Coma

22

Tuesday, February 24, 7:20 P.M.

The gloom of the winter Boston night had long since invaded the city when Susan alighted from the Harvard line train at the open-air Charles Street MBTA station. The wind, still blowing in from the Arctic, whistled in the river end of the station and traversed the length of the platform in short turbulent gusts. Susan bent over as she headed toward the stairs. The train lunged and slid out of the station, passing her on her right, its wheels screeching as it turned into the tunnel.

Susan used the pedestrian overpass to cross the intersection of Charles Street and Cambridge Street. Underneath, the traffic had dissipated to a minor dribble of cars, but the noxious odor of exhaust gases still fouled the night air. Susan descended to Charles Street. In front of the all-night drugstore there was the usual collection of wayward individuals, either drunk or stoned. Several of them reached toward Susan, asking for spare change. She responded by quickening her step. Then she collided with a seedy, bearded fellow who had deliberately stepped into her way.

“Real Paper or Phoenix, beautiful?” asked the bearded fellow with seborrheic eyelids. He held several newspapers in his right hand.

Susan recoiled, then pressed on, ignoring the lurid jibes and laughter of the night people. She passed down Charles Street and presently the surroundings changed. A few antique shop windows beckoned for her to dally, but the cold night wind urged her on. At Mount Vernon Street she turned up to the left and began to ascend Beacon Hill. From the numbers on the doors she knew she had a way to go. She passed Louisburg Square. The orange glow from the mullioned windows cast warm rays in the cold night. The houses gave a sense of peace and security behind their solid brick facades.

Bellows’s apartment was in a building on the left, about a hundred yards beyond Louisburg Square. The buildings along here sat back behind small lawns and towering elms. Susan pushed open a squeaking metal gate and went up the stone steps to the heavy paneled door. In the foyer she blew on her blue fingers while walking in place to encourage circulation in her feet. She always had cold feet and hands from November to March. While she blew and stamped she scanned the names next to the buzzer. Bellows was number five. She pushed the button hard, and was rewarded with a raucous buzz.

In a minor panic she reached for the doorknob, scraping her knuckle on the metallic guard on the door frame as the door swung open. A small amount of blood oozed from her knuckle, and she lifted her hand to her mouth. In front of her was a staircase twisting up to the left. A shining brass chandelier hovered above, and a gilded frame mirror served to make the hall seem more spacious. By reflex she checked her hair in the mirror, pressing it down at her temples. As she climbed she noticed attractively framed Brueghel prints on every landing.

Exaggerating her exhaustion, she reached the top flight and paused, gripping the banister. Down the stairwell she could see to the tiled floor of the foyer, five storeys below. Bellows opened his door before Susan knocked.

“There’s an oxygen bottle in here if you need it, Grandma,” he said, smiling.

“God, the air is thin up here. Maybe I should sit here on the steps and. recuperate for a few moments.”

“A glass of Bordeaux will fix you up perfectly. Give me your hand.”

Susan allowed Mark to help her into his apartment. Then she took off her coat, her eyes wandering around the room. Mark disappeared into the kitchen, returning with two glasses of ruby red wine.

Susan threw her coat over a straight-back chair near the door and pulled oft her high boots. Distracted, she took the wine and sipped it. Her attention had been captured by the room she found herself in.

“Pretty tastefully decorated for a surgeon,” said Susan, walking into the center of the room.

It was about twenty by forty feet. At each end was a large old-fashioned fireplace, and in each glowed a cheerful fire. The beamed cathedral ceiling was very high, perhaps twenty feet at the peak, slanting down toward both fireplaces. The far wall was an enormous complex of geometric shapes, some housing bookshelves, others with objets d’art and a large stereo, TV, and tape system. The near wall was of exposed brick and covered with paintings, lithographs, and medieval sheet music, attractively framed. An antique Howard clock ticked unobtrusively over the fireplace to the right, a ship model adorned the mantelpiece to the left. Through the windows, on either side of both fireplaces, a myriad of crooked chimneys was silhouetted against the night sky.

The furnishings were of a minimum; Bellows had relied on a collection of thick scatter rugs, dominated by a blue and cream Bukhara in the center of the room. On it was a low onyx coffee table, surrounded by a large number of sizable pillows covered in shocking shades of corduroy.

“This is beautiful,” said Susan twisting around in the center of the room and then collapsing on an armful of cushions. “I never expected anything like this.”

“What did you expect?” Mark sat down on the other side of the low table.

“An apartment. You know, tables, chairs, couch, the usual.”

They both laughed, aware that they really did not know each other very well. Conversation remained on a frivolous level as they enjoyed the wine. Susan hopefully pointed her stocking feet toward the fire, to warm her toes.

“More wine, Susan?”

“For sure. It tastes wonderful.”

Mark disappeared into the kitchen for the bottle. He poured each of them another glass.

“No one would ever believe the day I’ve had today, incredible,” said Susan, holding the glass of wine between her eye and the fire and appreciating its deep luscious red glow.

“If you haven’t abandoned your suicidal crusade, I believe anything. Did you go and see Stark?”

“You bet your ass, and contrary to your fears, he was very reasonable… more than I can say about Harris or even Nelson, for that matter.”

“Be careful, that’s all I can say. Stark is like an emotional chameleon. I usually get along with him extremely well. Yet today, out of the blue, I found out he’s furious at me because of some nut putting half-used medicine in a locker that I had used for a while. He doesn’t come to me and ask me about it the way a normal human being would. Instead he sics poor old Chandler, the chief resident, onto me, and Chandler cancels a case of mine to ask me about it Then later he calls me out of rounds to tell me Stark wants me to get to the bottom of it. You’d think I had nothing to do.”

“What’s this about drugs in a locker?” Susan remembered the doctor talking to Nelson.

“I’m not sure I have the whole story. Something about one of the surgeons coming across a whole bunch of drugs in an OR locker which old friggin’ Walters still had assigned to me. Apparently there were narcotics, curare, antibiotics—a whole pharmacy.”

“And they don’t know who put them there or why?”

“I guess not. It’s my idea that somebody’s been saving the stuff to ship off to Biafra or Bangladesh. There’s always a couple of people around with some cause like that. But why they’ve been storing them in a locker in the lounge is beyond me.”

“Curare is a nerve blocker, isn’t it, Mark?”

“Yup, a competitive nerve blocker. A great drug. Oh, in case you haven’t guessed-, we’re dining here tonight. I got some steaks, and the hibachi is all set on the fire escape outside the kitchen window.”

“Couldn’t be better, Mark. I’m exhausted. But I’m also hungry.”

“I’ll put the steaks on.” Mark walked into the kitchen with his wineglass.

“Does curare depress respiration?” asked Susan.

“Nope. It just paralyzes all the muscles. The person wants to breathe but can’t. They suffocate.”

Susan stared into the fireplace, resting the edge of her glass against her lower lip. The dancing flames hypnotized her and she thought about curare, about Greenly, about Berman. The fire crackled suddenly and angrily spat a red-hot coal against the screen. A piece of the coal ricocheted off the screen, landing in the rug to the side of the fireplace. Susan jumped up, flicked it off the rug and pushed it harmlessly onto the slate hearth. She then walked over to the kitchen door, watching Mark season the steaks.

“Stark actually was interested in what I had found out and has already tried to help. I had asked him to help me get the charts of the patients on my list. When I called back later this afternoon, he said he had tried to get them for me but had been told that they were all signed out to one of the professors of neurology, a Dr. Donald McLeary. Do you know him?”

“No, but that doesn’t mean anything. I don’t know very many of the nonsurgical types.”

“To my way of thinking, it makes McLeary look rather suspicious.”

“Oh oh, here we go again, imagination plus! Dr. Donald McLeary mysteriously destroys the cerebrum of six patients…”

“Twelve…”

“OK, twelve, and then he signs all their charts out to eliminate any chance of suspicion. I can just picture all this in the headlines of the Boston Globe.”

Mark laughed as he put the steaks on the hibachi through the open window, then drew it down against the cold.

“Go ahead and laugh, but at the same time come up with an explanation for McLeary. Everyone else so far has expressed surprise at the idea of relating all these cases together. Everyone except this Dr. McLeary. He has all the charts. I just think it’s worth looking into. Maybe he’s been investigating this thing for some time and he’s far ahead of me. That would be nice to believe and if so, maybe I could help him.”

Mark didn’t answer. He was wondering exactly how he was going to try to talk Susan out of the whole business. He was also concentrating on the salad dressing, his culinary specialty. When he reopened the kitchen window, the cold wind brought in the sizzling aroma of the cooking steaks. Susan leaned against the door frame, watching him. She thought about how marvelous it would be to have a wife, to be able to come home and have a wife keeping the house in order, the meals on the table. At the same time it seemed ridiculously unfair that she could never have a wife. It was a mental game that Susan played with herself, always to the same impasse, as which time she would simply deny the whole problem or at least postpone it until some indeterminate future date.

“I called the Jefferson Institute today.”

“What’d they have to say?” Mark handed Susan some plates, silver and napkins, and pointed toward the onyx table.

“You were right about it being difficult to visit,” said Susan, carrying the material to the table. “I asked if I could come out: and visit the facility because I wanted to see one of the patients. They laughed. They told me that only the very immediate family can visit and only on prearranged, brief visits. They said that the mass methods of taking care of the patients is generally unacceptable, emotionally, to the families, so they have to make special arrangements for them to visit. They did tell me about the monthly tour you mentioned. My being a medical student counted about the same as a wooden nickel, so far as making them alter their routine. Actually the place sounds interesting, especially since, as you say, the concept has been successful in keeping chronic cases from taking up acute-care beds in the local hospitals.”

Susan finished setting the table, then returned to staring into the fire. “I’d really like to visit, though, mostly to see Berman once more. I have a feeling that if I saw him again that I’d probably be able to ease up on this… crusade, as you call it. Even I realize I’ve got to get back to a semblance of normality.”

Mark straightened up from his activities in the kitchen at this last sentence, entertaining a ray of hope. He turned the steaks over again and closed the window.

“Why don’t you just show up there? I mean, it must be like any other hospital when it comes right down to it. It’s probably as chaotic as the Memorial. If you acted like you belong, probably nobody would even question you. You could even wear a nurse’s uniform. If anybody came into the Memorial dressed like a doctor or & nurse, they could go anywhere they chose.”

Susan looked back at Mark, who was standing in the kitchen door.

“That’s not a bad idea… not bad. But there’s a catch.”

“What’s that?”

“Simply that I wouldn’t know where the hell I was going even if I were able to walk into the building. It’s hard to look like you belong when you’re totally lost.”

“That’s not an insurmountable obstacle. All you’d have to do is visit the building department in City Hall and get a copy of the building plans or floor plans. There are plans on file of all public buildings. You’d have yourself a map.”

Mark returned to the kitchen to get the steaks and the salad.

“Mark, that’s ingenious.”

“Practical, not ingenious.” He brought the food into the room and served up the steaks and a generous helping of salad. There were also asparagus with hollandaise sauce and another whole bottle of red Bordeaux.

Each thought the meal perfect. The wine tended to smooth any potential rough edges, and the conversation flowed freely as each learned bits and pieces of the other’s background to fill in the gaps of the personality mosaics each was constructing of the other. Susan from Maryland, Mark from California. There was little intellectual common ground, for Mark’s education had been severely skewed in the direction of Descartes and Newton, while Susan’s tended toward Voltaire and Chaucer. But skiing emerged as a love of both, as well as the beach, and the outdoors in general. And they both liked Hemingway. There was an awkward silence after Susan asked about Joyce. Bellows had not read Joyce.

With the dishes cleared, they settled on a random grouping of pillows before the fireplace at the far end of the room. Bellows put on some additional oak logs, turning the smoldering embers into a crackling blaze. Grand Marnier and Fred’s Home Made vanilla ice cream made them quiet for some moments, both enjoying the peaceful and contented silence.

“Susan, getting to know you just a little better, and liking every minute of it, makes me even more motivated to urge you to forget this coma problem,” said Mark, after a while. “You’ve got an enormous amount of learning to do, and believe me, there’s no place better than the Memorial. In all likelihood this coma problem will be around for some time, plenty of time for you to begin again when you have a real background in clinical medicine. I’m not trying to suggest you cannot contribute; maybe you can. But the chances of making a contribution are small, just like in any research project, no matter how well conceived. And you have to consider the effect your activities will undoubtedly have, in fact already have had, on your superiors. It’s a poor gamble, Susan; the odds are stacked against you.”

Susan sipped her Grand Marnier. The viscous, smooth fluid slid down her throat, and sent warm sensations down her legs. She took in a deep breath and felt a certain levitation.

“Being a female medical student must be hard enough,” continued Bellows, “without adding a further handicap.”

Susan raised her head and looked at Bellows. He was staring into the fire. “Exactly what do you mean by that statement?” asked Susan with a sudden slight edge to her voice. Bellows was suddenly brushing against sensitive areas.

“Just what I said.” Bellows did not look up from the fire. The dancing flames had captured his attention. “I just think it must be particularly difficult being a female medical student. I never really thought too much about it until you forced me to come up with an alternative explanation for Harris’s behavior. Now, the more I think about it, the more I think I am right because… well, to be truthful, I can’t say I reacted to you as a medical student first. As soon as I saw you, I reacted to you as a woman, and maybe in kind of an immature way. I mean I found you immediately attractive—not seductive.” Bellows added the last comment quickly and turned to make sure Susan appreciated his reference to their previous conversation in the coffee shop.

Susan smiled. The defensive attitude, which Bellows’s initial statement had rekindled, had melted.

“That was why I reacted so foolishly when you walked into the dressing room yesterday and caught me in my shorts. If I had thought of you asexually, I wouldn’t have budged. But it was pretty apparent that was not the case. Anyway, I think most of your professors and instructors are going to react to you first as female and only second as a student of medicine.”

Bellows looked back into the fire; he almost had the attitude of a contrite sinner who has confessed. Susan felt a resurgence of the warmth she had begun to feel toward him. She felt again the urge to give him one of her people hugs, as she thought of them. In truth Susan was a physical person, although she did not show it often, especially since entering medicine. Even before applying to medical school, Susan had decided that the physical aspects of her personality had to be suppressed if she was going to make it in medicine. Now instead of reaching for Mark, she sipped her Grand Marnier.

“Susan, you are very apparent in any group and if you don’t show up at my lecture, I’m going to have to account for you.”

“The luxury of anonymity,” said Susan, “has not been something I could enjoy ever since I started medical school. I understand what you are saying, Mark. At the same time I feel I need just one more day. One more.” Susan held up one finger and tilted her head in a coquettish fashion. Then she laughed.

“You know, Mark, it is reassuring to hear you say that you think being a female medical student is difficult, because it is. Some of the girls in my class deny it, but they’re fooling themselves. They’re using one of the oldest and easiest defense mechanisms;, get around a problem by saying it’s not there. But it is. I remember reading a quote by Sir William Osier. He said there were three classes of human beings: men, women, and women physicians. I laughed when I read that the first time. Now I don’t laugh anymore.

“Despite the feminist movement there still lingers the conventional image of wide-eyed feminine naiveté and all that bullshit. As soon as you enter a field which demands a bit of competitive and aggressive action, the men all label you as a castrating bitch. If you sit back and try to use passive, compliant behavior, you find yourself being told that you can’t respond to the competitive atmosphere. So you’re forced to try to find your own compromise somewhere in the middle, which is difficult because all the while you feel like you’re on trial, not as an individual but as a representative of women in general.”

There was silence for a few moments, each digesting what had been said.

“The thing that bothers me the most,” added Susan, “is that the problem gets worse, not better, the farther, into medicine one goes. I cannot imagine how these women with families do it. They have to apologize for leaving work early and then they have to apologize for getting home late, no matter what time it is. I mean, the man can work late, no problem, in fact it makes him seem that much more dedicated. But a woman physician: her role is so diffuse. Society and its conventional female mores make it very difficult.

“How did you get me on this platform?” asked Susan suddenly, realizing the vehemence with which she had been speaking.

“You were just agreeing to my statement that being a female medical student was difficult. So how about agreeing to the last part, about not taking on any more handicaps?”

“Shit, Mark, don’t push me right at this moment. Obviously you can see that once I got involved in this thing, I probably need to resolve it somehow. Maybe it’s related to my feeling like I’m on trial for women. God, I’d like to show that Harris where to get off. Maybe if I can see Berman again, I’ll be able to give up without any loss of intellectual face or… what should I say, self-image or self-confidence. But let’s talk about something else. Would you mind if I were to give you a hug?”

“Me, mind?” Bellows sat up quickly but slightly flustered. “Not at all.”

Susan leaned over and gave him a squeeze with a force that surprised him. Instinctively his arms went around her and he felt her narrow back. Somewhat self-consciously he patted it, as if he were comforting her. She pulled back.

“I hope you’re not waiting for me to burp.”

For several moments they studied each other in the firelight. Then tentatively their lips sought each other, gently at first, then with obvious emotion, finally with abandon.