A Brain

by Robin Cook

  “Be sure to get her phone number,” said Dr. Lowry as Thomas left. Dr. Huggens laughed, he’d already thought it wasn’t a bad idea.

  Back in the ER Thomas looked around. From seven to nine there was a relative respite, as if people took time out from misery, pain, and illness while they ate. By ten, the drunks, the auto accidents, and the victims of thieves and psychos would begin to arrive; by eleven it would be the crimes of passion. So Thomas had a little time to think about Lynn Anne Lucas. Something was nagging him about the case; he felt as if he were missing some important clue.

  Stopping at the main desk, he asked one of the ER clerks if Lynn Anne Lucas’s hospital chart had arrived from the record room. The clerk checked, said no, but then reassured him that he’d call again. Dr. Thomas nodded absently, wondering if Lynn Anne had taken any exotic drugs. Turning down the main corridor, he headed back to the examination room, where the girl was waiting.

  Denise had no inkling what Martin’s “fabulous idea” was. He had asked her to come back to his office around 9 P.M. It was about a quarter past when she had a break from reading trauma films in the emergency room. Using the stairs across from the closed hospitality shop, she reached the Radiology floor. The corridor seemed a different place from the commotion and chaos of the day. At the very end of the hall one of the janitors was using a power polisher on the vinyl floor.

  The door to Philips’ office was open, and Denise could hear his dictating monotone. When she entered, she found him finishing up the day’s cerebral angiograms. In front of him on his alternator was a series of angiographic studies. Within each X ray of the skull the thousands of blood vessels showed up as white threads which appeared like an upside-down root system to a tree. While he spoke he pointed with his finger at the pathology for Denise’s benefit. She looked and nodded, although it was incomprehensible how he knew the names and the normal size and position of each vessel.

  “Conclusion:” said Philips, “Cerebral angiography shows a large arteriovenous malformation at the right basal ganglia in this nineteen-year-old male. Period. This circulatory malformation is supplied by the right middle cerebral artery via the lenticulostriate branches as well as from the right posterior cerebral artery via the thalamoperforate and the thalamogeniculate branches. Period.” End of dictation. Please send a copy of this report to doctors Mannerheim, Prince, and Clauson. Thank you.”

  With a click, the recorder stopped, and Martin swung around in his chair. He was wearing a mischievous smile and he rubbed his hands together like a Shakespearean rogue.

  “Perfect timing,” he said.

  “What’s gotten into you?” she asked, pretending to be scared.

  “Come,” said Philips, leading her outside. Against the wall was a loaded gurney complete with IV bottles, linen, and a pillow. Smiling at her surprise, Martin began pushing the gurney down the hall. Denise caught up to him at the patient elevator.

  “I gave you this fabulous idea?” she asked, helping guide the gurney into the car.

  “That’s right,” said Philips. He hit the button for the subbasement and the doors closed.

  They emerged in the bowels of the hospital. A tangle of pipes, like blood vessels, ran off in both directions, twisting and turning on one another as if in agony. Everything was painted gray or black, eliminating all sense of color. The light, which was sparse, came from wire-mesh encased fluorescent bulbs placed at distant intervals, causing contrasting patches of white glare to be separated by long stretches of heavy shadow. Across from the elevator was a sign: MORGUE: FOLLOW RED LINE.

  Like a trail of blood, the line ran along the middle of the corridor. It traced a complicated route through the dark passages, winding sharply when the corridor branched. Ultimately it ran down a sloping incline, which nearly pulled the gurney from Martin’s hands.

  “What in God’s name are we doing down here?” asked Denise, her voice echoing with their footsteps in the lifeless spaces.

  “You’ll see,” said Philips. His smile had waned and his voice sounded tense. His original playfulness had given way to a nervous concern about the prudence of what he was doing.

  The corridor abruptly opened up into a huge underground cavern. The lighting here was equally as meager as in the corridor, and the two-story-high ceiling was lost in shadow. On the left wall was the closed door to the incinerator, and the hiss of hungry flames could be heard.

  Ahead were the double swinging doors leading into the morgue. In front of them the red line on the floor ended with abrupt finality. Philips left the gurney and advanced toward the entrance. Pushing open the door on the right he looked inside. “We’re in luck,” he said, returning to the gurney. “We have the place to ourselves.”

  Denise followed reluctantly.

  The morgue was a large neglected room, which had been allowed to decay to the point that it resembled one of those unearthed porticoes of Pompeii. A multitude of hooded lights hung on bare wires from the ceiling, but only a few had bulbs. The floor was constructed of stained terrazzo, while walls were surfaced with cracked and chipped ceramic tile. In the center of the room was a partially sunken pit containing an old marble autopsy slab. It had not been used since the twenties, and standing amid the debris, it appeared like an ancient pagan altar. Autopsies were currently done in the department of Pathology on the fifth floor, in a modern stainless steel setting.

  Numerous doors lined the walls of the room, including a massive wooden one that resembled a meat refrigerator in a butcher shop. On the far wall was an inclined corridor that led up in utter darkness to a door opening on a back alley of the hospital complex. It was deathly quiet. The only noise was an occasional drip from a sink and the hollow sounds of their own footsteps.

  Martin parked the gurney and hung up the IV bottle.

  “Here,” he said, handing Denise a corner of one of the fresh sheets and directing her to tuck it around the pad on the gurney.

  He went over to the large wooden door, pulled the pin from the latch, and with great effort opened it up. An icy mist flowed out, layering itself on the terrazzo floor.

  After finding the light switch Martin turned and noticed Denise had not budged.

  “Come on! And bring the gurney.”

  “I’m not moving until you tell me what’s going on,” she said.

  “We’re pretending it’s the fifteenth century.”

  “What do you mean?”

  “We’re going to snatch a body for science.”

  “Lisa Marino?” asked Denise incredulously.

  “Exactly.”

  “Well I’m not going to have any part of this.” She backed up as if about to flee.

  “Denise, don’t be silly. All I’m going to do is get the CAT scan and X rays I wanted. Then the body is coming right back. You don’t think I’m going to keep it, do you?”

  “I don’t know what to think.”

  “What an imagination,” said Philips as he grabbed the end of the gurney and pulled it into the antique walk-in refrigerator. The IV bottle clanked against its metal pole. Denise followed, her eyes rapidly exploring the interior which was completely tiled; walls, ceiling and floor. The tiles had once been white; now they were an indeterminate gray. The room was thirty feet long and twenty feet wide. Parked in rows on each side were old wooden carts with wheels the size of those on a bicycle. Down the center of the room was an open lane. Each cart supported a shrouded corpse.

  Philips slowly moved down the center aisle, glancing from side to side. At the back of the room he turned around and began lifting the corner of each sheet. Denise shivered in the damp cold. She tried not to look at the bodies closest to her, which had been the gory result of one of the rush-hour traffic accidents. A foot, still wearing its shoe, stuck out at a crazy angle, advertising that the leg had been broken in mid-calf. Somewhere out of sight an old compressor chugged to life.

  “Ah, here she is,” said Philips, peering under one of the sheets. Thankfully, for Denise, he left the shroud in place and mo
tioned for her to bring the gurney down. She did it like an automaton.

  “Help me lift her,” said Philips.

  Denise grabbed Lisa Marino’s ankles through the sheet to avoid touching the corpse. Philips hefted the torso. On the count of three, they moved the body, noticing that it had already become stiff. Then with Denise pulling, and Martin pushing, they guided the gurney back out of the refrigerator. Philips closed and secured the door.

  “What’s the IV for?” asked Sanger.

  “I don’t want people to think we’re pushing around a corpse,” said Philips. “And for that effect, the IV is the maestro’s touch.” He pulled the sheet down, exposing Lisa Marino’s bloodless face. Denise looked away as Martin raised the head and shoved the pillow under it. Then he ran the blank IV line beneath the sheet. Stepping back, he checked the effect. “Perfect.” Then he patted the corpse’s arm, saying, “Are you comfortable now?”

  “Martin, for God’s sake, do you have to be so gruesome?”

  “Well, to tell you the truth, it’s a defense. I’m not sure we should be doing this.”

  “Now he tells me,” moaned Denise as she helped guide the gurney through the double door.

  They retraced their steps through the subterranean labyrinth and entered the patient’s elevator. To their dismay, it stopped on the first floor. Two orderlies were standing with a patient in a wheelchair. Martin and Denise stared at each other for a moment, in fear. Then Denise looked away, castigating herself for becoming involved in this ridiculous caper.

  The orderlies wheeled the patient onto the elevator so that he was facing the rear, which they weren’t supposed to do. They were involved in a conversation about the upcoming baseball season, and if they had noticed Lisa Marino’s appearance, they didn’t mention it. But the patient was different. He looked over and saw the huge sutured horseshoe incision on the side of Lisa Marino’s head.

  “She have an operation?” he asked.

  “Yeah,” said Philips.

  “She going to be alright?”

  “She’s a little tired,” said Philips. “She needs some rest.”

  The patient nodded as if he understood. Then the doors opened on the second floor, and Philips and Sanger got off. One of the orderlies even helped pull the gurney out.

  “This is ridiculous,” said Sanger as they made their way up the empty hallway. “I feel like a criminal.”

  They entered the CAT scan room. The redheaded technician saw them through the leaded window from the control room, and came in to help. Philips told him it was an emergency scan. After the technician adjusted the table, he positioned himself behind Lisa Marino’s head and put his hands under her shoulders, preparing to lift. Feeling the ice-cold, lifeless flesh, he jumped back.

  “She’s dead!” he said, shocked.

  Denise covered her eyes.

  “Let’s say she’s had a hard day,” said Philips. “And you’re not to talk about this little exercise.”

  “You still want a CAT scan?” asked the technician incredulously.

  “Absolutely,” said Philips.

  Pulling himself together, the technician helped Martin lift Lisa onto the table. Since there was no need for immobilization restraints, he immediately activated the table and Lisa’s head slid into the machine. After checking the position, he directed Philips and Sanger into the control room.

  “She might be pale,” said the technician, “but she looks better than some of the patients we get from neurosurgery.” He pushed the button to start the scanning process and the huge doughnut-shaped machine abruptly came to life and began its rotation around Lisa’s head.

  Grouping themselves in front of the viewing screen, they waited. A horizontal line appeared at the top of the screen, then moved down the face, seemingly unveiling the first image. The bony skull was apparent but no definition could be determined within. Inside the skull it was dark and homogeneous.

  “What the hell?” said Martin.

  The technician walked over to the control console and checked his settings. He came back, shaking his head. They waited for the next image. Again the skull outline was seen but the interior was uniform.

  “Has the machine been working okay tonight?” asked Philips.

  “Perfect,” answered the technician.

  Philips reached out and adjusted the viewing controls, called the window level and window width. “My God,” he said after a minute. “You know what we’re looking at? Air! There’s no brain. It’s gone!”

  They stared at one another with a shared sense of surprise and disbelief. Abruptly Martin turned and ran back into the scanner room. Denise and the technician followed. Martin grasped Lisa’s head with both hands and lifted. Owing to stiffness, the corpse’s whole torso came up from the table. The technician lent a hand, enabling Philips to see the back of Lisa’s head. He had to look closely at the livid skin, but he found it: a fine U-shaped incision extending around the base of her skull, which had been closed with a subcuticular stitch so that no sutures could be seen.

  “I think we’d better get this body back to the morgue,” said Martin uneasily.

  The trip back was fast with very little talk. Denise did not want to go but she knew Martin would need help lifting Lisa from the gurney. When they reached the incinerator, he again checked to make sure the morgue was empty. Holding the doors open, he waved Denise in, helping push the gurney over to the refrigerator. Quickly he opened the massive wooden door. Denise watched his breath coming in short puffs in the cold air as he backed down the aisle, pulling on the stretcher. They aligned it with the old wooden cart and were about to lift the body when a shocking sound reverberated in the frigid air.

  Denise and Martin felt their hearts jump, and it took them several seconds before they realized the noise was Denise’s beeper. She switched it off hurriedly, embarrassed as if the intrusion were her fault, grabbed Lisa’s ankles, and on the count of three helped lift her onto the cart.

  “There’s a wall phone out in the morgue,” said Martin lifting the shroud. “Answer your page while I make sure the body looks the way we found it.”

  Needing no more encouragement, Denise hurried out. She was totally unprepared for what happened. As she turned toward the phone, she ran directly into a man who had been approaching the open refrigerator door. An involuntary whimper escaped from her, and she had to put her hands up to absorb the impact.

  “What are you doing here?” snapped the man. His name was Werner and he was the hospital diener. He reached out and grabbed one of Sanger’s upright wrists.

  Hearing the commotion, Martin appeared at the refrigerator’s threshold. “I’m Dr. Martin Philips and this is Dr. Denise Sanger.” He wanted his voice to sound strong, instead it sounded hollow and dull.

  Werner let go of Denise’s wrist. He was a gaunt man with high cheekbones, and a cavernous face. The dim light made it impossible to see his deeply set eyes. The eye sockets were blank, like burnt holes in a mask. His nose was narrow and sharp, like a hatchet. He was dressed in a black turtleneck, fronted by a black rubber apron.

  “What are you doing with my bodies?” asked Werner, pushing past the doctors and the gurney. Inside the refrigerator he counted the corpses. Pointing to Marino, he said, “Did you take this one out of here?”

  Having recovered from his initial shock, Philips marveled at the diener’s proprietary feeling toward the dead. “I’m not sure it’s correct to say ‘your bodies,’ Mr . . . .”

  “Werner,” said the diener, walking back to Martin and poking a large index finger in Philips’ face. “Until somebody signs for these corpses, they’re my bodies. I’m responsible.”

  Philips thought it better not to argue. Werner’s mouth with its narrow lips was set in a firm, uncompromising line. The man seemed like a coiled spring. Philips started to speak but his voice came out in an embarrassing squeak. Clearing his throat, he started again: “We want to talk to you about one of these bodies. We believe it’s been violated.”

  Sang
er’s beeper went off for the second time. Excusing herself she hurried over to the wall phone and answered her page.

  “Which body are you talking about?” snapped Werner. His gaze never left Martin’s face.

  “Lisa Marino,” said Philips, pointing to the partially covered corpse. “What do you know about this woman?”

  “Not much,” said Werner, turning toward Lisa and relaxing to a degree. “Picked her up from surgery. I think she’s going out later tonight or early in the morning.”

  “What about the body itself?” Martin noticed the diener wore his hair in a crew cut, brushed straight up along the sides.

  “Nice,” said Werner, still looking at Lisa.

  “What do you mean, nice?” asked Philips.

  “Best looking woman I’ve had for some time,” said Werner. As he turned to face Martin, his mouth pulled back in an obscene smile.

  Momentarily disarmed, Martin swallowed. His mouth was dry and he was glad when Denise returned saying, “I’ve got to go. I’ve been paged from the ER to check a skull film.”

  “All right,” said Martin, trying to arrange his thoughts. “Meet me in my office when you’re free.”

  Denise nodded, and with a sense of relief, she left.

  Martin, distinctly ill-at-ease alone with Werner in the morgue, forced himself to walk over to Lisa Marino. Pulling back the sheet he rotated Lisa’s corpse by pulling up her shoulder. Pointing to the carefully sutured incision, Philips said, “What do you know about this?”

  “I don’t know anything about that,” said Werner quickly.

  Philips wasn’t even sure the diener had seen what Martin was pointing to. Letting Lisa’s body roll back on the cart, Philips studied the man. His rigid countenance reminded Martin of a Nazi cliché.

  “Tell me,” said Philips. “Have any of Mannerheim’s boys been down here today?”

  “I don’t know,” said Werner. “I was told there was to be no autopsy.”

  “Well, that’s no autopsy incision,” said Philips. Grabbing the edge of the sheet, Philips pulled it over Lisa Marino. “Something strange is going on. Are you sure you don’t know anything about this?”