Surgery

With a slight prickling sensation in his arm, Alexios felt something cool flowing into it.

The Forged Steel Angel must have been using a treatment called an IV drip. It came with a cool, slightly prickling sensation that traveled up his arm.

As the anesthetic entered Alexios's brain, he felt groggy, as if he were about to lose consciousness, caught between waking and dreaming. But the Forged Steel Angel Apothecary's hands didn't stop.

A slight prickling sensation came from his chest, as if his flesh were being cut with a sharp blade. The restraints around his limbs wouldn't let Alexios move. In fact, because of the anesthetic, he couldn't even lift a finger.

Next came the buzzing sound of an electric circular saw against bone. Alexios felt his chest vibrating. It seemed they were sawing through his ribs. Wouldn't that leave him with one less rib? But just then, the anesthetic finally took full effect. That was Alexios's last thought.

With the help of a medical Servitor, Apothecary Dioscorides carefully moved aside the ribs in the boy's chest, severed several arteries and veins connected to his original heart, and clamped them shut.

The Apothecary issued an order:

"Second Heart."

The Servitor removed the Second Heart, beating inside a ventricular assist device. This organ, grown from Gene-seed, was the first step in the implantation procedure.

The Apothecary quickly took the heart and implanted it in the boy's body. With deft movements, he connected the Second Heart to the arteries and veins, linking the Gene-seed-grown heart to the boy's circulatory system. He released the clamps, and blood flowed into the Second Heart before surging through the main vessels into the original heart. Both hearts began beating powerfully, and soon settled into the same rhythm.

Good. Both hearts were beating perfectly. But Dioscorides knew this was only the first step. A heart transplant was a minor procedure, not especially difficult. He'd performed it countless times on slaves.

The hard part was dealing with rejection afterward. Although they had brought the boys' physical condition to its peak and tested their compatibility, Gene-seed and the organs it produced were mysterious things. Even with perfect compatibility and a successful surgery, cases where inexplicable rejection or mutation set in after the operation and killed the Neophyte were common.

He used intramedullary nails to fasten the ribs he had sawed off back into their proper positions. At the next surgery, he would saw them open again and then nail them back together. He would repeat this until the operations inside the chest were complete, and remove the nails at the end.

Next, he used a skin stapler, a machine resembling a stapler, to close the boy's chest. The first augmentation surgery was complete. He would prescribe some drugs to reduce the risk of rejection, then pray the boy could pull through. After all, he still had seventeen more surgeries ahead of him. That was the simple process of an augmentation operation.

Dioscorides had finished another augmentation surgery and finally breathed a sigh of relief. It was the last operation of the day. But the work wasn't over. After surgery, he still had to monitor the boys' physical changes. If anything went wrong, he would have to remove the Second Heart while there was still time to save it, even if that meant killing the goose that laid the golden egg. Organs were more precious than people, after all. He wouldn't be getting any sleep for at least seventy-two hours.

Dioscorides left the operating room and headed for the organ cultivation chamber. Inside, he saw one cultivation tank after another, each containing something bizarre.

There were hearts pounding in liquid, a pair of ears connected to nutrient-fluid lines, and, most striking of all, huge black plastic plates floating in the nutrient solution, waiting for the day they would be used.

Dioscorides was on tenterhooks, afraid something might go wrong with an organ in his care or inside one of the boys. If even one organ failed, that would leave one set of augmentation organs incomplete.

Organs grown from the same Gene-seed had the highest chance of success when implanted into the same Neophyte. If anything was lost, it would be up to him, the Apothecary, to assess the situation and make arrangements. Losing one or two minor organs wouldn't be a major problem, but losing an essential one, like a Second Heart or Black Carapace, would be a serious setback.

Of course, there was another option. If two sets of organs were each missing different parts, they could try combining the two sets to "piece together" one complete set of augmentation organs. But that was a bad idea. The Neophytes already risked rejecting the organs; doing this would also cause the organs to reject each other. It was a last resort, with an extremely high risk.

Fortunately, they hadn't run into that situation yet. At least, not so far.

Dioscorides was a novice Apothecary. He had even learned his craft from the Dark Mechanicus, rather than from another Apothecary. So his first time performing augmentation surgery on his own had put him under great pressure. Still, even a rookie like him had noticed a few things.

Dioscorides went to the monitoring equipment and checked all the data.

"The genetic detection nerves in this set of organs are unexpectedly active. That's not a good sign."

"The Suan Membrane and salivary glands in this set of organs are far too inactive. There's no telling whether they'll work after implantation."

"This set of organs contains some kind of mutation. Some kind of animal gene? It could also be a Warp mutation."

"This set of organs looks pretty good. Everything is stable, and the Larraman's Organ shows only minor mutations, perhaps even benign ones."

"And this set. It failed to produce a Multi-lung during cultivation, and its level of mutation is close to the danger threshold."

Perhaps because this was his first hands-on procedure, he felt that these Gene-seed organs were all over the place, nothing like the data in the training simulations. None of it was under his control. At last, he understood what the Biologus Sage had meant by saying that the data was only for reference.

Dioscorides tried to recall the biological knowledge he had learned from the Dark Mechanicus. All he could do was follow the procedure as best he could.

Dioscorides sighed, hoping for the best.

"Let's hope nothing goes wrong with this batch of Neophytes. Who knows when we'll get a new batch otherwise?"

After completing his routine inspection of the augmentation organs, Dioscorides took some immunosuppressants from a nearby cabinet and handed them to the Servitor beside him.

"Take these to the kitchen and have them add them to the Neophytes' meals. The dosage is marked on the label."

The Servitor took the drugs, nodded, and left.

Dioscorides leaned back in his chair, eyes fixed on the operating-room monitors and vital-sign displays. He reached for the fine wine beside him. That was one thing the Maelstrom had over the Eye of Terror: at least there was fresh, normal food and drink.

The mortals said this precious wine was made from the finest fresh grapes, crushed underfoot by barefoot maidens in the bloom of youth. He couldn't tell a good vintage from a bad one, but they were the rulers of this planet, and the mortals were supposed to provide them with the best of everything.

He pulled out the cork and gulped down a few mouthfuls. Then Dioscorides leaned back in his chair and kept watching the monitors and instruments, doing his job.