There is a sudden sharp twanging in his left thigh, close to the hip, the place where he receives Genghis Mao’s cerebral output. Four rooms away, the Khan is awakening.

Mordecai’s office is an island of tranquility for him within the tumultuous intensity of life atop the Grand Tower of the Khan. The room, a sphere ten meters in diameter, has many entrances, but they are programmed to open only for himself or Genghis Mao. One is the door through which he has just come, out of Committee Vector One. Another goes to the Khan’s private dining room, and another, on the far side, to a seldom-used heavy-insulation study known as the Khan’s Retreat. The last door is Interface Five, connecting the doctor’s office to the two-story-high Surgery that occupies one of the five outer wedges of the tower.

In the sanctuary of his office Shadrach Mordecai enjoys a few moments of peace before proceeding on his voyage into the turmoils of the day. Though Genghis Mao is up, there is no need to hurry. Mordecai’s implants tell him — by now, he can equate every trifling inner signal with some concrete aspect of the Khan’s activities — that the imperial servitors have entered Genghis Mao’s bedchamber, have helped the Khan to his feet, are walking him through the series of mild arm-swinging chest-stretching exercises that the old man, at Dr. Mordecai’s insistence, performs every morning. Next they will bathe him, then they will shave him, finally they will dress him and bring him forth. Though there will be no breakfast for Genghis Mao today, because of the impending operation, Shadrach Mordecai has at least an hour before he must attend the Khan.

Simply being in the office buoys him. The dark, rich paneling, the subdued lighting, the curving uncluttered desk of strange exotic woods, the splendid bookcase of crystalline rods and thin travertine slabs in which he keeps his priceless library of classic medical texts, the elegant armoires that house his extensive collection of antique medical instruments — it is an ideal environment for him, a perfect enclosure for the doctor he would like to be and occasionally is able to believe he is, the master of the Hippocratic arts, the prince of healers, the preserver and prolonger of life. Not that this room is a place for the practice of medicine. The only medical tools here are ancient ones, romantic and quaint apparatus, odd beakers and scalpels and lancets, bloodletting knives and cauterizing irons, ophthalmoscopes and defibrillators, early and inaccurate anatomical models, chirurgical saws, sphygmomanometers, electrical invigorators, flasks of discredited antitoxins, trephines, microtomes, relics of more innocent times. He has acquired these things eagerly in the past five years, by way of establishing his professional kinship with the great physicians of yesterday. The books, too, rare and auspicious, landmarks of medical history, talismans of scientific progress: the Fabrica of Vesalius, De Motu Cordis of Harvey, Boerhaave’s Institutiones, Laennec on auscultation, Beaumont on digestion — with what joy be has collected them, with what reverence he has fondled them! Not without some guilt, too, for in this battered and deflated era it is all too easy for those few who have power and wealth to take advantage of those who have not; and Mordecai, so close to the throne, has accumulated his treasures cheaply, catching them as they slip from the grasp of older, unluckier, perhaps more worthy possessors. Still, had these things not descended to him they might have been lost altogether in the chaos that surges freely through the world beyond the Grand Tower of the Khan.

Mordecai’s actual medical work is done elsewhere, in the Surgery beyond Interface Five, which serves not only for actual surgical operations but also for any other medical attention Genghis Mao may need. Mordecai’s office is a place for research and reflection only. Just to the right of his desk are keyboards, compact data terminals, giving him instant access to entire libraries of medical knowledge; he need only touch a finger to a key or even speak a coded word, cite symptomata, facies, tentative diagnosis, and back will come, in neatly codified form, extracts from the accumulated scientific wisdom of the eons, the relevant distillate of everything from the Smith Papyrus and Hippocrates and Galen down through the latest findings of the microbiologists and immunologists and endocrinologists who labor in the laboratories of the Khan. It is all here: encephalitis and endocarditis, gastritis and gout, nephritis, nephrosis, neuroma, nystagmus, aspergillosis and bilharzia, uremia and xanthochromia, the thousand natural shocks that flesh is heir to. Time was when doctors were shamans in feathers and paint, bravely pounding drums to frighten away frightening demons, doing solitary battle against unfathomable causes and unaccountable effects, gamely piercing veins and ventilating skulls, grubbing for roots and leaves of purely magical merit. Alone against the dark spirits of disease, no guide but one’s stock of inherited supernatural lore and one’s intuition. And now! Here! The answer machine! A touch of the finger and behold: etiology, pathology, symptomatology, pharmacology, contraindications, prophylaxis, prognosis, sequelae, the whole miraculous scroll of diagnosis and treatment and cure and convalescence unrolling at a command! In moments of lull Shadrach Mordecai enjoys testing his wits against the computer, setting hypothetical problems for himself, postulating symptoms and proposing diagnoses; he is eleven years out of Harvard Medical School and still a student, ever a student.

Today allows few lulls. He swings to his left and taps out the telephone number of the Surgery. “Warhaftig,” he says crisply.

A moment, and there the screen shows the flat, homely face of Nicholas Warhaftig, surgeon to the Khan, veteran of a hundred critical transplant operations. The camera picks up a sweeping view of the operating room behind him, boards glittering with measuring dials and control panels, the laser bank, the anesthesiologist’s spidery maze of needles and tubes and pipes, and, only partly visible, the main surgical stage itself, dais and bed and lights and instruments, white linens and dazzling chrome-steel fixtures, everything awaiting the imperial patient.

“The Khan’s awake,” Mordecai says.

“We’re on schedule, than,” says Warhaftig.

He is sixty years old, silver-haired, phlegmatic. He was already the supreme organ-transplant man when Shadrach Mordecai was an idol-worshipping undergraduate, and though Mordecai is technically his superior on Genghis Mao’s staff now, there is no doubt in either man’s mind about which one of them actually holds the greater professional authority. This makes their relationship an uncomfortable one for Mordecai.

Warhaftig says, “Will you get him to me by 0900 sharp?”

“I’ll try.”

“Try hard,” Warhaftig replies dryly, mouth quirking. “We begin perfusion at 0915. The liver’s still on ice, but coordinating defrost is always tricky. How’s he feeling?”

“As usual. The strength of ten men.”

“Can you give me quick readings on blood glucose and fibrinogen production?” “A moment,” Mordecai says. Those are not factors on which he receives direct telemetering from Genghis Mao’s body; but he has become skillful in deducing hundreds of the Chairman’s lesser body functions from clues given by the main metabolic responses. He says shortly, “Glucose doing fine, within the expected reduced levels caused by the general hepatic necrosis. It’s harder to get the fibrinogen reading, but my feeling is that all the plasma proteins are on the low side. Probably the fibrinogen not as bad as the heparin.”

“And bile?”

“Off sharply since Friday. Down some more this morning. No critical breakdowns of any function yet.”