Coma (45 page)

Susan’s fight reaction tapered, her heart rate reached an apogee and began to slow. She swallowed. “I don’t think so, but I can’t be sure.”

“Come and sit down. You look like you’ve been through World War I.” Stark touched Susan’s arm, guiding her to a chair in front of his desk. “Looks like you could use a little Scotch, at the very least.”

Susan felt a terrible exhaustion; mental, physical, and emotional, descend over her. She didn’t respond audibly. She simply followed, her chest heaving. She sank into the chair, barely comprehending what she had been through.

“You’re an amazing girl,” said Stark, walking over to the small bar cabinet across the room.

“I don’t think so,” returned Susan, her voice reflecting her exhaustion. “I just happened to walk blindly into an amazing horror.”

Stark got a bottle of Chivas Regal. He carefully poured out two drinks and brought them over to the desk. He handed one to Susan. “I think you’re being too modest.” Stark rounded his desk and sat down, his gaze fixed on Susan. “You’re not hurt, are you?”

Susan shook her head, her hand inadvertently shaking her drink so that the ice clinked against the side of the glass. She tried to steady herself by using both hands. She took a mouthful of the comforting, fiery liquid, letting it slide down her throat between deep breaths.

“Now then, Susan. I want to make sure where we stand. Have you spoken to anyone since we talked?”

“No,” said Susan taking another drink.

“Good, that’s very good.” Stark paused, watching Susan sip her drink. “Does anyone besides yourself have any idea about all this?”

“No. No one.” The Scotch felt delightfully warm inside Susan, and she began to feel a calmness settle over her. Her breathing began to slow to normal. She looked at Stark over her glass.

“OK, Susan, now why do you think the Jefferson Institute is a clearinghouse for transplant organs?”

“I heard them talking. I even saw the shipping cartons for the organs myself.”

“But Susan, it isn’t surprising to me that a hospital filled with chronic-care, comatose patients would be a source of transplant organs as the patients succumb to their disease processes.”

“That might be true. But the problem is that the people behind this were the ones making at least some of those patients comatose in the first place. Besides, they were getting paid for these organs. Paid a lot of money.” Susan felt her upper eyelids droop, and she raised them forcefully. She felt a torpor stealing over her. She knew she was exhausted but dragged herself straighter in the chair. She took another mouthful of the Scotch and tried not to think of D’Ambrosio. At least she felt warm.

“Susan, you are amazing. I mean, you were only in the place for a short time. How did you learn so much so quickly?”

“I had floor plans from City Hall. They showed operating rooms, and the girl who was showing me around said there were no operating rooms. So I checked them out myself. Then it was clear. Frightfully clear.”

“I see. Very clever.” Stark nodded his head, marveling at Susan. “And they let you leave. I would have imagined that they would have preferred that you stay.” He smiled again.

“I was lucky. Extremely lucky. I left with a heart and a kidney on their way to Logan.” Susan suppressed a yawn, trying to hide it from Stark. She felt tired, very tired.

“That’s all very interesting, Susan, and that’s probably all the information I really need. But . . . you are to be commended. Your activities over the last few days are a study in clairvoyance and perseverance. But
let me ask you a few more questions. Tell me . . .” Stark put his hands together and rotated in his chair so that he could see out over the black waters of the harbor. “Tell me if you can think of any other reasons for this fantastic operation you have so cleverly exposed.”

“You mean, other than money?”

“Yes, other than money.”

“Well, it is a good way to get rid of someone you don’t want around.”

Stark laughed inappropriately, or so it seemed to Susan.

“No, I mean a real benefit. Can you think of any benefits other than financial?”

“I guess the recipients of the organs get a certain benefit, if they don’t have to know how the donor organ was obtained.”

“I mean a more general benefit. A benefit for society.”

Susan again tried to think, but her eyes wanted to close. She straightened up again. Benefit? She looked at Stark. The meaning of the conversation was becoming diffuse, strange.

“Dr. Stark, I hardly think this is the time . . .”

“Come on, Susan. Try. You’ve done such a remarkable job at uncovering this thing. Try to think. It’s important.”

“I can’t. It’s such a horror that I have difficulty even considering the word
benefit.
” Susan’s arms began to feel heavy. She shook her head. For a second she thought she had actually fallen asleep.

“Well, then I’m surprised at you, Susan. From the intelligence that you have so amply displayed over the last couple of days, I thought that you would have been one of the few to see the other side.”

“Other side?” Susan closed her eyes tightly, then opened them, hoping they would stay open.

“Exactly.” Stark rotated back toward Susan, leaning forward, arms on the desk. “Sometimes there are situations where . . . what should I say . . . the common folk, if you will, cannot be depended upon to make decisions which will provide long-term benefits. The common man thinks only of his short-run needs and selfish requirements.”

Stark got up and wandered over to the corner where the expansive walls of glass joined. He looked out
over the great medical complex he had helped to build. Susan felt herself unable to move. She even had difficulty turning her head. She knew she was tired but she never felt so heavy, so languorous. Besides, Stark kept going in and out of focus.

“Susan,” Stark said suddenly, turning around to face her again, “you must realize that medicine is on the brink of probably the biggest breakthrough in all of its long history. The discovery of anesthesia, the discovery of antibiotics . . . any of those epochal achievements will pale before the next giant step. We are about to crack the mystery of the immunological mechanisms. Soon we’ll be able to transplant all human organs at will. The fear of most cancer will become a thing of the past. Degenerative disease, trauma . . . the scope is infinite.

“But such breakthroughs do not come easy, not without hard work and sacrifice. Not without a price. We need first-rate institutions, like the Memorial and its facilities. Next we need people like myself, indeed like Leonardo Da Vinci, willing to step beyond restrictive laws in order to ensure progress. What if Leonardo Da Vinci had not dug up his bodies for dissection? What if Copernicus had knuckled under to the laws and dogma of the church? Where would we be today? What we need for the breakthrough to actually happen is data, hard data. Susan, you have the mind to appreciate that.”

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.

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.