Coma

26

Wednesday, February 25, 4:30 P.M.

Susan entered the dean of students’ office with some trepidation, but Dr. James Chapman’s demeanor quickly put her at ease. He was not angry, as Susan anticipated, just concerned. A small man with dark hair, closely trimmed, he always looked the same, in his three-piece dark suit complete with a gold chain and a Phi Beta Kappa key. Dr. Chapman paused between his sentences and smiled, not out of emotion, but more as a device to put students at ease. It was a distinctive habit and not unpleasant.

Suggesting the essence of the university, the office of the dean of students at the medical school had a more pleasant atmosphere than offices at the Memorial. A brass antique lamp stood on the desk. The chairs were all of the black academic sort, bearing a decal of the medical school’s emblem on the back. An oriental rug brightened the floor. The far wall was covered with pictures of previous classes at the medical school.

After some traditional pleasantries, Susan sat down across from Dr. Chapman. The dean removed his executive reading glasses and carefully placed them on his blotter.

“Susan, why didn’t you come to me and discuss this affair before it got out of hand? After all, that’s what I’m here for. You could have saved a lot of grief not only for yourself but also for the school. I’ve got to try to keep everyone as happy as possible. Obviously, keeping everybody happy is impossible, but I do a reasonable job of it. Still, I need warning when there’s a special problem. I like to hear when things go poorly and when things go well.”

Susan nodded her head in agreement as Dr. Chapman spoke. She was still dressed in the same clothes which she had been wearing during the MBTA mishap. There were obvious abrasions on both of her knees. The parcel containing the nurse’s uniform was on her lap. It looked worse than she did.

“Dr. Chapman, the whole affair began innocently enough. The first days of the clinics are difficult enough without the series of coincidences I encountered. They sent me fleeing to the library. As much to get my head together as to learn something, I started to look into anesthetic complications. I thought I could get back to the usual routine in a day or so. But then I got involved so quickly. I turned up some information that astounded me and I thought… maybe… you’re going to laugh when I tell you. It almost embarrasses me to think about it.”

“Try me.”

“I thought maybe I was on the track of a new disease or syndrome or drug reaction at the least.”

Dr. Chapman’s face lit up with a genuine smile. “A new disease! Now that would have been a coup for someone’s first days as a clinical clerk. Well, one way or the other, it’s water under the bridge. I trust you feel differently now?”

“You’d better believe it. I do have a self-preservation reflex. Besides I’m starting to get delusional about the whole thing. I think I had some sort of paranoid reaction this afternoon. I was convinced a man was following me to the point that I actually panicked. Look at my knees and my clothes, as if you haven’t already noticed. To make a long story short, I tried to cross from the inbound to the outbound platform at Kendall Station of the MBTA. Idiotic!” Susan tapped her head lightly with her index finger for emphasis.

“After that I realized that it behooved me to get back to normal, quickly. Like right away. But I’m still worried that there is something peculiar about these coma incidents at the Memorial, and I would like to continue studying the problem in some capacity. Apparently there are more cases involved than I originally suspected, and maybe that is why Dr. Harris and Dr. McLeary were irritated at my naive interference. One way or another, I’m sorry I’ve caused trouble for you at the Memorial. It goes without saying that it was not my intent.”

“Susan, the Memorial is a big place. It’s probably blown over already. The only tangible legacy is that I’m going to have to switch your surgery to the V.A. hospital. I’ve already made the arrangements, and you are to report tomorrow morning to Dr. Robert Piles’s office.” Dr. Chapman paused, looking at Susan intently. “Susan, you have a long road ahead of you. There will be plenty of time to discover new diseases or syndromes, if that is what you want. But now, today, this year, your primary goal should be basic medical education. Let Harris and McLeary work on the coma incidents. I want you to get back to work because I expect nothing but good reports about you. You’ve done very well so far.”

Susan emerged from the medical school Administration Building with a mild sense of euphoria. It was as if Dr. Chapman had powers of absolution. The ponderous problem of being ejected from medical school in disgrace had vanished. Obviously the surgery rotation at the V.A. was not as good as that at the Memorial, but in comparison to what could have happened, the transfer was a mild inconvenience indeed.

Although it was only a little after five, the winter night had begun in earnest. The rain had stopped as another cold front pushed the weakening warm front out over the Atlantic. The temperature had plummeted to about eighteen. The sky was speckled with bright stars, at least directly overhead. Toward the horizon the stars disappeared, their light unable to penetrate the noxious urban atmosphere. Susan crossed Longwood Avenue by running between the cars of impatient commuters in the clogging traffic.

In the lobby of the dorm she passed a few acquaintances, who were quick to notice Susan’s skinned knees and the greasy stain of the rail across her coat. There were some clever jibes about how tough surgery rotation must be at the Memorial, to judge by Susan, who looked as if she had been in a barroom brawl. Despite the fact that she thought the comments were rather funny, Susan almost stopped to snap back at the wisecracks. Instead she passed through the lobby and crossed the quad. The tennis court in the center had a sad, neglected winter look.

The well-trodden wooden staircase curved gracefully up, and Susan mounted the steps slowly and deliberately, looking forward to the isolation and security her room promised. She intended to take a long bath, sort out the day mentally, and, above all, relax.

As she always did, Susan entered her room and bolted the door behind her without turning on a light. The switch by the door activated the circular fluorescent bulb in the center of the ceiling, and Susan preferred the richer glow of the incandescent lights, either the lamp by the bed or the modern floor lamp by the desk. With the help of the light coming from the parking lot she walked over to the bed to turn on the lamp. Just as her hand reached for the switch she heard a noise. It was not loud but it was nonetheless distinctive enough to make her aware that it was not part of the normal sounds of her room. It was a foreign noise. She switched on the light, listening for the noise to repeat itself, but it did not recur. She decided it must have come from a neighboring room.

She hung up her coat and her white jacket, and unpacked the new nurse’s uniform. It had survived the afternoon remarkably well. Then she unbuttoned and removed her blouse, throwing it onto the pile of dirty laundry in the easy chair. Her bra followed. Reaching behind her with her right hand, she began to struggle with the button on her skirt. At the same time she headed for the bathroom to start the bath water.

She opened the bathroom door and flipped on the fluorescent light, preparing to look in the mirror when the light came on. With a screech of plastic hooks along metal, the shower curtain was whipped back; a figure leaped into the room. Almost at the same instant the fluorescent light blinked and then filled the room with its raw light. There was a flash of a knife and a lightning blow to Susan’s head. She twisted backward under its impact, crashing into the wall of the bathroom. By sheer reflex her arms straightened and her hands groped to keep herself from falling. It all happened so quickly that she had no time to react. A cry had started in her throat but the blow to the head had dislodged it.

Instantly the left hand of the intruder grabbed Susan by the throat, forcing her up to her full height against the wall, her naked breasts tensing. Despite all her fantasies about what she would do if she were attacked, knees to the balls, fingernails in the eyes, Susan did nothing but breathe as best she could and gaze at her assailant in utter horror. Her eyes flung open to their very limit. The fury of the unexpected attack had been totally overwhelming. The power of the hand that held her by the throat was unmistakable. And she recognized the man. They had met on the subway platform.

“One sound and you’re dead, baby,” snarled the man, bringing the knife in his right hand up beneath Susan’s chin.

Just as suddenly and roughly as he had originally seized Susan’s throat, the man released his hold, causing Susan to stumble forward. Her assailant backhanded her brutally, and she pitched to her hands and knees, with her lip split and numerous small capillaries broken over her left cheekbone.

Hooking his foot under Susan’s shoulder, the man forced Susan to rise up on her knees. Then with a callous kick he dumped Susan backward against the wall, where she lay with one arm lewdly draped over the toilet. A trickle of blood ran down from the corner of her mouth and dropped onto a pale breast. The image of the man momentarily swam before her. When he came in focus she could see his pockmarked face crack in a fiendish grin. He was obviously relishing the thought of ravishing her. She felt numb and unable to respond.

“Too bad I’m only authorized on this visit to talk to you, or as we say in my business, to make a preliminary contact The message is simple. There’s a lot of people who are very, very unhappy with the way you have been spending your time lately. Unless you get back to your usual activities and stop getting people mad, I’ll have to come back to see you again.”

The man paused to let his message sink in. Then he continued: “And just to encourage you a little more, this boy will also get to meet me and maybe even have an unexpected, serious, and probably fatal accident.”

The man flipped a picture onto Susan’s lap. In slow motion she picked it up.

“And I’m sure you don’t want your brother, James, down there in Coopers, Maryland, to suffer from your hobbies. And I don’t have to tell you that our little meeting here is just between us. If you go to the cops, the punishment is the same.”

Without another word, the man slipped from the bathroom. Susan heard the outside door to her room open and then close quietly. The only sound was a slight buzz from the fluorescent light over the mirror. She did not move for several minutes, uncertain whether her attacker had really left. Her arm was still draped over the toilet.

As the terror subsided, confusion and emotion mounted. Tears welled up in her eyes, forming a bulging meniscus. She lifted the picture of her younger brother with his bike, smiling in front of her parents’ home. “Christ,” said Susan, shaking her head and closing her eyes tightly. As her eyes closed, the tears overflowed from her lids, running down her cheeks in profusion. There was no doubt that the photograph was authentic.

Footsteps in the hall made Susan suddenly alert, and she pushed herself up onto her feet. The footsteps passed her room and receded down the hall. Susan staggered into her bedroom and rebolted the door. Turning, she scanned her room. Everything seemed undisturbed. Then she realized she felt wet. With her hand she felt herself and couldn’t believe it. She had urinated in her panic.

The confusion began to metamorphose into analytical thought, and the thought brought the tears rapidly in check. There had been a host of unexplained episodes in the last couple of days, but one thing began to take definite form in Susan’s consciousness. She was now more sure than ever that she had stumbled onto something, something big, something strange.

Looking into the mirror, Susan assayed the damage. Her left eyelids were slightly swollen and might turn into a black eye. Her left cheek sported a contused area about the size of a quarter, and her left lower lip was swollen and tender. By pulling her lip out gently and looking into the mirror Susan could see that she had a two-or three-millimeter laceration on the inside surface. It had been crushed against her lower teeth when she had been struck. The small amount of blood in the corner of her mouth came away easily, improving her appearance tremendously,

Susan decided she was not going to overreact to the latest episode. She also decided that despite Chapman’s pleas she was not ready to give up completely. She had a competitive spirit and, although it was deeply buried by years of stereotypical conditioning, it was very strong. Susan had never been challenged in an equivalent capacity before. Never had the potential stakes been so high. But she was also aware of two realities: she had to be extraordinarily careful from then on, and she had to work fast.

Susan got into the shower, turning on the water as hard as it would go. She let it crash down on her head while she slowly rotated. She cupped her hands over her breasts to protect them from the needlelike jets of water. The effect was soothing and it gave her time to think. She thought about calling Bellows but decided against it. Their embryonic intimacy would make it difficult for Bellows to react to the information objectively. He’d probably respond in some idiotic male overprotective fashion. What she needed was a mind with the perspective to challenge her deductions. Then she thought about Stark. He had not been overly influenced by her lowly position as a medical student or by her sex. Besides, his astonishing grasp of medical and business matters was immediately apparent. Above all, he was maturely rational and could be counted on to be objective.

Once out of the shower, Susan wrapped her hair in a towel and donned her terrycloth bathrobe.

She sat down by the phone and dialed the Memorial. She asked for Dr. Stark’s office.

“I’m sorry, but Dr. Stark is on another line. Can I have him call you back?”

“No, I’ll wait. Just say that it is Susan Wheeler calling and that it is important.”

“I’ll try, but I cannot promise anything. He’s talking long distance and may be on the line for some time.”

“I’ll hold just the same.” Susan was well aware that doctors often ignore returning a call.

Stark finally came onto the line.

“Dr. Stark, you said that I could call you if I found out anything interesting in my little investigation.”

“Of course, Susan.”

“Well I have found out something extraordinary. This whole affair is definitely…” She paused.

“Is definitely what, Susan?”

“Well, I’m not sure how to put it. I guess I’m now sure that there is a criminal aspect. I don’t know how or why, but I’m quite certain. In fact, I have a feeling that some large organization is involved… like the Mafia or something.”

“Sounds like a pretty wild conjecture to me, Susan. What has brought this idea to mind?”

“I’ve had a pretty funny afternoon with no laughs.” Susan looked closely at her abraded knees.

“And?”

“I’ve been threatened tonight.”

“Threatened with what?” Stark’s voice changed from interest to concern.

“My life, I guess.” Susan looked at the photo of her brother.

“Susan, if that is true, then this becomes a serious affair, to say the very least. But are you sure this isn’t some sort of prank by some of your classmates? Medical school pranks can get rather elaborate on occasion.”

“I must admit I hadn’t thought of that.” Susan gingerly felt her lacerated lip with the tip of her tongue. “But I think this was the real thing.”

“Conjecture is not what’s needed at this point. I will personally advise the hospital executive committee of this. But, Susan, now is definitely the time for you to withdraw from further involvement. I advised you to do that before, but only because I was afraid it might hurt you academically. Now, it’s apparently a different game. I think professionals should take over. Have you reported this to the police?”

“No, the threat included my younger brother, and there was a plain warning not to go to the police. That’s why I’ve called you. Besides, if I went to the police, they’d probably dismiss it as a simple attempted rape rather than a specific threat.”

“I doubt it very much.”

“Most males would.”

“But if the threat included your family, you are probably right to be careful with whom you talk. But my gut reaction suggests that you should report the incident to the police.”

“I’ll give it some thought. Meanwhile, I wondered if you’d heard that I’ve been kicked out of my surgery rotation at the Memorial. I have to go to the V.A. to do my surgery.”

“No, I’ve not been told about that When did this happen?”

“This afternoon. Obviously I’d much prefer to stay at the Memorial. I think that I could prove that I am a good student if given the chance. Since you are Chief of Surgery and since you are aware that I have not been merely goofing off, I thought maybe you might be willing to reverse that decision.”

“As Chief of Surgery I should have been told about your dismissal. I will get in touch with Dr. Bellows immediately.”

“I don’t think he knows about it, either, to tell you the truth. It was a Mr. Oren.”

“Oren? Well that’s interesting. Susan, I cannot promise anything, but I’ll look into it. I must tell you that you have not been the most popular student here with Anesthesia and Medicine.”

“I’d appreciate anything you can do. One other question. Would it be possible for you to arrange a visit for me to the Jefferson Institute? I’d very much like to visit the patient, Berman. I’m sort of hoping that if I can see him again that maybe I’ll be able to forget this whole affair.”

“You certainly have a lot of difficult demands, young lady. But I’ll call and see what I can do. The Jefferson is not university-controlled. It was built by government funds through HEW, but its operation has been turned over to a private medical management firm. So I have little voice there. But I’ll check. Give me a call after nine tomorrow, and I’ll let you know.”

Susan hung up the phone. Obviously in deep thought, she bit her lower lip, as was her habit. The result was painful. She stared at one of the posters on her walls but with unseeing eyes. Her mind raced over the events of the last few days, searching for possible associations that she had missed.

Impulsively she got up and took out the nurse’s uniform she had purchased. Then she began to dry her hair. Fifteen minutes later, she viewed herself in the mirror. The uniform fitted reasonably well.

She picked up the photograph of her brother for the second time. At least she felt reasonably confident that there was no immediate danger for her family. It was winter vacation for public schools and her family was skiing in Aspen for the week.