Robin Cook - Coma

“It’s going to be strange getting used to being called Doctor,” said Susan looking around for the nearest phone.

“You’d better get used to it because that’s the way you’ll be paged. It’s not meant to flatter you. The idea is to make it easier on the patients. You shouldn’t hide the fact that you’re students, but don’t advertise it either. Some of the patients wouldn’t let you touch them if they thought you were med students; they’d yell and scream they were being used as guinea pigs. Anyway go answer the page, Dr. Wheeler, and then catch up with us. After we finish here we’ll be up in the conference room on ten.”

Susan walked over to the main desk and dialed 938. Bellows watched her cross the room. He couldn’t help but notice that under the white coat lurked a sensuous figure. Bellows was being attracted to Susan Wheeler by quantum leaps.

Monday, February 23, 11:40 A.M.

It gave Susan a feeling of unreality to answer a page for “Dr. Wheeler.” She felt transparent as if she were an actress playing the role of a doctor. She had on the white coat and the scene was melodramatic and appropriate. Yet on the inside she just didn’t feel like the part, and there was the thought that she would be exposed at any moment as a charlatan.

At the other end of the phone line, the nurse was matter-of-fact and to the point.

“We need an I.V. started on a pre-op. The case has been delayed and anesthesia wants some fluid in him.”

“When would you like me to start it?” asked Susan twisting the phone cord.

“NOW!” answered the nurse before hanging up.

The other members of Susan’s group had moved on to another patient and were again huddled about the desk, straining to see the chart Bellows had pulled from the rack and had in front of him. No one looked up as Susan traversed the half-light of the ICU. She reached the door and her left hand wrapped around the upturned stainless steel handle. Turning her head slowly to the right she chanced another glance at the immobile and lifeless-appearing Nancy Greenly. Once again Susan’s mind stumbled through a painful identification. She left the ICU with difficulty but also with a sense of relief.

The sense of relief was short-lived. Hurrying along the crowded corridor, Susan began to prepare herself for the next mini-hurdle. Susan had never started an I.V. before. She had drawn blood from several patients, including her lab partner, but she never had started an I.V. Intellectually she knew what was required and she knew that she could do it After all, it only involved punching a razor-sharp needle through some thin skin and impaling a vein without going all the way through the vessel. The difficulties arose from the fact that frequently the vein was only the size of thin spaghetti with a corresponding smaller lumen. In addition, sometimes the vein could not be seen from the surface of the skin and had to be attacked blindly with only the help of the sense of touch.

With these difficulties in mind Susan knew that even something as mundane as starting an I.V. was going to be a challenge of sorts. Her biggest concern was that it was going to be very apparent that she was new at the game, and perhaps the patient might rebel and demand a real doctor. Besides, she was in no frame of mind to have to put up with any exasperated ridicule from any of those bitchy nurses.

When Susan arrived at Beard 5, the scene was unchanged. The bustle of activity was as hectic as ever. Terry Linquivist gave a fleeting look at Susan before disappearing into the treatment room. One of the other nurses, whose cap had a bright orange stripe and whose name tag read “Sarah Sterns,” responded to Susan’s arrival by handing her the I.V. tray and a bottle of I.V. fluid.

“The name’s Berman. He’s in 503,” said Sarah Sterns., “Don’t worry about the rate. I’ll be down there in a few minutes to regulate it.”

Susan nodded and headed for 503. En route she examined the I.V. tray. There were all sorts of needles: scalp needles, long-dwelling catheters, CVP lines, and traditional disposable needles. There were packets of alcohol sponges, a few lengths of flat rubber tubing to be used as the tourniquets, and a flashlight. Eyeing the flashlight, Susan wondered how many times she would repeat the scene of trudging off in the middle of the night to start an I.V.

Susan passed 507, then 505, As 503 loomed she rummaged in the I.V. tray among the scalp needles until she located a #21 in a bright yellow packet. That was the needle she had seen an I.V. started with in the past. She was tempted to try one of the impressive-looking long-dwells but she decided to keep the experimenting to a minimum, at least on her first I.V.

“Room 503” was stenciled plainly on the door. It stood slightly ajar. Susan didn’t know whether she should knock or just walk in. With a self-conscious glance over her shoulder to make sure she was not being watched, she knocked.

“Come in,” said a voice from within.

Susan pushed open the door with her foot, clutching the I.V. tray in her right hand and the D5W bottle in her left. Expecting to see an elderly ill individual, Susan moved into the room. It was a typical private room at the Memorial: small, old, the floor tiled with vinyl squares. The window was curtainless and dirty. An old radiator stood in the corner covered with a dozen layers of paint.

Contrary to Susan’s expectations, the patient was neither old nor infirm. Propped up in the hospital bed was a youngish man, seemingly in perfect health. Susan quickly estimated that he was about thirty. He was wearing the usual hospital garb with the sheet pulled up to his waist. His hair was dark and very thick, and it was brushed back on both sides of his temples so that it covered the top part of each ear. His face was narrow, intelligent, and tanned despite the winter season. He had a sharp nose with flared nostrils, making him appear as if he were constantly breathing in. He looked athletic and in good physical condition. His muscular arms encircled his updrawn knees. His hands worked at each other nervously as if they were cold. Susan sensed immediately the man’s anxiety through a patina of contrived calmness.

“Don’t be bashful, come right in. It’s like Grand Central here,” smiled Berman. The smile wavered. It was apparent that the man welcomed an interruption in the tenseness of waiting to be called for surgery.

Susan entered and allowed herself only a short look at Berman while she returned the smile. She then pushed the door to its original position. She put the tray on the foot of the bed and hung the I.V. bottle from the stand at the head of the bed. She consciously avoided Berman’s eyes while she wondered why in God’s name did Berman have to be so young, healthy, and obviously in charge of all his faculties. Susan certainly would have preferred an unconscious centenarian.

“Not another needle!” said Berman with partially feigned overconcern.

“I’m afraid so,” said Susan opening a package of I.V. tubing, which she inserted into the bottle of D5W on the stand, allowing some of the fluid to run through the tube before securing it with a stopcock. With that accomplished, Susan looked up at Berman, to find that he was staring intently at her.

“Are you a doctor?” asked Berman with a tone of disbelief.

Susan didn’t respond immediately. She continued to look directly into Berman’s deep brown eyes. In her mind she weighed the possibilities of her response. She wasn’t a doctor, that was obvious. What did she want to say? She wanted to say that she was a doctor. But Susan was a realist and she wondered if she would ever be able to say she was a doctor and believe it herself.

“No,” said Susan with finality while returning her gaze to the #21 scalp needle. The reality disappointed her and she thought that it would add to Berman’s anxiety. “I’m just a medical student,” she added.