Робин Кук - Brain

With her coat taken care of, Denise brushed past Philips, giving his left elbow a furtive squeeze. It was so fast that Philips couldn’t respond. She sat down at the screen, adjusted the viewing controls to her liking, and introduced herself to the students. The technician returned and announced that the contrast material had been given. He prepared the scanner for another run.

Philips leaned over so that he had to support himself on Denise’s shoulder. He pointed to the image on the screen. “Here’s a lesion in the temporal lobe, and at least one, maybe two, in the frontal.” He turned to the medical students. “I noted in the chart that the patient is a heavy smoker. What does all this suggest to you?”

The students stared at the image afraid to make any gesture. For them it was like being at an auction without money; any slight movement could have been interpreted as a bid.

“Let me give you all a hint,” said Philips. “Primary brain tumors are usually solitary, whereas tumors coming from other parts of the body, what we call metastasis, can be single or multiple.”

“Lung cancer,” blurted one of the students as if he were on a TV game show.

“Very good,” said Philips. “At this stage you can’t be one hundred percent sure, but I’d be willing to put money on it.”

“How long does the patient have to live?” asked the student, obviously overwhelmed by the diagnosis.

“Who’s the doctor?” asked Philips.

“He’s on Curt Mannerheim’s neurosurgical service,” said Denise.

“Then he doesn’t have long to live,” said Martin. “Mannerheim will operate on him.”

Denise turned quickly. “A case like this is inoperable.”

“You don’t know Mannerheim. He operates on anything. Especially tumors.” Martin again bent over Denise’s shoulder, smelling the unmistakable aroma of her freshly washed hair. It was as unique to Philips as a fingerprint, and despite the professional setting, he felt a faint stirring of passion. He stood up to break the spell.

“Doctor Sanger, can I speak to you for a moment,” he said suddenly, motioning her over to a corner of the room.

Denise complied willingly, with a bewildered expression.

“It’s my professional opinion...” said Philips in the same formal tone of voice. He then paused and when he continued he lowered his voice to a whisper “... that you look incredibly sexy today.” Denise’s expression was slow to change. It took a moment for the comment to register. When it did, she almost laughed. “Martin, you caught me off-guard. You sounded so severe I thought I’d done something wrong.”

“You have. You’ve worn this sexy outfit purely to inhibit my powers of concentration.”

“Sexy. I’m buttoned up to my larynx.”

“On you, anything looks sexy.”

“That’s your dirty mind, old man!”

Martin had to laugh. Denise was right. Whenever he saw her he inadvertently remembered how wonderful she looked naked. He’d been dating Denise Sanger for over six months, and he still felt like an excited teenager. At first they’d taken every precaution to keep the rest of the hospital from getting wind of their affair, but as they’d become more and more confident that their relationship was serious, they’d become less concerned with secrecy, especially since the more they got to know each other, the narrower the difference in their ages became. And the fact that Martin was the Assistant Chief of Neuroradiology while Denise was a second-year resident in Radiology was a source of professional stimulus to them both, particularly after she began her rotation on his service, three weeks previously. Already Denise could match performance with the two fellows who had already finished their radiology residencies. And on top of that it was fun.

“Old man, huh?” whispered Martin. “For that comment, you’re going to be punished. I’m leaving these medical students in your hands. If they start to get bored, send them over to the angiography room. We’ll give them an overdose of the clinical before the theoretical.”

Sanger nodded in resigned agreement.

“And when you finish the morning CAT schedule,” continued Philips, still whispering, “come over to my office. Maybe we can steal away to the coffee shop!”

Before she could answer he took his long white coat, and left.

The surgical suites were on the same floor as Radiology, and Philips headed in that direction. Dodging a traffic jam of gurneys laden with patients waiting for fluoroscopy, Philips cut through the X-ray reading room. It was a large area with partitions formed by banks of X-ray viewing boxes, populated currently by a dozen or so residents chatting and having coffee. The daily avalanche of X ray had yet to arrive, although the X-ray machines had been busy for about half an hour. First it would be a trickle of films, then a flood. Philips remembered all too well from his days as a resident. He’d trained at the Med Center and, responding to the tough atmosphere of one of the biggest and best radiology departments in the country, he had passed many twelve-hour days in that very room.

His reward for his effort had been an invitation to stay on for his fellowship in neuroradiology. When he’d finished, his performance had been so outstanding, he’d been offered a staff position with a joint appointment with the medical school. From that fledgling position he’d risen rapidly to his present status, Assistant Chief of Neuroradiology.

Philips stopped momentarily in the very center of the X-ray reading room. Its unique, low-level illumination, coming from the fluorescent bulbs behind the frosted glass of the X-ray viewing boxes, cast an eerie light over the people in the room. For a moment the residents looked like corpses with dead white skin and empty eye sockets. Philips wondered why he had never noticed this before. He looked down at his own hand. Its color was the same pasty hue.

He walked on feeling strangely unsettled. It was not the first time in the last year he had seen some familiar hospital scene through jaundiced eyes. Perhaps the reason was a slight but fomenting dissatisfaction with his job. His work was becoming progressively more administrative and, on top of that, he felt stagnated by circumstance. The Chief of Neuroradiology, Tom Brockton, was fifty-eight and was not considering retiring. Besides, the Chief of Radiology, Harold Goldblatt, was also a neuroradiologist. Philips had to recognize that his meteoric rise within the department had ground to a halt, not for lack of ability on his part, but because the two positions over him were solidly occupied. For almost a year Philips had reluctantly begun to entertain the idea of leaving the Med Center for another hospital where he would have a shot at the top.

Martin turned down the corridor leading to surgery. He passed through the double swinging doors, whose sign warned visitors that they were entering a restricted area, and went through another set of swinging doors, to the patient-holding room. Here stood a swarm of gurneys filled with anxious patients awaiting their turn to be dissected. At the end of this large area was a long built-in white Formica desk guarding the entrance to the thirty operating rooms and to the recovery area. Three nurses in green surgical scrub dresses were busy behind the desk making sure the right patient got into the right room so he’d get the right operation. With almost two hundred operations in any twenty-four-hour period, this was a full-time job.

“Can someone tell me about Mannerheim’s case?” asked Philips as he leaned over the desk.

All three nurses looked up and began to speak at once. Martin, being one of the few eligible doctors, was a welcome visitor to the OR. When the nurses realized what had happened, they laughed and then made an elaborate ceremony of deferring to one another.