heal up too much before we get to Ceres. I checked the policy, and Paj here’s been signed on long enough to get one with force feedback, pressure and temperature sensors, fine-motor software. The whole package. It'll be almost as good as the real thing. The inner planets have a new biogel that regrows the limb, but that isn’t covered in our medical plan.
     "F**k the Inners, and f**k their magic Jell-O. I'd rather have a good Belter-built fake than anything those bastards grow in a lab. Just wearing their fancy arm probably turns you into an a**hole,” Paj said. Then he added "Oh, uh, no offense, XO.”
     “ None taken. Just glad we're going to get you fixed up, " Holden said.

     “Tell him the other bit,” Paj said with a wicked grin. Shed blushed.
     “I've, ah, heard from other guys who’ve gotten them," Shed said, not meeting Holden’s eyes. "Apparently there’s a period while you're still building identification with the prosthetic when ******** *** feels just like ******* * *******.”
     Holden let the comment hang in the air for a second while Shed’s ears turned crimson.
     “Good to know,” Holden said. “And the necrosis?”
     "There's some infection. " Shed said. “The maggots are keeping it under control, and the inflammation’s actually a good thing in this context, so we're not fighting too hard unless it starts to spread.”

     “Is he going to be ready for the next run?” Holden asked.
     For the first time, Paj frowned.
     “S**t yes, I’ll be ready. l’m always ready. This is what I do, sir."
     “Probably,” Shed said. Depending on how the bond takes. If not this one, the one after. "
     "F**k that," Paj said. “I can buck ice one-handed better than half the skags you've got on this b**h."
     “Again,” Holden said, suppressing a grin, "good to know. Carry on.”

From LEVIATHAN WAKES by James S. A. Corey (2011)
ATLOTL/GIBIRIL REGIMEN

      At the I-A medical center, the oval crechepod containing Orne's flesh dangled from ceiling hooks in a private room.
     There were humming sounds in the dim, watery green of the room, and rhythmic chuggings, sighings, clackings. Occasionally, a door opened quietly and a white-clad figure would enter, check the graph tapes on the crechepod's instruments, examine the vital connections, then depart.
     In the medical euphemism, Orne was lingering.

     He became a major conversation piece at the interns' rest breaks: 'That agent who was hurt on Sheleb, he's still with us.'
     'Man, they must build those guys different from the rest of us!'
     '... Yeah. I heard he only has about one-eighth of his insides — liver, kidneys, stomach, all gone … Lay you odds he doesn't last out the month … Look at what old sure-thing Tavish wants to bet on!'

     On the morning of his eighty-eighth day in the crechepod, the day nurse entered Orne's room for her first routine check.
     She lifted the inspection hood, looked down at him. The day nurse was a tall, lean-faced professional who had learned to meet miracles and failures with equal lack of expression. She was just here to observe.
     The daily routine with the dying (or already dead) I-A operative had lulled her into a state of psychological unpreparedness for anything but closing out the records.
     Any day now, poor guy, she thought.
     Orne opened his only remaining eye and she gasped as he said in a low whisper: 'Did they clobber those dames on Sheleb?'
     'Yes, sir!' the day nurse blurted. 'They really did, sir!'
     'Another damn mess,' Orne said. He closed his eye. His breathing-simulation deepened and heart-demand increased.
     The nurse rang frantically for the doctors.

     Orne began to show small but steady signs of recovery. Within a month, the medics ventured an intestinal transplant which increased his response rate. Two months later, they placed him on an atlotl/gibiril regimen, forcing the energy transfer which allowed him to regrow his lost fingers and eye, restore his scalp line and erase the other internal-external damage.
     Fourteen months, eleven days, five hours and two minutes after he had been picked up on Sheleb 'as good as dead', Orne walked out of the hospital on his own two legs, accompanied by an oddly silent Umbo Stetson.
     Orne paused on the steps above the pad, breathed deeply of the chill air. 'Beautiful day,' he said. His new kneecap felt strange, a better fit than the old one. He was acutely conscious of all his new parts and the regrowth syndrome which made all crechepod graduates share the unjoke label of 'twice-born'.

From THE GOD MAKERS by Frank Herbert (1972)
REGROWTH TANKS

      So I lay there in the tank and craned my neck to see how the foot was growing. The regenerator fluid is thick, yellowish, and murky, but I could see I'd already sprouted a neat bunch of tarsal bones, coated with a misty jelly where the flesh was starting to creep back over them. The fluid filled my mouth and nostrils and lungs, which no doubt were healing at a good rate. The only real quarrel I've got with this death-and-regeneration business is that it's boring: even for fiddling little injuries the process can take hours. Once I was cut not so neatly in half by a riot-gun and spent five whole days growing a new me, from the belly down, like some stupid flatworm. Learning to die and live again is a necessary thing, though. Like they told us on the induction course, deep down in all our genes we've got this locked-in program that shrieks survival when death's about, and shrieks it so loud that you can't hear your other thoughts. Only way to stop that and get efficient is to get used to dying … and then, maybe, you can start thinking about promotion.
     That one had been my forty-sixth death. I reckoned I was used to it.
     They let me out of the sickbay in the end, after all the usual unpleasantness (lying there in the tank is dreamy and nice if you can turn off your brain awhile, but being disconnected isn't so good). I marched off on my own two tender feet — the treatment leaves you uncalloused, like a baby — feeling ready to rush that laser again and this time smear the crew good and proper. I'd been in some of those bunkers myself, of course. Sooner or later the crew always get smeared.

     "Extraordinary," Ngabe muttered as he worked me over. "I very rarely have the opportunity to study patients resuscitated by tissue regeneration ... the technique is used only sparingly in my country, we have such problems of birthrate, alas … Yes, I feel I could have predicted the characteristic complexion, the atypical callousing … Of course this mole can have no malignant tendencies?"
     "No. None. We don't talk about that much," I mumbled. That was one of the risks, you get a few rogue cells multiplying and, well, it had happened to my big-mouthed drinking buddy Hoare in the tank next to mine once. Hard to forget waking up from a night of regrowth, turning your head to say "Hi there" and finding something man-sized but quite shapeless in the tank next door. The thing had been still alive, they said. I don't know what they did with it.

     The third time was the worst, but it was a familiar sort of worst. The jointed arms of the tank machinery whipped a plastic film around my head; the needle went into my arm to "partly de-inhibit the coughing reflex" (Mk III Regeneration Module: Subjects' Manual, p. 64). Air hissed into the bubble and the tank waited patiently while I coughed my lungs out and the bubble's outlet tube sucked away the gobs of yellow nastiness I spewed through mouth and nostrils. Starting to breathe again just isn't a nice business: it took something like an hour for me to settle down and live in the ordinary way, chest hurting like hell. Through the plastic bubble I could see, in a distorted fishbowl view, that the rest of me was safely there as I remembered it.

     A week in the tank was big bad medicine. I'd only known one guy stay in longer, and he could never think straight afterward. But physically, I guessed, we'd been smashed up more than he had — perhaps we'd been in longer than a week, two weeks, three weeks? It was too late to ask how much of a rebuild job either of us was now, how much nonessential muscle and bone had been shoveled into disposal drums back at Tunnel — like the whiskery old Force gag about how to lose ten pounds of unsightly fat. The fluid was a kind of liquid flesh matrix, it said in the manual, and it could replace one hell of a lot.

From THE SPACE EATER by David Langford (1982)

Plague

DEAD LIGHTS 4

PROCEDURES IN THE EVENT OF IRREVERSIBLE CONTAMINATION

In the event of irreversible contamination by biological or nanotechnological plagues, and standard quarantine responses are deemed insufficient, either (a) as declared by consensus of the Flight Commander, Environmental Systems Engineer, and Flight Surgeon, or (b) as imposed by order of a duly authorized representative of the Emergency Management Authority, the following actions are to be undertaken:

  1. The Flight Commander is authorized to maintain order aboard by any means necessary, including the use of lethal force in such circumstances where it would not otherwise be permissible.
  2. All airlocks and spacetight doors providing sophont access to the exterior of the vessel are to be placed in the closed and sealed state; their local control systems rendered inert by null-flashing; and secured in the sealed state by welding or other permanent closure.
  3. All other apertures, of whatever purpose, providing access to the exterior of the vessel are to be placed in the closed and sealed state; their local control systems rendered inert by null-flashing; and secured in the sealed state by welding or other permanent closure. This is to include all apertures used for the jettisoning of waste, and all radiator systems in which coolant is exposed directly to space, without exception.
  4. The Flight Commander shall designate the most appropriate compartment within the vessel for the temporary storage of such waste material as can no longer be jettisoned and for known-contaminated material that cannot be properly disposed of, including corpses.
  5. Once a stable orbit which does not take the vessel into the local forbidden zone of planets, moons, habitats, or other bodies (see Quarantine) has been established, the flight control systems of the vessel, including local drive controllers, are to be shut down and rendered inert by null-flashing.
  6. All running lights of the vessel are to be configured to display the “death ship” pattern, as prescribed by the Imperial Navigation Act: a 2p period of yellow-quarantine alternating with a 1p period of crimson-caution.
  7. An EM beacon is to be configured on the local-distress channel, broadcasting the following repeating message: ALERT CASE ICHOR I SAY AGAIN ALERT CASE ICHOR. VESSEL [registered name] IS UNDER SEQUESTRATION. DO NOT APPROACH UNDER ANY CIRCUMSTANCES. IGNORE ALL CONTRADICTORY TRANSMISSIONS. MESSAGE REPEATS.
  8. If the vessel possesses a point-defense system, this system is to be configured to fire upon any other vessel attempting to dock with or otherwise close to within the forbidden quarantine zone (see Quarantine) of the irreversibly contaminated vessel, other than a vessel whose transponder is signed with the Emergency Management Authority private key.
  9. At the Flight Commander’s discretion, euthanatoics may be issued to passengers and crew.

UNDER NO CIRCUMSTANCES IS A VESSEL MARKED BY THE PREVIOUSLY SPECIFIED SIGNALS TO BE APPROACHED BY ANY OTHER VESSEL OTHER THAN IN RESPECT OF SPECIFIC ORDERS ISSUED BY THE EMERGENCY MANAGEMENT AUTHORITY.

Any vessel which

  • docks with; or
  • takes aboard passengers, cargo, flotsam, jetsam, or debris from; or
  • enters any emissions plume, from any source whatsoever, of;

an irreversibly contaminated vessel shall itself be deemed irreversible contaminated, and all the foregoing procedures and warnings shall apply to it in like wise.

IN THE ABSENCE OF SPECIFIC ORDERS ISSUED BY THE EMERGENCY MANAGEMENT AUTHORITY, ANY IRREVERSIBLY CONTAMINATED VESSEL SHALL BECOME SUBJECT TO ARBITRARY DESTRUCTION BY LOCAL AUTHORITIES NO FEWER THAN 72 HOURS POST-DETECTION, PROVIDED THAT SAID LOCAL AUTHORITIES COMMAND MEANS TO DO SO IN ACCORDANCE WITH THE CAUTERY PROTOCOL, LATEST ISSUED REVISION, ENSURING THE SAFE DISPOSAL AND NON-DISPERSAL OF CONTAMINANTS.

DEAD LIGHTS 3

"You touched him?" At the other's nod he added an order. "Stay in your quarters until I have a chance to look you over—understand?"

Dane had no chance to answer, the Medic was already on his way. He went to his own cabin, understanding the reason for his imprisonment, but inwardly rebelling against it. Rather than sit idle he snapped on the reader—but, although facts and figures were dunned into his ears—he really heard very little. He couldn't apply himself—not with a new specter leering at him from the bulkhead.

The dangers of the space lanes were not to be numbered, death walked among the stars a familiar companion of all spacemen. And to the Free Trader it was the extra and invisible crewman on every ship that raised. But there were deaths and deaths—And Dane could not forget the gruesome legends Van Rycke collected avidly as his hobby—had recorded in his private library of the folk lore of space.

Stories such as that of the ghostly New Hope carrying refugees from the first Martian Rebellion—the ship which had lifted for the stars but had never arrived, which wandered for a timeless eternity, a derelict in free fall, its port closed but the warning dead lights on at its nose—a ship which through five centuries had been sighted only by a spacer in similar distress. Such stories were numerous. There were other tales of "plague" ships wandering free with their dead crews, or discovered and shot into some sun by a patrol cruiser so that they might not carry their infection farther. Plague—the nebulous "worst" the Traders had to face. Dane screwed his eyes shut, tried to concentrate upon the droning voice in his ears, but he could not control his thoughts nor—his fears.

At a touch on his arm he started so wildly that he jerked the cord loose from the reader and sat up, somewhat shamefaced, to greet Tau. At the Medic's orders he stripped for one of the most complete examinations he had ever undergone outside a quarantine port. It included an almost microscopic inspection of the skin on his neck and shoulders, but when Tau had done he gave a sigh of relief.

"Well, you haven't got it—at least you don't show any signs yet," he amended his first statement almost before the words were out of his mouth.


He glanced over the board before he brought his hand down on a single key set a distance apart from the other controls. "Put some local color into it," was his comment.

Dane understood. Rip had turned on the distress signal at the Queen's nose. When she set down on the Stat field she would be flaming a banner of trouble. Next to the wan dead lights, set only when a ship had no hope of ever reaching port at all, that signal was one every spacer dreaded having to flash. But it was not the dead lights—not yet for the Queen.

From PLAGUE SHIP by Andre Norton (1956)
DEAD LIGHTS 1

It was the first time she had decided to cash in on her own tip and she was there—that was all. Maybe that point weighed with Cliff, maybe he just didn’t care. Anyway the three were together when they sighted the Empress riding, her dead-lights gleaming, a ghost ship in night space.

She must have been an eerie sight because her other lights were on too, in addition to the red warnings at her nose. She seemed alive, a Flying Dutchman of space.

From ALL CATS ARE GRAY by Andre Norton (1953)
DEAD LIGHTS 2

But Van Rycke was not just a machine of facts and figures, he was also a superb raconteur, a collector of legends who could keep the whole mess spellbound as he spun one of his tales. No one but he could pay such perfect tribute to the small details of the eerie story of the New Hope, the ship which had blasted off with refugees from the Martian rebellion, never to be sighted until a century later — the New Hope wandering forever in free fall, its dead lights glowing evilly red at its nose, its escape ports ominously sealed — the New Hope never boarded, never salvaged because it was only sighted by ships which were themselves in dire trouble, so that "to sight the New Hope" had become a synonym for the worst of luck.

Then there were the "Whisperers", whose siren voices were heard by those men who had been too long in space, and about whom a whole mythology had developed. Van Rycke could list the human demi-gods of the star lanes, too. Sanford Jones, the first man who had dared Galactic flight, whose lost ship had suddenly flashed out of Hyperspace, over a Sirius world three centuries after it had lifted from Terra, the mummified body of the pilot still at the frozen controls, Sanford Jones who now welcomed on board that misty "Comet" all spacemen who died with their magnetic boots on. Yes, in his way, Van Rycke made his new assistant free of more than one kind of space knowledge.

From SARGASSO OF SPACE by Andre Norton (1955)
HOCK-LOCK

      Until he was close to fifty planet years old, he was prime assessor to the Veep Estampha, a sector boss of the Thieves' Guild. My father never tried to hide this association; in fact it was a matter of pride to him. Since he seemed to have an inborn talent, which he fostered by constant study, for the valuing of unusual loot, he was a valuable man, ranking well above the general core of that illegal combine. However, he appeared to have lacked ambition to climb higher, or else he simply had an astute desire to remain alive and not a target of the ambition of others.
     Then Estampha met a rootless Borer plant, which someone with ambition secreted in his private collection of exotic blooms, and came to an abrupt finish. My father withdrew prudently and at once from the resulting scramble for power. Instead he bought out of the Guild and migrated to Angkor.
     For a while, I believe, he lived very quietly. But during that period he was studying both the planet and the openings for a lucrative business. It was a sparsely settled world on the pioneer level, not one which at that time attracted the attention of those with wealth, nor of the Guild. But perhaps my father had already heard rumors of what was to come.
     Within a space of time he paid court to a native woman whose father operated a small hock-lock for pawning, as well as a trading post, near the only space port. Shortly after his marriage the father-in-law died of an off-world fever, a plague ship having made a crash landing before it could be warned off. The fever also decimated most of the port authorities. But Hywel Jern and his wife proved immune and carried on some of the official duties at this time, which entrenched them firmly when the plague had run its course and the government was restored.
     Then, some five years later, the Vultorian star cluster was brought into cross-stellar trade by the Fortuna Combine, and Angkor suddenly came to life as a shipping port of exchange. My father's business prospered, though he did not expand the original hock-lock.

From THE ZERO STONE by Andre Norton (1968)

Quarantine

As long as there have existed naval vessels and bubonic plague, there has been a fear that arriving ships might bring a cargo of the Black Death.

When the plague ravaged 14th century Europe, the city state of Venice decreed that arriving ships had to anchor away from the city for 40 days before they could unload passengers or cargo. 40 days was considered long enough so that infected people aboard would either have blatantly obvious symptoms or be dead. The Italian term quaranti giorni means '40 days'. The term evolved into the word "Quarantine".

Within our solar system currently there does not seem to be any extraterrestrial life, and thus no extraterrestrial plagues. The operative word is seem. Under the Extra-Terrestrial Exposure Law NASA quarantined the astronauts from Apollo 11 through 14 for twenty-one days, just in case they brought back the Andromeda Strain or something. NASA stopped bothering after Apollo 14 since no space germ was ever found.

  • Terrestrial disease germs might become mutated into virulent new strains by the high-radiation space environment
  • There is a chance that life can be found in such places as the oceans of Europa and other icy moons
  • If your science fiction universe has faster-than-light starships capable of traveling to life-bearing extrasolar planets, all bets are off.

Space station and space port medical officers must be vigilant to detect signs of pandemic diseases in incoming passengers or crew, such patients must be immediately quarantined. A quarantine facility will need to be hermetically sealed, with the only available access through decontamination airlocks.

You will also need a quarantine if the space station contains a laboratory working on dangerous technology. Things like civilization-destroying biowarfare plagues or planet-eating nanotechnology.

THE RING OF CHARON

Gerald was an exobiologist, a student of life off the planet Earth. The flaw, of course, was that there wasn’t any life beyond Earth. Except, of course, such Earth-evolved life that continued to evolve even off planet. Every human being, every plant, every animal brought along to the Settlements carried microscopic life-forms by the billions.

Anywhere humans went, viruses, bacteria, and other microbes, disease-causing and benign, traveled as well. Normal medical practice was enough to keep most of the nasties at bay inside the sealed colonies—but some microbes escaped the domes, tunnels, ships and habitats to the outside environments. Virtually all of them died the moment they left the controlled environment. But a few survived. And of those survivors, a very few managed to reproduce, and evolve, often at a ferocious rate.

Earth-derived microbes lurked in the soil around Martian cities, living off dome leakages of air, moisture and organics; lived inside the rock of mining asteroids, dining on a witches’ brew diet of complex hydrocarbons; lived as mildew-like patches in airlocks all over the Solar System, absorbing air, moisture and bits of organic matter whenever the locks were pressurized, encysting when they went into vacuum.


A divine hand that worked in mysterious and sometimes horrifying ways. For a few, a terrifying few, of the outsider organisms came back inside the domes and the spacecraft. Most such Returnees were wiped out by the drastically different environment, but some readapted to life back inside. That was when terror struck. Hardened by their generations outside air, light and pressure, some Returnee organisms bred hellaciously back inside, carrying in their genes the ability to digest unlikely things. Plastics, metal, resin compounds, semiorganic superconductors. And some of them, ancestors of disease organisms, retained the ability to infect the human body.

There were microorganisms that could cause disease in humans and also eat through pressure suits and air domes from the inside. Or dissolve the superconducting wires of power grids. Or jam valves in fusion systems.

From THE RING OF CHARON by Roger MacBride Allen (1990)
WHY BACTERIA 'SHAPESHIFT' IN SPACE

Bacterial cells treated with a common antibiotic in the near-weightlessness of the International Space Station (ISS) responded with some clever shapeshifting that likely helped them survive, findings with implications for both astronauts and people on Earth.

Researchers from CU Boulder’s BioServe Space Technologies designed an experiment to culture the common E. coli bacteria on ISS and treat it with several different concentrations of the antibiotic gentamicin sulfate, a drug that kills them on Earth. The response of the cultured bacteria included a 13-fold increase in cell numbers and a 73 percent reduction in cell volume size compared to an Earth control group, said BioServe Research Associate Luis Zea, lead study author.

“We knew bacteria behave differently in space and that it takes higher concentrations of antibiotics to kill them,” said Zea. “What’s new is that we conducted a systematic analysis of the changing physical appearance of the bacteria during the experiments.”

A paper on the subject was published in Frontiers in Microbiology. CU Boulder co-authors included BioServe Director Louis Stodieck, aerospace engineering sciences Professor David Klaus and former graduate student Frederico Estante.

Because there are no gravity-driven forces in space like buoyancy and sedimentation, the only way the ISS bacteria can ingest nutrients or drugs is through natural diffusion, said Zea. The large decrease of the bacteria cell surface in space also decreases the rate of molecule-cell interaction, which may have implications for more effectively treating astronauts with bacterial infections in space.

The new study also showed the bacterial cell envelope—essentially its cell wall and outer membrane—became thicker, likely protecting the bacteria even more from the antibiotic, said Zea. The E. coli bacteria grown in space also tended to form in clumps, perhaps a defensive maneuver of sorts that may involve a shell of outer cells protecting the inner cells from antibiotics, said Zea.

In addition, some of the E. coli cells also produced outer membrane vesicles—small capsules that form outside the cell walls and act as messengers for cells to communicate with each other, Zea said. When cells with such vesicles reach a critical mass they can sync up to initiate the infection process.

“Both the increase in cell envelope thickness and in the outer membrane vesicles may be indicative of drug resistance mechanisms being activated in the spaceflight samples,” said Zea. “And this experiment and others like it give us the opportunity to better understand how bacteria become resistant to antibiotics here on Earth.”

The BioServe experiment was launched to ISS in 2014 on a commercial Orbital Sciences Cygnus spacecraft. Astronauts manually initiated and ended the experiments on ISS using BioServe-built hardware—including high-tech incubators and test tubes—over the course of two days. The experiment was returned to Earth for analysis on a commercial SpaceX Dragon spacecraft several months later.

“The low gravity of space provides a unique test bed for developing new techniques, products and processes that can benefit not only astronauts, but also people on Earth,” said Stodieck, a research professor in the Ann and H.J. Smead Aerospace Engineering Sciences. “In space, for example, scientists can learn more about biochemical changes in various cells and organisms that the force of gravity on Earth may be masking.”

The clumping of E. coli bacterial cells may be related to biofilm formation—multicellular communities held together by a self-produced matrix. Examples of biofilms on Earth include the scum on vinyl shower curtains, dental plaque and even collections of bacteria that can adhere to silicon in medical devices like catheters. Biofilms also can form on various surfaces of space vehicles, said Zea, making them a potential health threat to space travelers.

Other study co-authors were from University of Copenhagen in Denmark, the German Aerospace Center in Cologne, Germany and Pontifical Catholic University of Rio Grande du Sol in Porto Alegre, Brazil.

GARDEN WORLDS, PARK WORLDS

In the old days, interstellar colonization was pretty simple and straightforward (once you had a starship handy). Heinlein, naturally, provided the real estate pitch:

"Imagine a place like Earth, but sweeter than Terra ever was … forests aching to be cut, game that practically jumps into the stew pot. If you don't like settlements, you move on until you've got no neighbors, poke a seed in the ground, then jump back before it sprouts. No obnoxious insects. Practically no terrestrial diseases and no native diseases that like the flavor of our breed." (Starman Jones, Ballantine pback, p. 68.)

The good news is that the local tigers and local germs won't find us tasty and nutritious. But by the same token we can't eat the local venison or berries, and chances are only slightly better that our cattle can graze on the grass. Plants have a far less demanding diet, and might well grow nicely in any soil that has nitrogen fixed in it. In fact they might grow too well, at least the ones that don't rely on bees or other terrestrial creatures as their dating service.

Terrestrial plants, devoid of natural enemies, might crowd the native stuff out of any remotely suitable environment – wrecking entire ecosystems. But this too could go both ways. To local para-algae we could be walking Petri dishes: warm, moist, and fertile. Our bodies' defenses, if any, are likely to take the form of allergic reactions, not terribly helpful to us.


Daniel:

" To local para-algae we could be walking Petri dishes: warm, moist, and fertile. Our bodies' defenses, if any, are likely to take the form of allergic reactions, not terribly helpful to us."

I find this to be a highly questionable assertion. Without even going into far afield things like amino acid chirality, most earth-born bacteria and virii do a poor job jumping across species. It can't recall the last time I caught a cold from a tree. :)

But beyond that I think you vastly underestimate the sheer hostility of the environment that is the human body. While you may be right about our response being an allergic reaction, our bodies aren't the only factor. Those foreign bacteria will be trying to compete with the fauna you already carry around with you. Fauna that has been selected for ruthless survival in that environment over uncountable generations.

Think like this — a gang wants to move into the city to do their business. You are talking about how they would do against the cops, but completely ignoring the fact that Don Corleone is going to have some very pointed ideas about them moving in on his territory.

From GARDEN WORLDS, PARK WORLDS by Rick Robinson (2009)
TROPE-A-DAY: NO BIOCHEMICAL BARRIERS

No Biochemical Barriers: Averted, mostly.


Cross-Species Diseases: Uncommon, since for one thing, viruses just won’t work, and parasites often need to interact enough with their hosts’ biology to not work either. Bacteria — well, they’re more often a problem since the environment can offer enough of the right stuff to let them grow, the resilient and resourceful little buggers that they are, even if it’s not exactly the same disease when it happens to a different host, and immune responses can vary. (They tend to be much more of an ecological problem than a medical one, which is why they sterilize you — no, not like that — when you go offworld.) And allergen issues are downright common.

But anything cross-species that’s effective, similar, and contagious… that’s bioweapon/nanoweapon sign.

So, where does our Navy Space Force operate? Obviously, in orbital space, of course. This is the perfect place to operate using Patrol Rockets and smaller craft to zip to and fro. It is also where Espatiers get the most use — boarding inspections, SAR, and the classic orbital drop on a planet. But that's just the tip of the iceteroid — what about enforcement of quarantine? This could be an even bigger deal than it is today, since the enclosed system of a space station or rocket pretty much insures that if I got it, you got it.

(ed note: The legendary Gharlane of Eddore had some recommendations for a lab trying to analyze and reverse-engineer captured alien technology)

Since you're dealing with an unknown technology, and artifacts/lifeforms potentially engineered for purposes you're not aware of, you'd have to be REAL danged careful how you handled them. A special-purpose handling lab with a gigaton-nuke auto-destruct and remote-control handling gear would seem to be a minimal safe procedure, and you'd also have to dope out some way of picking up the pieces with no risk, and preferably no physical contact with your own ships and artifacts. Remote-control handling ships that scoop up parts, deliver them to the analysis lab, and then dive into the nearest sun, might be a good approach.

GHARLANE OF EDDORE aka David G. Potter
SHIP PLAGUE

(ed note: The good ship Rolling Stone is en route to Mars with captain Roger Stone commanding and his wife Dr. Edith Stone as the doctor. The rest of the crew is Roger's canny mother, and the four children. They are following a larger spacecraft named War God.)

     The call was taken by Meade. She hurried aft to the hold where her father was helping the twins spray enamel on reconditioned bicycles. 'Daddy, you're wanted on the phone? War God, master to master — official.'
     'Coming.' He hurried forward and took the call. 'Rolling Stone, Captain Stone speaking.'
     'War God, commanding officer speaking. Captain, can you —'
     'Just a moment. This does not sound like Captain Vandenbergh.'
     'It isn't. This is Rowley, Second Officer. I —'
     'I understand that your captain wanted me, officially. Let me speak with him.'
     'I'm trying to explain, Captain.' The officer sounded strained and irritable. 'I am the commanding officer. Both Captain Vandenbergh and Mr O'Flynn are on the binnacle list.'
     'Eh? Sorry. Nothing serious, I hope?'
     'I'm afraid it is, sir. Thirty-seven cases on the sick list this morning — and four deaths.'
     'Great Scott, man! What is it?'
     'I don't know, sir.'
     'Well, what does your medical officer say it is?'
     'That's it, sir. The Surgeon died during the midwatch.'
     'Oh—'
     'Captain, can you possibly match with us? Do you have enough maneuvering margin?'
     'What? Why?'
     'You have a medical officer aboard. Haven't you?'
     'Huh? But she's my wife!'
     'She's an M.D., is she not?'
     Roger Stone remained silent for a long moment. Then he said, 'I'll call you back shortly, sir.'

     It was a top level conference, limited to Captain Stone, Dr Stone, and Hazel. First, Dr Stone insisted on calling the War God and getting a full report on symptoms and progress of the disease. When she switched off her husband said, 'Well, Edith, what is it?'
     'I don't know. I'll have to see it.'
     'Now, see here, I'm not going to have you risking —'
     'I'm a doctor, Roger.'
     'You're not in practice, not now. And you are the mother of a family. It's quite out of the ques—'
     'I am a doctor, Roger.'
     He sighed heavily. 'Yes, dear.'
     'The only thing to be determined is whether or not you can match in with the War God. Have you two reached an answer?'
     'We'll start computing.'
     'I'm going aft and check over my supplies.' She frowned. 'I didn't expect to have to cope with an epidemic.'

     When she was gone Roger turned his face, twisted with indecision, to Hazel. 'What do you think, Mother?'
     'Son, you don't stand a chance. She takes her oath seriously. You've known that a long time.'
     'I haven't taken the Hippocratic oath! If I won't move the ship, there's nothing she can do about it.'
     'You're not a doctor, true. But you're a master in space. I guess the "succour & rescue" rule might apply.'
     'The devil with rules! This is Edith.'
     Well,' Hazel said slowly, 'I guess I might stack the Stone family up against the welfare of the entire human race in a pinch, myself. But I can't decide it for you.'
     'I won't let her do it! It's not me. There's Buster — he's no more than a baby still; he needs his mother.'
     'Yes, he does.'
     'That settles it. I'm going aft and tell her.'
     'Wait a minute! If that's your decision, Captain, you won't mind me saying that's the wrong way to do it.'
     'Eh?'
     'The only way you'll get it past your wife is to get on that computer and come out with the answer you're looking for... an answer that says it's physically impossible for us to match with them and still reach Mars.'
     'Oh. You're right. Look, will you help me fake it?'
     'I suppose so.'
     'Then let's get busy.'
     'As you say, sir. You know, Roger, if the War God comes in with an unidentified and uncontrolled disease aboard, they'll never let her make port at Mars. They'll swing her in a parking orbit, fuel her up again, and send her back at next optimum.'
     'What of it? It's nothing to me if fat tourists and a bunch of immigrants are disappointed.'
     'Check. But I was thinking of something else. With Van and the first officer sick, maybe about to check in, if the second officer comes down with it, too, the War God might not even get as far as a parking orbit.'

     Roger Stone did not have to have the thought elaborated; a ship approaching a planet, unless manoeuvred at the last by a skilled pilot, can do one of only two things — crash, or swing on past and out endlessly into empty space to take up a comet-like orbit which arrives nowhere ever.

     He covered his face with his hands. 'What do I do, Mother?'
     'You are captain, son.'
     He sighed. 'I suppose I knew it all along.'
     'Yes, but you had to struggle with it first.' She kissed him. 'Orders, son?'
     'Let's get to it. It's a good thing we didn't waste any margin in departure.'
     'That it is.'

     Eleven hours from blast time the Rolling Stone hung in space close by the War God. The ships were still plunging toward Mars at some sixteen miles per second; relative to each other they were stationary — except that the liner continued her stately rotation, end over end. Dr Stone, her small figure encumbered not only with space suit, pressure bottles, radio, suit jet, and life lines, but also with a Santa Claus pack of surgical supplies, stood with her husband on the side of the Stone nearest the liner. Not knowing exactly what she might need she had taken all that she believed could be spared from the stock of their own craft — drugs, antibiotics, instruments, supplies.
     The others had been kissed good-by inside and told to stay there. Lowell had cried and tried to keep his mother from entering the lock. He had not been told what was going on, but the emotions of the others were contagious.
     Roger Stone was saying anxiously, 'Now see here, the minute you have this under control, back you come — you hear?'
     She shook her head. 'I'll see you on Mars, dearest.'
     'No indeed! You —'
     'No, Roger. I might act as a carrier. We can't risk it.'
     'You might act as a carrier corning back to us on Mars, too. Don't you ever expect to come back?'
     She ignored the rhetorical question. 'On Mars there will be hospitals. But I can't risk a family epidemic in space.'
     'Edith I've a good mind to refuse to—'
     'They're ready for me, dear. See?'

     Over their heads, two hundred yards away, a passenger lock on the rotation axis of the mighty ship had opened; two small figures spilled silently out, flipped neatly to boot contact, stood on the ship's side, their heads pointing 'down' at Mr and Mrs Stone. Roger Stone called into his microphone, 'War God!'
     'War God aye aye!'
     'Are you ready?'
     'Whenever you are.'
     'Stand by for transfer.'
     Acting Captain Rowley had proposed sending a man over to conduct Dr. Stone across the gap. She had refused, not wishing to have anyone from the infected ship in contact with the Rolling Stone.

     'She thinks she's on the track of something. So far as she can tell from their medical records, nobody has caught it so far who is known to have had measles.'
     Meade said, 'Measles? People don't die of that, do they?'
     'Hardly ever,' agreed her grandmother, 'though it can be fairly serious in an adult.'
     'I didn't say it was measles,' her father answered testily, 'nor did your mother. She thinks it's related to measles, a mutant strain maybe more virulent.'
     'Call it "neomeasles",' suggested Hazel. 'That's a good question-begging tag and it has an impressive scientific sound to it Any more deaths, Roger?'
     'Well, yes.'
     'How many?'
     'She wouldn't say. Van is still alive, though, and she says that he is recovering. She told me,' he added, as if trying to convince himself, 'that she thought she was learning how to treat it.'

     Hazel deliberately waited around for the phone call the next day, determined to get a few words at least with her daughter-in-law. The call came in about the usual time; Roger took it. It was not his wife.
     'Captain Stone? Turner, sir Charlie Turner. I'm the third engineer. Your wife asked me to phone you.'
     'What's the matter? She busy?'
     'Quite busy.'
     'Tell her to call me as soon as she's free. I'll wait by the board.'
     'I'm afraid that's no good, sir. She was quite specific that she would not be calling you today. She won't have time.'
     'Fiddlesticks! It will only take her thirty seconds. In a big ship like yours you can hook her in wherever she is.'
     The man sounded embarrassed. 'I'm sorry, sir. Dr. Stone gave strict orders not to be disturbed'
     'But confound it! I —'
     'I'm very sorry, sir. Good-by.' He left him sputtering into a dead circuit.

     Roger Stone remained quiet for several moments, then turned a stricken face to his mother. 'She's caught it.'
     Hazel answered quietly, 'Don't jump to conclusions, Son.' But in her own heart she had already reached the same conclusion. Edith Stone had contracted the disease she had gone to treat.
     The same barren stall was given Roger Stone on the following day; by the third day they gave up the pretence. Dr. Stone was ill, but her husband was not to worry. She had already, before she gave into it herself, progressed far enough in standardizing a treatment that all the new cases — hers among them — were doing nicely. So they said.
     No, they would not arrange a circuit to her bed. No, he could not talk to Captain Vandenbergh; the Captain was still too ill.
     'I'm coming over!' Roger Stone shouted.
     Turner hesitated. 'That's up to you, Captain. But if you do, we'll have to quarantine you here. Dr. Stone's written orders.'

     Roger Stone switched off. He knew that that settled it; in matters medical Edith was a Roman judge — and he could not abandon his own ship, his family, to get to Mars by themselves. One frail old woman, two cocksure half-trained student pilots — no, he had to take his ship in.

     It was seven endless, Earth-standard days later when the daily call was answered by, 'Roger — hello, darling!'
     'Edith! Are you all right?'
     'Getting that way.'
     'What's your temperature?'
     'Now, darling, I won't have you quack-doctoring me. My temperature is satistactory, as is the rest of my physical being. I've lost a little weight, but I could stand to — don't you think?'
     'No, I don't. Listen — you come home! You hear me?'
     'Roger dearest! I can't and that's settled. This entire ship is under quarantine.'


     At last they reached her (War God in its landing area on Phobos) — to find a temporary barrier of line and posts around her and signs prominently displayed: 'WARNING! — QUARANTINE — no entrance by order of Phobos Port Authority.'
     I can t read,' said Hazel.
     Roger Stone pondered it 'The rest of you stay here, or go for a walk — whatever you please. I'm going in. Mind you stay off the field proper.'

     Roger Stone promptly caught the epidemic disease and had to be nursed through it — and thereby extended the quarantine time.

From THE ROLLING STONES by Robert Heinlein (1952)

Decontamination

If your ship may be boarding people who are infected with a deadly plague, malignant alien parasites, covered in dangerous chemicals, crawling with combat nanotechnology, or dusted with radioactive fallout, you probably do not want them getting your ship or crew dirty. A special airlock leading into a decontamination chamber would be in order.

This is a specialized feature not found on all ship types. You'd expect it on hospital ships, rescue ships, exploration ships, and ships bringing emergency supplies to planetary disaster sites.

A less effective but cheaper option is to use a "suitport". This is where a special space suit attaches its backpack to a hatch on the ship, and the astronaut exist the suit through the backpack. It does reduce, for instance, the external skin of the suit from transporting abrasive lunar dust contamination into the airlock. But the contamination on the backpack still has to be dealt with. A more serious problem is the pressure difference habitat module and the space suit.

In H. Beam Piper's Uller Uprising, the atmosphere of the planet was highly toxic to humans (large amounts of fluorine and fluoride gasses). The pressurized human bases and vehicles had special airlocks, with three consecutive chambers and four doors. Only one door would open at a time, and the middle chamber was always in vacuum. The purpose was to minimize traces of the planetary atmosphere entering the pressurized base.

In the novel and movie The Andromeda Strain the doctors had to remove and burn their clothing, bathe in various chemical disinfectants, be exposed to ultraviolet rays, and have a xenon-flash unit burn the outer layer of skin and all their body hair into ash (except for the head).

The Andromeda Strain also had something akin to a suitport, but it was more like an entire body glove-box. Pressure suits had long telescoping tubes instead of backpacks.

Naturally the decontamination method depends upon the expected contaminant.

Also note that the decontamination only removes surface contamination. If the people have internal contamination (infected by plague or inhaling radioactive fallout) they will have to be put into a quarantine chamber.

In the TV show Star Trek, they use the hand-waving Transporter to remove contamination, internal and external. As their atomic structure is removed from the starting location and transported to the ship, any (known) harmful bacterial, virus, or dangerous elements are "filtered out". Which is hand-waving at best and has creepy dystopian applications at worse.

THE ANDROMEDA STRAIN

1. THERE ARE TO BE FIVE STAGES:

Stage I: Non-decontaminated, but clean. Approximates sterility of hospital operating room or NASA clean room. No time delay of entrance.

Stage II: Minimal sterilization procedures: hexachlorophene and methitol bath, not requiring total immersion. One-hour delay with clothing change.

Stage III: Moderate sterilization procedures: total-immersion bath, UV irradiation, followed by two-hour delay for preliminary testing. Afebrile infections of UR and GU tracts permitted to pass. Viral symptomatology permitted to pass.

Stage IV: Maximal sterilization procedures: total immersion in four baths of biocaine, monochlorophin, xantholysin, and prophyne with intermediate thirty-minute UV and IR irradiation. All infection hafted at this stage on basis of symptomatology or clinical signs. Routine screening of all personnel. Six-hour delay.

Stage V: Redundant sterilization procedures: no further immersions or testing, but destruct clothing x2 per day. Prophylactic antibiotics for forty-eight hours. Daily screen for superinfection, first eight days.


They began at a door, which said in plain white letters: TO LEVEL II. It was an innocuous, straightforward, almost mundane sign. Hall had expected something more — perhaps a stern guard with a machine gun, or a sentry to check passes. But there was nothing, and he noticed that no one had badges, or clearance cards of any kind.

He mentioned this to Stone. “Yes,” Stone said. “We decided against badges early on. They are easily contaminated and difficult to sterilize; usually they are plastic and high-heat sterilization melts them.”

The four men passed through the door, which clanged shut heavily and sealed with a hissing sound. It was airtight. Hall faced a tiled room, empty except for a hamper marked ‘clothing’. He unzipped his jumpsuit and dropped it into the hamper; there was a brief flash of light as it was incinerated.

Then, looking back, he saw that on the door through which he had come was a sign: “Return to Level I is NOT Possible Through this Access.”

He shrugged. The other men were already moving through the second door, marked simply EXIT. He followed them and stepped into clouds of steam. The odor was peculiar, a faint woodsy smell that he guessed was scented disinfectant. He sat down on a bench and relaxed, allowing the steam to envelop him. It was easy enough to understand the purpose of the steam room: the heat opened the pores, and the steam would be inhaled into the lungs.

The four men waited, saying little, until their bodies were coated with a sheen of moisture, and then walked into the next room.

Leavitt said to Hall, “What do you think of this?”

“It's like a goddam Roman bath,” Hall said.

The next room contained a shallow tub (“Immerse Feet ONLY”) and a shower. (“Do not swallow shower solution. Avoid undue exposure to eyes and mucous membranes.”) It was all very intimidating. He tried to guess what the solutions were by smell, but failed; the shower was slippery, though, which meant it was alkaline. He asked Leavitt about this, and Leavitt said the solution was alpha chlorophin at pH 7.7. Leavitt said that whenever possible, acidic and alkaline solutions were alternated.

“When you think about it,” Leavitt said, “we've faced up to quite a planning problem here. How to disinfect the human body — one of the dirtiest things in the known universe — without killing the person at the same time. Interesting.”

He wandered off. Dripping wet from the shower, Hall looked around for a towel but found none. He entered the next room and blowers turned on from the ceiling in a rush of hot air. From the sides of the room, UV lights clicked on, bathing the room in an intense purple light. He stood there until a buzzer sounded, and the dryers turned off. His skin tingled slightly as he entered the last room, which contained clothing. They were not jumpsuits, but rather like surgical uniforms — light-yellow, a loose-fitting top with a V-neck and short sleeves; elastic banded pants; low rubber-soled shoes, quite comfortable, like ballet slippers.


The second decontamination procedure was similar to the first. Hall's yellow clothing, though he had worn it just an hour, was incinerated.

“Isn't that rather wasteful?” he asked Burton.

Burton shrugged. “It's paper.”

“Paper? That cloth?”

Burton shook his head. “Not cloth. Paper. New process.”

They stepped into the first total-immersion pool. Instructions on the wall told Hall to keep his eyes open under water. Total immersion, he soon discovered, was guaranteed by the simple device of making the connection between the first room and the second an underwater passage. Swimming through, he felt a slight burning of his eyes, but nothing bad.

The second room contained a row of six boxes, glass-walled, looking rather like telephone booths. Hall approached one and saw a sign that said, “Enter and close both eyes. Hold arms slightly away from body and stand with feet one foot apart. Do not open eyes until buzzer sounds. BLINDNESS MAY RESULT FROM EXPOSURE TO LONG-WAVE RADIATION.”

He followed the directions and felt a kind of cold heat on his body. It lasted perhaps five minutes, and then he heard the buzzer and opened his eyes. His body was dry. He followed the others to a corridor, consisting of four showers. Walking down the corridor, he passed beneath each shower in turn. At the end, he found blowers, which dried him, and then clothing. This time the clothing was white.

They dressed, and took the elevator down to Level III.


After two hours, he rejoined the others, and proceeded to Level IV.

Four total-immersion baths, three sequences of ultraviolet and infrared light, two of ultrasonic vibrations, and then something quite astonishing at the end. A steel-walled cubicle, with a helmet on a peg. The sign said, “This is an ultraflash apparatus. To protect head and facial hair, place metal helmet securely on head, then press button below.”

Hall had never heard of ultraflash, and he followed directions, not knowing what to expect. He placed the helmet over his head, then pressed the button.

There was a single, brief, dazzling burst of white light, followed by a wave of heat that filled the cubicle. He felt a moment of pain, so swift he hardly recognized it until it was over. Cautiously, he removed the helmet and looked at his body. His skin was covered with a fine, white ash — and then he realized that the ash was his skin, or had been: the machine had burned away the outer epithelial layers. He proceeded to a shower and washed the ash off. When he finally reached the dressing room, he found green uniforms.

From THE ANDROMEDA STRAIN by Michael Crichton (1969)
ANTARES PASSAGE

“Decontamination complete, Milady!  You may step through into the next cubicle and get dressed.”

Bethany watched the last of the vile smelling decontamination fluid gurgle down the drain at her feet, and then glanced up at the overhead speaker from which the unseen operator’s voice had emanated.  As she did so, she wondered if he could see her.

“What about my clothing?” she asked, shivering slightly in the sudden cold draft of the chamber.

“Undergoing fumigation, Milady.  You will find a new shipsuit in the cubicle.”

“Thank you!”

“You are most welcome.”

Bethany pressed the control that opened the airtight door leading from the chamber to the changing cubicle beyond.  True to the operator’s word, the plastic bag into which she had sealed the clothing she had worn on Corlis was gone.  In its place was a neatly folded replacement outfit.  She dried herself, then carefully slipped into new underwear, shipsuit, and soft boots.  She brushed her hair using a brush from the tiny personal effects kit that had accompanied the clothing, and studied the result in the full length mirror that hung on the inside of the cubicle door.  Other than temporarily looking like a drowned rodent and smelling of disinfectant, she decided that she was none the worse for wear.  She slipped the packet of personal effects into a pocket of the shipsuit, opened the cubicle door, and stepped into the corridor beyond.

“Welcome aboard Terra,” a voice said from somewhere behind her.

She turned to find Captain Lord Rheinhardt Dreyer, the Sandarian cruiser’s captain, waiting for her.  The captain was a tall man, with a lean figure, close-cropped sandy hair, and eyes that were a pale blue.  He wore the undress uniform of the Royal Sandarian Navy.

“Captain Dreyer!  There was no need for you to come down to meet me.”

The Sandarian officer chuckled.  “Oh, but there was.  Captain Drake would have my ears if you were not treated properly while aboard my ship.  I’m sorry that you couldn’t have been routed directly to Discovery, but the regulations concerning decontamination after a visit to an alien biosphere are extremely stringent.

As they should be,” Bethany replied.  “I understand from Varlan that the Ryall had a number of laborers come down with unknown diseases on Corlis.  I’m no expert, but it seems to me that any microorganism that can feed off Ryall biochemistry might do as well on human.”

EARTHMAN COME HOME

(ed note: The Okie flying cities are sort of like FTL generation ships who are the migrant workers of space. The germanium monetary standard has unexpectedly crashed, so the entire blasted galaxy is suddenly broke. Amalfi, mayor of the flying city of New York, leads a boarding party into an apparently derelict flying city.)

      The boarding-squad men deployed quickly along opposite sides of the street while the technics took cover. Amalfi sidled along the near wall to where the sergeant was crouching.
     "What do you think, Anderson?"
     "I don't like it, Mr. Mayor. It stinks of mouse traps. Maybe everybody's dead and the last man didn't have the strength to turn out the light. On the other hand, just one light left burning for that reason, in the whole city?"
     "I see what you mean. Dulany, take five men down that side street where the facsimile pillar is, follow it until you're tangent to the corner of this building up ahead, and stick out a probe. Don't use more than a couple of micro-volts, or you might get burned."
     "Yessir." Dulany's squad—the man himself might best be described as a detector-detector—slipped away soundlessly, shadows among shadows.
     "That isn't all I stopped us for, Mr. Mayor," Anderson said. "There's a grounded aircab just around the corner here. It's got a dead passenger in it. I wish you'd take a look at him."
     Amalfi took the proffered torch, covered its lens with the mitten of his suit so that only a thin shred of light leaked through and played it for half a second through the cab's window. He felt his spine going rigid.
     Wherever the light touched the flesh of the hunched corpse, it—glistened

     "Communications!"
     "Yes, sir!"
     "Set up the return port for decontamination. Nobody gets back on board our town until he's been boiled alive—understand? I want the works."
     There was a brief silence. Then: "Mr. Mayor, the city manager already has that in the works."
     Amalfi grimaced wryly in the darkness. Anderson said, "Pardon me, sir, but—how did Mr. Hazleton guess?"
     "Why, that's not too hard to see, at least after the fact, sergeant. This city we're on was desperately poor. And being poor under the new money system means being low on drugs. The end result, as Mr. Hazleton saw, and I should have seen, is—plague."
     "The sons of bitches," the sergeant said bitterly. The epithet seemed intended to apply to every non-Okie in the universe.

From EARTHMAN COME HOME by James Blish (1955)

Rejuvenation

This is some science-fictional method to restore a person's youth, to remove the ravages of age. A sci-fi version of the Fountain of Youth. And you can bet your last rocket that TV Tropes has a page all about it.

This doesn't fit well here since it is more elective cosmetic surgery than it is health- or life-saving medical treatment. But it doesn't properly go in Technology and Society since it is just a high-tech form of face-lifts, which already exist and have already changed our current society. Otherwise it would go right next to Immortality.

Obviously, aging movie stars would kill for access to such technology.

And keep in mind that in fiction such treatments do not necessarily prolong a person's lifespan. They may well die at about the same age they would have ordinarily, they'll just leave a good-looking corpse. Or maybe not. In stories traditionally a person granted eternal youth will instantly have their body shrivel up to match to their chronological age upon death.

In the Greek myth, this is the bit that the goddess Eos left out of the fine print when took Tithonus as her lover, and asked Zeus to grant him eternal life. Zeus noticed she had forgotten to also ask to grant eternal youth, so he decided to be an asshat and omit it. Poor Tithonus lived forever; but grew more aged, feeble, and pained with each passing year. He begs for death as Zeus snickers in the background.


THE TRIUMPH OF CAPTAIN FUTURE by Edmond Hamilton (1940)
The insidious drug Lifewater brings back one's youthful appearance, removing wrinkles and gray hair. But once you've taken one dose, you have to have a new dose every three months or you suffer an agonizing death from accelerated aging. Users find themselves at the mercy of the drug-dealer
A GIFT FROM EARTH by Larry Niven (1968)
The human colony in the Tau Ceti system receives technology from Terra via robot Bussard Ramjet starships. The latest shipment has all sorts of goodies, including a rejuvenation virus. You dip your finger in the solution to become infected. Over the weeks to come a sort of traveling wave of young skin and muscle gradually spreads from your finger, as the virus reprogrammes your cells to be young again and reproduces. Eventually your entire body is young again.
CERBERUS: A WOLF IN THE FOLD by Jack Chalker (1982)

On the planet Cerberus, a semi-sentient nano-organism imbues colonists with a strange power. If two people fall asleep while within a few meters of each other, their electrical brain patterns swap bodies. As far as the people can tell, they woke up in the other's body. This is considered normal, and there is a gizmo that can identify who is in what body.

The aristocrats use this in a nasty fashion. They make sure they have good healthy children. Then when they feel like their current body has become too old, they forcibly switch bodies with their healthiest 20 year old offspring. They now have a fresh new body. The offspring is stuck in the decrepit old body, and is imprisoned or otherwise disposed of.

This is actually verging on immortality, since you can live forever if you have access to fresh new bodies.

JUPITER ASCENDING (2015)
In this movie, the interstellar aristocracy maintain their youthful appearance by using a youth serum. The vital ingredient is creatures living on planets whose bodies are harvested in order to produce the serum. The aristocrats have established lots of colonies of these creatures on various planets so they always have a plentiful supply. Viewers of a suspicious mind have already figured out that the creatures are human beings and one of the established colonies is Earth.

And even though it doesn't work, in fiction the hideous Elizabeth Báthory technique never gets old.

BLOOD FROM HUMAN TEENS REJUVENATES BODY AND BRAINS OF OLD MICE

Blood plasma from young people has been found to rejuvenate old mice, improving their memory, cognition, and physical activity. The method has the potential to be developed into a treatment for people, says Sakura Minami of Alkahest, the company behind the work.

Previous research has found that stitching old and young mice together has an interesting effect. While sharing a blood system works out well for the older mouse, the younger one isn’t so lucky. The young animals started to show signs of brain ageing, while the brains of the older mice started to look younger. “We see a rejuvenation effect,” says Minami.

The key to youth appears to be in the blood plasma – the liquid part of blood. Several studies have found that injecting plasma from young mice into old mice can help rejuvenate the brain and other organs, including the liver, heart, and muscle.

Could blood plasma from young people have the same benefits? To find out, Minami and her colleagues took blood samples from 18-year-olds, and injected them into 12-month-old mice. At this age, the equivalent of around age 50 for people, the mice start to show signs of ageing – they move more slowly, and perform badly on memory tests.

The mice were given twice-weekly injections of the human plasma. After three weeks of injections, they were submitted to a range of tests. The treated mice’s performance was compared to young, 3-month-old mice, as well as old mice who had not received injections.

New neurons

They found that human plasma does have the power to rejuvenate. Treated mice ran around an open space like young mice. Their memories also seemed to improve, and they were much better at remembering their way around a maze than untreated mice.

“Young human plasma improves cognition,” says Minami, who presented her findings at the Society for Neuroscience annual meeting in San Diego, California, on Monday. “Their memory was preserved.”

“It’s more or less what we would expect,” says Victoria Bolotina, at Boston University in Massachusetts. “The blood of young people must have something in it that’s important for keeping them young,” she says.

The team then examined the brains of the treated and untreated mice. They looked for clues on the birth of new neurons in the hippocampus – a process called neurogenesis, which is thought to be important for memory and learning. Sure enough, the treated mice appeared to have created more new cells in their brain. “Young human plasma treatment can increase neurogenesis,” says Minami.

Minami says she has identified some factors in young blood that might be responsible for these benefits, but that she won’t reveal what they are yet. Some of them seem to be crossing into the brain, while others may be acting remotely, elsewhere in the body, she says.

She hopes to one day translate the findings into an anti-ageing treatment for people – one that might help those who start to experience the effects of an ageing brain. “There’s anecdotal evidence that people experience benefits after blood transfusions,” she says.

The company she works for, Alkahest, has already started a trial of young blood in people with Alzheimer’s disease.

Read more: Young blood to be used in ultimate rejuvenation trial

MECHANICAL FOUNTAIN OF YOUTH

      How would you like to step into a machine, vested with strange but scientific powers, and come out vibrantly young (if you are past youth), ravishingly handsome (if you wish), and in rigorous, sparkling health?
     The well-known artist, Norman Saunders, has depicted such a machine on the cover of this issue of MARVEL—a Mechanical Fountain of Youth. Hopeful souls, before and since Ponce de Leon, have searched for such a mythical source of physical well-being. all through history. Can science one day fulfill the miracle?

     Let us assume it is some future year, and whatever age you are now, you are in need of rejuvenation by then. You enter the Youth Emportum, pay the fee (in accordance with your pocketbook, perhaps), and the Operator questions you. How young do you want to feel—about twenty-one? How handsome do you want to look—like the current matinee idol? And the best of health, of course?
     Step this way!” says the smiling Operator, guiding you into the apparatus. You are surrounded by glass and mechanical contrivances, and you try to remember if your insurance is paid up, but the Operator smiles reassuringly. He has stipulated that he will use no drugs, no knives and will cause you no pain. He steps to a panel of controls, and moves a lever slowly.

     You start as a humming sound arises and your skin tingles all over. An inductive field of electrical forces is bathing your body, penetrating inward with a soothing sensation. The innumerable cells, tiny batteries themselves, are being recharged. Old, worn-out tissue awakens to new life and activity. Flesh rejuvenates under the magic touch, becoming more surcharged with vital forces that have slowly drained out through the years. The electro-chemical peak of the body’s metabolism is once again attained. You awaken from a blissful doze some time later, feeling like a new person. One is as old as one feels, and you feel like—twenty-one!
     Now the tingling ceases. The Operator moves another lever. You experience a new sensation, that of something probing you in localized spots. You roll your eyes and notice several distinct beams of violet touching you—artificial gamma-rays of just the right intensity to penetrate flesh but not harm it. One beam impinges at the base of your brain, focused on ths pituitary gland, and corrects its secretion-rate by an infinitesimal, but very important, amount. The ionic-beam, regulating secretion by controlling acidity, next stimulates the thyroid gland, in the neck. Here your metabolism is slightly altered, toning up your whole system. Another gamma-ray centers on the adrenal glands, in the abdomen, and soon a tide of strength flows through you, as adrenalin sweeps into the blood stream.

     Your heart pumps more strongly now, your lungs take deeper breaths. All the accumulated poisons of past years are cleaned out, as the readjusted glands perform their proper duties as regulators of all the organs. Lurking disease germs vanish under a wave of reinforced leucocytes—white corpuscles. There is a thorough house-cleaning going on, throng every inch of you, as the gamma-rays stir these ductless glauds to the proper pitch of activity. Even your brain feels cleansed, awakened, and you glow with health. You feel happy simply because you have a sound mind in a healthy body.
     So far so good. You feel young and healthy, but you were promised gracious looks also for your fee. Yon still have a large nose, pointed chin and not too shapely body. The Operator nods and moves a third control. Now something touches your nose, shaping it. It is a mitogenetic ray, the fundamental wave-energy of growth. Under its powerful influence, positive or negative, flesh grows or withers. With this intangible tool of plastic surgery, the Operator reforms you almost at will. He pares down your nose, with deft touches. He smooths the curve of that chin. He does wonders with your body.

     The treatment is done. You step from the machine, and look in a mirror. You are astonished at the wonderful transformation that the Mechanical Fountain of Youth has wrought in you and you hurry off to surprise all your friends.
     Fantastic? Impossible? Remember that biology is one of the youngest of sciences. The study of glands, of the electro-chemical nature of life, and of mysterious vital forces is gaining rapid momentum toward what today is—fantastic.

From MECHANICAL FOUNTAIN OF YOUTH by Eando Binder (1939)

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