Coma

1

Monday, February 23, 7:15 A.M.

Several small flakes of snow danced down Longwood Avenue in the half-light of February 23, 1976. The temperature was a crisp twenty degrees and the delicate crystalline structures fluttering earthward were intact even after striking the pavement. The sun was obscured by a low cover of thick gray clouds which shrouded the waking city. More and more clouds were swept in by the sea breeze, enveloping the tops of the taller buildings in a mist, making it become paradoxically darker as dawn spread its frail fingers over Boston. It was not supposed to snow, yet a few flakes had crystallized over Cohasset and had blown all the way into the city. The few that reached Longwood Avenue and were blown right on Avenue Louis Pasteur were the survivors until a sudden down-draft slammed them against a third-story window of the medical school dorm. They would have slid off had it not been for the layer of greasy Boston grime on the pane. Instead they stuck there while the glass slowly transmitted the heat from within, and their delicate bodies dissolved and mingled with the dirt.

Within her room Susan Wheeler was totally unaware of the drama on the window pane. Her mind was preoccupied with extracting itself from the clutches of a meaningless, disturbing dream after a restless, near-sleepless night. February 23 was going to be a difficult day at best and possibly a disaster. Medical school is made up of a thousand minor crises occasionally interrupted by truly epochal upheavals. February 23 was in the latter category for Susan Wheeler. Five days earlier she had completed the first two years of medical school, the basic science part taught in the lecture halls and science labs with books and other inanimate objects. Susan Wheeler had done very well because she could handle the classroom, the lab, and the papers. Her class notes were renowned and people always wanted to borrow them. At first she lent them indiscriminately. Later, as she began to perceive the realities of the competitive system which she thought she had left behind in Radcliffe, she changed her tactics. She lent her notes only to a small group of people who were her friends, or at least were people from whom she could borrow notes if she had had to miss a class. But she rarely missed a class.

A number of people chided Susan playfully about her. marvelous attendance record. She always responded by saying she needed all the help she could get. Of course that was not the reason. Having entered a profession dominated by males, in which essentially all the professors and instructors were males, Susan Wheeler could not skip a class without being missed. Despite the fact that Susan looked on her mentors in a neutral sexless way as her professional superiors, they did not return the view in kind. The fact of the matter was that Susan Wheeler was a very attractive twenty-three-year-old female.

Her hair was the color of winter wheat and very wispy. Since it was long and fine it drove her batty in the wind unless she had it pulled back and clasped with a barrette at the back of her head. From there it fell in a sheen to the lower edges of her shoulder blades. Her face was broad with high cheekbones, and her eyes, set well back in their sockets, were a mixture of blue and green with flecks of brown so that the chromatic effect changed with different light sources. Her teeth were ultra white and perfectly straight, the result of fifty percent nature and fifty percent suburbanite orthodontist.

All in all Susan Wheeler appeared like the girl of the Pepsi-Cola people’s dreams. At twenty-three years old she was young, healthy, and sexy with that American, Californian style that made eyes turn and hypothalamuses awaken. And on top of it all, perhaps in spite of it all, Susan Wheeler was very sharp. Her grammar school IQ ratings had hovered around the 140 range and were a source of infinite delight to her socially committed parents. Her school record was a monotonous series of A’s with numerous other evidences of achievement. Susan liked school and learning and reveled in using her brain. She read voraciously. Radcliffe had been perfect for her. She did well but she earned her grades. She had majored in chemistry but had taken as much literature as possible. She had no trouble getting into medical school.

But being attractive as Susan was had certain definite drawbacks. One was the difficulty of missing class without being noticed. Whenever questions were asked, she was among those unfortunate few who served to demonstrate the stupidity of the students or the brilliance of the professors. Another drawback was that people formed opinions about Susan, with very little information. She so resembled models glaring out from advertisements that people continuously confused her with those frequently mindless girls.

There were advantages, though, to being bright and beautiful, and Susan was slowly beginning to realize that it was reasonable to exploit them to a degree. If she needed a further explanation regarding some complicated topic, she only had to ask once. Instructors and professors alike would hasten to help Susan understand a fine point of endocrinology or a subtle point of anatomy.

Socially, Susan did not date as much as people imagined she would. The explanation for this paradox was severalfold. First, Susan preferred reading in her room to a boring date, and with her intelligence, Susan, found quite a few men boring. Second, few men actually asked Susan out, just because Susan’s combination of beauty and brains was a bit intimidating. Susan spent many Saturday nights engrossed in novels, some literary, some otherwise.

Starting February 23, Susan feared her comfortable world was going to be blown up. The familiar lecture routine was over. Susan Wheeler and one hundred and twenty-two of her classmates were being rudely weaned from the security of the inanimate and tossed into the arena of the clinical years. All the confidence in one’s abilities formed during the basic science years were hardly proof against the uncertainties of actual patient care.

Susan Wheeler had no illusions concerning the fact that she knew nothing about actually being a doctor, about taking care of real live patients. Inwardly she doubted that she ever would. It wasn’t something she could read about and assimilate intellectually. The idea of trial by fire was diametrically opposed to her basic methodology. Yet on February 23 she was going to have to deal with patients some way, somehow. It was this crisis of confidence that made sleep difficult for her and filled the night with bizarre, disturbing dreams in which she found herself wandering through foreign mazes searching for horrible goals. Susan had no idea how closely her dreams would approximate her experience during the next few days.

At 7:15 the mechanical click of the clock radio broke her dream’s feedback circuit and Susan’s brain awakened to full consciousness. She turned off the radio before the transistors had a chance to fill the room with raucous folk music. Normally she relied on the music to wake her. But on this particular morning she needed little assistance. She was too keyed up.

Susan put her feet onto the floor and sat on the edge of the bed. The floor was cold and uninviting. Her hair descended from her head haphazardly, leaving only a two-to-three-inch gap through which to regard her room. It wasn’t much of a room, about twelve by fourteen feet, with two multipaned windows at the end. The windows gave out onto another brick building and a parking lot so that Susan rarely looked out. The paint was reasonably fresh because she had painted the room herself about two years previously. The color was a pleasing pastel yellow which accented perfectly the Marimekko Printex fabric she had used to make the curtains. Their colors were several shades of electric green, separated by dark blue. On the walls hung a variety of colorful posters, framed with stainless steel, advertising past cultural events.

The furniture was medical school issue. There was an old-fashioned single bed, which was too soft, and difficult for entertaining. There was a worn, overstuffed easy chair, which Susan never used save for depositing dirty laundry. Susan liked to read on the bed and study at the desk so that the easy chair really wasn’t “critical,” in her words. The desk was oak and ordinary except for the pattern of initials and scratches carved in the top. In its right corner, Susan had even found a few obscene words associated with the word biochem. A physical diagnosis book was open on the desk. During the last three days she had totally reread it, but the text had failed to buoy her sagging confidence.

“Shit,” she said out loud, with little inflection. The remark was directed at no one and at nothing. It was a basal response as she comprehended that February 23 had indeed arrived. Susan liked to swear and she did it a lot, but mostly to herself. Since such language contrasted sharply with her wholesome image, the effect was truly remarkable. She had found it a useful and entertaining tool.

Having pulled herself from the warmth of her covers with such dispatch, Susan realized that she had an extra fifteen minutes to spare. That was the usual duration of her ritual of repeatedly turning off her radio alarm before actually making it into the bathroom. Her ambivalence toward starting this day made her squander the time by just sitting and staring ahead, wishing that she had gone to law school or graduate school in literature… anything besides medical school.

The coldness of the bare waxed floor worked its way into Susan’s feet. As she sat there, her circulatory system dissipated her body heat into the cold room, making her nipples rise up from the summits of her shapely breasts. Goose pimples appeared from nowhere along the insides of her naked thighs. She wore only a thin worn-out flannel nightgown she had gotten for Christmas when she was in the fifth grade. She still wore it to bed almost every night, at least when she was sleeping alone. Somehow she loved that nightgown. Amid the furious pace of change in her life, it seemed to afford a sanctuary of consistency. Besides, it had always been her father’s favorite.

Susan had enjoyed pleasing her father from a very early age. Her first remembrance of him was his smell: a mixture of the outdoors and deodorant soap covering a distinctive odor she later realized was male. He had always been good to her, and she knew that she was his favorite. That secret she never shared with anyone, especially not with her two younger brothers. It had always been a source of confidence for her as she faced the usual hurdles of childhood and adolescence.

Susan’s father was a strong-willed individual, a dominant but generous and gentle man who ran his family and his insurance business like an enlightened despot. A charming man whose brood acknowledged him as the last word on any subject. It wasn’t that Susan’s mother was a weak-willed individual. It was just that she had met more than her match in the man she married. For much of her life Susan accepted this situation as the invariable norm. Eventually, however, it began to cause her some inner confusion. Susan was very much like her father, and her father encouraged her development in that direction. Then Susan began to realize she could not be like her father and expect one day to have a home of her own like the one in which she was reared. For a time she wanted desperately to be like her mother, and consciously tried. But it was to no avail. Her personality showed more and more her father’s traits, and in high school she was literally forced into a leadership role. Susan was voted president of her graduating class at a time in her life when she thought that she would have preferred to be more in the background.

Susan’s father was never particularly demanding, and certainly never pushy. He remained a source of confidence and encouragement for Susan to do whatever she wanted, without considering her sex. After Susan had entered medical school and became familiar with some of her female classmates, she realized that many of them had emerged from a similar paternalistic background. In fact when she met some of their parents, the fathers seemed to be vaguely familiar, as if she had actually known them in the past.

A resonant thumping issued from the radiator beneath the window, heralding the coming of heat. A tiny bit of steam hissed from the overflow valve. The radiator’s stirring reminded Susan of the coldness of the room. Stiffly she stood up, stretched, and closed the window. It had been open only about a half-inch. Susan lifted the nightgown over her head and regarded her naked body in the mirror on the bathroom door. Mirrors held a strange attraction for her. It was almost impossible for her to pass a mirror without at least a quick reassuring look.

“Maybe you should be a dancer, Susan Wheeler,” she said rising up onto her tiptoes and stretching her arms straight up, “and give lip this idea of becoming a fucking doctor.” Like a balloon being deflated, she let herself sag until she was slumped over. She was still looking at herself in the mirror. “I wish I could do that,” she added more quietly. Susan was proud of her body. It was soft and supple, yet strong and well tuned. She could have been a dancer. She had good balance and she was filled with a sense of rhythm and movement. She envied Carla Curtis, a friend from Radcliffe who had gone into dance after college and was somewhere in the New York world. But Susan knew she could not actually go into dance despite her fantasy about it She needed a vocation which would constantly exercise her brain. Susan made a horrible grimace and stuck her tongue out at the girl in the mirror, who did the same. Then Susan went into the bathroom.

In the bathroom she turned on the shower. It took four or five minutes to get hot. She looked at her face in the bathroom mirror, after shaking her hair from her line of sight. If only her nose had been made a little more narrow, she thought that she would be quite attractive. Then she started her bathroom routine with one lavender tablet of Ortho-Novum. Among her other characteristics, Susan Wheeler was a practical woman; strong-willed and practical.