Coma

by Robin Cook

  When Susan awoke the second time, it was already quite light. Sudden gusts of wind blew rain against the windowpanes with a sound like rice hitting glass. With a contrariness typical of Boston weather, the wind had shifted during the night from northwest to due east. Thanks to the Gulf Stream, the temperature had risen into the high thirties, so precipitation was in the liquid rather than solid phase. The commuters were relieved, the skiers disgusted.

  It was hard for Susan to believe the clock next to the bed, because it said almost nine. Bellows had showered, dressed, and exited without having reawakened her. Susan was amazed, for she was a relatively light sleeper. Just to be sure, she checked the bathroom and the living room for any sign that Bellows might still be there. She was alone.

  Susan found a clean towel, then showered vigorously, remembering the previous night’s passion with a pleasant sense of warmth. Bellows had turned out to be a far more sensitive and innately generous lover than Susan had surmised. She was genuinely pleased, although she had some serious reservations about the relationship going very far. Bellows’s commitment to surgery seemed somehow too encompassing, as if everything else in his life would necessarily be relegated to a secondary position like a hobby.

  In the refrigerator, Susan found some cheese and an orange. She helped herself to Grapenuts and toast while thumbing through the Yellow Pages. Checking to be sure that she had everything, she left Bellows’s apartment, locking the door securely behind her. It was going to be a busy day.

  The rain had let up significantly by the time Susan hit the street. The weather did not appear to be clearing, but now it would be more pleasant to walk about. Susan turned left up Mt. Vernon toward the State House. She crossed the Boston Common at its northern tip and entered the downtown shopping area.

  Of all the young girls who had come to the Boston Uniform Company retail store seeking a nurse’s uniform, the salesman found Susan the easiest and fastest customer. She seemed totally uninterested in the bewildering permutations of the plain white dress. She asked for size ten and told the salesman that any size ten would do.

  “We have this style here which you might like,” he said, bringing out one uniform.

  Susan took the dress and held it against herself as she looked into the mirror.

  “The changing rooms are in the back if you’d like to try it.”

  “I’ll take it.”

  The salesman was stunned if gratified at the speed of the sale.

  The rain started again halfheartedly as Susan walked up Washington Street toward Government Center. As she reached the middle of the bricked mall in front of the ultra-geometric City Hall, the wind brought in another moisture-laden cloud over the city. As the rain came down in earnest Susan ran for cover.

  The girl at the information booth told Susan that the building department was on the eighth floor. It was easy to find. Once there, though, things were different. Susan waited for twenty-five minutes at the main counter only to be told that she was at the wrong place. This happened twice before she was directed to the rear of the vast room. There was another wait of a quarter of an hour despite the fact she was the only customer. Behind the counter were five desks, of which three were occupied. Two men and one woman. The two men looked surprisingly alike, with large red noses, plastic black-rimmed glasses, and tasteless ties. They were engaged in a heated argument about the Patriots. The woman had a ratted hairdo recalling the early sixties and shocking red lipstick that used the natural lip borders only as suggestions. She was engrossed with a pocket mirror, examining her face from every possible angle.

  The smaller of the two men eventually eyed Susan and realized that she was not going to disappear despite the fact that she was being ignored. He rambled over, uninterested. When he reached the counter he took his cigarette from his mouth. A few of the ashes from the tip dusted down the front of his tie. He crushed the butt repeatedly in a cheap and already overflowing metal ashtray.

  “What can I do for you?” said the bureaucrat, looking at Susan for a moment. He turned before she could answer.

  “Hey, Harry, that reminds me. What are you going to do about the GRI 5 request? Remember, it was filed as urgent and it’s been in your box for two months.” Looking back at Susan, “What is it, honey? Let me guess. You want to file a complaint about your landlord. Well, this isn’t the right place.”

  He looked back at his colleague. “Harry, if you’re going for coffee, pick me up a regular and a Danish. I’ll pay you later.” His red eyes turned to Susan. “Now then . . .”

  “I’d like to look at some plans; the floor plans for the Jefferson Institute. It’s a relatively new hospital in South Boston.”

  “Plans. What do you want plans for? How old are you, fifteen?”

  “I’m a medical student and I’m interested in hospital design and construction.”

  “Kids today! With your looks you don’t have to be interested in anything.” He laughed obnoxiously.

  Susan closed her eyes, resisting the retort the comment deserved.

  The state employee started toward a stack of oversized books on the counter. “What ward is it in?” he asked with obvious ennui.

  “I haven’t the slightest idea.”

  “All right then,” said the man, making an about-face. “First we’ll have to find out which ward it is in.”

  A smaller book on the counter supplied the needed information.

  “Ward 17.”

  With calculated slowness, he returned to the large books on the counter. From his side pocket he withdrew a crumpled pack of cigarettes. He put one cigarette in his mouth, leaving it unlit. After picking several wrong volumes, he found the Ward 17 volume. The other books were pushed aside. Turning back the cover, he slobbered over his index finger. He flipped the pages forcefully, running his finger across his tobacco-stained tongue every four or five pages. Having found the reference, he copied the figures onto a piece of scrap paper. Motioning for Susan to follow, he started toward a large bank of filing cabinets.

  “Harry!” called the bureaucrat, continuing his conversation with his colleague en route to the filing cabinets, the unlit cigarette bobbing up and down in his mouth. “Before you go downstairs, call up Grosser and find out if Lester is coming in today. Somebody’s goin’ to have to file that stuff on his desk if he’s not; that’s been there longer than your GRI 5 request.”

  It was a simple affair to find the correct drawer and extract a large packet of plans. “Here you are, Goldilocks; there’s a Xerox machine over in that room beyond the counter, if you want. It takes nickels.” He pointed with his unlit cigarette.

  “Maybe you could show me which of these are floor plans.” Susan had withdrawn the contents from the jacket.

  “You’re interested in hospital construction and you don’t know what floor plans look like? My God. Here, these are the floor plans . . . basement, first floor, and second floor.” He lit his cigarette with a pocket lighter.

  “How do you decipher these abbreviations?”

  “For Christ’s sake, right here in the lower corner. It says ‘OR’ means operating room. ‘W (main)’, that means main ward. And ‘Comp. R.’ stands for computer room and so forth.” The man showed signs of incipient irritation.

  “And the Xerox machine?”

  “Over there. There’s a change machine on the wall. When you finish with the plans, just put them in the metal bin on the counter.”

  Susan carefully Xeroxed the floor plans and labeled the rooms on the copy with a felt-tipped pen. Then she headed for the Memorial.

  Susan entered the Memorial through the main entrance. It was just after ten in the morning. Yet the inevitable daily crowds were already there. Every conceivable seat was occupied. There were people of all ages, waiting, forever waiting. These were not people seeking attention in either the clinic or the emergency room. They were people waiting for a relative to be admitted or discharged, or perhaps they were patients who had been seen and treated and were now waiting to be pi
cked up and taken home. There was little conversation and no smiles. These were all distinct and separate islands, united only by their healthy awe of the hospital and its shrouded mysteries.

  The dense crowd impeded Susan’s progress, forcing her to push her way through to the directory. The plastic letters spelled out “Neurology Department, Beard 11,” Susan made her way to the Beard elevators and waited with the crowd. The person next to her turned and Susan recoiled in ill-concealed horror. The man’s—or was it a woman’s—eyes were surrounded by dark areas of hemorrhage. The nose was swollen and distorted, with nasal packs partially extruding from the nostrils. Several wires came from within the nose and were taped to either cheek. The visage was that of a monster. Susan tried to keep her eyes on the elevator indicator, unprepared for the visual surprises of the hospital.

  Dr. Donald McLeary was one of the younger members of the full-time neurology staff and, because of the ever-mounting pressure of space, had not been given an office on eleven. Susan had to take the stairs up to twelve before she found the door with “Dr. Donald M. McLeary” stenciled on it in black letters. She opened the door and squeezed into a tiny outer office; the door could not be opened all the way because of a filing cabinet. The desk, of average size, appeared huge in the room. An aging secretary looked up. She had extraordinarily thick makeup, including rouge and false eyelashes. Her totally bleached hair was glued into short, tight curls. She wore a tight pink pants-suit outfit that strained over unnatural bulges.

  “Excuse me, is Dr. McLeary in?”

  “He’s in, but he is very busy.” The secretary was annoyed at the intrusion. “Have you an appointment?”

  “No. No, I haven’t, but I only want to ask him a quick question. I’m a medical student rotating here at the Memorial.”

  “I’ll check with the doctor.”

  The secretary stood up, eyeing Susan from head to foot. Even more irritated at Susan’s lissome figure, she entered the inner office to Susan’s right. Susan looked around the outer office for any signs of the hospital charts she wanted.

  Almost immediately, the woman returned, sat down at her desk, put a piece of stationery into the typewriter and typed several lines. Only then did she look up.

  “You may go in; he says he has a moment for you.”

  The secretary resumed her typing before Susan could respond. Whispering some choice epithets under her breath, Susan opened the door and entered the inner office.

  Reminiscent of Dr. Nelson’s office, McLeary’s office was equally messy, with journals and papers in innumerable haphazard stacks. Several of the stacks had tipped over at some previous time and had never been reerected. Dr. McLeary was a thin, intense-looking man with a deep crease that ran down through the middle of each cheek. His sharply angular nose and chin were separated by a small mouth that twitched as he eyed Susan over his glasses and through his bushy eyebrows.

  “Susan Wheeler, I presume,” said Dr. McLeary, with no friendliness in his voice.

  “Yes.” Susan was surprised that he knew her name. She could not decide if that were propitious or not.

  “And you have come concerning these ten charts I have here.” McLeary half-turned in his chair, waving toward a large group of hospital charts in his bookcase.

  “Ten? Is that all you have?”

  “Isn’t ten enough?” asked McLeary somewhat sarcastically.

  “Fine. I just thought that maybe you’d have more. Are those the charts of the coma victims?”

  “Possibly. What do you have in mind if they are?”

  “I’m not sure. Dr. Stark told me you had the charts, and I thought I’d come by and ask if I could perhaps look at them or help you extract them.”

  “Young lady, I’m a neurologist with considerable training. My expertise is neurology, and I am evaluating the extensive neurological evaluations that were done on these patients by our resident staff. I really don’t need any help.”

  “I’m not insinuating that you need help, Dr. McLeary, least of all in a professional capacity. I admit that I know next to nothing about neurology. But these patients all have suffered a tragedy akin to death and there is something very strange about the whole affair. I think these cases have to be viewed in terms of some kind of association rather than as random events.”

  “And of course you are going to be the one to do that.”

  “Well, somebody has to do it.”

  McLeary paused and Susan had the uncomfortable feeling that the conversation was rapidly deteriorating.

  “Well, let me tell you this,” continued McLeary with a forceful quality to his voice. “This kind of a problem is far broader than your current capabilities. Not only that, but your efforts so far are already responsible for a disproportionate amount of trouble in this hospital. Rather than a help you are fast becoming a definite handicap. What I want you to do now is sit down.” McLeary pointed to one of the chairs in front of his desk.

  “I beg your pardon?” Susan had heard but the tone was confusing. McLeary wasn’t asking; he was ordering.

  “I said, sit down!” The anger in his voice now was unmistakable.

  Susan sat down in the only chair without a complement of journal articles.

  McLeary picked up the phone and dialed. He looked directly at Susan with unblinking, beady eyes. His mouth twitched as he waited for a connection.

  “Director’s office, please. . . . I’d like to speak to Philip Oren.”

  There was a longer pause. McLeary’s expression did not change.

  “Mr. Oren, Dr. McLeary here. You were quite right. She is sitting here in front of me. . . . The charts? Of course not, you must be joking . . . All right . . . fine.”

  McLeary hung up the phone, still looking directly at Susan. Susan could not detect even an iota of human warmth. She thought that he deserved the secretary he had. After an awkward silence Susan started to get up.

  “I have a feeling that I should not . . .”

  “Sit down!” shouted McLeary even more loudly than before.

  Susan sat down quickly, surprised at the sudden outburst.

  “What is going on here? I came in here to see if you could use some help in looking into the coma problem, not to be shouted at.”

  “I really have nothing more to say to you, young lady. You have overstepped your boundaries here at the Memorial. I was told that you would probably come snooping for these charts. I was also told you obtained unauthorized information from the computer. And on top of that, you managed to alienate Dr. Harris. Anyway, Mr. Oren will be here in a moment and you can talk with him. This is his problem, not mine.”

  “Who is Mr. Oren?”

  “The director of the hospital, my young friend. He is the administrator, and personnel problems are in his bailiwick.”

  “I’m not personnel. I’m a medical student.”

  “True enough. And that actually puts you on somewhat of a lower plane. You are a guest here . . . a guest of the hospital . . . and as such, your conduct should be suitable to the hospitality extended to you. Instead you have chosen to be disruptive and to ignore rules and regulations. You medical students of today somehow have gotten your sense of position in the scheme of things reversed. The hospital does not exist for your benefit. The hospital does not owe you an education.”

  “This is a teaching hospital and is associated with the medical school. Teaching is supposed to be one of the major functions of this hospital.”

  “Teaching, of course, but that certainly doesn’t mean just medical students. It means the whole medical community.”

  “Exactly. Supposedly it is a symbiotic atmosphere for everyone’s benefit: student and professor alike. The hospital doesn’t exist for the benefit of the medical student nor for the benefit of the professor. In fact, it’s supposed to be primarily for the patient.”

  “Well, it is indeed easy to understand Harris’s reaction to you, Miss Wheeler. As he said, you lack respect for people as well as institutions. But it is a reflection of yo
uth in general today. They believe their very existence alone entitles them to all the luxuries of society, education being one of them.”

  “Education is more than a luxury; it is a responsibility that society owes to itself.”

  “Society undoubtedly has a responsibility to itself but not to individual students, not to youth just because they are youth. Education is a luxury in that it is expensive beyond belief and the major burden, particularly in medicine, falls on the public at large, the workingman. The students themselves pay a small amount of the money needed. Not only does it cost an enormous amount of money to have you here, Miss Wheeler, but your being here means that you are economically unproductive. Hence the cost to society automatically doubles. And besides, your being a woman means that your future per-hour productivity . . .”

  “Oh save me,” said Susan sarcastically, standing up. “I’ve heard about as much bullshit as I can stand.”

  “Stay put, young lady,” shouted McLeary, furious. He too stood up.

  Susan tried to look behind the face of the man trembling with anger in front of her. She thought about Bellows’s suggestion relative to sexuality explaining Harris’s behavior. She was hard put to believe that was a factor in McLeary’s performance. Once again she was facing very irregular behavior, to say the least. The man was breathing rapidly, his chest heaving. She had apparently and unknowingly challenged the man. But how? In what capacity? She had no idea. Susan debated whether she should just walk out. A mixture of curiosity and respect for the apparent irrationality of McLeary’s actions made her stay. She sat down, watching McLeary, who now couldn’t decide what to do. He too sat down and began nervously playing with an ashtray. Susan sat motionless. She wouldn’t have been surprised if the man cried.

  She heard the outer office door opening. Voices drifted into the inner office. Then the inner office door opened. Without being announced or knocking, an energetic individual entered. He appeared like a businessman, in a smartly tailored blue suit. Reminding Susan of Stark’s attire, a silk handkerchief peeked out of his left breast pocket. His hair was carefully combed and frozen with a ruler-straight part on the left side. There was a definite aura of authority about the man; he exuded an air of assurance at handling a wide spectrum of problems.