Coma (10 page)

Berman looked up at Susan with a broad smile. He was obviously enjoying the interlude.

“The patient is the one who is supposed to do the talking,” continued Susan, “not the doctor. Why don’t you tell me what you do so that I have to shut up?”

“I’m an architect,” said Berman. “One of the million or so that haunt the Cambridge scene. But that is another story. I’d much prefer to get back to you. You cannot guess how reassuring it is to me to hear you talk like a human being in this place.” Berman’s eyes swept around the room. “I don’t mind having a little operation, but this waiting around is driving me up the wall. And everybody is so Goddamn matter-of-fact.” He looked back at Susan. “Tell me what you were going to say about your former roommate; I’d like to hear.”

“Are you putting me on?” asked Susan with narrowed eyes.

“Honest.”

“Well it’s not all that important. It’s just that she was smart. She went to law school and has maintained herself as a woman yet has satisfied her urge and capacity to compete and contribute intellectually.”

“I have no idea how you have been doing intellectually but there is no doubt about you being a woman. You couldn’t be any less than the absolute antithesis of neuter.”

At first Susan was tempted to get into an argument with Berman over the fact that he equated being a woman with outward appearance. She felt that was only a part, a small part. But she caught herself and refrained. After all, Berman was on his way to surgery and didn’t need a debate.

“I can’t help the way I feel,” said Susan, “and ‘neuter’ is the best description. Initially I thought that medicine would be good for a number of reasons, including the fact that it would provide the social insurance I needed; I didn’t want to think or worry about any social pressure to get married. Well,” sighed Susan, “it provided social insurance all right, and a good deal more. Actually, I have begun to feel excommunicated from normal society.”

“In that vein I would love to be of assistance,” said Berman, pleased with his pun. “Provided, of course, you consider architects normal society. There are some who don’t, I can assure you. Anyway . . .” Berman scratched the back of his head while he put his words in order. “I hardly feel capable of carrying on a reasonable conversation in this humiliating nightgown, in this depersonalized milieu, and I would like very much to continue this conversation. I’m sure you get accosted continuously and I hate to add to your burden, but perhaps we could get together for some coffee or a drink or something after I get this Goddamn knee taken care of.” Berman held up his right knee. “Screwed the thing up years ago playing football. It’s been my Achilles’ heel ever since, so to speak.”

“Is that what you’re scheduled for today?” asked Susan while she thought about how to respond to Berman’s offer. She knew that it was hardly professional by any stretch of the imagination. At the same time she was attracted to Berman.

“That’s right, a minuscule-ectomy, or something like that,” said Berman.

A knock at the door, followed by the rapid entry of Sarah Sterns before Susan could even respond,
made Susan jump, and nervously she began to fuss with the stopcock on the I.V. Almost at the same time Susan realized how childish this action was, and it made her angry that the system could affect her to such a degree.

“Not another needle!” voiced Berman, dejected.

“Another needle. It’s your pre-op. Roll over, my friend,” said Miss Sterns. She crowded Susan in order to put her tray on the night table.

Berman glanced at Susan in a self-conscious way before rolling over on his right side. Miss Sterns bared Berman’s left buttock and grabbed a handful of flesh. The needle flashed into the muscle. It was over almost before it began.

“Don’t worry about the I.V. rate,” said Miss Sterns on her way to the door. “I’ll adjust it shortly.” She was gone.

“Well, I must be going,” said Susan quickly.

“Is it a date?” asked Berman, trying not to lean on his left buttock.

“Sean, I don’t know. I’m not sure how I feel about it; I mean professionally and all that.”

“Professionally?” Berman was genuinely surprised. “You must be being brainwashed.”

“Maybe I am,” said Susan. She looked at her watch, the door, and back at Berman. “All right,” said Susan finally, “we’ll get together. Meanwhile you have to get back to normal. I’ll live with being unprofessional but I don’t want to be accused of taking advantage of a cripple. I’ll stop in here before you go home. Do you have any idea how long you are going to be in the hospital?”

“My doctor said three days.”

“I’ll stop back before you go,” said Susan already on her way to the door.

At the door she had to give way to an orderly arriving with a gurney to transport Berman to the OR, to room No. 8, for his meniscectomy. Susan glanced back at Berman before turning down the corridor. She gave him the thumbs-up sign, which he returned with a smile. As she moved down toward the nurses’ station, Susan pondered over her mixed emotions. There was the warmth of meeting someone with whom she felt a rather immediate chemical attraction; at the same time there was the nagging reality of the
unprofessionalism of it all. Susan couldn’t help but acknowledge that for her to be a doctor was going to be very difficult in every respect.

February 23

12:10 P.M.

Like a slalom skier Susan wove her way down the hospital corridor crowded with lunch carts filled with an assortment of colorless food. The reasonably pleasant aromas emanating from the evenly stacked trays reminded her that she hadn’t eaten that day: two pieces of toast on the run hardly constituted a meal.

The arrival of the lunch carts added to the appearance of utter chaos at the nurses’ station on Beard 5. It seemed to Susan that it was a wonder indeed that the right patient got the right drug, therapy, or meal. To Susan’s pleasant surprise, Sarah Sterns had a smile and a quick thank-you for Susan before pointing to the resting place for the I.V. tray. No one else even acknowledged Susan’s presence and she left. It took her about three seconds to decide to use the stairs rather than wait for the crowded elevator. After all, it was only three floors down to the ICU.

The stairs were made of metal with an embossed surface like beaten silver. The color had been orange but now had become something approaching a dirty tan except in the center of each step, which was worn shiny by multitudinous footsteps. The walls of the stairwell were made of cinder block, painted dark gray. But the paint was old and peeling. Some previous plumbing catastrophe or accident had provided a series of longitudinal stains that descended from above along the wall to the right. The stains reappeared each time.
Susan rounded the platform and started down another flight. The only light in the stairwell came from a bare bulb at each floor landing. On the fourth floor the bulb had blown, and because of the relative darkness Susan had to proceed with caution, advancing her foot to find the first stair on the next flight down to three. The distances between the floors seemed remarkably long to Susan.

By leaning out over the metal banister Susan could see down into the subbasement and up to where the spiraling stairs became lost in collapsing perspective. Susan felt slightly ill at ease in the stairwell. The decaying darkness of the walls seemed to move in on her, awakening some atavistic fear. Perhaps it reminded her of a recurrent dream she used to have as a child. Although she had not had the dream for a long time, she remembered it well. It did not concern a stairwell but the overall effect was similar. The dream involved moving through a tunnel of twisted shapes which would progressively impede her progress. She never made it to the end of the tunnel in her dream despite the fact that the goal seemed very important.

In spite of the mildly disquieting atmosphere in the stairwell, Susan descended slowly, step by step. Her deliberate footsteps rang out with a dull metallic echo. She was alone. There were no people and it gave her a few uninterrupted moments to think. For a short period of time the immediacy of the hospital receded from Susan’s consciousness.

The encounter with Berman became more complicated in her mind. The lack of professionalism was diluted because, in reality, Berman was not Susan’s patient. She had been called simply to provide a peripheral service. The fact that Berman was a patient was important only in facilitating their chance meeting. But Susan wasn’t sure if she were just rationalizing. Rounding the landing on the third floor, she paused at the head of the next flight.

She had reacted to Berman as a woman. For a constellation of inexplicable reasons, Berman had appealed to her in a basic, natural, even chemical way. To an extent that was encouraging and reassuring. There was no doubt in Susan’s mind that she had begun to think of herself in a sexless sort of way over the first two years of medical school. She had used the word
neuter
in talking with Berman but only because she had been forced on the spur of the moment to find a term for it. Obviously she was female; she felt female and her monthly menstrual flow emphasized its reality. But was she a woman?

Susan started down the next flight of stairs. For the first time events had forced her to intellectualize a tendency which had been developing for several years. She wondered if Carpin had been called instead of her and if Berman had been some equally attractive female, would Carpin have responded as a male? Susan stopped again, considering this hypothetical situation.

From her experience she decided that there was a very good possibility that Carpin would have performed in an equivalent fashion.

Susan recommenced descending the stairs, very slowly now. But if it were true that a male would respond in a way similar to hers, why was it so different for her? Why did she dwell on it?

It was more than the debatable question of medical ethics. Berman had made Susan feel like a woman. All at once it came to Susan. The biggest difference between herself and Carpin was that Susan had an extra obstacle. She knew that both of them wanted to become doctors; to act like doctors, think like doctors, to be taken for doctors. But for Susan there was an additional step. Susan wanted also to become a woman; to feel like a woman, to be taken for and respected as a woman. When she had entered medicine, she knew it was a male-dominated career choice. That had been one of the challenges. Susan had never imagined that medicine would make it difficult for her to achieve fulfillment in a social sense. Academically she could compete; she was reasonably sure of that. The next step was going to be harder, an uncharted course. And Carpin? Well, for him the social part was easy. He was a male in a recognized male role. Being in medicine only supported his image of himself as a man. Carpin only had to worry about convincing himself he was a doctor; Susan had to convince herself that she was a doctor and a woman.

Arriving on the second floor, Susan was greeted by a sign which stated in bold letters: “Operating Room Area: Unauthorized Entry Forbidden.” But the sign wasn’t necessary. To Susan’s momentary consternation, the door was locked! Her overly active imagination suddenly had all the doors from the stairwell locked, and she thought of herself caught within a vertical prison. It was a fleeting thought, totally irrational. “Wheeler, you’re too much,” she said aloud for her own benefit and encouragement. She quickly descended to the first floor. The door opened easily and Susan joined the surging mob on the main floor.

She took the elevator and returned to the ICU entrance. It took a bit of fortitude to begin to open the door.
Once she started, it took strength. The ICU door was massive and very heavy.

Susan stepped once again into the nether world of the ICU interior. One of the nurses looked up from the desk but then went back to an EKG tracing in front of her. As Susan scanned the room, she was again struck by the purely mechanical appearance, the lack of human voices, even the lack of movement save for the fluorescent blips tracing their incessant patterns. And there was Nancy Greenly, as immobile as a statue, a casualty of medicine, a victim of technology. Susan wondered about her life, her loves. Everything was gone, all because of a simple menstrual irregularity, a routine D&C.

Susan forced her eyes away from Nancy Greenly and ascertained that her group had since departed from the ICU, presumably for Grand Rounds. At the same instant Susan acknowledged to herself her acute discomfort about being in the ICU. The psychological and technical complexity of the room caused any residual euphoria from the I.V. episode to vanish. Her imagination forced her to ponder the situation if something suddenly went wrong with one of the patients while she was standing there. What if someone expected her to make some life-death decision to go along with her white coat and her impotent stethoscope in her pocket?

Controlling the urge to succumb to a minor panic, Susan tugged at the inertia of the door and escaped into the corridor. Retracing her steps to the elevator, Susan mused about the difference between fact and fancy, between reality and mythology, between what it really was like being a medical student and what people thought it was like.

Remembering Bellows’s comment about Grand Rounds on 10, Susan pushed the tenth-floor button and allowed herself to be compressed toward the rear of the elevator. It was a miserable trip. The car was a potpourri of human beings with every conceivable affliction, and it stopped at every floor. The air was heavy and hot, particularly since one rude passenger was smoking despite the sign plainly forbidding it. The occupants did not look at each other; they stared blankly at the light progressing from number to number, as did Susan, wishing the doors would open and close more quickly.

Impetuously she pushed her way to the front of the elevator at the ninth floor. At 10, she broke from the crowded cubicle with relief.

The atmosphere changed immediately. The tenth floor was carpeted and the walls shone with an even luster of newly applied semigloss paint. Gilded frames set off portraits of former Memorial greats in their sartorial academic splendor. Chippendale tables topped with a variety of lamps were interspersed between comfortable chairs along the length of the corridor. Neat piles of
New Yorker
magazines were arranged at rational intervals.