A Brain

by Robin Cook

  Even allowing for Goldblatt’s dislike of the new computer unit, his behavior still did not make sense. It suggested collusion with Mannerheim and Drake, and for Goldblatt to be siding with Mannerheim, if that were the case, something out of the ordinary had to be going on. Something very bizarre.

  Philips sat up and snatched his list: Marino, Lucas, Collins, McCarthy and Lindquist. After McCarthy he had written “Neurosurgical lab.” If Mannerheim could be devious, so could he. Philips walked out of his dim office into the brightness of the corridor. Toward the fluoroscopy rooms he saw what he was looking for: the cleaning carts of the janitorial staff.

  Having accustomed himself to working long hours, Martin had had numerous opportunities to become acquainted with the cleaning crew. On several occasions they had cleaned his office with him in it, joking that he secretly lived under his desk. It was an interesting group composed of two men in their middle twenties, one white and one black, and two older women, one Puerto Rican, the other Irish. Philips wanted to speak to the Irish woman. She’d worked for the center for fourteen years and was their nominal supervisor.

  Philips found the crew inside one of the fluoroscopy rooms having their coffee break. “Listen, Dearie,” said Martin to the woman. Dearie was her nickname, because it was how she addressed everyone else. “Can you get into the Neurosurgical Research lab?”

  “I can get into everything in this hospital except the narcotics cabinets,” said Dearie proudly.

  “Wonderful,” said Martin. “I’m going to make you an offer you can’t refuse.” He went on to say that he wanted to borrow her passkey for fifteen minutes to get a specimen from the Neurosurgical lab which he wanted to X-ray. In return she could have a free CAT scan!

  It dook Dearie a full minute to stop laughing. “I’m not supposed to give this out, but considering who you are . . . . Just have it back before we leave Radiology. That gives you twenty minutes.”

  Philips used the tunnel to get to the Watson Research Building. The elevator was waiting in the deserted lobby and he got right in and pressed his floor. Although Martin was in the middle of a busy medical center within a populous and sprawling city, he felt isolated and alone. Research was done between eight and five, and the building was vacant. The only sound was the wind hissing in the elevator shaft as the car sped upward.

  The doors opened and he stepped out into a poorly illuminated foyer. Passing through a fire door he found himself in a long hallway that ran the length of the building. To conserve energy nearly all the lights were out. Dearie hadn’t given him a key, she’d given him her whole brass ring of keys and it jangled in the silence of the empty building.

  The Neurosurgical lab was the third door on the left, close to the other end of the corridor, and as Martin got closer, he felt himself tense. The door to the lab was metal with a central frosted pane of glass. After glancing over his shoulder, he slipped the passkey into the lock. The door swung open. Philips quickly stepped in and closed the door. He tried to laugh at his own sense of suspense, but it didn’t do any good. His nervousness had increased out of proportion to what he was doing. He decided he’d make a lousy burglar.

  The light switch made an inordinately loud snap when he turned it on. Banks of fluorescent light bathed the huge lab. Two central counter tops ran down half of the room, complete with sinks, gas jets, and overlying shelves of laboratory glassware. At the far end was an animal surgical area, which looked like a modern operating room in three-quarter size. It had operating lights, a small operating table, and even an anesthesia machine. There was no separation between the operating area and the lab except that the operating area was tiled. All in all it was an impressive setup and stood as tribute to Mannerheim’s ability to obtain research grants.

  Philips had no idea where a brain specimen would be stored, but he thought there might be a collection, so he only looked in the larger cabinets. He drew a blank but noticed there was another door down near the surgical area. It had a clear glass panel with embedded wire mesh and he leaned against the window, peering into a dark room beyond. Just beyond the door he could see a series of bookshelves containing glass jars; a whole group of which held brains immersed in preserving fluid.

  With every second that passed Martin’s anxiety continued to increase. The moment he saw the brains, he wanted to find McCarthy’s and leave. He pushed open the door and began quickly scanning the labels. A strong animal smell assaulted his nose and in the darkness to the left he caught a glimpse of cages. But the jars held his interest; each was labeled with a name, a unit number and a date. Guessing that the date was the death of the patient, Philips walked quickly down the long row of jars. Since the only light was that which came through the glass panel in the door, he had to lean closer to the jars with each step. McCarthy’s was at the very far end of the room near an exit door.

  Reaching up to grasp the specimen, Philips was devastated by a bloodcurdling scream that reverberated around the small room. It was immediately followed by a crash of metal against metal. Philips’ legs buckled as he spun around to defend himself, his shoulder hitting the wall. Another scream shattered the air, but an attack did not materialize. Instead Martin found himself staring into the face of a caged monkey. The animal was in an absolute rage. His eyes were burning black coals. His lips were drawn back exposing his teeth, two of which had broken when he had tried to bite through the steel bars of his prison. From the top of the monkey’s head protruded a group of electrodes like multicolored spaghetti.

  Philips realized he was looking at one of the animals Mannerheim and his boys had turned into a screaming monster. It was well known in the Med Center that Mannerheim’s latest interest was finding the exact location in the brain associated with rage reaction. The fact that other researchers felt that there was not one single center had not deterred Mannerheim at all.

  As Philips’ eyes adjusted to the dim light, he could see many cages. Each contained a monkey with all varieties of head mutilation. Some had the entire back of their skulls replaced by Plexiglas hemispheres through which passed hundreds of embedded electrodes. A few were docile as if they had been lobotomized.

  Philips pushed himself back to a standing position. Keeping an eye on the raging animal who continued to scream and noisily shake his cage, Philips lifted the jar containing McCarthy’s partially dissected brain. Behind it was a group of slides bound by a rubber band. Philips took those as well. He started to leave when he heard the outer door of the lab open and close, followed by muffled noises.

  Martin panicked. Balancing the jar, the slides, and the ring of keys, he opened the back door of the animal room. In front of him the fire stairs plunged down in an endless series of retreating angles. Philips paused at the top stair and realized that fleeing was not the answer. Catching the door before it clicked shut, he returned to the lab.

  “Doc Philips,” said a startled security man. His name was Peter Chobanian. He was on the Med Center’s intermural basketball team and had had several late-night conversations with Philips. “What are you doing up here?”

  “Needed a snack,” said Martin with a straight face. He held up the specimen jar.

  “Ahhh,” said Chobanian, looking away. “Before I worked here I thought only psychiatrists were nuts!”

  “Seriously,” said Philips, walking ahead on rubbery legs. “I’m going to X-ray this specimen. I was supposed to pick it up today but didn’t . . .” He nodded to the other security man whom he didn’t know.

  “You oughtta let us know when you’re coming up here,” said Chobanian. “Some of the microscopes have been walking outta this building and we’re trying to tighten up.”

  Philips got one of the evening radiology technicians to come over to Neuroradiology between ER trauma cases to offer an opinion. Philips had tried unsuccessfully to take an X ray of McCarthy’s partially dissected brain, which he had put on a paper plate. No matter what Philips did, the X rays were bad. On all the films it was difficult to make out the internal structur
e. He’d tried reducing the kilovoltage, but it didn’t help. The technician took one look at the brain and turned green. After he left, Martin finally decided what the problem was. Even though the brain had been in formaldehyde, the internal structure must have decomposed enough to blur any radiological definition. Plopping the brain back into its jar, Philips took it and the pack of slides up to Pathology.

  The lab wasn’t locked up but it was deserted. If someone wanted to steal microscopes, this is where they should come, thought Philips. He opened the door to the autopsy room. No one there either. Walking down the long central table supporting a whole line of microscopes, each with its dictation unit next to it, Philips remembered the first time he had looked at his own blood. He recalled his terror that the slide would be leukemic. Medical school had been a time for imaginary diseases and Martin had contracted almost all of them.

  Toward the back of the room he found a Bunsen burner busily boiling a beaker of water. Putting down the jar and the slides, he waited. It wasn’t long. A grossly overweight pathology resident waddled in. He wasn’t expecting company because he was zipping his fly as he came through the door. His name was Benjamin Barnes.

  Philips introduced himself and asked if Barnes would do him a favor.

  “What kind of favor? I’m trying to get this autopsy done so I can get my ass out of here.”

  “I’ve got a few slides. I wonder if you would take a quick look at them?”

  “There’s plenty of scopes here. Why don’t you help yourself?”

  It was a presumptuous way to treat a staff man even if he was from another department, but Martin forced himself to suppress his irritation. “It’s been a few years,” he said, “Besides, it’s a brain and I was never good at brain.”

  “It would be better to wait for Neuropath in the morning,” said Barnes.

  “I’m interested in a quick impression now,” Martin said.

  Philips had never found fat people to be jolly, and the pathologist was confirming his impression.

  Barnes reluctantly took the slides and placed one under the scope. He scanned around, then put in another. It took about ten minutes to go through the group.

  “Interesting,” he said. “Here, take a look at this.” He moved aside so Philips could see.

  “See that open area?” asked Barnes.

  “Yeah.”

  “Used to be a nerve cell there.”

  Philips looked at Barnes.

  “All these slides with the red-grease-pencil marks have areas where the neurons are either missing or in bad shape,” said the resident. “The curious thing is that there’s very little if any inflammation. I don’t have any idea what it is. I’d have to describe it as ‘multifocal, discrete neuron death,’ etiology unknown.”

  “You don’t even want to guess the cause?” asked Philips.

  “Nope.”

  “What about multiple sclerosis?” asked Philips.

  The resident made a strange face, wrinkling his forehead. “Maybe. Occasionally there’s some gray matter lesions in multiple sclerosis, even though the lesions usually are all white matter. But they don’t look like this. There’d be more inflammation. But to be sure I’d have to do a myelin stain.”

  “How about calcium?” asked Philips. Philips knew there weren’t too many things that affected X-ray density, but calcium was one of them.

  “I didn’t see anything that suggested calcium. Again, I’d have to do a stain.”

  “One other thing,” said Philips. “I’d like to have some slides made from the occipital lobe.” He patted the top of the glass jar.

  “I thought you only wanted me to look at the slides,” said Barnes.

  “That’s right. I don’t want you to look at the brain, just section it.” Martin had had a bad day and he wasn’t in a mood to deal with a lazy pathology resident.

  Barnes had sense enough not to say anything else. He picked up the glass jar and waddled into the autopsy room. Philips followed. With a scoop, Barnes took the brain out of the formaldehyde and put it on the stainless steel counter next to the sink. Brandishing one of the large autopsy knives, he allowed Philips to point to the area he wanted. Barnes then took several half-inch slices and put them in paraffin.

  “The sections will be done tomorrow. What kind of stains do you want?”

  “Everything you can think of,” said Philips. “And one last thing. Do you know the diener who works nights down in the morgue?”

  “You mean Werner?”

  Philips nodded.

  “Vaguely. He’s a little weird but he’s reliable and a good worker. He’s been there for years.”

  “Do you think he’s on the take?”

  “I don’t have any idea. What could he be on the take for?”

  “Anything. Pituitary glands for growth hormone; gold teeth; special favors.”

  “I don’t know. But I guess it wouldn’t surprise me.”

  After the unsettling experience in the Neurosurgical lab, Philips felt particularly ill-at-ease as he followed the red line toward the morgue in the subbasement. The huge, dark, cavern-like room outside of the morgue looked like the perfect setting for some gothic horror. The quartz window in the door of the incinerator glowed in the darkness like the eye of a cyclopean monster.

  “For God’s sakes, Martin. What the hell is wrong with you?” said Philips, trying to fortify his waning confidence. The morgue looked exactly as it had the evening before. The bulbless hooded light fixtures hanging down on their wires gave the scene a weird unearthliness. There was a faint odor of decay. The door to the refrigerator was ajar and a bit of its interior light spilled out along with a current of cold mist.

  “Werner!” called Philips. His voice echoed in the old tiled room. There was no response. Philips stepped into the room and the door closed insistently behind him. “Werner!” The silence was only broken by a dripping faucet. Tentatively Philips advanced to the refrigerator and glanced within. Werner was struggling with one of the corpses. It had apparently fallen from its gurney because Werner was lifting the naked, stiff cadaver and awkwardly trying to reposition it on the movable stretcher. He could have used some help but Philips stayed where he was and watched. When Werner succeeded in getting the body onto the gurney, Martin stepped into the refrigerator.

  “Werner!” Martin’s voice sounded wooden.

  The diener flexed his knees and lifted his hands like a jungle creature about to attack. Philips had startled the man.

  “I want to talk to you,” said Philips. He had decided to be authoritative, but his voice sounded weak. Surrounded by the dead, his defenses dissolved. “I understand your position and I don’t want to cause any trouble, but I need some information.”

  Recognizing Philips, Werner relaxed, but he didn’t move. His breath came in short puffs of condensed vapor.

  “I have to find Lisa Marino’s brain. I don’t care who took it or for what reason. I just want a chance to look at it for a research project.”

  Werner was like a statue. Except for his visible breaths he was like one of the dead.

  “Look,” said Martin. “I’ll pay.” He had never bribed anyone in his life.

  “How much?” said Werner.

  “A hundred dollars,” said Philips.

  “I don’t know anything about Marino’s brain.”

  Philips looked at the frozen features of the man. Under the circumstances he felt impotent. “Well, give me a call in X ray if you suddenly remember.” He turned and walked out, but in the corridor he found himself running to the bank of elevators.

  Entering the outer foyer of Denise’s apartment building, Philips scanned the nameplates. He knew approximately where hers was, but there were so many, that he always had to search a little. After pushing the black button he waited with his hand on the front doorknob for the buzzer to let him in.

  Inside the building it smelled as if everyone had sautéed onions for their dinner. Philips started up the stairs. There was an elevator, but if it wasn’t
already waiting in the lobby it took too long to arrive. Denise only lived on the third floor and Philips didn’t mind climbing the stairs. But on the last flight, he began to realize how tired he was. It had been a long grueling day.

  Denise had again metamorphosed. She no longer looked tired and she said she’d taken a short nap after her bath. Her shining hair had been released from its barrette and cascaded from her head in gentle waves. She was dressed in a pink satin camisole with matching tap pants that left just the right amount to the imagination. Some of Martin’s fatigue lifted. He was always amazed by her ability to drop her efficient hospital personality, though he understood that she was confident enough in her intellectual abilities that she could indulge her feminine fantasies. It was a rare and wonderful balance.

  They embraced at the door, and then without speaking they walked arm in arm into the bedroom. Martin pulled her down onto the bed. At first she just acquiesced, enjoying his eagerness, but then she joined, her passion matching his until they both spent themselves in mutual fulfillment.

  For some time they lay together, just enjoying the closeness and wishing to retain in their minds the pleasure they gave to each other. Finally Martin propped himself up on an elbow so he could trace his finger down her finely crafted nose and across her lips.

  “I think this relationship is getting entirely out of hand,” he said, smiling.

  “I agree.”

  “I’ve shown symptoms for a couple of weeks, but it’s only been over the last two days that I’m sure of the diagnosis. I’m in love with you, Denise.”

  For Denise the word had never had more meaning. Martin had not mentioned love before, even when he told her how much he cared for her.

  They kissed lightly. The words hadn’t been necessary but they added a new dimension of closeness.

  “Admitting my love for you,” said Martin after a few moments, “scares me in one way. Medicine destroyed my previous relationship and I worry it could do it again.”