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

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)
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.

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.

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)
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

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.

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.

In Edmond Hamilton's CAPTAIN FUTURE'S TRIUMPH the insidious 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.

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

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)

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.


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.

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)

In the techno-magic area, there are many instances of science fictional technology of some kind of technobabble ray that instantly heals the patient. They are all pretty much fantasy.

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.
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
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.

Plague

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)

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)

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