Robin Cook - Coma

“Do you have a question, Mr. Fairweather?” demanded Bellows.

“No,” answered Fairweather rapidly. He was intimidated by the fact that Bellows knew his name.

“As for the rest of the morning,” said Bellows, eyeing his watch again. “First I will take you to the ward and introduce you to the nursing staff, who will be thrilled to meet you all, I’m sure,” said Bellows with a wry smile.

“We have experienced their joy already,” said Susan, speaking for the first time. Her voice brought Bellows’s eyes around and held them. “We didn’t expect a brass band for our arrival but at the same time we didn’t expect a cold shoulder.”

Susan’s appearance had already somewhat unnerved Bellows. With the animation that the sound of her voice provided, Bellows’s pulse quickened slightly. There was a certain surge within his body which reminded him of watching cheerleaders in high school and wishing that they were naked. Bellows searched for words.

“Miss Wheeler, you’ll have to understand that the nurses here are primarily interested in one thing.”

Niles winked in agreement to Goldberg, who didn’t understand what Niles was implying.

“And that is patient care, damn good patient care. And when new medical students and/or new interns arrive that becomes a rather difficult goal From actual experience they have all learned that new house staff is probably more deadly than bacteria and virus put together. So don’t expect to be greeted as saviors here, least of all from the nurses.”

Bellows paused but Susan did not respond. She was thinking about Bellows. At least he was a realist and that was a glimmer of hope in the otherwise poor impression he had made on her.

“At any rate, after showing you the ward, we’ll head up to surgery. There’s a staff gallbladder at ten-thirty and it will give you all a chance to get into a scrub suit and see the inside of an OR.”

“And the handle of a retractor,” added Fairweather. For the first time the atmosphere lightened and everyone laughed.

Down in the OR area Dr. David Cowley was absolutely pissed and he spared no one. The circulating nurse had broken into tears before the case was over and had to be replaced. The anesthesiology resident had had to weather one of the worst bombardments of foul words and captious epithets that had ever been hurled over an anesthesia screen. The surgical resident first assisting had a small cut in his right index finger from Cowley’s scalpel.

Cowley was one of the more prosperous of the general surgeons at the Memorial with a spacious private office on Beard 10. He had been spawned, trained, and now nurtured by the Memorial. When things went well, he was a most pleasant chap, full of jokes and ribald stories, always eager to offer an opinion, to bet on a game, to laugh. But when things went contrary to his wishes, he was a firebrand of the most vicious nature, a seething cauldron of invective. In short, he was a juvenile in adult clothing.

His only case that day had gone poorly. To start with, the circulating nurse had put out the wrong surgical instruments. She had set up the Mayo stand with the gallbladder instruments used by the residents. Dr. Cowley had responded by picking up the whole tray and dashing it to the floor. Next the patient quivered a little as he made the initial incision. It was only with great self-discipline that Cowley had curbed his inclination to hurl the scalpel at the anesthesiology resident. Then there was X-ray, who failed to show up at exactly the moment he called. Cowley’s viciousness had so unnerved the poor technician that the first couple of films were totally black.

Somehow Cowley forgot the real reason the case went poorly. Cowley himself had accidentally pulled off the proximal tie on the artery to the gallbladder, causing the wound to fill up with Mood in seconds. It had been a struggle to re-isolate the vessel and get a tie around it without disturbing the integrity of the hepatic artery. Even after the bleeding had been controlled, Cowley still was not positive that he had not compromised the blood supply to the liver.

Coming into the deserted doctors’ lounge, Cowley was raging. He was mumbling inaudibly as he passed down the row of lockers to his own. With emphasis he flung his scrub hat and mask onto the floor. Then he kicked his locker with jarring force.

“Fucking incompetent assholes. This Goddamned place is going to the dogs.”

The fury of his kick followed by an overhead fist which he brought against the door of the locker did several things. First, it raised a cloud of previously undisturbed dust which had settled on top of the locker over some five years. Second, it dislodged a single scrub shoe, which fell, just missing Cowley’s head. Third, it jarred open the locker next to Cowley’s, causing some of the contents to spill out onto the floor.

Cowley dealt with the shoe first He threw it as hard as he could against the far wall. Then he kicked open the locker next to hit in preparation to replace the objects which had fallen out. One glance into the locker, however, made him pause.

Looking closer, Cowley was astonished to see that the locker contained an enormous collection of medications. Many were open, half-used containers and vials, but there were also many unopened. There were ampules, bottles, and pills in a bewildering assortment. Of the drugs that had fallen out, Cowley noted Demerol, succinylcholine, Innovar, Barocca-C, and curare. Within the locker were many more varieties, including an entire carton of unopened morphine bottles, syringes, plastic tubing, and tape.

Quickly Cowley replaced the medicines that had fallen to the floor. Then he locked the locker once again, In his calendar book he wrote the number 338. Cowley was going to check on that locker and see to whom it was assigned. Despite his anger, he had the presence of mind to realize that such a cache was important and had serious implications for the entire hospital. And with things that bothered him, Cowley had the memory of a sage.

Monday, February 23, 10:15 A.M.

Susan Wheeler could not go into the doctors’ lounge to change into a scrub suit because the doctors’ lounge was synonymous with the men’s lounge. Susan had to go into the nurses’ locker, which was synonymous with women’s lounge. So creeps society from day to day, thought Susan angrily. To her it was just another blatant example of male chauvinism and it gave her a momentary lift to think that she was upsetting this unfair identification. The locker room was at that moment deserted and Susan located an empty locker with ease and began to change by hanging up her white coat. Nearby the shower entrance she found the scrub suits. They were one-piece pale blue dresses made from plain cotton fabric. They were actually for the scrub nurses. She held it up and then against herself. Looking into the mirror, she felt suddenly rebellious despite the intimidating surroundings.

“Screw the dress,” said Susan to the mirror. The scrub dress arched in a tumble into the canvas hamper while Susan retraced her steps into the hall. She paused before the doctors’ lounge, and she almost lost her nerve. Impulsively she pushed open the door.

Bellows was at that very instant next to the door that Susan opened. He was reaching into one of the cabinets at the entrance for a scrub suit. He was clothed in his James Bond-style skivvies (that’s what he called them) and black socks. He looked as if he belonged in the beginning of a grade C porno movie. Horror spread across his face as he caught sight of Susan. In a flash, he fled into the safety of the depths of the dressing room. As in the nurses’ locker room, one could not see into the dressing room from the door. Spurred by her rebelliousness despite the unexpected encounter, Susan advanced to the cabinet and selected a small scrub top and pants; then she left as quickly as she had entered. She could hear a tangle of excited voices in the interior of the doctors’ lounge.