Robin Cook: Coma

Having pulled herself from the warmth of her covers with such dispatch, Susan realized that she had an extra fifteen minutes to spare. That was the usual duration of her ritual of repeatedly turning off her radio alarm before actually making it into the bathroom. Her ambivalence toward starting this day made her squander the time by just sitting and staring ahead, wishing that she had gone to law school or graduate school in literature… anything besides medical school.

The coldness of the bare waxed floor worked its way into Susan’s feet. As she sat there, her circulatory system dissipated her body heat into the cold room, making her nipples rise up from the summits of her shapely breasts. Goose pimples appeared from nowhere along the insides of her naked thighs. She wore only a thin worn-out flannel nightgown she had gotten for Christmas when she was in the fifth grade. She still wore it to bed almost every night, at least when she was sleeping alone. Somehow she loved that nightgown. Amid the furious pace of change in her life, it seemed to afford a sanctuary of consistency. Besides, it had always been her father’s favorite.

Susan had enjoyed pleasing her father from a very early age. Her first remembrance of him was his smell: a mixture of the outdoors and deodorant soap covering a distinctive odor she later realized was male. He had always been good to her, and she knew that she was his favorite. That secret she never shared with anyone, especially not with her two younger brothers. It had always been a source of confidence for her as she faced the usual hurdles of childhood and adolescence.

Susan’s father was a strong-willed individual, a dominant but generous and gentle man who ran his family and his insurance business like an enlightened despot. A charming man whose brood acknowledged him as the last word on any subject. It wasn’t that Susan’s mother was a weak-willed individual. It was just that she had met more than her match in the man she married. For much of her life Susan accepted this situation as the invariable norm. Eventually, however, it began to cause her some inner confusion. Susan was very much like her father, and her father encouraged her development in that direction. Then Susan began to realize she could not be like her father and expect one day to have a home of her own like the one in which she was reared. For a time she wanted desperately to be like her mother, and consciously tried. But it was to no avail. Her personality showed more and more her father’s traits, and in high school she was literally forced into a leadership role. Susan was voted president of her graduating class at a time in her life when she thought that she would have preferred to be more in the background.

Susan’s father was never particularly demanding, and certainly never pushy. He remained a source of confidence and encouragement for Susan to do whatever she wanted, without considering her sex. After Susan had entered medical school and became familiar with some of her female classmates, she realized that many of them had emerged from a similar paternalistic background. In fact when she met some of their parents, the fathers seemed to be vaguely familiar, as if she had actually known them in the past.

A resonant thumping issued from the radiator beneath the window, heralding the coming of heat. A tiny bit of steam hissed from the overflow valve. The radiator’s stirring reminded Susan of the coldness of the room. Stiffly she stood up, stretched, and closed the window. It had been open only about a half-inch. Susan lifted the nightgown over her head and regarded her naked body in the mirror on the bathroom door. Mirrors held a strange attraction for her. It was almost impossible for her to pass a mirror without at least a quick reassuring look.

“Maybe you should be a dancer, Susan Wheeler,” she said rising up onto her tiptoes and stretching her arms straight up, “and give lip this idea of becoming a fucking doctor.” Like a balloon being deflated, she let herself sag until she was slumped over. She was still looking at herself in the mirror. “I wish I could do that,” she added more quietly. Susan was proud of her body. It was soft and supple, yet strong and well tuned. She could have been a dancer. She had good balance and she was filled with a sense of rhythm and movement. She envied Carla Curtis, a friend from Radcliffe who had gone into dance after college and was somewhere in the New York world. But Susan knew she could not actually go into dance despite her fantasy about it She needed a vocation which would constantly exercise her brain. Susan made a horrible grimace and stuck her tongue out at the girl in the mirror, who did the same. Then Susan went into the bathroom.

In the bathroom she turned on the shower. It took four or five minutes to get hot. She looked at her face in the bathroom mirror, after shaking her hair from her line of sight. If only her nose had been made a little more narrow, she thought that she would be quite attractive. Then she started her bathroom routine with one lavender tablet of Ortho-Novum. Among her other characteristics, Susan Wheeler was a practical woman; strong-willed and practical.

Monday, February 23, 7:30 A.M.

The Boston Memorial Hospital is certainly not an architectural landmark, despite the disproportionately large number of architects in the Boston area. The central building is attractive and interesting. It was constructed over a century ago with brownstone blocks carefully fitted together with skill and feeling. But the structure is inconveniently small and only two stories tall. Besides, it was designed with large, general wards, now outmoded. Hence its present-day practicality is minuscule. Only the ooze of medical history which permeates its halls keeps the wreckers and the planners at bay.

The innumerable larger buildings are studies in American gothic. Extending off at obtuse angles, millions upon millions of bricks join together to hold up dirty windows and flat monotonous roofs. The buildings were added in spurts, responding to the purported need for beds or the availability of funds. There is no doubt that it is an ugly combination of buildings, except perhaps for a few smaller research buildings. Those had architects and money to burn.

But very few people ever noticed the appearance of the buildings. The whole is larger than the sum of its parts; perception is too clouded by innumerable layers of emotional response. The buildings are not buildings by themselves. They are the famed Boston Memorial Hospital, containing all the mystery and wizardry of modern medicine. Fear and excitement intermingle in an ambivalent dialogue as lay people approach the structure. And for the professional individual, it is the mecca: the pinnacle of academic medicine.

The setting for the hospital adds very little. On one side a maze of railroad tracks leading to North Station and a bewildering array of elevated highways forms an enormous sculpture of rusting steel. On the other side is a modern housing project for low income families. Somehow that goal got mixed up in the renowned corruptness of the Boston government. The apartment buildings look like housing for the underprivileged because of their lack of outward design. But the rents are out of sight and only the rich and privileged live there. In front of the hospital is a stagnant corner of Boston Harbor with water like Mack coffee, sweetened with sewer gas. Separating the hospital and the water is a cement playground filled with discarded newspapers.

By seven-thirty this Monday morning all the operating rooms at the Memorial hummed with activity. Within a five-minute interval, twenty-one scalpels sliced through unresisting human skin as the scheduled operations commenced. The fate of a sizable number of people depended on what was done or not done, what was found or not found in the twenty-one tiled rooms. A furious pace was set which would not slow down until two or three in the afternoon. By eight or nine o’clock in the evening only two rooms would still be functioning, and they often continued until the seven-thirty rush the following morning.