Robin Cook - Coma

Despite the darkening cloud she felt settling over her brain, Susan began to realize what Stark was saying. She tried to get up, but she found she could not lift her arms. She strained but only succeeded in knocking the remains of her drink to the floor. The ice cubes scattered.

“You do understand what I am saying, Susan? I think you do. Our legal system is not geared to handle our needs. My God, they cannot make a decision to terminate a patient even after it is certain that his brain has turned to lifeless Jell-O. How can science proceed under a public policy handicap of that proportion?

“Now, Susan, I want you to think carefully. I know it is a little hard for you to think at this moment, but try. I want to say something to you and I want your response. You are a bright, very bright, girl. You’re obviously one of the… what should I say?… elite sounds too much like a cliché, but you know what I mean. We need you, people like you. What I want to say is that the people who run the Jefferson Institute are on our side. Do you understand, our side?”

Stark paused, looking at Susan. She struggled to keep her eyelids above her pupils. It took all her strength.

“What do you say to that, Susan? Are you willing to dedicate that brain of yours to the good of society, science, and medicine?”

Susan’s mouth formed words but they came out in a whisper. Her face was expressionless. Stark leaned forward to hear. He had to bring his head up to within inches of Susan’s lips.

“Say it again, Susan. I’ll be able to hear if you say it again.”

Susan’s mouth struggled to bring her lower lip against her upper teeth to form the first consonant. It spilled out in a whisper.

“Fuck you, you cra—” Susan’s head slumped back, her mouth gaping and her respirations coming in regular deep-sounding breaths.

Stark looked at Susan’s drugged body for a few moments. Susan’s defiance angered him. But after a few moments of silence his emotion faded into disappointment. “Susan, we could have used that brain of yours.” Stark shook his head slowly. “Well, maybe you can still be useful.”

Stark turned to his phone and called the emergency room. He asked for the admitting resident.

Thursday, February 26, 11:51 P.M.

The surgical residents’ on-call room at the Memorial was rather minimal in its amenities. It had a bed, a hospital bed, which could be cranked into a number of interesting positions, a small desk; a TV which got two stations provided you didn’t mind a double image; and a collection of torn, stained old Penthouse magazines. Bellows was sitting at his desk, trying to read an article in the American Journal of Surgery, but he couldn’t concentrate. His mind, particularly his conscience, was functioning in an abnormally irritating manner. It kept reminding him of Susan’s appearance a few hours earlier. Bellows had seen her when she entered the Memorial. He knew she had come up behind him, and he had expected her to stop him. It had been a surprise when she didn’t.

Bellows had not looked at Susan directly, but enough to see her matted hair, her bloodied and torn dress. He had felt immediate concern, but at the same time felt a definite inclination to leave well enough alone. His job at the Memorial was on the line. If Susan needed medical help, she had come to the right place. If she needed psychological support, it would have been better to call and meet him outside the hospital. But Susan had not stopped him and had not called.

Now Bellows had learned that Susan had been admitted as a patient, that Stark himself was handling her case. As the senior surgical resident on call, Bellows knew that Susan was scheduled for an appendectomy. It seemed quite a coincidence, but there it was. Stark was going to operate. At first Bellows thought he’d scrub. Then prudence told him he was far from objective about Susan and that could become a handicap in the OR. So he decided to send a junior resident and wait it out.

Bellows looked at his watch. It was almost midnight. He knew that they’d be starting Susan’s appy in ten minutes or so. He tried to go back to the Journal article but something else bothered him. Bellows stared out of the grimy window and brooded. Then he picked up the phone and asked in which room the appy was scheduled.

“Number eight, Dr. Bellows,” said the OR duty nurse.

Bellows put the phone down. Funny. Susan had told him about finding the T-valve in the oxygen line to that room, the room in. which so much had gone wrong.

Bellows looked at his watch again. Suddenly he got up. He’d forgotten about getting his mid rats in the cafeteria. He was hungry. Bellows pulled on his shoes and set off for the cafeteria. But he thought about the T-valve.

He got on the elevator and pushed 1 for the cafeteria. In the middle of the descent he changed his mind and pushed 2. What the hell, he could take a look for that T-valve on the oxygen line himself, while Susan was having her surgery. It was stupid, but he decided to do it anyway. At least it would satisfy his conscience.

A phantasmagoria of geometric images, color and motion emerged from the darkness, gradually expanding. The geometric images collided, split, and recombined into forms and shapes without meaning. Out of the confusion the image of a hand being stabbed by scissors preceded a sequence of chase. The autopsy room at the Memorial appeared with a realism that included auditory and olfactory aspects. A spiral staircase took dominance; then a corridor filled with the face of D’Ambrosio grinning in sadistic delight seemed to move closer and closer. But D’Ambrosio’s face disintegrated and he fell spinning into the abyss. The corridor twisted and turned kaleidoscopically.

Susan regained her consciousness in fluctuating stages. Finally she realized that she was looking at a ceiling, the ceiling of a corridor that was moving. No, she was moving. Susan tried to move her head but it seemed to weigh a thousand pounds. She tried to move her hands. They too were unbelievably heavy, and it took all her concentration just to lift her hands up from her elbows. Susan was lying on her back, moving down a corridor. Sounds started to appear. Voices… but they were unintelligible. She felt someone grip her hands and push them down to her side. But she wanted to get up. She wanted to know where she was. She wanted to know what happened to her. Was she asleep? No, she’d been drugged. Suddenly Susan knew that. She fought with the effects of the drug, to try to lift herself from its grasp. Her mind began to clear. She could understand the voices.

“She’s an emergency appendectomy. Apparently a hot one, too. And she’s a medical student You’d think she would have had enough sense to be seen sooner.”

Another voice, deeper than the first “I understand she had called in sick this morning to the dean’s office, so obviously she knew something was wrong. Maybe she was worried about being pregnant.”

“Maybe you’re right But she tested negative.”

Susan’s mouth tried to form words but no sounds issued from her larynx. She found that her head could move from side to side. The drug was beginning to wear off. Then the movement stopped. Susan recognized the area. She was in the scrub room. By turning her head to the right she could see the scrub sink. A surgeon was scrubbing.

“You want one or two assistants, sir?” said one of the voices behind Susan.

The man at the scrub sink turned. He was wearing a hood and a mask. But Susan recognized him. It was Stark.

“One’s enough for a simple appy. I’ll have it out in twenty minutes.”

“No, no,” cried Susan, voicelessly. Only a bit of air hissed between her lips. Then she began to move toward the operating room. She could see the door open. She saw the number over it. Room No. 8.