Coma

by Robin Cook

  “Thank you for your call, Donald,” said Oren.

  Then he faced Susan condescendingly.

  “So this is the infamous Susan Wheeler. Miss Wheeler, you have been causing a great commotion in this hospital. Are you aware of that?”

  “No, I haven’t been aware of that.”

  Oren leaned back on McLeary’s desk, folding his arms in a professional fashion.

  “Out of curiosity, Miss Wheeler, let me ask you a rather simple question. What do you think is the major goal of this institution?”

  “Caring for the sick.”

  “Good. At least we agree in general. But I must add a crucial phrase to your answer. We are caring for the sick of this community. That might sound redundant to you because obviously we are not caring for the sick of Westchester County, New York. Yet this is an extremely important distinction because it underlines our responsibility to the people right here in Boston. As a direct corollary, anything that could interrupt or otherwise disturb this relationship to the community would, in effect, negate our primary mission. Now this may sound very . . . what should I say . . . irrelevant to you. But quite the contrary. I have been receiving complaints about you over the last few days which have grown from being irritated to intolerable. Apparently you are bent on specifically disrupting our carefully maintained relationship with the community.”

  Susan felt color rising in her cheeks. Oren’s condescending manner began to irritate her.

  “I suppose bringing to the forefront of everyone’s awareness that the chances of becoming a vegetable, of losing one’s brain, is very high, intolerably high, by being a patient here would ruin the reputation of the hospital.”

  “Exactly.”

  “Well, it seems to me that the reputation of the hospital is nothing compared to the irreparable damage suffered by these people. I have become more and more convinced that the reputation of the hospital deserves to be ruined if that’s what it takes to solve the problem.”

  “Now, Miss Wheeler, you can’t be serious. Where would all the people turn . . . all the people who are in daily need of the facilities in this hospital? Come . . . come. And by glibly drawing attention to an unfortunate but nevertheless unavoidable complication . . .”

  “How do you know it’s unavoidable?” interrupted Susan.

  “I can only believe what the chiefs of the respective departments assure me. I am not a doctor nor a scientist, Miss Wheeler, nor do I pretend to be. I am an administrator. And when I am faced with a medical student who is here to learn surgery, but instead spends her time calling attention to a problem which is already under investigation by qualified people such as Dr. McLeary here—a problem whose indiscreet disclosure has the potential to cause irreparable harm to the community, I am forced to react quickly and decisively. Obviously the warnings and exhortations you have already received to assume your normal duties have gone unheeded. But this is not a debate. I’m not here to argue with you. On the contrary, with all due respect, I thought it best to give you an explanation for my decision about your surgery rotation. Now, if you’ll excuse me, I will phone your dean of students.”

  Oren picked up McLeary’s telephone and dialed.

  “Dr. Chapman’s office, please. . . . Dr. Chapman, please. Phil Oren calling. . . . Jim, Phil Oren here. How’s the family? Everyone in our house is just fine. . . . I suppose I told you that Ted’s been accepted at the University of Pennsylvania. . . . I hope so. . . . The reason I called is about one of your third-year students rotating on surgery, a Susan Wheeler. . . . That’s right. . . . Sure, I’ll hold.”

  Oren looked at Susan. “You are a third-year student, Miss Wheeler?”

  Susan nodded. Her nascent anger had melted into dejection.

  Oren looked back at McLeary, who suddenly stood up, apparently bored. “I’m sorry, Don, for this intrusion,” said Oren. “I suppose we should have gone to my office. I’ll be finished . . .” Oren redirected his attention into the telephone. “Yes, I’m here, Jim . . . well that’s nice to know she’s been a good student. But nonetheless she has exhausted her welcome here at the Memorial. She is supposed to be on surgery but has decided never to attend rounds, conferences, or surgery. Instead, she has been irritating the staff, particularly our Chief of Anesthesia, and exacting unauthorized information from our computer storage facility by some devious means. We obviously have enough trouble around here without her kind of help. . . . Sure, I’ll tell her you want to see her . . . this afternoon at four-thirty. Good enough. I’m sure the V.A. would be happy to have her . . . right (chuckle). Thanks, Jim. Speak to you soon, and let’s get together.”

  Oren hung up the phone and smiled diplomatically at McLeary. Then he turned to Susan.

  “Miss Wheeler, your dean, as you have plainly heard, would like to have a word with you this afternoon at four-thirty. From this moment on, your professional welcome at the Memorial has been terminated. Goodbye.”

  Susan looked from Oren to McLeary and then back. McLeary’s expression was unchanged. Oren sported a self-satisfied smile, as if he had just won a debate. There was an awkward silence. Susan realized that the scene was over, and she got up without a word, picked up the parcel containing the nurse’s uniform, and left.

  Wednesday

  February 25

  11:15 A.M.

  Finding the hospital intolerably oppressive from an emotional point of view, Susan fled. She pushed her way through the lingering crowds, out into the rainy, raw February day. Once outside and without any particular destination in mind, she just walked, aimlessly, lost in her own thoughts. She turned on New Chardon Street and then on Cambridge Street.

  “Assholes,” she hissed as she kicked a stray, partially crunched Campbell’s soup can. The light rain flattened her hair against her forehead. Small droplets coalesced and dripped from the tip of her nose. She wandered up Joy Street into the back side of Beacon Hill, preoccupied with her stream of consciousness. She saw but her mind did not record the clutter of life, dogs, garbage, and other debris of the decaying urban surroundings.

  She could not remember ever feeling quite so rejected and isolated. She felt totally alone, and sudden fears of failure kept reoccurring in her compulsively conditioned brain. Waves of depression alternated with anger as she went over the conversations with McLeary and Oren. She yearned to talk with someone, someone whose counsel she could trust and respect. Stark, Bellows, Chapman; each was a possibility but each had a specific disadvantage. Bellows’s objectivity would have to be suspect; Stark’s and Chapman’s overriding loyalties would be to their respective institutions.

  Susan thought of the worst: being dismissed from medical school in disgrace. Not only would it be a personal failure but she felt it would be a failure for all women in medicine. Susan wished there were some woman doctor to whom she could turn, but she did not know any. There were so few on the medical school staff, and none in any positions that made them accessible for counseling.

  In the middle of her tormented musing, Susan felt her right foot slide as she put her weight on it. She had to steady herself with her hand on a nearby building to keep from falling. Expecting the worst, she looked down to see that she had stepped in a large steaming pile of dog feces.

  “Goddamn Beacon Hill.” Susan cursed Boston and all the literal and figurative shit a city government tolerated. Using the curb to dislodge most of the material, Susan choked on the odor. Still she couldn’t help but think about the symbolic aspect of her misfortune. Perhaps she had been stepping into a pile of shit, and as she was forced to do in regard to the actual shit in the city, she should try to ignore the whole affair. Just walk around it. Her responsibility was to become a doctor; that should take precedence over everything. The Bermans and the Greenlys were not her concern.

  The rain continued and rivulets ran down her cheeks. She began to walk more carefully, prudently noticing the innumerable piles of dog crap that characterized Beacon Hill as much as the gas lamps or the red brick. She watched where she put h
er feet and the going was easier. But she could not dismiss her sense of responsibility to the Bermans and the Greenlys so easily. She thought about the age similarity between herself and Nancy Greenly. She thought about her own periods and the several episodes when she had bled more heavily than usual; how it had frightened her and made her feel helpless and out of control. She might have had to have a D&C herself, possibly at the Memorial.

  But now she was out of the Memorial, maybe out of medical school. There was little that was up to her at that point, whether she wanted to pursue the problem or not. It was finished. It embarrassed her slightly to think of the frame of mind she had when she started the affair. “A new disease!” Susan laughed at her own vanity and deluded sense of ability.

  Susan strolled down Pinckney Street, crossed Charles Street and headed for the river. As aimlessly as on her Beacon Hill wandering, Susan mounted the stairs to the Longfellow Bridge. The graffiti stood out in bold outlines and she lingered, reading some of the nonsensical phrases, the faceless names. In the center of the span she paused, gazing up the Charles River toward Cambridge and Harvard and the B.U. Bridge. The river was a curious pattern of ice patches and open water, like a gigantic piece of abstract art. A flock of seagulls stood motionless on one of the floes of ice.

  Susan did not know what it was that drew her attention to the left, the way she had come. She saw a man in a dark overcoat and hat who turned toward the river and stopped when Susan looked in his direction. She returned to her undirected musing and the scene in front of her without giving the man in the dark overcoat a thought. But after five to ten minutes passed, Susan noticed the man had not moved. He was smoking and gazing up the river, seemingly as oblivious to the rain as was Susan. Susan thought that it was a coincidence to have two people standing on a bridge on a rainy day in February brooding over the river when as a rule the bridge was deserted even in nice weather.

  Susan crossed the bridge to the Cambridge side and walked up the riverbank toward the MIT boathouse. She felt a little cold as some moisture worked its way into her collar. The mild discomfort was somewhat therapeutic. But presently she decided that getting back to the dorm and a hot bath were in order.

  Abruptly she turned, intending to recross the Longfellow Bridge and take the MBTA home. But she stopped. The same man with the dark coat was about a hundred yards away, still staring out over the expanse of the Charles River. Susan felt an uneasiness that she couldn’t characterize. She changed her plans, to avoid passing the man. She would traverse the corner of the MIT campus and take the MBTA at Kendall Station.

  As she crossed Memorial Drive, she noticed that the man began to move in her direction. Obviously it was stupid, she assured herself, to concern herself with some stranger. She had difficulty explaining to herself why she would be so apt to have ungrounded paranoia. She decided that she was more upset than she had imagined. Just to be sure, she turned another corner and walked to the end of the block, stopping in front of the Political Science Library. Trying to be natural, she adjusted the string on her parcel.

  The man appeared almost immediately but did not turn into the block. Instead, he crossed the street and disappeared from sight. But Susan had not convinced herself that he was not following her. There had been the slightest suggestion that the man had reacted to her delaying tactics. Susan mounted the steps and entered the library. She used the ladies’ room and relaxed for a few moments. In the mirror her face reflected a definite uneasiness. She thought about calling someone but dismissed the idea. What could she say that wouldn’t sound ridiculous? Besides, she felt better and was willing to forget the episode as a construct of her imagination.

  Emerging from the ladies’ room, she had regained her composure enough to appreciate the architecture of the library. It was ultramodern with a sense of serenity and space. There was none of that overbearing stuffiness one associated with old university libraries. The chairs were bright orange canvas. The shelves and the card catalogues were highly polished oak.

  Then Susan saw the man again! This time at a very close range. She knew it was he although he did not look up from the magazine he appeared to be reading. He was obviously out of place in the library, dressed in a dark overcoat, white shirt, and white tie. His plastered-down hair had a shiny appearance suggesting multiple layers of Vitalis. His irregular face was pockmarked from adolescent years of acne.

  Susan mounted the stairs to the mezzanine, watching the man whenever she could. He did not seem to look up from his reading. From the outside of the building Susan had noted a connection between the library and the building immediately adjacent. She found the overpass and quickly crossed. The adjacent building was a classroom-office building and a number of people were milling through it. Susan felt more comfortable as she descended to the street floor. She left the building and headed rapidly for Kendall Square.

  Since the area was unfamiliar to Susan, it took her a few minutes to find the entrance to the MBTA underground. Just before she descended she hesitated, then she looked around. To her amazement and consternation, the man in the dark coat was about a block away, coming toward her. Susan felt a sinking feeling in her abdomen and a quickening pulse. She also felt undecided about what to do.

  A slight breeze moving up the stairs and a low threatening rumble helped her make up her mind. A train was coming into the station. A train filled with people.

  In a partially controlled panic she descended the stairs and entered the shadowy subterranean world. She fumbled for a quarter at the turnstile. She knew she had several in her pocket, but her mitten made it impossible. She tore off her mitten and pulled out her change. A few coins fell to the concrete and rolled spiraling away. No one got off the train. A few people blankly watched Susan’s uncoordinated efforts at the turnstile. The quarter dropped into the slot and Susan tried to push through. With a gasp she realized she had pushed too soon; the arm of the turnstile dug into her stomach rather than giving way. She let up, and the quarter dropped into the release mechanism. On her second attempt the turnstile turned so freely that she stumbled forward, just managing to keep herself from falling. The doors to the train closed as she ran up to them.

  “Please!” she shouted but the train began to pull away from the station. Susan ran alongside for a few steps. Then as the end of the train slid by her, Susan caught the image of the conductor looking at her through the glass with a blank face. The train receded rapidly into the inbound tunnel as Susan panted and looked after it.

  The station was totally deserted. Even the outbound platform on the other side was empty. The sound of the departing train fell off astoundingly rapidly, to be replaced by the regular sound of dripping water. Kendall Station was not a busy station and had not been renovated. The mosaic walls which had once been fashionable were a study in decay; the place recalled some ancient archeological site. Soot covered everything, and the platform was strewn with paper debris. Stalactite forms hung from the ceiling with droplets of moisture falling from their tips, as if it were a limestone cave of the Yucatan.

  Susan leaned out over the tracks as far as she could and peered into the tunnel toward Cambridge, hoping to see another train materialize. Straining her ears, she heard only the dripping water. Then there was the unmistakable sound of unhurried footsteps on the subway stairs. Susan rushed over to the heavily grated change booth. It was empty. A sign said that it was occupied only at rush hour, from 3 to 5 P.M. The footsteps on the stairs grew closer and Susan backed away from the entrance. She turned and ran down the platform toward the Cambridge end of the station. At the extreme end of the platform, she once again looked into the darkness of the tunnel. There was only the steady sound of dripping water. And footsteps.

  Looking back toward the entrance, Susan watched the man in the dark coat enter through the turnstile. He stopped, cupping his hands over a match to light a cigarette, casually tossing the used match onto the tracks. Obviously in no hurry, he took several puffs from his cigarette before starting toward Susan. He see
med to savor the fear he was causing. His shoes echoed metallically as he came closer and closer.

  Susan wanted to scream or run but she could do neither. It occurred to her that she might be dreaming up the terrifying situation. Perhaps it was just a series of coincidences. But the appearance and the expression of the man approaching her convinced her that this was no dream.

  Susan began to panic. She was cornered unless she wanted to enter the tunnel. She discarded that idea despite her panic. The other platform? She looked across the inbound and outbound tracks to the other side. Between the tracks were steel I-beam uprights with room to squeeze through between them. But next to the uprights, running along on either side of them, were the third rails, the power source for the trains with enough voltage and amperage to fry a person instantly.

  About ten to twenty feet within the tunnel, the

  I-beam uprights terminated and the power rails switched to the outsides of the respective tracks. Susan estimated that it would be relatively easy to sprint into the tunnel just far enough to round the end of the row of uprights. That way she could avoid stepping over the third rails.

  The man was within fifty feet of Susan, and he flipped his unfinished cigarette onto the tracks. He appeared to take something from his pocket. A gun? No, it wasn’t a gun. A knife? Perhaps.

  Susan needed no more encouragement. She switched the nurse’s uniform parcel to her right hand and squatted down at the edge of the platform, placing her left palm on the edge. Then she vaulted the four feet down onto the tracks, landing on her feet but allowing herself to absorb the shock by bending her legs. In an instant she was up, running into the tunnel.

  Panic flooded over her and she stumbled on the wooden ties. She fell sideways toward the third rail. Instinctively she let go of her parcel and grabbed for one of the I-beams, managing to deflect herself enough so that she missed the third rail by inches. As she landed, her left hand hit a small piece of wood, which flipped up and landed against the third rail and the ground. With a blinding flash of electricity and a popping noise the piece of wood was incinerated. The acrid smell of an electrical fire filled the air.