Robin Cook: Coma

“Terrible weather,” said Walters, presumably to Bellows but in an offhand undirected way. That was what Walters always said because to him the weather was always terrible. The only conditions which made him feel comfortable were seventy-six degrees and thirty percent humidity. That temperature and water content apparently agreed with the ailing bronchial tubes in the depths of Walters’s lungs. Boston weather rarely fulfilled such narrow limits, so to Walters the weather was always terrible.

“Yeah,” said Bellows in a noncommittal sort of way while he directed his attention outside. Most people would have agreed with Walters at that point The sky was darkened by racing gray clouds. But Bellows wasn’t thinking about the weather. Rather suddenly he was pleased about the pending five medical students. He decided that they probably would help him in his standing in the program. And if that were the case, then the time investment was more than worthwhile. Bellows was Machiavellianly practical in the final analysis; he had to have been to have got a position at the Memorial. The competition was fierce.

“Actually, Walters, this is my favorite kind of weather,” said Bellows, getting up from the lounge chair, indecently teasing the coughing Walters. Walters’s cigarette twitched in the corner of his mouth as he looked up at Bellows. But before he could say anything Bellows was through the door, on his way to meet his five medical students. He was convinced he could turn the burden into an asset.

Monday, February 23, 9:00 A.M.

Susan Wheeler got a ride in Geoffrey Fairweather’s Jaguar front the dorm to the hospital. It was an older vintage model, an X150, and only three of them could squeeze into it. Paul Carpin was good friends with Fairweather so he was the other lucky one. George Niles and Harvey Goldberg had to bear the brunt of the rush hour Boston MBTA in order to get to the Memorial for the nine o’clock meeting with Mark Bellows.

Once the Jaguar started, which was a minor ordeal typically associated with English motor cars, it covered the four miles in good time. Wheeler, Fairweather and Carpin walked into the main entrance of the Memorial at 8:45. The two others, having expected a miracle of modern transport to carry them the same distance in thirty minutes, arrived at 8:55. It had taken about one hour. The meeting with Bellows was to take place in the lounge of Beard 5 ward. No one knew where the hell they were going. They all trusted to fate to lead them to the proper place as long as they walked into the Memorial itself. Medical students tend to be rather passive, especially after the first two years of sitting in lecture halls daily from nine until five. The two groups met up partly by chance, partly by design, at the main elevators. Wheeler, Fairweather, and Carpin had tried to get to Beard 5 by going up the Thompson Building elevators directly opposite the main entrance. Having been built in haphazard spurts, the Memorial was labyrinthine.

“I’m not sure I’m going to like this place,” said George Niles rather quietly to Susan Wheeler as the group squeezed onto the crowded elevator amid the morning rush. Susan was well aware of the meaning behind Niles’s simple statement. When you don’t want to go somewhere and then have trouble finding it, it’s like adding insult to injury. Besides, all five medical students were in an acute crisis of confidence. They all knew the Memorial was the most renowned teaching hospital and for that reason wanted to be there. But at the same time they felt diametrically opposed to the concept of actually being a doctor, to actually being able to handle some judgmental decision. Their white coats ostensibly associated them with the medical community and yet their ability to handle even the most simple patient-related matter was nonexistent. The stethoscopes which dangled conspicuously from their left side pockets had been used only on each other and a few hand-picked patients. Their memory of the complicated biochemical steps in the degradation of glucose within the cell afforded little support and even less practical information.

Yet they were medical students from one of the best medical schools in the country and that should count for something. They all shared this delusion as the elevator lifted them floor by floor to Beard 5. The doors opened for a doctor in a scrub suit to get out on Beard 2. The five medical students caught a glimpse of the OR holding area in full swing.

Emerging on the fifth floor, the medical students spun on their heels, not sure of which direction to take. Susan took the lead by walking down the corridor to the nurses’ station. Like the OR area below, the nurses’ station on Beard 5 was a beehive of activity. The ward clerk had his right ear glued to the telephone getting A.M. stat blood-work reports. The head nurse, Terry Linquivist, was checking the OR schedule to be sure the pre-op meds had been given to those patients who would be called within the next hour or so. The other six nurses and three LPNs were in all stages of endeavor trying either to get those patients to surgery who had been called or to take care of those patients whose surgery was already part of the past.

Susan Wheeler approached this area of directed activity with an outward show of aplomb, carefully concealing her inner uncertainties. The ward clerk seemed the most accessible.

“Excuse me, but could you tell me…” began Susan.

The ward clerk raised his left hand toward Susan. Tell me that hematocrit again. There’s pandemonium here,” he shouted into the telephone he held between his head and cocked-up shoulder. He wrote on a pad in front of him. “And the patient had a BUN ordered tool” He looked up at Susan, shaking his head about the person he was talking to on the phone. Before she could say anything, his eyes went back to the patient’s chart he had out. “Of course I’m sure a BUN was ordered.” He frantically looked through the chart to find the order sheet. “I filled out the lab request myself.” He checked in the order sheet. “Look, Dr. Needem is going to be bananas if there’s no BUN…. What?… Well if you don’t have enough serum get your ass up here and get some more. The patient is scheduled for eleven. And what about Berman; you got his lab work now? Of course I want it!”

The clerk looked up at Susan, keeping the phone pressed between his ear and his shoulder. “What can I do for you?” he asked Susan rapidly.

“We’re medical students and I wondered if…”

“You’d better talk to Miss Linquivist,” said the clerk suddenly as he looked down at his paper and began madly scribbling figures. He paused long enough to extend his pencil toward Terry Linquivist for Susan’s benefit.

Susan looked over at Terry Linquivist. She noted that the nurse was probably about four or five years her senior. She was attractive in a wholesome sort of way, but definitely overweight according to Susan’s taste. She seemed no less busy than the clerk but Susan was not about to argue. With a quick glance at the rest of her group, who were more than willing to let Susan take the initiative, Susan walked up to Miss Linquivist.

“Excuse me,” said Susan in a polite tone, “we are medical students assigned to…”

“Oh no,” interrupted Terry Linquivist, looking up and then rapidly putting the back of her right hand to her forehead as if she were in the throes of a migraine attack. “Just what I need,” said Linquivist to the wall, carefully emphasizing each word. “On one of the busiest days of the year, I get a new batch of medical students.” She turned to Susan and eyed her with an obvious air of exasperation. “Please don’t bother me now.”

“I don’t intend to bother you at all,” said Susan defensively. “I was just hoping you could tell me where the Beard 5 lounge is.”