Coma (29 page)

“Mr. Oren, Dr. McLeary here. You were quite right. She is sitting here in front of me. . . . The charts? Of course not, you must be joking . . . All right . . . fine.”

McLeary hung up the phone, still looking directly at Susan. Susan could not detect even an iota of human warmth. She thought that he deserved the secretary he had. After an awkward silence Susan started to get up.

“I have a feeling that I should not . . .”

“Sit down!” shouted McLeary even more loudly than before.

Susan sat down quickly, surprised at the sudden outburst.

“What is going on here? I came in here to see if you could use some help in looking into the coma problem, not to be shouted at.”

“I really have nothing more to say to you, young lady. You have overstepped your boundaries here at the Memorial. I was told that you would probably come snooping for these charts. I was also told you obtained unauthorized information from the computer. And on top of that, you managed to alienate Dr. Harris. Anyway, Mr. Oren will be here in a moment and you can talk with him. This is his problem, not mine.”

“Who is Mr. Oren?”

“The director of the hospital, my young friend. He is the administrator, and personnel problems are in his bailiwick.”

“I’m not personnel. I’m a medical student.”

“True enough. And that actually puts you on somewhat of a lower plane. You are a guest here . . . a guest of the hospital . . . and as such, your conduct should be suitable to the hospitality extended to you. Instead you have chosen to be disruptive and to ignore rules and regulations. You medical students of today somehow have gotten your sense of position in the scheme of things reversed. The hospital does not exist for your benefit. The hospital does not owe you an education.”

“This is a teaching hospital and is associated with the medical school. Teaching is supposed to be one of the major functions of this hospital.”

“Teaching, of course, but that certainly doesn’t mean just medical students. It means the whole medical community.”

“Exactly. Supposedly it is a symbiotic atmosphere for everyone’s benefit: student and professor alike. The hospital doesn’t exist for the benefit of the medical student nor for the benefit of the professor. In fact, it’s supposed to be primarily for the patient.”

“Well, it is indeed easy to understand Harris’s reaction to you, Miss Wheeler. As he said, you lack respect for people as well as institutions. But it is a reflection of youth in general today. They believe their
very existence alone entitles them to all the luxuries of society, education being one of them.”

“Education is more than a luxury; it is a responsibility that society owes to itself.”

“Society undoubtedly has a responsibility to itself but not to individual students, not to youth just because they are youth. Education is a luxury in that it is expensive beyond belief and the major burden, particularly in medicine, falls on the public at large, the workingman. The students themselves pay a small amount of the money needed. Not only does it cost an enormous amount of money to have you here, Miss Wheeler, but your being here means that you are economically unproductive. Hence the cost to society automatically doubles. And besides, your being a woman means that your future per-hour productivity . . .”

“Oh save me,” said Susan sarcastically, standing up. “I’ve heard about as much bullshit as I can stand.”

“Stay put, young lady,” shouted McLeary, furious. He too stood up.

Susan tried to look behind the face of the man trembling with anger in front of her. She thought about Bellows’s suggestion relative to sexuality explaining Harris’s behavior. She was hard put to believe that was a factor in McLeary’s performance. Once again she was facing very irregular behavior, to say the least. The man was breathing rapidly, his chest heaving. She had apparently and unknowingly challenged the man. But how? In what capacity? She had no idea. Susan debated whether she should just walk out. A mixture of curiosity and respect for the apparent irrationality of McLeary’s actions made her stay. She sat down, watching McLeary, who now couldn’t decide what to do. He too sat down and began nervously playing with an ashtray. Susan sat motionless. She wouldn’t have been surprised if the man cried.

She heard the outer office door opening. Voices drifted into the inner office. Then the inner office door opened. Without being announced or knocking, an energetic individual entered. He appeared like a businessman, in a smartly tailored blue suit. Reminding Susan of Stark’s attire, a silk handkerchief peeked out of his left breast pocket. His hair was carefully combed and frozen with a ruler-straight part on the left side. There was a definite aura of authority about the man; he exuded an air of assurance at handling a wide spectrum of problems.

“Thank you for your call, Donald,” said Oren.

Then he faced Susan condescendingly.

“So this is the infamous Susan Wheeler. Miss Wheeler, you have been causing a great commotion in this hospital. Are you aware of that?”

“No, I haven’t been aware of that.”

Oren leaned back on McLeary’s desk, folding his arms in a professional fashion.

“Out of curiosity, Miss Wheeler, let me ask you a rather simple question. What do you think is the major goal of this institution?”

“Caring for the sick.”

“Good. At least we agree in general. But I must add a crucial phrase to your answer. We are caring for the sick of this community. That might sound redundant to you because obviously we are not caring for the sick of Westchester County, New York. Yet this is an extremely important distinction because it underlines our responsibility to the people right here in Boston. As a direct corollary, anything that could interrupt or otherwise disturb this relationship to the community would, in effect, negate our primary mission. Now this may sound very . . . what should I say . . . irrelevant to you. But quite the contrary. I have been receiving complaints about you over the last few days which have grown from being irritated to intolerable. Apparently you are bent on specifically disrupting our carefully maintained relationship with the community.”

Susan felt color rising in her cheeks. Oren’s condescending manner began to irritate her.

“I suppose bringing to the forefront of everyone’s awareness that the chances of becoming a vegetable, of losing one’s brain, is very high, intolerably high, by being a patient here would ruin the reputation of the hospital.”

“Exactly.”

“Well, it seems to me that the reputation of the hospital is nothing compared to the irreparable damage suffered by these people. I have become more and more convinced that the reputation of the hospital deserves to be ruined if that’s what it takes to solve the problem.”

“Now, Miss Wheeler, you can’t be serious. Where would all the people turn . . . all the people who are in daily need of the facilities in this hospital? Come . . . come. And by glibly drawing attention to an
unfortunate but nevertheless unavoidable complication . . .”

“How do you know it’s unavoidable?” interrupted Susan.

“I can only believe what the chiefs of the respective departments assure me. I am not a doctor nor a scientist, Miss Wheeler, nor do I pretend to be. I am an administrator. And when I am faced with a medical student who is here to learn surgery, but instead spends her time calling attention to a problem which is already under investigation by qualified people such as Dr. McLeary here—a problem whose indiscreet disclosure has the potential to cause irreparable harm to the community, I am forced to react quickly and decisively. Obviously the warnings and exhortations you have already received to assume your normal duties have gone unheeded. But this is not a debate. I’m not here to argue with you. On the contrary, with all due respect, I thought it best to give you an explanation for my decision about your surgery rotation. Now, if you’ll excuse me, I will phone your dean of students.”

Oren picked up McLeary’s telephone and dialed.

“Dr. Chapman’s office, please. . . . Dr. Chapman, please. Phil Oren calling. . . . Jim, Phil Oren here. How’s the family? Everyone in our house is just fine. . . . I suppose I told you that Ted’s been accepted at the University of Pennsylvania. . . . I hope so. . . . The reason I called is about one of your third-year students rotating on surgery, a Susan Wheeler. . . . That’s right. . . . Sure, I’ll hold.”

Oren looked at Susan. “You are a third-year student, Miss Wheeler?”

Susan nodded. Her nascent anger had melted into dejection.

Oren looked back at McLeary, who suddenly stood up, apparently bored. “I’m sorry, Don, for this intrusion,” said Oren. “I suppose we should have gone to my office. I’ll be finished . . .” Oren redirected his attention into the telephone. “Yes, I’m here, Jim . . . well that’s nice to know she’s been a good student. But nonetheless she has exhausted her welcome here at the Memorial. She is supposed to be on surgery but has decided never to attend rounds, conferences, or surgery. Instead, she has been irritating the staff, particularly our Chief of Anesthesia, and exacting unauthorized information from our computer storage facility by some devious means. We obviously have enough trouble around here without her kind of help. . . . Sure, I’ll tell her you want to see her . . . this afternoon at four-thirty. Good enough. I’m sure the V.A. would be happy to
have her . . . right (chuckle). Thanks, Jim. Speak to you soon, and let’s get together.”

Oren hung up the phone and smiled diplomatically at McLeary. Then he turned to Susan.

“Miss Wheeler, your dean, as you have plainly heard, would like to have a word with you this afternoon at four-thirty. From this moment on, your professional welcome at the Memorial has been terminated. Goodbye.”

Susan looked from Oren to McLeary and then back. McLeary’s expression was unchanged. Oren sported a self-satisfied smile, as if he had just won a debate. There was an awkward silence. Susan realized that the scene was over, and she got up without a word, picked up the parcel containing the nurse’s uniform, and left.

February 25

11:15 A.M.

Finding the hospital intolerably oppressive from an emotional point of view, Susan fled. She pushed her way through the lingering crowds, out into the rainy, raw February day. Once outside and without any particular destination in mind, she just walked, aimlessly, lost in her own thoughts. She turned on New Chardon Street and then on Cambridge Street.

“Assholes,” she hissed as she kicked a stray, partially crunched Campbell’s soup can. The light rain flattened her hair against her forehead. Small droplets coalesced and dripped from the tip of her nose. She wandered up Joy Street into the back side of Beacon Hill, preoccupied with her stream of consciousness. She saw but her mind did not record the clutter of life, dogs, garbage, and other debris of the decaying urban surroundings.

She could not remember ever feeling quite so rejected and isolated. She felt totally alone, and sudden fears of failure kept reoccurring in her compulsively conditioned brain. Waves of depression alternated with anger as she went over the conversations with McLeary and Oren. She yearned to talk with someone, someone whose counsel she could trust and respect. Stark, Bellows, Chapman; each was a possibility but each had a specific disadvantage. Bellows’s objectivity would have to be suspect; Stark’s and Chapman’s overriding
loyalties would be to their respective institutions.

Susan thought of the worst: being dismissed from medical school in disgrace. Not only would it be a personal failure but she felt it would be a failure for all women in medicine. Susan wished there were some woman doctor to whom she could turn, but she did not know any. There were so few on the medical school staff, and none in any positions that made them accessible for counseling.

In the middle of her tormented musing, Susan felt her right foot slide as she put her weight on it. She had to steady herself with her hand on a nearby building to keep from falling. Expecting the worst, she looked down to see that she had stepped in a large steaming pile of dog feces.

“Goddamn Beacon Hill.” Susan cursed Boston and all the literal and figurative shit a city government tolerated. Using the curb to dislodge most of the material, Susan choked on the odor. Still she couldn’t help but think about the symbolic aspect of her misfortune. Perhaps she had been stepping into a pile of shit, and as she was forced to do in regard to the actual shit in the city, she should try to ignore the whole affair. Just walk around it. Her responsibility was to become a doctor; that should take precedence over everything. The Bermans and the Greenlys were not her concern.

The rain continued and rivulets ran down her cheeks. She began to walk more carefully, prudently noticing the innumerable piles of dog crap that characterized Beacon Hill as much as the gas lamps or the red brick. She watched where she put her feet and the going was easier. But she could not dismiss her sense of responsibility to the Bermans and the Greenlys so easily. She thought about the age similarity between herself and Nancy Greenly. She thought about her own periods and the several episodes when she had bled more heavily than usual; how it had frightened her and made her feel helpless and out of control. She might have had to have a D&C herself, possibly at the Memorial.

But now she was out of the Memorial, maybe out of medical school. There was little that was up to her at that point, whether she wanted to pursue the problem or not. It was finished. It embarrassed her slightly to think of the frame of mind she had when she started the affair. “A new disease!” Susan laughed at her own vanity and deluded sense of ability.

Susan strolled down Pinckney Street, crossed Charles Street and headed for the river. As aimlessly as
on her Beacon Hill wandering, Susan mounted the stairs to the Longfellow Bridge. The graffiti stood out in bold outlines and she lingered, reading some of the nonsensical phrases, the faceless names. In the center of the span she paused, gazing up the Charles River toward Cambridge and Harvard and the B.U. Bridge. The river was a curious pattern of ice patches and open water, like a gigantic piece of abstract art. A flock of seagulls stood motionless on one of the floes of ice.